instruction
stringclasses 1
value | input
stringlengths 56
2.58k
| output
stringlengths 11
1.71k
|
|---|---|---|
Generate impression based on findings. | Male; 66 years old. Reason: left lower pole cystic lesion and left midpole solid lesion; interval exam/see CT 1/2014 for comparison History: known solid midpole and cystic lower pole left renal mass, survey RIGHT KIDNEY: Right kidney measures 12.6 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. No suspicious renal mass is identified.LEFT KIDNEY: The left kidney measures 12.7 cm in length. The renal parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. Within the lower pole of the kidney is a 2.1 x 1.9 x 1.8 cm lesion (previously 2.3 x 1.5 x 2.0 cm) which demonstrates posterior acoustic enhancement. There is no wall nodularity and no internal vascularity. There is a thin septation. Within the mid pole of the kidney is a 1.3 x 1.0 x 1.2 cm cyst with a thin septation, no wall nodularity, and no internal vascularity. No additional renal lesion identified.OTHER: The bladder is nondistended. | Stable appearance of minimally complex left lower and mid pole renal cysts. |
Generate impression based on findings. | Female; 57 years old. Reason: r/o recurrence History: h/o thyroid cancer, s/p thyroidectomy RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: 4 x 4 x 7 mm hypoechoic nodular focus in the inferior thyroid bed is redemonstrated and unchanged in appearance. This previously measured 3 x 4 x 8 mm. A second hypoechoic focus is seen in the mid thyroid bed. This measures 6 x 8 x 8 mm and was not definitely seen on the recent prior ultrasounds, but was measured and reported on a more remote thyroid ultrasound from 7/27/2011. It is stable in appearance compared to that study when it measured 8 x 6 x 7 mm.LEFT LOBE: Soft tissue echogenicity in the left thyroid bed measures 1.1 x 0.6 x 1.0 cm (previously 1.0 x 0.5 x 0.5 cm).ISTHMUS: No significant abnormality noted.LYMPH NODES: 0.8 to 0.4 x 2.1 cm right mid neck lymph node has a fatty hilum. | 1. Stable exam with no change in hypoechoic lesions in the right thyroid bed.2. Hyperechoic structure in the left thyroid bed may represent residual thyroid tissue given its appearance and stability over time. |
Generate impression based on findings. | Female; 76 years old. Reason: evaluate nodularity, History: concern for parathyroid adenoma RIGHT LOBE MEASUREMENTS: 4.9 x 1.8 x 1.1 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.8 x 1.9 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: The thyroid gland is mildly heterogeneous. Along the posterior inferior aspect of the right lobe of the thyroid gland is an ovoid, heterogenous structure. This is hypervascular compared to the background thyroid. It measures approximately 1.1 by 0.8 cm transverse by AP however the margins are somewhat indistinct making precise measurement difficult.LEFT LOBE: Thyroid gland is mildly heterogeneous. In the midgland is a subcentimeter 0.8 x 0.7 x 0.5 cm (previously 0.7 x 0.7 x 0.5 cm) heterogeneous, hypoechoic at least partially solid nodule with internal vascularity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 0.7 x 0.7 x 0.5 cm right level 3 lymph node with fatty hilum.OTHER: Note is made of left internal jugular vein thrombosis. | 1. Stable left thyroid nodule.2. Heterogeneous structure alluded to above appears to be outside of the right thyroid lobe and has imaging features suggestive of a parathyroid adenoma. Correlation is recommended with patient's clinical history and laboratory results.3. Left internal jugular vein thrombosis.Findings discussed with Louann Shea APN at 5:13 pm on 2/20/2015. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Male; 77 years old. Reason: Primary HPT. Please evaluate for parathyroid adenoma. History: Primary HPT. Please evaluate for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 4.6 x 1.7 x 1.5 cmLEFT LOBE MEASUREMENTS: 3.0 x 1.4 x 1.4 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: The thyroid is mildly heterogeneous but there is no discrete nodule.LEFT LOBE: The thyroid is mildly heterogeneous but there is no discrete nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Small amount of calcification is noted in the left carotid artery. | Mildly prominent thyroid with no discrete nodule. |
Generate impression based on findings. | Male; 25 years old. Reason: hyperparathyroidism, evaluate for mass in neck History: hyperparathyroidism RIGHT LOBE MEASUREMENTS: 4.3 x 1.8 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.2 x 1.9 x 1.2 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.0 x 0.9 x 0.4 cm right level 3 lymph node has a fatty hilum. 2.0 x 1.4 x 0.9 cm the left level 2 lymph node has a fatty hilum.OTHER: No significant abnormality noted. | 1.No discrete thyroid nodule.2.Prominent cervical lymph nodes have a benign appearance and are likely reactive. |
Generate impression based on findings. | Female; 38 years old. Reason: cholecystitis? impacted stone? History: RUQ pain, prior stones, ++tender/vomiting LIVER: The liver measures 18.8 cm in length. The liver surface is smooth. The parenchyma is mildly increased in echogenicity appearing similar to the prior study. No worrisome liver mass identified. The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: Cholelithiasis seen dependently within the gallbladder, measuring up to 6 x 5 mm. There is no gallbladder wall thickening or pericholecystic fluid. There is no intrahepatic biliary ductal dilatation. The common duct measures up to 6 mm in diameter.PANCREAS: The body of the pancreas is unremarkable. The head and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 9.8 cm in length and contains a 1.6 x 1.4 x 1.6 cm cyst with a fine septation, new from the prior CT.RIGHT KIDNEY: The right kidney measures 11.2 cm in length. The renal cortex is mildly increased in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: Left kidney measures 12.1 cm in length. The renal cortex is mildly increased in echogenicity. There is no hydronephrosis or shadowing renal stone. | 1.Hepatomegaly and hepatic steatosis. 2.Cholelithiasis without evidence of acute cholecystitis. No biliary ductal dilatation..3.Echogenic kidneys compatible with medical renal disease.4.Minimally complex splenic cyst is new compared to the prior study, correlation with patient's clinical history recommended. |
Generate impression based on findings. | Male; 41 years old. Reason: abdominal fullness, early satiety, h/o EtOH LIVER: The liver measures 17.8 cm in length. The parenchyma demonstrates a mildly coarsened echotexture. No worrisome hepatic mass is identified. The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. There is no intrahepatic or extrahepatic biliary ductal dilatation.PANCREAS: Head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.6 cm in length.RIGHT KIDNEY: The right kidney measures 11.5 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measures 11.3 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. | Hepatomegaly and mildly coarsened echotexture of liver parenchyma compatible with fatty infiltration/parenchymal dysfunction. No worrisome hepatic mass is identified. |
Generate impression based on findings. | Male; 25 years old. Reason: elevated ALT, evaluate for fatty liver History: elevated ALT LIVER: The liver measures 16.6 cm in length. The liver surface is smooth, the parenchyma is diffusely increased in echogenicity and coarsened in echotexture which limits sensitivity for detection of hepatic masses. Within this limitation, no worrisome mass identified. There are geographic areas of focal sparing, particularly along the gallbladder fossa. The portal vein is patent and demonstrates hepatopetal flow with peak velocity 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The common duct measures 2 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 10.6 cm in length.KIDNEYS: The right kidney measures 11.5 cm in length. The left kidney measures 11.8 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone bilaterally. | Borderline hepatomegaly and coarse, echogenic liver compatible with hepatic steatosis/parenchymal dysfunction. |
Generate impression based on findings. | Female; 74 years old. Reason: 74yp F w/ adenocarcinoma, evaluate for cholestasis/transaminitis cause History: as above LIVER: The liver is enlarged measuring 20.8 cm in length. There is an ill-defined 4.8 x 2.0 by 2.5 cm heterogeneous but predominantly hypoechoic focus near the gallbladder fossa. There is some internal vascularity within this focus which may represent the course of normal vessels. Please refer to the recent CT for additional findings. The main portal vein is not definitely seen but appeared patent on CT. There is portal venous branch flow suggested with a somewhat decreased velocity of 10 to 20 cm/sec.BILIARY TRACT: The gallbladder is nondistended. There is no cholelithiasis or gallbladder wall thickening. The gallbladder wall measures 3 mm. There is no intrahepatic or extrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.6 cm in length.RIGHT KIDNEY: The right kidney measures 9.2 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. LEFT KIDNEY: The left kidney measures 10.9 cm in length. There is no hydronephrosis or shadowing renal stone. In the superior pole of the kidney is a 2.7 x 2.4 x 2.7 cm predominantly cystic lesion with nodular components along the wall. This lesions correlates with that seen on the recent CT. | 1.Hepatomegaly and increased parenchymal echogenicity suggestive of underlying parenchymal dysfunction/steatosis. Ill-defined, heterogenous, hypoechoic focus near the gallbladder fossa could represent an area of focal fatty sparing but this finding is nonspecific. MRI is recommended for further characterization.2.2.7 cm left renal mass has an ultrasound appearance concerning for primary renal neoplasm. |
Generate impression based on findings. | Female; 53 years old. Reason: Patient s/p paracentesis in RLQ with pain at paracentesis site; evaluate for hematoma Scanning was performed over the right lower quadrant in the area of the paracentesis site. Within the subcutaneous tissues is edema and small areas of fluid, measuring up to 4 mm. There is no drainable collection otherwise. | Small edema/fluid in the ventral subcutaneous tissues measuring up to 4 mm. There is no drainable collection otherwise. These findings are compatible with postprocedural sequela/small hematoma. Correlation with physical exam is recommended to exclude cellulitis. |
Generate impression based on findings. | Female; 36 years old. Reason: cholecystitis? History: RUQ pain, tenderness, vomiting LIVER: Liver measures 18.7 cm in length. The liver contour is smooth, the parenchyma is normal in echogenicity. No worrisome masses identified.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The common duct measures 0.6 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are normal in appearance. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.4 cm in length.RIGHT KIDNEY: The right kidney measures 10.7 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. LEFT KIDNEY: The left kidney measures 10.7 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. | Mild hepatomegaly but otherwise normal ultrasound right upper quadrant. Specifically there is no cholelithiasis, biliary ductal dilatation, or evidence of acute cholecystitis. |
Generate impression based on findings. | Male 33 years old Reason: history of ex vivo transplant for metastatic rectal cancer, now s/p creation of colostomy for recurrent obstructive rectal cancer, please evaluate for hepatic venous flow VASCULAR: Status post right hepatectomy. Main portal vein patent with normal directional flow, velocity measures 30 cm/sec. Left portal vein not well evaluated.Patent common hepatic artery, peak systolic velocity measures 90 cm/sec and resistive index measures 0.54. Left hepatic artery not well assessed.Visualized IVC and hepatic veins patent.Visualized splenic vein patent.OTHER: Incompletely imaged relatively echogenic liver masses and pleural effusion formation. Common bile duct not well seen but no definite intrahepatic or extrahepatic biliary duct dilatation delineated. | 1. Patent hepatic veins.2. Partially seen liver masses, metastatic disease a consideration. |
Generate impression based on findings. | Male; 52 years old. Reason: r/o recurrence History: h/o thyroid cancer RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No evidence of recurrenceLEFT LOBE: No evidence of recurrenceISTHMUS: No evidence of recurrencePARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 2.0 x 0.4 x 0.6 cm left level 2 lymph node has a fatty hilum and normal ultrasound appearance and is likely reactive.OTHER: No significant abnormality noted. | Stable exam. No evidence for disease recurrence. |
Generate impression based on findings. | Male; 50 years old. Reason: hep C eval for lesions History: hep c LIVER: The liver measures 18.0 cm in length. The liver contour is smooth, the parenchyma is diffusely increased in echogenicity and coarsened in echotexture is which limits the identification of focal lesions. Within this limitation, no suspicious lesion is identified. Within the right lobe near the capsule is a 4 x 4 x 5 mm hypoechoic lesion with posterior acoustic enhancement and a single thin septation.The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: Multiple shadowing gallstones are seen within the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: Head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 10.0 cm in length.KIDNEYS: The right kidney measures 11.1 cm in length, the left kidney measures 11.4 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone. OTHER: No significant abnormalities noted. | 1.Hepatomegaly and echogenic, coarse liver compatible with hepatic steatosis/parenchymal dysfunction.2.5-mm hypoechoic right liver lesion is too small to accurately characterize but likely represents a minimally complex cyst.3.Cholelithiasis. No evidence obstruction or cholecystitis. |
Generate impression based on findings. | Male; 67 years old. Reason: eval for cirrhosis History: pt with GAVE vs portal hypertension on endoscopy in a LIVER: The liver measures 17.2 cm in length. The liver surface is smooth. Liver parenchyma demonstrates a mildly coarsened echotexture. No focal hepatic lesion is identified.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well evaluated due to overlying bowel gas.SPLEEN: The spleen measures 9.8 cm in length.KIDNEYS: The right kidney measures 9.0 cm in length, the left kidney measures 9.4 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone. OTHER: No significant abnormalities noted. | Mildly coarsened hepatic echotexture but no definite evidence of cirrhosis. No focal hepatic lesion. |
Generate impression based on findings. | 65 year old woman with history of Sjogren's, possible axillary lymph node enlargement and history of left axillary biopsy. A targeted bilateral axillary ultrasound was performed. Normal appearing lymph nodes are noted bilaterally measuring up to 1.3 cm in length and with normal morphology and normal hilar blood flow. Biopsied lymph node in the left axilla is noted with clip, normal in morphology. | Normal appearing lymph nodes in the bilateral axillae. The patient is seeing Dr. Jaskowiak today. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female; 67 years old. Reason: usg of liver, hcc screen for cirrhosis History: same LIVER: The liver measures 13.0 cm in length. The liver surface is nodular, the parenchyma is diffusely echogenic and coarsened in echotexture. No focal hepatic lesion is evident. There is no ascites.The main portal vein is patent and demonstrates a hepatopetal flow with a peak velocity of 0.2 m/sec. Portal vein diameter is 1.6 cm in diameter on the current study, previously 2.3 cm.BILIARY TRACT: Status post cholecystectomy. The common duct measures 9 mm in diameter, unchanged. There is no intrahepatic biliary duct dilatation.PANCREAS: The pancreas is not well visualized due to overlying bowel gas.SPLEEN: The spleen measures 14.4 cm in length.KIDNEYS: The right kidney measures 11.0 cm in length, the left measures 11.5 cm in length. The renal parenchyma is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone. OTHER: No significant abnormalities noted. | 1.Cirrhotic liver morphology. No focal hepatic lesion.2.Splenomegaly. |
Generate impression based on findings. | Female; 64 years old. Reason: evaluate for cirrhosis and ascites History: history of heavy alcohol use and abdominal distention LIVER: The liver measures 11.9 cm in length. The liver capsule is smooth. The parenchyma is heterogeneous in echotexture. No focal hepatic mass is identified. There is no ascites.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no bladder wall thickening or pericholecystic fluid. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas is unremarkable. The body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 6.4 cm in length.KIDNEYS: The right kidney measures 9.7 cm in length. The left kidney measures 9.2 cm in length. The kidneys have a lobulated contour bilaterally likely secondary to scarring as seen on the prior CT. The renal parenchyma is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing stone.OTHER: No significant abnormalities noted. | 1.Heterogeneous liver parenchyma is nonspecific but likely represents chronic parenchymal dysfunction.2.No focal hepatic lesion.3.No ascites. |
Generate impression based on findings. | Female; 35 years old. Reason: pt w hyperthyroidism, to assess gland anatomy and thyroid volume to calculate RAI dose History: hyperthyroidism RIGHT LOBE MEASUREMENTS: 4.3 x 2.0 x 1.7 cmLEFT LOBE MEASUREMENTS: 2.8 x 1.4 x 1.3 cmISTHMUS MEASUREMENTS: 0.19 cmRIGHT LOBE: The right lobe is nodular and certain nodular portions are hypervascular.LEFT LOBE: The left lobe is atrophic and hypervascular.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left level 3 lymph node measures 1.6 x 0.7 cm and has a fatty hilum.OTHER: No significant abnormality noted. | 1.Nodular, partially hypervascular right thyroid lobe and atrophic, hypervascular left thyroid lobe, suspicious for thyroiditis.2.Measurements as above. |
Generate impression based on findings. | Female; 27 years old. Reason: 27 yo F 25 wk pregnant with h/o Crohn's disease s/p total proctocolectomy with h/o portal vein thrombosis. Evaluate portal vein residual thrombosis History: none LIVER: The liver measures 17 cm in length. Renal parenchyma is normal in echogenicity. There is no focal hepatic lesion is identified. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.4 m/sec.BILIARY TRACT: Gravel-like shadowing stones and sludge are seen layering in the dependent portions of the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreatic head and body are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 11 cm in length. No focal splenic lesion is identified.KIDNEYS: The right kidney measures 10.0 cm in length, the left measures 9.6 cm in length. The renal parenchyma is normal in echogenicity bilaterally. There is mild bilateral hydronephrosis. No shadowing renal stone is identified. OTHER: No significant abnormalities noted. | 1.Patent portal vein with normal directional flow.2.Gallbladder gravel and sludge without evidence of acute cholecystitis.3.Mild hydronephrosis bilaterally, unchanged and likely physiologic given pregnancy. |
Generate impression based on findings. | Male; 49 years old. Reason: Patient with elevated creatinine, likely long standing CKD, rule out obstruction History: As above RIGHT KIDNEY: The right kidney measures 14.1 cm in length. The renal parenchyma is echogenic. There is no shadowing renal stone or hydronephrosis.LEFT KIDNEY: The left kidney measures 14.0 cm in length. The renal parenchyma is echogenic. In the lower pole there is a focal, hypoechoic tubular structure without vascularity. There is no hydronephrosis or shadowing renal stoneBLADDER: The bladder is nondistended. Bilateral ureteral jets are identified. | 1.Bilateral echogenic kidneys compatible with medical renal disease.2.Focal, hypoechoic tubular structure in the lower pole of left kidney likely represents a small dilated calix. No hydronephrosis bilaterally. |
Generate impression based on findings. | Male; 60 years old. Reason: history of AML s/p allogeneic transplant with mid-epigastric pain since November 2014 but normal liver enzymes. Evaluate for gallbladder process History: mid-epigastric pain LIVER: The liver measures 13.3 cm in length. The liver surface is smooth, the parenchyma is increased in echogenicity. No focal mass is identified. There is no ascites.The main portal vein is patent and demonstrates a hepatopetal flow with a peak velocity of 0.2 m/sec. BILIARY TRACT: The gallbladder is normal in appearance. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.9 cm in length.KIDNEYS: The right kidney measures 10.4 centimeters in length, the left kidney measures 10.4 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone. | 1.Echogenic liver compatible with hepatic steatosis/parenchymal dysfunction.2.No cholelithiasis or biliary ductal dilatation. |
Generate impression based on findings. | Female; 24 years old. Reason: Twenty Four Year Old Female Perinatal HIV Infection with CD4 220 plus Left Thyroid Nodule for two years. RIGHT LOBE MEASUREMENTS: 5.7 x 2.2 x 2.1 cmLEFT LOBE MEASUREMENTS: 5.7 x 1.5 x 1.6 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: The dominant nodule in the inferior pole measures 2.4 x 1.5 x 1.6 cm. It is mixed solid and cystic with foci of increased echogenicity suggestive of focal colloid or microcalcification. There is a second nodule more superiorly with a similar appearance as well as the suggestion of other similar appearing underlying nodules. Adjacent to the anterior pole nodule is a macrocalcification with a hypoechoic rim measuring 0.5 x 0.3 x 0.4 cm.LEFT LOBE: The dominant nodule in the left lobe measures 1.7 x 1.2 x 1.3 cm, it is predominantly solid with cystic components solid and cystic and foci of increased echogenicity suggestive of colloid.ISTHMUS: In the left isthmus knee there is a 1.5 x 0.3 x 0.8 cm hyperechoic, solid nodule without calcification. This nodule is palpable, reported by the patient.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Prominent lymph nodes with fatty hila are seen in the bilateral cervical chains. | 1.Bilateral thyroid nodules. A dominant nodule in the right lobe is amenable to ultrasound guided biopsy.2.The palpable left isthmus nodule does not meet definite imaging criteria for biopsy and can be followed. |
Generate impression based on findings. | Female; 25 years old. Reason: please evaluate gall bladder History: recurrent abdominal pain, right sided and upper abdomen, can last hours LIVER: The liver measures 16.4 cm in length. The liver surface is smooth, the parenchyma is slightly heterogeneous. No focal hepatic lesions are identified. There is no ascites.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.31 m/sec.BILIARY TRACT: The gallbladder is unremarkable. There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The common duct measures 2 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: Head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 10.8 cm in length.KIDNEYS: The right kidney measures 10.0 cm in length, the left kidney measures 9.3 cm in length. The renal cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone. OTHER: No significant abnormalities noted. | 1.The liver parenchyma is slightly heterogeneous in echogenicity which is nonspecific. 2.Normal ultrasound of the gallbladder. Specifically there is no cholelithiasis, evidence of cholecystitis, or biliary ductal dilatation. |
Generate impression based on findings. | Male; 59 years old. Reason: cholecystitis History: elevated lft LIMITED ABDOMENLIVER: The liver measures 12.9 cm in length. The liver surface is nodular, the parenchyma is diffusely increased in echo density and coarsened in echotexture. No focal hepatic lesion is identified. There is a mild amount of ascites.BILIARY TRACT: Small shadowing stones are seen within the gallbladder neck. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 0.4 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: Pancreas is not well-visualized due to overlying bowel gas.SPLEEN: The spleen measures 11.2 cm in length. KIDNEYS: The right kidney measures 10.4 cm in length, the left measures 1.2 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.OTHER: No significant abnormalities noted. | 1.Cirrhotic liver morphology with a mild amount of ascites and right pleural effusion.2.Reversal of flow in the main portal vein.3.Cholelithiasis without evidence acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | 27-year-old male with acute myeloid leukemia and acute kidney injury. RIGHT KIDNEY: The right kidney measures 10.7 cm in length. Echo texture within normal limits. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 11.5 cm in length.Echo texture within normal limits. No hydronephrosis, shadowing calculus or mass. OTHER: Bladder poorly distended. | Normal kidneys. |
Generate impression based on findings. | 63 old female with abnormal liver function. Prior history demonstrates stem cell transplant. LIVER: Liver is again noted to be mildly echogenic. There is a complex, lobulated and partly septated cystic mass in the left lobe measuring 3.3 cm in greatest diameter which is stable.Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Post cholecystectomy. The intrahepatic delay tract is normal in caliber. The common duct is normal on today's exam.PANCREAS: The head and body are normal. The tail is incompletely visualized.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Stable examination. No biliary tract dilatation. |
Generate impression based on findings. | Male; 63 years old. Reason: AKI vs CKD History: uremia RIGHT KIDNEY: The right kidney measures 11.1 cm in length. The renal cortex is highly echogenic and the margins are indistinct. There is no hydronephrosis.LEFT KIDNEY: The left kidney is not well visualized.URINARY BLADDER: The bladder is decompressed by Foley catheter.OTHER: No significant abnormalities noted. | 1.Echogenic right kidney compatible with medical renal disease. No hydronephrosis on the right.2.The left kidney is not well visualized. |
Generate impression based on findings. | Male; 59 years old. Reason: renal failure History: renal failure The exam is somewhat limited by and and patient's body habitus.RIGHT KIDNEY: The right kidney measures 12.9 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measures 13.4 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.URINARY BLADDER: The bladder is not visualized.OTHER: There is a small amount of ascites. | 1.No hydronephrosis. 2.Small amount of ascites |
Generate impression based on findings. | Male; 66 years old. Reason: renal failure History: renal failure RIGHT KIDNEY: Right kidney measures of 10.5 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. At the inferior aspect of the right kidney is a 5.2 x 4.7 x 5.5 cm anechoic lesion with posterior enhancement. No internal septations or wall nodularity are visualized. There is no vascular flow on color Doppler.LEFT KIDNEY: The left kidney measures 12.7 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.URINARY BLADDER: The bladder is decompressed by Foley catheter.OTHER: No significant abnormalities noted. | 1.5.5 cm simple appearing right renal cyst.2.No hydronephrosis. |
Generate impression based on findings. | Female; 41 years old. Reason: S/p stem cell transplant, now w/ sharp rise in LFTs and abdominal pain, concern for cholecystitis, gall stones, pancreatitis History: Abdominal pain LIVER: The liver measures 17.5 cm in length. No focal hepatic lesion is identified. The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.4 m/sec.BILIARY TRACT: The gallbladder is mildly distended. No gallstones are identified. There is no gall bladder wall thickening or pericholecystic fluid. The common duct is prominent measuring 7 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas is unremarkable. The body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 14.5 cm in length.KIDNEY: The right kidney measures 12.0 cm in length, the left kidney measures 13.9 cm. The renal parenchyma is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone. OTHER: No significant abnormalities noted. | 1. Borderline hepatomegly. 2. Splenomegaly..3.Mildly distended gallbladder and prominent common bile duct but no gallstones, evidence of acute cholecystitis, or intrahepatic biliary ductal dilatation. |
Generate impression based on findings. | Male; 38 years old. Reason: cholecystitis? History: ct evidence pericholecystic fluid, abd pain LIVER: The liver measures 16.1 cm in length. The liver surface is smooth, the parenchyma is diffusely heterogeneous. In the right lobe of the liver is a 2.1 x 2.2 x 1.9 cm hyperechoic lesion without vascularity on color Doppler. This correlates with the lesion seen on same day CT. There is a moderate amount of ascites.The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: There is no cholelithiasis. The gallbladder wall is thickened measuring up to 7 mm. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas has a lobulated appearance correlating with the appearance on the two prior CTs from February 2015. The body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: The spleen measures 14.1 cm in length.KIDNEYS: The right kidney measures 11.9 cm in length, the left kidney measures 12.1 cm in length. The cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing renal stone.OTHER: Note is made of bilateral pleural effusions. | 1.Thickened gallbladder wall is likely secondary to ascites. There is no cholelithiasis or other evidence of acute cholecystitis.2.2.2-cm hyperechoic lesion in the right lobe of the liver is indeterminate. Continued follow-up is recommended. Alternatively, correlation with MRI may be considered if clinically warranted.3.Splenomegaly.4.Moderate amount of ascites.5.Bilateral pleural effusions. |
Generate impression based on findings. | Male; 61 years old. Reason: Evaluate possible mets, testicular cancer History: HCC, HCV elevated AFP RIGHT TESTIS: The right testis measures 3.0 x 2.9 x 2.7 cm. It is is normal in echogenicity, no worrisome lesion is identified. Vascular flow is symmetric.LEFT TESTIS: The left testes measures 2.0 x 3.1 x 1.8 cm. It is normal in echogenicity. There is a 1 mm calcification within the left testicle. No worrisome lesion is identified. Vascular flow is symmetric.RIGHT EPIDIDYMIS: The right epididymis measures 0.7 x 0.9 x 0.7 cm and is normal in appearance.LEFT EPIDIDYMIS: The left epididymis measures 1.5 x 1.1 x 0.6 cm and contains a 0.7 x 0.9 x 0.7 cm simple cyst.OTHER: Bilateral hydroceles. | 1.No worrisome testicular lesion is identified.2.Simple left epididymal cyst.3.Bilateral hydroceles. |
Generate impression based on findings. | Male; 51 years old. Reason: Increasing kidney function tests in setting of OLT RIGHT KIDNEY: The right kidney measures 10.1 cm in length. Renal parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: Evaluation of the left kidney is somewhat limited. The left kidney measures 11.9 cm in length. Renal parenchyma is normal in echogenicity. A few simple appearing cysts are seen within the kidney, the largest measures 1.2 x 0.9 x 1.1 cm. There is no hydronephrosis or shadowing renal stone.URINARY BLADDER: The bladder is decompressed which limits evaluation for focal lesions. Free fluid is seen superior to the bladder.OTHER: Adjacent to the liver, in the right upper quadrant there is a complex, loculated fluid collection likely representing postoperative fluid/hematoma.. | 1.No hydronephrosis.2.2.1 cm simple appearing left renal cyst.3.Heterogeneous collection in the right upper quadrant is of uncertain significance. |
Generate impression based on findings. | Male; 65 years old. Reason: Nodules History: Thyroid cancer s/p thyroidectomy RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No evidence of recurrence in the thyroid bed.LEFT LOBE: No evidence of recurrence in the thyroid bed.ISTHMUS: No evidence of recurrence in the thyroid bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious lymphadenopathy.OTHER: No significant abnormality noted. | Status post thyroidectomy with no evidence of recurrent disease. |
Generate impression based on findings. | Female; 26 years old. Reason: r/o goiter, nodules History: enlarge thyroid RIGHT LOBE MEASUREMENTS: 4.6 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 3.9 x 1.4 x 1.0 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Heterogeneous thyroid with innumerable small hypoechoic nodules. There is no dominant nodule. The background gland is hypervascular.LEFT LOBE: Heterogeneous thyroid with innumerable small hypoechoic nodules. There is no dominant nodule. The background gland is hypervascular.ISTHMUS: Heterogeneous thyroid with innumerable small hypo echoic nodules. There is no dominant nodule. The background gland is hypervascular.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Prominent left level 3 lymph node measures 2.1 x 0.6 x 0.3 cm with a fatty hilum.OTHER: No significant abnormality noted. | 1.Hypervascular, heterogeneous thyroid gland with innumerable small hypoechoic nodules compatible with thyroiditis.2.Prominent left level 3 lymph node has a normal ultrasound appearance and is likely reactive in etiology. |
Generate impression based on findings. | Male; 81 years old. Reason: aki History: aki RIGHT KIDNEY: The right kidney measures 9.7 cm in length. The parenchyma is normal echogenicity. There is a 1.3 x 0.7 x 1.1 cm simple appearing cyst. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney is poorly visualized, it measures 10.8 cm in length. The parenchyma is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.URINARY BLADDER: The bladder is decompressed by Foley catheter.OTHER: The prostate measures 6.5 x 5.8 x 3.8 cm. | 1.No hydronephrosis.2.1.3-cm simple appearing right renal cyst.3.Enlarged prostate with measurements as above. |
Generate impression based on findings. | Ms. Mukhopadhyay is a 24 year old female presenting with a palpable abnormality in the left breast for the past 6 months. She denies any tenderness or history of trauma. Upon physical exam at the patient's area of concern, no discrete mass is appreciated.A targeted left breast ultrasound was performed for the palpable area of concern. Dense fibroglandular tissue is identified at the area of concern along with a 6 mm cyst. No suspicious cystic or solid masses are identified. | Dense fibroglandular tissue without sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted. All results and recommendations were relayed to the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female; 47 years old. Reason: HCC screening History: hepatitis B LIVER: The liver measures 15.2 cm in length. The liver surface is smooth, the parenchyma demonstrates a mildly coarsened echotexture. No worrisome hepatic lesion is identified. There is no ascites. The main portal vein is patent with hepatopetal flow and a peak velocity of 0.3 m/sec. BILIARY TRACT: The gallbladder is unremarkable. There is no cholelithiasis or gallbladder wall thickening. The common duct measures 0.3 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.7 cm in length.KIDNEYS: The right kidney measures 11.1 cm in length. There is mild dilation of the renal collecting system, new from the prior study. The cortex is normal in echogenicity. There is no shadowing renal stone identified. The left kidney measures 10.9 cm in length. There is no hydronephrosis or shadowing renal stone identified. OTHER: The bladder is not distended. | 1.No evidence of cirrhosis or focal hepatic mass.2.Mild dilation of the right renal collecting system is new from the prior study, an underlying obstructing stone is not entirely excluded with this study, correlation with patient history is recommended. |
Generate impression based on findings. | Ms. Zhang is a 22-year-old female presenting with left breast pain for the past 3 to 4 days. However, on examination today, patient states that the pain is no longer present. Upon physical exam at the patient's area of concern, no discrete mass is appreciated.A targeted left breast ultrasound was performed for the patient’s area of concern. In the left breast 3 o'clock location, approximately 2 cm from the nipple, no suspicious cystic or solid mass is identified. | No sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male; 66 years old. Reason: Pt with low platelets and elevated AST, ALT. Please evaluate for liver disease. May also be working up for heart transplant History: elevated transaminases, thrombocytopenia LIVER: The liver measures 15.1 cm in length. The liver surface is smooth, the parenchyma echogenic and heterogenous in echotexture. No focal lesion identified.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.3 m/s.GALLBLADDER, BILIARY TRACT: The gallbladder is unremarkable. There is no cholelithiasis or gallbladder wall thickening. The common duct measures up to 5 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 13.6 cm in length.KIDNEYS: The right kidney measures 9.3 cm in length. The cortex is normal echogenicity. There is no hydronephrosis or shadowing renal stone. The left kidney measures 10.9 cm in length. The cortex is normal in echogenicity. 1.6 x 1.4 x 2.3 cm exophytic, simple appearing renal cyst is seen. There is no hydronephrosis or shadowing stone.ABDOMINAL AORTA: The proximal aorta measures 2.5 cm in diameter, the mid aorta measures 2.2 cm in diameter. The distal aorta is not visualized.INFERIOR VENA CAVA: The most superior portion of the inferior vena cava is imaged it is patent and unremarkable.OTHER: The bladder is not distended and incompletely evaluated. A left ureteral jet is visualized. | 1.Heterogenous and echogenic liver parenchyma compatible with hepatic steatosis/parenchymal dysfunction.2.Simple appearing left renal cyst. |
Generate impression based on findings. | Male; 72 years old. Reason: pancreas/RUQ History: increasing amylase, abdominal pain LIVER: The liver measures 17.6 cm in length. The liver surface is smooth, the parenchyma is heterogeneous in echotexture. No focal hepatic lesion is identified. There is mild ascites. The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The common duct measures 6 mm in diameter. There is no intrahepatic biliary ductal dilatationPANCREAS: The pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.8 centimeters in length.KIDNEYS The right kidney measures 15.9 cm in length. Multiple anechoic lesions are seen in the right kidney, largest measures 5.2 x 5.3 x 4.4 cm. There is no hydronephrosis or shadowing renal stone. The left kidney measures 19.8 cm in length and contains multiple and lesions, the largest measures 10.6 x 10.9 x 1.8 cm. There is no hydronephrosis or shadowing renal stone. OTHER: Bilateral pleural effusions. | 1.Limited evaluation of the pancreas due to overlying bowel gas.2.No cholelithiasis or evidence of acute cholecystitis.3.Multiple simple appearing renal cysts bilaterally. The largest on the left measures up to 10.9 cm.4.Heterogeneous liver parenchyma compatible with hepatic steatosis/parenchymal dysfunction.5.Bilateral pleural effusions. |
Generate impression based on findings. | Female 65 years old; Reason: s/p renal transplant 5-18-2000 History: proteinuria Ultrasound guidance and technical assistance provided for a right iliac fossa transplanted kidney biopsy by the nephrology service. 2 passes were reportedly performed. On the provided images, no peritransplant hematoma delineated. | Sonographic assistance provided for renal transplant biopsy by the clinical service. |
Generate impression based on findings. | Male; 72 years old. Reason: assess for mass or cyst, suspect RCC History: increasing hemoglobin RIGHT KIDNEY: Right kidney measures 9.2 cm in length. The cortex is echogenic. There is no hydronephrosis or shadowing renal stone. No renal mass is identified on ultrasound.LEFT KIDNEY: Left kidney measures 10.0 cm in length. The cortex is echogenic. There is no hydronephrosis or shadowing renal stone. No renal mass is identified on ultrasound.OTHER: The bladder is decompressed. A right ureteral jet is visualized. | 1.Echogenic kidneys, compatible with medical renal disease.2.No renal mass is identified on ultrasound imaging. If there is continued concern for renal cell carcinoma, dedicated contrast enhanced cross-sectional imaging would be more sensitive and is recommended. |
Generate impression based on findings. | Male; 61 years old. Reason: Evaluate for HCC History: HCV, cirrhosis LIVER: The liver measures 15.2 cm in length. The parenchyma is mildly coarse in echotexture and heterogeneous. No focal hepatic lesion is identified.The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: Cholelithiasis is again seen, there is no gallbladder wall thickening or pericholecystic fluid. The common duct measures up to 1.5 cm in diameter which is slightly increased compared to the prior ultrasound. There is no intrahepatic biliary ductal dilatation seen.PANCREAS: Again seen is a 2.0 x 2.0 x 1.2 cm peripancreatic lymph node (image time stamped 1:19:14 p.m.) this previously measured 1.7 x 1.4 x 1.1 cm. The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 10.0 cm in length.KIDNEYS: The left kidney measures 10.0 cm in length, the right kidney measures 9.2 cm in length. The cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing stone. | 1.Mildly coarse liver parenchyma without focal lesion identified.2.Prominent peripancreatic lymph node may be benign and reactive in etiology in the setting of cirrhosis however would be better characterized on ERCP/MRCP if clinically warranted.3.Cholelithiasis without evidence of acute cholecystitis.4.Slight increase in extrahepatic biliary ductal dilatation. This would be further evaluated with ERCP/MRCP if clinically warranted. No intrahepatic biliary ductal dilatation delineated. |
Generate impression based on findings. | Female; 60 years old. Reason: pain at r femoral vein site, evaluate for hematoma History: pain No evidence of fluid collection or hematoma at the site of the right femoral line. There is perhaps mild skin thickening at the line site, correlation with physical exam is recommended. | No fluid collection or hematoma at the right femoral line site. |
Generate impression based on findings. | Male; 60 years old. Reason: complete abdominal ultrasound for heart transplant evaluation History: pre-cardiac transplant evaluation LIVER: The liver has a smooth contour. Liver measures 17.3 cm in length. The parenchyma is normal in echotexture. There is no focal hepatic mass identified. The main portal vein is patent and demonstrates normal direction of flow with a peak velocity of 0.29 m/sec.BILIARY TRACT: The gallbladder has an anechoic lumen. There is no gallbladder wall thickening. There is no intrahepatic biliary ductal dilatation. Common duct measures 2 mm in diameter. PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 12.2 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. A hypoechoic band in the right kidney raises the question of a duplicated collecting system. The left kidney measures 12.3 cm. The cortex is normal in echogenicity. SPLEEN: The spleen measures 13.6 cm. in length. ABDOMINAL AORTA: Proximal portion: 1.6 x 1.8 x 2.2 cmMid portion: 1.7 x 1.7 x 1.8 cmDistal portion: 1.6 x 2.0 x 2.1 cmINFERIOR VENA CAVA: The imaged portions are patent. | 1.Focal hypoechoic band in the right kidney raises the question of a duplicated collecting system, this may be correlated with cross-sectional imaging if clinically warranted.2.Hepatomegaly. |
Generate impression based on findings. | Male; 55 years old. Reason: stones Supernumerary kidneys fused at the midline.RIGHT KIDNEY: The right superior kidney measures 10.8 cm in length. Renal cortex is normal in echogenicity. At least two nonobstructing, shadowing stones with twinkle artifact are seen in the right kidney. The largest measures 0.6 cm. There are two collecting systems on the right, the inferior collecting system is prominent similar to CT. In the inferior aspect of the right duplicated inferior kidney is a 2.4 x 1.7 x 1.8 cm hypoechoic lesion with some internal echoes, a septation, and no internal flow on color Doppler. This corresponds to the lesion seen on recent CT.LEFT KIDNEY: The left superior kidney measures 14.6 cm. The renal cortex is normal in echogenicity. There are two collecting systems. There is no hydronephrosis or shadowing renal stone on the left.BLADDER: The bladder is nondistended. | 1.Supernumerary kidneys fused at the midline.2.At least 2 nonobstructing stones on the right. Prominent inferior right collecting system, similar to prior CT exam, no significant hydronephrosis otherwise.3.2.4 cm hypoechoic lesion in the inferior right duplicated kidney corresponds to the lesion seen on recent CT. This is indeterminant on ultrasound and may be further evaluated with MRI if clinically warranted. |
Generate impression based on findings. | Male; 70 years old. Reason: assess for stones and medical renal disease History: urosepsis x2 RIGHT KIDNEY: Right kidney measures 13.2 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measured 13.3 cm in length. Simple appearing renal cyst measuring up to 0.8 cm. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.BLADDER: The bladder is nondistended.OTHER: 0.9 x 0.8 x 0.8 cm hyperechoic right liver lesion. The prostate measures 5.6 x 5.3 x 6.3 cm. | 1.No nephrolithiasis or hydronephrosis. Renocortical echogenicity within normal limits.2.Enlarged prostate.3.Subcentimeter hyperechoic right liver lesion may represent a hemangioma, should be confirmed with dedicated contrast enhanced CT or MRI. |
Generate impression based on findings. | Male; 62 years old. Reason: hydronephrosis History: hydronephrosis RIGHT KIDNEY: The right kidney measures 10.3 cm in length. The renal cortex is echogenic. There is no hydronephrosis or shadowing renal stone. There is a 0.6 x 0.5 x 0.4 cm anechoic lesion in the midpole of the kidney.LEFT KIDNEY: Left kidney measures 10.6 cm in length. The renal cortex is echogenic. There is no hydronephrosis or shadowing renal stone. There is a 1.2 x 1.3 x 1.3 cm mildly complex left renal cyst with no vascular flow.BLADDER: The bladder is decompressed by a Foley catheter. | 1.1.3 cm mildly complex left renal cyst would be better evaluated with contrast enhanced CT or MRI.2.No hydronephrosis. |
Generate impression based on findings. | Male; 63 years old. Reason: ascites History: distention Cirrhotic liver morphology. Mild ascites, redistributed but overall stable to slightly decreased from prior. | Mild ascites, stable to slightly decreased from prior. |
Generate impression based on findings. | Male; 60 years old. Reason: h/o hemangioma, assess for interval change LIVER: The liver has a nodular contour. Liver measures 18.0 cm in length. The parenchyma is normal in echotexture. There is no focal hepatic mass identified.The portal vein is patent and demonstrates normal directional flow with a peak velocity of 0.25 m/sec.BILIARY TRACT: The gallbladder contains layering sludge. There is no cholelithiasis, wall thickening or pericholecystic fluid. Common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 6.9 cm. The cortex is normal in echogenicity but thin. No shadowing calculi or hydronephrosis is present. 1.2 x 0.9 x 1.3 cm slightly hypoechoic structure is seen in the right kidney. There is no associated abnormally increased vascular flow. The left kidney measures 13.8 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 12.6 cm. in length. OTHER: Bilateral pleural effusions. | 1.Hepatomegaly.2.No hepatic hemangioma is identified and no prior imaging was available for comparison at the time of this dictation.3.Right kidney lesion likely represents a prominent column of Bortan but follow up with contrast-enhanced CT or MRI is recommended to exclude underlying neoplasm.4.Bilateral pleural effusions. |
Generate impression based on findings. | 48 years, Female, Reason: Lymph node mapping for PTC History: Lymph node mapping for PTC. RIGHT LOBE MEASUREMENTS: 1.7 x 1.1 x 3.8 cmLEFT LOBE MEASUREMENTS: 1.3 x 1.4 x x 4 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Heterogeneous, predominantly hypoechoic solid hypovascular lesion in the left mid pole containing calcifications compatible with patient's known papillary thyroid carcinoma measures 1.2 x 1.5 x 2.1 cm.ISTHMUS: Hypoechoic lesion in the isthmus measuring 0.6 x 0.3 x 0.6 cm with increased through transmission likely represents a cyst.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left level 3 node measures 0.7 x 0.3 x 0.8 cm, but has an abnormal morphology and contains a calcification.OTHER: No significant abnormality noted. | 1.Left lower pole lesion corresponding to patient's known papillary thyroid carcinoma.2.Subcentimeter left level 3 node with abnormal morphology and calcification. |
Generate impression based on findings. | 27 years, Female, Reason: r/o adenopathy, recurrence History: h/o thyroid cancer. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. No significant abnormality.LEFT LOBE: Status post thyroidectomy. No significant abnormality.ISTHMUS: Status post thyroidectomy. No significant abnormality.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes bilaterally, the largest including a right level Ib node measuring 2.3 x 1.4 x 0.6 cm and a left level Ib node measuring 2.5 x 1.4 x 0.7 cm.OTHER: No significant abnormality noted. | No evidence of local recurrence or significant interval change. |
Generate impression based on findings. | Female 66 years old; Reason: Change in nodules History: Multinodular goiter, dominant right nodule with previous benign FNA RIGHT LOBE MEASUREMENTS: 7.9 x 5.0 x 3.8 cm (previously 8.0 x 6.1 x 5.4 cm)LEFT LOBE MEASUREMENTS: 3.3 x 1.0 x 1.3 cm (previously 4.6 x 1.0 x 1.3 cm)ISTHMUS MEASUREMENT: 0.3 cm (previously 0.2 cm)RIGHT LOBE: In the right inferior thyroid lobe is a predominantly solid nodule with an internal calcification which appears similar to the prior study. This measures 6.4 x 4.0 x 2.9 cm (previously 7.2 x 5.6 x 4.5 cm).LEFT LOBE: 0.5 x 0.7 x 0.4 cm solid nodule in the inferior pole previously measured 0.6 to 0.4 x 0.7 cm.ISTHMUS: No significant abnormality noted.OTHER: Scattered prominent cervical lymph nodes are seen with fatty hila and a benign appearance. | 1.Interval decrease in the size of the right lobe nodule. Stable left thyroid nodule.2.No suspicious lymphadenopathy. |
Generate impression based on findings. | Female 62 years old; Reason: Thyroid nodules RIGHT LOBE MEASUREMENTS: 4.7 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.1 x 1.3 x 1.6 cmISTHMUS MEASUREMENT: 0.24 cmRIGHT LOBE: Two small nodules are seen within the inferior aspect of the right thyroid lobe. The first is solid, heterogeneous but predominantly hyperechoic and measures 0.8 x 0.7 x 0.8 cm and has no increased vascularity. The second nodule is solid and hypoechoic and measures 0.9 x 0.6 x 0.8 cm.LEFT LOBE: The left lobe contains a poorly defined, heterogeneous, hypoechoic nodule with no increased vascularity which measures 3.2 x 1.1 x 1.4 cm.ISTHMUS: No significant abnormality noted.LYMPH NODES: Multiple prominent bilateral cervical nodes with fatty hila. | 1.Heterogeneous, ill defined 3.2-cm left thyroid nodule and reactive cervical lymphadenopathy may be seen with thyroiditis and correlation with clinical signs/labs is recommended. If clinically warranted, this nodule is amenable to ultrasound guided biopsy. |
Generate impression based on findings. | Male; 71 years old. Reason: assess for AAA History: ex smoker Aortic measurements are as follows:Proximal aorta: 2.8 x 2.3 x 2.4 cm.Mid aorta: 2.1 x 2.1 x 2.1 cm.Distal aorta: 1.7 x 2.0 x 1.7 cm.Right common iliac artery 0.9 cm.Left common iliac artery 1.1 cm. In | Normal caliber of the aorta without evidence of aneurysm. |
Generate impression based on findings. | Female 31 years old; Reason: History of enlarging mass on neck, history of nodule/1.3 cm on L now with enlarging thyroid b/l, assess for thyroiditis vs mass vs other RIGHT LOBE MEASUREMENTS: 4.2 x 2.9 x 7.8 cm (previously 3.9 x 2.5 x 9.0 cm)LEFT LOBE MEASUREMENTS: 3.5 x 2.6 x 6.6 cm (previously 3.4 x 2.7 x 8.3 cm)ISTHMUS MEASUREMENT: 0.37 cm (previously 0.47 cm)RIGHT LOBE: The thyroid is enlarged and heterogeneous. A nodule in the posterior aspect of the gland measures 1.0 x 0.8 x 1.1 cm, is mixed solid/cystic with no significant vascular flow and may have been present on the previous ultrasound although difficult to measure.LEFT LOBE: The thyroid is large and heterogeneous. In the left lower pole a mixed solid/cystic nodule is again seen which measures 1.2 x 0.7 x 1.0 cm (previously 1.3 x 1.0 x 1.3 cm). A second nodule more superiorly in the midpole is mixed solid/cystic and measures 1.2 x 0.6 x 1.0 cm.ISTHMUS: No significant abnormality noted.LYMPH NODES: A right level 2 lymph node measures 2.4 x 1.1 x 2.5 cm with a fatty hilum and lobular contour. | 1.Diffusely large and heterogeneous thyroid gland compatible with thyroiditis.2.Dominant predominantly solid left lower pole thyroid nodule has decreased in size.3.Two nodules on the right may have been present on the previous study but were not as clearly visualized and may represent colloid nodules.4.Enlarged right level 2 lymph node has a benign appearance and is likely reactive, may be seen in setting of thyroiditis. |
Generate impression based on findings. | Male; 37 years old. History of a remote right inguinal hernia repair now with pain. Scanning of the bilateral inguinal area reveals no evidence of hernia at rest or with Valsalva maneuver, no hematoma/fluid collection. | No evidence of hernia or fluid collection/hematoma. |
Generate impression based on findings. | Female 53 years old; Reason: previously diagnosed left lower pole thyroid nodule- s/p aspiration in 2014 History: query changes or residua RIGHT LOBE MEASUREMENTS: 5.1 x 1.5 x 1.3 cmLEFT LOBE MEASUREMENTS: 4.9 x 1.7 x 1.5 cmISTHMUS MEASUREMENT: 0.21 cmRIGHT LOBE: 0.8 x 0.6 x 0.6 cm hypoechoic nodule in the posterior inferior right thyroid. No calcifications or increased vascularity. LEFT LOBE: In the mid thyroid is a 1.5 x 1.0 x 1.3 cm hypoechoic nodule that is predominantly solid with cystic components. No definite calcifications or increased vascularity. In the inferior pole is a 1.6 x 1.1 x 1.3 cm hyperechoic nodule that is predominantly solid with cystic spaces and small hyperechoic foci suggestive of colloid.ISTHMUS: There is a small microcalcification in the isthmus. This is nonspecific.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.1.6-cm inferior pole nodule is amenable to ultrasound guided biopsy. However, correlation with previous pathology is recommended to determine if this is clinically indicated. |
Generate impression based on findings. | Female 43 years old; Reason: r/o cystic structure. assess size. r/o adenopathy, growth of lesion History: h/o thyroid cancer. Had small cystic structure in neck, biopsied and mostly drained. Low Tg level, but atypical cells seen. This is a follow up study to see if cyst still visible, and for any other changes RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENT: Status post thyroidectomy.RIGHT LOBE: Subcentimeter hypoechoic focus in the right thyroid bed measures 0.4 x 0.3 x 0.2 cm (previous 0.3 x 0.3 x 0.3 cm).LEFT LOBE: No evidence of disease recurrence.ISTHMUS: No evidence of disease recurrence.LYMPH NODES: Hypoechoic focus in the left lateral neck level IV region which was previously aspirated is redemonstrated and currently measures 0.3 x 0.2 x 0.3 cm (previously 0.6 x 0.6 x 0.6 cm). | 1.Persistent cystic structure in the left level IV region is smaller in size than on the prior ultrasound. Again, adequate tissue sampling would be difficult due to the cystic composition.2.No evidence of recurrence in the thyroid bed. |
Generate impression based on findings. | 32 year-old female with history of hyperparathyroidism. RIGHT LOBE MEASUREMENTS: 5.6 x 2.5 x 1.5 cmLEFT LOBE MEASUREMENTS: 4.9 x 1.8 x 1.5 cmISTHMUS MEASUREMENTS: 0.4 cm in thickness. RIGHT LOBE: Mildly heterogenous echotexture without nodules. LEFT LOBE: Mildly heterogenous echotexture without nodules. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Multiple hypoechoic, oval shaped lesions are present compatible with parathyroid adenomas.The first is posterior to the midpole of the right thyroid gland and measures 1.4 x 1.2 x 0.7 cm. The medial edge of this lesion is approximately 2 mm from the trachea.The second is posterior to the inferior pole of the right thyroid gland and measures 1.5 x 0.4 x 0.6 cm. The medial edge of this lesion is approximately 2 mm from the trachea and the inferior edge is approximately 4 mm cephalad to the inferior tip of the thyroid.The third is posterior to the inferior one third of left lobe of the thyroid gland and measures 1.8 x 0.7 x 0.8 cm. The inferior tip of the lesion extends to the inferior tip of the thyroid gland. LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple lesions compatible with parathyroid adenomas as described above. |
Generate impression based on findings. | 44 year old woman with history of calcifications seen on screening mammogram 1/23/15. Also complains of a palpable mass in right superolateral axilla. An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Regional, round calcifications are seen in the left superolateral breast. These are highly likely benign based on distribution and morphology. ULTRASOUND | 1. Regional round calcifications in the left superolateral breast are highly likely benign. Followup with unilateral diagnostic mammogram is recommended in 6 months. Recommendation was discussed with and provided to the patient in writing.2. Sebaceous cyst of the right axilla.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 55-year-old with history of left lumpectomy in 1995. Today, Dr. Chhablani palpates an area of concern in the high left axilla. A targeted left ultrasound was performed for the palpable area of concern. A subcentimeter normal morphology lymph node is found at the site marked by the clinical service. There is no suspicious lymph node, or solid or cystic mass identified. | No sonographic evidence for malignancy. Normal morphology left axillary lymph node. The patient's next bilateral diagnostic mammogram will be due in December 2015.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is a vague hypoechoic area lateral to the right nipple near the 9:00 position at posterior depth. There is no solid or cystic mass identified in the left breast. | Right breast hypoechoic area for which further evaluation with hand held targeted diagnostic ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Ms. Maxwell is a 79 year old female with a personal history of biopsy proven left breast cancer, currently on anti-estrogen therapy. Targeted ultrasound was performed for the left breast at 2 o'clock and 3 o'clock. The intramammary node at 2 o'clock is about the same size, measuring 5 x 4 mm. No abnormal findings were seen in the 3 o'clock position. | Known left breast cancer; no significant changes since the prior study.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 88 years old; Reason: assess interval change in size or character of thyroid nodule History: none. Hx of dominant large 4.2 x 3.3 cm heterogeneous nodule in R thyroid. FNA in 2004 colloid nodule, with no subsequent records or follow up imaging. RIGHT LOBE MEASUREMENTS: 5.4 x 2.0 x 2.6 cmLEFT LOBE MEASUREMENTS: 5.6 x 1.6 x 2.1 cmISTHMUS MEASUREMENT: 0.4 cmRIGHT LOBE: In the inferior pole of the right lobe is a 3.3 x 3.1 x 2.1-cm heterogeneous nodule with shadowing dystrophic calcification.LEFT LOBE: The gland is heterogeneous. In the mid aspect of the left lobe is a 2.5 x 1.8 x 1.8 cm solid, heterogeneous, but predominantly isoechoic, nodule with punctate hyperechoic foci.ISTHMUS: Small anechoic structure in the left aspect of Isthmus measures 0.4 x 0.3 x 0.5 cm.LYMPH NODES: 1.1 x 0.6 x 0.4 cm right level 2 lymph node with a fatty hilum.OTHER: No significant abnormality noted. | Bilateral thyroid nodules are amenable to percutaneous biopsy if clinically indicated. |
Generate impression based on findings. | Female 63 years old; Reason: please evaluate for malignancy, progression of cirrhosis, portal HTN History: 63 yo F with NAFLD and Hep C cirrhosis LIMITED ABDOMENLIVER: The liver measures 20.8 cm in length. The liver has a micronodular contour. The parenchyma is echogenic with coarsened echotexture which limits the evaluation for focal mass. Within this limitation, no suspicious mass is identified. Again seen within segment 2 of the liver is a portosystemic shunt, unchanged. There is no ascites. The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec. BILIARY TRACT: The gallbladder is absent. Common duct measures 0.3 cm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 9.8 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 9.7 cm. The cortex is normal in echogenicity. There is a 1.4-cm nonobstructing, shadowing stone in the inferior aspect of the kidney. There is no hydronephrosis. SPLEEN: The spleen measures 10.8 cm. in length. | 1.Hepatomegaly with micronodular contour and coarse, echogenic parenchyma compatible with cirrhosis. Within the limitations of the exam, no suspicious liver mass is identified.2.No change in segment two intrahepatic portosystemic shunt. 3.Nonobstructing left renal stone. |
Generate impression based on findings. | Female; 27 years old. Reason: VP shunt, evaluate abdomen shunt tubing and placement /status/connectivity History: pain to abdomen The shunt tubing was identified in the mid abdomen but could not be traced throughout its course due to overlying bowel gas. | Limited exam due to bowel gas. The status of the shunt tubing can not be commented on based on this study. |
Generate impression based on findings. | Female; 44 years old. Reason: 44 yo female with enlarged left inguinal area; please evaluate for hernia History: left inguinal pain Imaging of the left inguinal area in the area of the patient's pain demonstrates a small, 3 mm defect in the fascia. No bowl or fat is seen protruding despite provocative maneuvers. | 3 mm left inguinal fascial defect without evidence of fat or bowel herniation. |
Generate impression based on findings. | 45-year-old male with AML now with neutropenic fever, bacteremia, and elevated bilirubin. LIVER: The liver measures 18.5 cm in length. The parenchyma is moderately echogenic. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: The gallbladder is contracted without evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: The spleen measures 17 cm in length. RIGHT KIDNEY: Kidney measures 10.8 cm in length. The cortex is mildly echogenic. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.9 cm in length. The cortex is mildly echogenic. No hydronephrosis, shadowing calculus or mass. A simple cyst is present in the mid pole measuring 1.2 x 1.0 x 0.9 cm.OTHER: No significant abnormalities noted. | 1.Echogenic liver suggestive of fatty infiltration.2.Splenomegaly. |
Generate impression based on findings. | Female 37 years old; Reason: enlarged nontender thyroid gland RIGHT LOBE MEASUREMENTS: 4.8 x 2.0 x 1.2 cmLEFT LOBE MEASUREMENTS: 5.1 x 1.8 x 0.1 cmISTHMUS MEASUREMENT: 0.4 cmRIGHT LOBE: Slight heterogeneity of the gland with no dominant nodule.LEFT LOBE: Slight heterogeneity of the gland no dominant nodule.ISTHMUS: No significant abnormality noted.LYMPH NODES: 1.1 centimeter right level 2 and 2.0 cm left level 2 lymph nodes have fatty hila and benign appearance. | 1.Slight heterogeneity of the thyroid gland which is nonspecific but can be seen as a sequela of thyroiditis.2.No dominant nodule. |
Generate impression based on findings. | 59-year-old male with history of severe hepatic steatosis. LIVER: The liver measures 19.5 cm in length. The parenchyma is severely coarse and echogenic which limits evaluation of discrete liver lesions. The portal vein is patent demonstrating brisk hepatopetal flow with a velocity of 0.5 m/s.BILIARY TRACT: The gallbladder is absent. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.0 cm in length. RIGHT KIDNEY: Kidney measures 12.8 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. Previously visualized right renal calculus is not visualized on this exam. LEFT KIDNEY: Kidney measures 12.4 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.OTHER: Bilateral pleural effusions. | 1.Enlarged, echogenic liver suggestive of severe hepatic steatosis, similar to prior. 2.Echogenic kidneys suggestive of medical renal disease/parenchymal dysfunction. 3.Bilateral pleural effusions. |
Generate impression based on findings. | Female; 51 years old. Reason: R/o mass v/s hernia History: Patient with gum ball size supraumbilical mass painful Superior to the umbilicus in the area of the patient's palpated abnormality is a fascial defect measuring approximately 0.9 x 0.7 cm transverse by AP. The hernia measures 3.4 x 1.0 x 2.1 cm and contains bowel and a small amount of free fluid. Peristalsis of the bowel is seen. There is no evidence of bowel wall thickening or dilation of the bowel loops. | Ventral wall hernia containing bowel without evidence of other complication. |
Generate impression based on findings. | Male; 52 years old. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer. 1 year follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No suspicious mass in the right thyroid bed.LEFT LOBE: Redemonstrated 3 x 3 x 6 mm hyperechoic focus in the left thyroid bed (previously 4 x 3 x 5 cm), unchanged. A new 4 x 3 x 5 mm hypoechoic lesion with flow on color Doppler is seen in the left thyroid bed.ISTHMUS: No suspicious mass in the isthmus bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right: Level 6 lymph node measures 6 x 3 x 7 mm with increased vascularity.Left: A 3 x 3 x 4 mm level 4 and a subclavicular 5 x 3 x 4 mm lack a normal fatty hilum.OTHER: No significant abnormality noted. | Abnormal lymph nodes and a new lesion in the left thyroid bed suspicious for recurrence. The thyroid bed lesions are small and may not be amenable to biopsy. The lymph nodes are amenable to biopsy. |
Generate impression based on findings. | 83-year-old male with prostate cancer, HIV and abnormal liver function. LIVER: Liver is normal in size and appears mildly echogenic which is non-specific. Scattered calcifications due to previous granulomatous disease. In any of the liver there is a septated cystic mass measuring 4.8 x 7.8 x 8.5 cm with a small amount of septal calcification.BILIARY TRACT: The biliary tract is normal in caliber. The gallbladder appears unremarkable without stones, wall thickening or pericholecystic fluid.PANCREAS: The head and body appear normal. The tail was not well seen due to bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 11 cm in length without gross abnormality. OTHER: The left kidney measures 11.8 cm in length with minimally complex 1.9-cm cyst. | Echogenic liver.Mildly complex cystic mass left lobe of the liver. If there is prior outside imaging this would be most helpful for comparison.Minimally complex left renal cyst requires no follow-up. |
Generate impression based on findings. | 50 year-old male with abnormal liver function LIVER: The liver is normal in size and is moderately to markedly echogenic. Although not specific, this may be due to fatty infiltration. No focal hepatic abnormality. Limited spectral and color Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Echogenic liver. |
Generate impression based on findings. | 24-year-old male with cholecystostomy tube, abdominal pain. Evaluate for tube position. LIVER: Liver appears mildly coarsely echogenic without focal abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein. Tracing is pulsatile which may be seen with congestive heart failure.GALLBLADDER, BILIARY TRACT: Gallbladder is nondistended. There is a portion of a drainage tube identified within the gallbladder. There are also moderately echogenic and non-shadowing foci which may be due to sludge or small amount of hemorrhage. No pericholecystic fluid.PANCREAS: Not visualized due to bowel gas.RIGHT KIDNEY: Atrophic with calcifications.OTHER: Ascites and right pleural effusion. | Echogenic liver.Drainage tube identified within the gallbladder.Ascites and right pleural effusion. |
Generate impression based on findings. | Male; 71 years old. Reason: 71 yo with bladder cancer and AKI - on anti PD-1 agent and steady rise in creatinine since then - creatinine baseline of 1.4 in November and now 4.8 needs kidney biopsy Ultrasound guidance and technical assistance was provided for a right native kidney biopsy by the nephrology service. Images demonstrate moderate hydronephrosis. | Biopsy of right native kidney by nephrology service.Hydronephrosis. |
Generate impression based on findings. | Female; 69 years old. Reason: nephrotic syndrome of unclear etiology, elevated liver enzymes. please eval for pathology History: BLE, weakness LIVER: The liver measures 14.9 cm in length. The liver has a smooth contour. The parenchyma is normal in echotexture. Within the left lobe of the liver there is a cluster of mildly complex cystic structures. The largest the cyst measures 2.4 x 1.9 x 1.9 cm. There is ascites. The portal vein is patent but and demonstrates hepatopetal flow with a peak velocity of 0.17 m/sec.BILIARY TRACT: The gallbladder has an anechoic lumen. There is no gallbladder wall thickening or pericholecystic fluid. Common duct measures 0.4 cm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is obscured due to bowel gas.KIDNEYS: The right kidney measures 10.2 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 10.6 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 9.8 cm. in length. ABDOMINAL AORTA: Proximal: 2.0 x 1.7 x 2.4 cmMid: Obscured by overlying bowel gasDistal: 1.6 x 1.5 x 1.6 cmINFERIOR VENA CAVA: No significant abnormality noted.OTHER: There are bilateral pleural effusions.The urinary bladder is unremarkable. | 1.A cluster of mildly complex cystic structures in the left liver may simply be related to a complex cyst/hamartoma however biliary cystadenoma remains a possibility.2.Ascites and bilateral pleural effusions.3.Echogenic kidneys bilaterally compatible with medical renal disease. |
Generate impression based on findings. | 53 year old woman with history of left breast cancer, enhancing lesion seen in right breast on pre-treatment MRI. A targeted right ultrasound was performed for the MR/mammographic area of concern. There is a hypoechoic, circumscribed oval mass measuring 1.1 x 1.0 x 0.6 cm in the 9:00 position of the right breast 7 cm from the nipple, corresponding to the MR/mammographic findings. Mild peripheral flow is noted. The lesion is consistent with fibroadenoma. No additional or suspicious findings noted. | Right breast fibroadenoma for which a biopsy is not needed. Recommend follow-up with Breast Surgery, results discussed with patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 48 year old female with abnormal liver function tests. LIVER: The liver measures 14.9 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 9.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. Superior pole simple cyst measuring 1.8 x 1.5 x 1.9 cm. LEFT KIDNEY: Kidney measures 13.1 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.2.Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | 41-year-old male with history of kidney stones, please assess for stones/obstruction. RIGHT KIDNEY: Kidney measures 11.7 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. Stable left benign cyst.BLADDER: No significant abnormalities. OTHER: No significant abnormalities noted. | 1.No hydronephrosis. Previously seen nonobstructive renal calculi not well-visualized on this exam. |
Generate impression based on findings. | Male 34 years old; Reason: 34 year old M with left thyroid cyst noted on CT imaging History: Patient reports additional history of recent sinus infection on antibiotics. RIGHT LOBE MEASUREMENTS: 8.0 x 2.7 x 2.4 cmLEFT LOBE MEASUREMENTS: 8.4 x 2.8 x 2.1 cmISTHMUS MEASUREMENT: 0.8 cmRIGHT LOBE: Diffusely heterogeneous gland with multiple small hypoechoic mainly cystic or complex cystic nodules. There is no dominant nodule.LEFT LOBE: Diffusely heterogeneous gland with multiple small hypoechoic mainly cystic or complex cystic nodules. A dominant nodule in the midpole measures 1.1 x 0.7 to 0.8 cm. It is cystic with a peripheral solid component. Vascularity is not increased on color Doppler. There is no calcification.ISTHMUS: Diffusely heterogeneous without dominant nodule.LYMPH NODES: Prominent bilateral cervical lymph nodes. A left level 2 node measures 0.6 x 0.5 x 0.9 centimeters with a fatty hilum. A right level 3 node measures 1.3 x 0.5 x 1.6 cm with a fatty hilum.OTHER: No significant abnormality noted. | 1.Bilateral small cystic and complex cystic nodules with appearance most consistent with colloid nodules.2.Prominent bilateral cervical chain lymph nodes are likely reactive given their otherwise normal ultrasound appearance and the patient's reported current sinus infection. |
Generate impression based on findings. | Female; 76 years old. Reason: 76 y/o with CLL s/p right inguinal lymph node excisional biopsy, now with fluid collection and concern for seroma/hematoma. Please evaluate if amenable to aspiration. In the right groin deep to the area of the prior lymph node biopsy today 5.8 x 5.3 x 3.0 cm well-circumscribed complex fluid collection. There is no vascularity within this collection on color Doppler. | 5.8 x 5.3 x 3.0 cm complex fluid collection in the right groin compatible with hematoma. Infected fluid collection is a secondary possibility. |
Generate impression based on findings. | Female 32 years old; Reason: Primary hyperparathyroidism. Please evaluate for parathyroid adenoma RIGHT LOBE MEASUREMENTS: 5.3 x 1.3 x 1.7 cmLEFT LOBE MEASUREMENTS: 5.3 x 1.5 x 1.3 cmISTHMUS MEASUREMENT: 0.3 cmRIGHT LOBE: 0.5 x 0.5 x 0.4 cm solid, hypoechoic mid pole nodule is not well defined. It does not contain calcification or demonstrate increased vascularity on color Doppler.LEFT LOBE: At least two subcentimeter cysts are noted.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No evidence of parathyroid adenoma. | 1.Small left lobe colloid cysts and 0.5 cm non-descript right thyroid nodule.2.No evidence of parathyroid adenoma. |
Generate impression based on findings. | 62-year-old female with acute renal insufficiency. RIGHT KIDNEY: Right kidney measures 9.8 cm in length. Echotexture appears within normal limits. There is a 2.7 cm simple cyst arising from the upper pole. No hydronephrosis or shadowing calculus.LEFT KIDNEY: Left kidney measures 9 cm in length. Echotexture appears within normal limits. Likely small cyst in the lower pole. No hydronephrosis or shadowing calculus.OTHER: Right pleural effusion.Bladder decompressed with Foley catheter. | No hydronephrosis. Echotexture within normal limits. |
Generate impression based on findings. | 55 year-old female with metastatic colon cancer for potential biopsy of liver. LIVER: The patient's known metastatic disease to the liver is very poorly visualized by ultrasound and not approachable for biopsy | Inadequate visualization of hepatic metastatic disease for biopsy. This was discussed with the patient and research coordinator. |
Generate impression based on findings. | Reason: 41 y/o female with left calf pain for three weeks. Mild prominence. Left calf compared to Right. R/O Muscle Injury. Imaging through the soft tissues of the posterior lower leg demonstrates asymmetric prominence of the subcutaneous fat on the left compared with the right. However, no fluid collection or abnormality of the underlying muscle is evident. | Asymmetric prominence of the subcutaneous fat of the posterior left lower leg without fluid collection or evidence of underlying muscle abnormality. |
Generate impression based on findings. | 8-month-old female with hydronephrosis. BLADDER Wall Thickness: Normal Contents: Not adequately distended Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 1 Left: 0 Length*** Right: 4.9 cm Left: 4.7 cm Mean for age: 6 cm Range for age: 4.5 - 7.5 cmADDITIONAL OBSERVATIONS: None | Kidneys are lower limits of normal for size.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | 45 year old presents for a short term follow up ultrasound for an enlarged lymph node in the left axilla. Focused ultrasound of left axilla revealed that the enlarged lymph node seen on the prior study has become normal sized. There are several normal size lymph nodes in the left axilla. | No sonographic evidence of malignancy. Normal lymph nodes in left axilla. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Female; 82 years old. Reason: Please evaluate etiology of visible and palpable probable foreign body in left upper quadrant History: Patient states this is been present since her surgery approximately 45 years ago however, the patient's daughter and physician were not aware of it until a few weeks ago. Within the subcutaneous soft tissues left upper abdominal wall in the region of the palpable abnormality and just deep to a well healed surgical scar is a looped tubular structure. It is followed to its termination at only one end near the liver with no definite intraperitoneal penetration. | Looped tubular foreign body suspicious for tubing seen in the area of the patient's palpable abnormality. The termination is seen at only one end with no definite intraperitoneal penetration. |
Generate impression based on findings. | 67 years, Female, Reason: rule out recurrence of thyroid cancer History: none. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: Status post thyroidectomy. No residual or recurrent tissue identified.LEFT LOBE: Status post thyroidectomy. No residual or recurrent tissue identified.ISTHMUS: Status post thyroidectomyPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A benign appearing left level 3 node measures 0.5 x 0.3 x 0.8 cm, previously 1.0 x 0.7 x 0.4 cm.OTHER: No significant abnormality noted. | No evidence of local recurrence or lymphadenopathy. |
Generate impression based on findings. | 74 year old male with history of HCV, evaluate for HCC. LIVER: The liver measures 17 cm in length. Cirrhotic morphology without focal solid lesions. Two small lesions, likely cysts, one in the right lobe measuring 1.5 x 1.4 x 1.1 cm (previously 1.5 x 1.5 x 1.3 cm) and one in the left lobe measuring 0.6 x 0.5 x 0.6 cm (previously 0.5 x 0.7 x 0.5 cm). The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common hepatic duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.6 cm in length. RIGHT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.1 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No evidence of ascites. | 1. Cirrhotic morphology with two small lesions, likely cysts, not significantly changed. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are ultrasound images of right breast (2/16/15) performed at Indiana Breast Center and ultrasound images of left breast (9/5/14) performed at St. Anthony Crown Point. ULTRASOUND IMAGES OF RIGHT BREAST (2/16/15):Sonographic images of right retroareolar region, right upper outer quadrant and axilla are submitted. No abnormal findings including solid or cystic masses are visualized.ULTRASOUND IMAGES OF LEFT BREAST (9/5/14):Sonographic images of left retroareolar region are submitted. No abnormal findings including solid or cystic masses are visualized. | No sonographic evidence of malignancy. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Ms. Tomasi is a 21 year old female presenting with a palpable abnormality in the right breast for the past one week. Upon physical exam at the palpable area of concern, a soft, mobile mass is appreciated in the right upper inner breast.A targeted right breast ultrasound was performed for the palpable area of concern. In the right breast two o'clock location (approximately 3 cm from the nipple), there is an ovoid, hypoechoic solid mass measuring 1.9 x 0.6 x 1.5 cm. There is minimal amount of associated vascularity.In addition, just adjacent to the solid mass is a small anechoic lesion measuring 0.7 cm, compatible with a simple cyst. | Sonographic findings likely represent a fibroadenoma. However, given the palpability, a surgical consultation is recommended at this time. All results and recommendations were relayed to the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 68-year-old female with history thyroid cancer status post total thyroidectomy. RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Single left level 2 benign-appearing lymph node measuring 1.8 x 0.3 x 0.7 cm. OTHER: No significant abnormality noted. | Status post thyroidectomy without mass in surgical bed. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Multiple, nonenlarged and benign morphology lymph nodes are identified. There is no solid or cystic masses identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Male; 81 years old. Reason: Evaluation for Diaphragmatic Hernia/Abdominal Wall Hernia. History: Abdominal Wall Hernia. Scanning of the left upper quadrant abdominal wall reveals no evidence of abdominal wall hernia at rest or with Valsalva. | No evidence of abdominal wall hernia. |