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Generate impression based on medical findings. | Male, 49 years old.Reason: Preop MVR History: Preop MVR Patient is status post mitral valve replacement and sternotomy. Mild basilar reticulation and Kerley B lines. Mild left-sided pleural thickening. Normal heart size. | Probably mild interstitial pulmonary edema. Mild left-sided pleural thickening/scarring. Status post mitral valve replacement. |
Generate impression based on medical findings. | 78-year-old male with dyspnea, cough, wheeze, tachypnea, tachycardia, and chronic immobilization. Technically adequate exam.PULMONARY ARTERIES: Bilateral lower lobe pulmonary emboli (right lower lobe and segmental artery; left lower segmental artery).LUNGS AND PLEURA: Small bilateral pleural effusions with predominant basilar groundglass opacities and interlobular septal thickening.Few nodular opacities in the right upper lobe are nonspecific.Mild centrilobular emphysema.MEDIASTINUM AND HILA: Mild cardiomegaly with extensive coronary artery calcifications. Few slightly enlarged mediastinal lymph nodes, may be secondary to edema. CHEST WALL: Large soft tissue lipoma with calcifications superficial to the left latissimus dorsi distribution. Additional smaller superficial lipoma of left lateral chest wall. Degenerative changes of the spine.UPPER ABDOMEN: Atrophic kidneys bilaterally with nonspecific perinephric stranding. Multiple renal cystic lesions bilaterally are incompletely evaluated on current exam, a few of the right cystic lesions are relatively high density. Cystic lesion of the superior pole of the right kidney (series 11 image two to 4) measures 5.5 x 6.2 cm and appears to have a solid component. | 1) Bilateral pulmonary emboli.2) Mild CHF with pulmonary edema, small pleural effusions. 3) Bilateral renal lesions incompletely evaluated, cannot exclude malignancy. Recommend additional renal ultrasound imaging. |
Generate impression based on medical findings. | Male; 60 years old. Reason: abdominal free air History: h/o PUD p/w severe epigastric pain; significant TTP No subdiaphragmatic free air as clinically questioned. Normal cardiac silhouette. No specific evidence of infection or edema. | No subdiaphragmatic free air or other acute abnormality. |
Generate impression based on medical findings. | 45-year-old female with history of breast cancer status post radiation, chemo, and right mastectomy presents with seizure and newly discovered lung nodule, MR of the brain is suspicious for metastatic disease (information obtained from EPIC) CHEST:LUNGS AND PLEURA: Post radiation changes in the right apex. Subsegmental atelectasis associated with areas of groundglass opacities and septal thickening are noted in right middle lobe and right upper lobe.Right lower lobe solid lung nodule measuring 11.2 x 11 .5 mm (series 4 image 158).MEDIASTINUM AND HILA: Significant mediastinal lymphadenopathy including right hilar, subcarinal, and peritracheal associated with center hypoattenuation suggestive of necrosis.Right hilar lymphadenopathy measuring 33.8 x 30.7mm compressing the right upper lobe bronchus (series 3 image 41).Right hilar lymphadenopathy measuring 29.9 x 21 .5 mm compressing the right middle bronchus (series 3 image 39).CHEST WALL: Postsurgical changes post known history of right mastectomy and reconstruction surgery are noted. Right axillary surgical clips are noted. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.LYMPH NODES: No abnormal lymphadenopathy is identified within abdomen or pelvis.VASCULATURE: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:REPRODUCTIVE TRACT: Intrauterine device is seen in the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Subcarinal, pretracheal, and right hilar with compression of right upper and middle lobe main stem bronchi associated with ground glass opacities and subsegmental atelectasis in right upper and middle lobes as detailed above. 2.Right lower lobe solid nodule.3.Constellation of findings highly suspicious of metastatic disease. |
Generate impression based on medical findings. | Age: 79 yearsGender: FemaleReason for Study: Reason: CP to back without URI sx History: CP with white count Loculated left pleural effusion/thickening and peripheral consolidation similar in appearance to the prior CT.Pulmonary nodules including dominant right apical nodule not as well-visualized as on the recent CT.No new airspace opacities. | No specific evidence of acute infection. Pulmonary nodules and left-sided pleural effusion/thickening and peripheral consolidation similar to the recent CT. |
Generate impression based on medical findings. | 81-year-old female presents with AMS. Evaluate for infection, edema, or effusion., Surgical changes of prior median sternotomy are noted.Elevation of the right hemidiaphragm; unchanged. The cardiomediastinal silhouette is at the upper limits of normal. No focal pulmonary opacity, pleural effusion, or pneumothorax. Atherosclerotic calcification of the aorta is noted. Degenerative changes of the spine are best appreciated on the lateral view. | No acute cardiopulmonary disease. |
Generate impression based on medical findings. | Age: 79 yearsGender: MaleReason for Study: Reason: Does it seem more like pneumonia or hypervolemia? History: Cough Pleural effusion/thickening, right greater than left, and pulmonary opacities throughout the left lung and right lung base are similar to the prior exam.No new focal areas of consolidation.Stable cardiomediastinal silhouette | No interval change in pleural effusions and pulmonary opacities suggestive of edema. No specific evidence of infection. |
Generate impression based on medical findings. | Age: 83 yearsGender: FemaleReason for Study: Reason: eval for PNA History: productive cough ET tube and NG tube have been removed.Decreased lung volumes with elevation right hemidiaphragm.Stable cardiomediastinal silhouette.Right basilar opacity compatible with consolidation/atelectasis similar to the prior exam .No new pulmonary opacities noted. | Persistent right basilar consolidation/atelectasis. No acute abnormality identified. |
Generate impression based on medical findings. | Female, 53 years old.History of AML and fever. The cardiac and mediastinal contours are within normal limits.Lung volumes are normal. No abnormal focal lung parenchymal opacities.The pleural spaces are within normal limits.Right IJ central venous catheter terminating in the distal SVC.Surgical clearance in the left paraspinal region again noted. | No radiographic findings to suggest pneumonia. In the setting of immunosuppression, consider further assessment with chest CT if there is persistent concern for opportunistic pulmonary infection. |
Generate impression based on medical findings. | Female, 64 years old. ET tube tip approximately 5 cm above the carina.NG tube tip at the GE junction.New diffuse airspace and interstitial opacities suggestive of edema or possibly aspiration, with small pleural effusions. | ET tube in acceptable position. Proximal location of NG tube. |
Generate impression based on medical findings. | Male, 76 years old.Status post PICC placement. PICC not conclusively visualized. Two left-sided apically directed chest tubes, unchanged.Persistent low lung volumes.Questionable trace apical left pneumothorax.Patchy consolidation and atelectasis of the left lower and midlung zones, not significantly changed.Left-sided subcutaneous emphysema unchanged. | PICC not conclusively visualized. No significant pneumothorax. Patchy consolidation/atelectasis at the left lung. No significant interval change. No new acute process.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Male 68 years old with history of hereditary hemorrhagic telangiectasia, evaluate for brain AVMs. MRI:There is no evidence of intracranial hemorrhage, mass, or acute infarct. Few foci of scattered periventricular and subcortical T2/FLAIR hyperintensity, which are nonspecific. The brain parenchyma otherwise appears unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. Trace right maxillary mucosal thickening. The orbits, skull, and scalp soft tissues are grossly unremarkable.MRA:The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and right cerebral arteries are normal in course and caliber. There is a fetal origin of the left posterior cerebral artery. The right posterior communicating artery is not well visualized. There is no evidence of AVM, flow-limiting stenosis, or aneurysm. | 1. No evidence of vascular malformation, high-grade stenosis, or aneurysm.2. No evidence of intracranial hemorrhage, mass, or acute infarct. |
Generate impression based on medical findings. | Female, 55 years old.Reason: intubated History: intubated Moderate cardiomegaly is present, with a left pleural effusion or pleural thickening.The contour of the left cardiac border is highly suggestive of left atrial appendage enlargement, often seen in mitral valvular disease or rheumatoid heart disease.Compression atelectasis left lower lobe, but no evidence of edema.ET tube tip approximately 2 cm above the carina.Right subclavian catheter, tip in SVC.Left subclavian pacemaker, leads unchanged in position.An NG tube terminates in the stomach.Surgical bandage material overlies the chest. | Cardiomegaly and a left atrial appendage enlargement pattern, but no acute edema or pneumonia. |
Generate impression based on medical findings. | Age: 85 yearsGender: FemaleReason for Study: Reason: r/o pna History: fever Patient is severely rotated.Remarkably decreased lung volumes with elevation left hemidiaphragm.Stable cardiomediastinal silhouette.Basilar atelectasis.No focal areas of consolidation. | Decrease in size of mild basilar atelectasis. No specific evidence of infection. |
Generate impression based on medical findings. | 39-year-old male with seizure status post a partial suprasellar mass resection. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. Right frontoparietal craniectomy with overlying skin staples and surgical drain with adjacent frontal and left temporal pneumocephalus consistent with postsurgical procedure. A small amount of hemorrhage is present in the subarachnoid space and overlying the left cerebellar hemisphere. This examination is nondiagnostic for evaluation of the pituitary sella; for evaluation of residual disease, MRI of the pituitary may be considered.The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | 1. Postsurgical changes as described above without acute abnormality.2. For evaluation of residual disease MRI of the pituitary may be considered. |
Generate impression based on medical findings. | History of abdominal pain and transaminitis, evaluate for cholecystitis. BILIARY TRACT: The gallbladder is mildly hydropic but lacks significant wall thickening or associated pericholecystic fluid. No gallstones identified. No biliary ductal dilatation. The common bile duct measures up to 5.5 mm in diameter. The sonographic Murphy's sign is negative. | Hydropic gallbladder. Given lack of associated inflammatory changes or cholelithiasis, acute cholecystitis is considered less likely. |
Generate impression based on medical findings. | Reason: esoph cancer s/p chemorads and surg ck respnse History: dysphagia Gastric interposition extending to the right of the mediastinum.Opacity at both bases, greater on the right consistent with effusion and atelectasis.No new findings. | Persistent basilar opacities and effusions with no acute change. |
Generate impression based on medical findings. | 50 year-old male with history of pancreatic adenocarcinoma CHEST:LUNGS AND PLEURA: Large left-sided pleural effusion which has significantly increased in size compared to previous study. Scattered micronodules are unchanged.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Again noted no static lesions in the liver. Index lesion in segment 6 now measures 9 x 10 mm image number 105, series number 4, not significantly changed from previous study. Second index lesion in the left lobe is slightly smaller measuring 8-mm in diameter image number 104, series number 4.SPLEEN: Small hypodense lesion in the lower pole of the spleen is unchanged and most likely benign.PANCREAS: Patient's known pancreatic mass is slightly smaller measuring 4.9 by 4.9 cm on image number 110, series number 4 when measured in a similar fashion to the prior exam. This cystic component in the tail of the pancreas has increased in size now measuring 2.7 x 4 cm on image number 113, series number 4. Vascular encasement of retroperitoneal vessels are again noted. Splenic vein is thrombosed.Solid mass anterior to the cystic component of patient's known pancreatic carcinoma is also slightly smaller.ADRENAL GLANDS: The mass in the left adrenal gland has increased in size and now measures 2.9 x 3.4 cm in image number 107, series number 4. Right adrenal gland is unremarkable.KIDNEYS, URETERS: Interval development of left-sided hydronephrosis. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy is unchanged. Index left para-aortic node measures 1.9 x 1.1 cm on image number 127, series number 4.Left psoas muscle is asymmetrically and heterogeneously enlarged compared to the right side suspicious for infiltration by the patient's known cancer.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse increased density of the subcutaneous tissues of the anterior abdominal wall associate with small amount of air likely represents changes secondary to injection, new from previous study.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Ill-defined, and new soft tissue density along the right side of the pelvis is also suspicious for a peritoneal deposit and measures 2.6 x 1.9 cm in image number 176 on series number 4.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: New, small amount of ascites, associate with mild nodularity in the pelvis suspicious for peritoneal carcinomatosis. | Interval decrease in the size of the solid component of patient's known pancreatic cancer.Hepatic metastases are grossly unchanged.Interval increase in the amount of the left-sided pleural effusion.New peritoneal carcinomatosis, left adrenal metastases, hydronephrosis and enlargement of the left psoas muscle suspicious for metastatic disease. |
Generate impression based on medical findings. | 32-year-old female with right upper quadrant pain and urinary frequency. Assess for recurrent teratoma CHEST:LUNGS AND PLEURA: Previously seen right-sided pleural effusion has resolved. Linear calcifications involving the right lower lobe pleura or diaphragm. No focal lesions within the liver.MEDIASTINUM AND HILA: No focal lesions within the liver.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is new right-sided hydronephrosis. Minimally dilated right-sided ureter can be traced down to the pelvis and in the pelvis is decompressed. Etiology of right sided hydronephrosis is unknown.RETROPERITONEUM, LYMPH NODES: New right-sided retroperitoneal adenopathy. An index lesion measures 3.1 x 1.3 cm image number 100, series number 10335.BOWEL, MESENTERY: Nonobstructive paraumbilical hernia containing small and large bowel segments.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: Distended bladder.LYMPH NODES: Small right inguinal lymph node is unchanged measuring 1.1 x 0.8 cm image number 180.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | New right para-aortic adenopathy. New mild right-sided hydronephrosis and hydroureter. Etiology is unknown. Pelvic recurrent disease cannot be excluded.Perihepatic linear calcification which may be diaphragmatic or pleural. Correlation with surgical history is recommended. |
Generate impression based on medical findings. | Cough Interval improvement with decreased left pleural effusion, currently moderate to large in size. Underlying atelectasis observed in both bases given the smaller more moderate right effusion.Cardiomegaly persists, however decreased perihilar edema pattern is otherwise observed, representing nearly resolved suspected CHF | Decreasing pleural effusions and resolving CHF |
Generate impression based on medical findings. | Female, 70 years old.Reason: 70F with right sided pleural effusion s/p bedside thoracentesis History: s/p bedside thoracentesis Left lower lobe consolidation with pleural effusions, improved compared to the prior study.Moderate cardiomegaly is unchanged.Status post extubation.Right jugular catheter, tip in SVC.A Dobbhoff tube extends below the lower margin of the image. | Improvement in basilar opacities and pleural effusions, with no pneumothorax following thoracentesis. |
Generate impression based on medical findings. | Left hip pain There is severe osteoarthritis of the left knee as evidenced by subchondral sclerosis, subchondral cystic change, and joint space narrowing. Moderate to severe osteoarthritis of the right hip also noted. There is no malalignment. Moderate multilevel degenerative changes of the lower lumbar spine also noted. | Severe osteoarthritis of the hip. |
Generate impression based on medical findings. | 59-year-old female with pain and limited mobility of the shoulder, rule out tear in the shoulder area ROTATOR CUFF: There is marked thinning of the anterior fibers of the supraspinatus tendon reflecting both articular and bursal surface tearing. At its thinnest, the tendon measures only 1 mm in thickness. This high-grade partial-thickness tear is approximately 1 cm in AP dimension. There appears to be delamination resulting in approximately 1 cm of proximal retraction of the articular and bursal surface fibers. More posteriorly, there is less pronounced articular surface tearing and bursal surface fraying with underlying tendinosis. There is fatty infiltration along the myotendinous junction of the supraspinatus, but more proximally the muscle appears normal. Mild tendinosis affects the infraspinatus tendon without a discrete tear. The subscapularis and teres minor tendons are intact.SUPRASPINATUS OUTLET: Moderate osteoarthritis affects the acromioclavicular joint with spurring along the undersurface of the acromion. A trace amount of fluid is present in the subacromial bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: Mild osteoarthrosis affects the glenohumeral joint. There is deformity of the posterior superior labrum which likely represents degenerative tearing. There is also mild degenerative tearing of the anterior inferior labrum. A small amount of fluid is present in the glenohumeral joint, but no large effusion is present.BICEPS TENDON: There is mild increased signal intensity along the long head of the biceps at its transition into the intertrabecular groove, suggesting mild tendinosis. | 1.High-grade partial-thickness tearing of the supraspinatus tendon involving both articular and bursal surfaces.2.Osteoarthritis and other findings as described above. |
Generate impression based on medical findings. | Female, 31 years old. History of renal angiomyolipoma, hx of partial nephrectomy x 2 RIGHT KIDNEY: The right kidney measures 9.9 cm in length, with normal cortical echogenicity. A small round hyperechoic focus in the upper pole measures 0.7 x 0.7 x 0.8 cm, unchanged in appearance from prior.LEFT KIDNEY: The left kidney measures 9.5 cm. Multiple punctate hyperechoic foci are again noted throughout the left kidney, similar to prior.OTHER: No significant abnormalities noted. | 1.Unchanged right upper pole hyperechoic focus, compatible with an angiomyolipoma.2.Multiple punctate hyperechoic foci throughout the left kidney appear similar to prior. |
Generate impression based on medical findings. | Left pelvic tenderness and mass. PELVIS:UTERUS, ADNEXA: Anteverted anteflexed uterus. The uterine morphology is unremarkable. The endometrium measures 15 mm in thickness, within normal limits for a premenopausal patient in the secretory phase. It is homogeneously hyperintense on T2-weighted imaging and has normal endometrial/inner myometrial interface. The inner myometrium/junctional zone measures approximately 4 mm, within normal limits. It is well-defined. Punctate cystic focus in the fundus is non-specific.1.3 x 1.1 cm left uterine body intramural fibroid demonstrating postcontrast enhancement.Tiny nabothian cysts. Otherwise the cervical stroma is unremarkable.The right ovary measures 2.6 x 1.4 x 1.5 cm, within normal limits and contains several physiologic follicles. There is minimal adjacent free fluid.The left ovary measures 2.8 x 2.4 x 3.7 cm. It contains a 2.5 x 1.9 x 2.3 cm focal lesion demonstrating low T1 weighted signal intensity, high T2-weighted signal intensity with thin-walled peripheral enhancement and a crenulated contour, likely representing a corpus luteal cyst. Possible small nodular enhancing component may be related to collapsed cyst walls. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Trace free pelvic fluid, within physiologic limits.BONES, SOFT TISSUES: In the lower left rectus abdominis muscle there is a 3.3 x 1.4 x 3.0 cm (series 15 image 37 and series 10 image 42). The lesion demonstrates low T2 weighted signal intensity and scattered punctate T1-weighted hyperintensity. The lesion involves the anterior half of the muscle with ill-defined margins between itself and the muscle as well as spiculated margins suggestive of desmoplastic reaction. On subtraction imaging there is suggestion of mild internal septal enhancement. OTHER: No significant abnormality noted. | 1. 2.5 cm left ovarian lesion with imaging characteristics most compatible with a corpus luteal cyst. Follow-up pelvic ultrasound in 2-3 weeks is recommended to document resolution. 2. 3.3 cm lesion involving the lower left rectus abdominis muscle. It's imaging characteristics may represent c-section scar endometriosis with associated desmoplastic reaction or less likely dermoid given the increased T1 signal. |
Generate impression based on medical findings. | 49 year-old female with right flank pain and a history of stones. Rule out right nephrolithiasis. ABDOMEN:Given the lack of intravenous contrast, evaluation of lesions within the solid organs is limited.LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Multiple punctate calcifications are noted within the pancreas these findings may represent chronic pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small calcification within the lower pole right kidney likely represents a nonobstructing renal calculus. There is mild hydronephrosis of the right kidney with no visualized obstructing stone, hydroureter, or perinephric fat stranding. There is no hydronephrosis, renal calculi, or hydroureter involving the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Right nonobstructing renal calculus without evidence of obstructing stone. Mild hydronephrosis of the right kidney. No hydroureter or perinephric fat stranding.2. Multiple punctate calcifications within the body of the pancreas. These findings can be seen in chronic pancreatitis. |
Generate impression based on medical findings. | Patient with AML, now presents with worsening low back pain for one month. Status post bone marrow transplant, left iliac crest. Extensive marrow replacement is observed bilaterally in a largely symmetric pattern involving both the pelvis and proximal femurs. Pattern and signal abnormality consistent with patient's underlying known AML and marrow replacement. No discrete focal marrow or osseous abnormalities observed other than a small faint biopsy track observed in the posterior left iliac crest correlating with the known previously described marrow sampling.Mild degenerative changes of both hips and SI joints without evidence of superimposed acute or subacute abnormalitySurrounding musculature and compartments are otherwise intact without evidence of complication or superimposed focal abnormality. Vasculature unremarkable. The demonstrated is the anterolisthesis involving the lower lumbar upper sacrum described more detail on the concomitant lumbar spine imaging; please correlate.Intrapelvic contents are also unremarkable. No distinct lymphadenopathy | No superimposed acute or subacute additional abnormality observed outside of the lower lumbar spine findings described on the concomitant exam. Extensive marrow replacement compatible with known AML and treatment. |
Generate impression based on medical findings. | Female 72 years old Reason: patient with liver hemangioma seen on MRI at Little Company of Mary, solid mass in the medial segment of the the left hepatic lobe with imaging characteristics most compatible with a giant hemangioma LIVER: Liver measures 15.7 cm in length. In left hepatic lobe, there is echogenic mass measuring approximately 5.1 x 4.1 x 3.7 cm, posterior acoustic enhancement seen, likely reflects patient's reported liver hemangioma. Also seen is ovoid anechoic right hepatic lesion measuring 3.3 x 1.4 x 1.3 cm. Parenchyma is mildly coarse in echotexture (may reflect underlying hepatic steatosis/parenchymal dysfunction), no suspicious lesion. Main portal vein patent with normal directional flow, velocity measures 17 cm/s. BILIARY TRACT: Gallbladder unremarkable. No significant gallbladder distention, wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: Not well seen due to obscuration by bowel gas.KIDNEYS: The right kidney measures 9.4 cm. The left kidney measures 10 cm. No hydronephrosis or perinephric free fluid.SPLEEN: The spleen measures 7.1 cm. in length. OTHER: No significant abnormality noted. | 5.1 cm echogenic liver mass described above likely represents patient's reported hemangioma. Additional ovoid cystic lesion seen in right liver lobe, may reflect cyst or subcapsular/perihepatic fluid collection. Correlation with patient's clinical history and outside MRI recommended.Liver parenchyma is mildly coarse in echotexture, may reflect underlying hepatic steatosis/parenchymal dysfunction. |
Generate impression based on medical findings. | Male, 42 years old.History of renal cancer, evaluate for metastatic disease. Unremarkable cardiomediastinal silhouette.No evidence of pulmonary or pleural disease.No evidence of metastasis. | No significant abnormality or interval change. |
Generate impression based on medical findings. | Male, 32 years old.Reason: eval lung fields for consolidation History: sickle cell crisis w/cp Right central catheter with tip at the cavoatrial junction. Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. No specific evidence of infection or edema. No focal pulmonary opacity. | No acute cardiopulmonary abnormality. No focal pulmonary opacity. |
Generate impression based on medical findings. | Female, 35 years old. Status post chest tube placement, bronchial valve placement. Follow-up. Left chest tube with a moderate pneumothorax, unchanged.Bronchial valves in the left perihilar region, unchanged.Stable chronic diffuse interstitial lung disease.Right chest port tip at the cavoatrial junction. | Moderate left pneumothorax with a chest tube in place, unchanged. |
Generate impression based on medical findings. | Female, 70 years old with hypoxia. Evaluate for CHF. Cardiomegaly with pulmonary vascular redistribution and small bilateral pleural effusions with associated atelectasis. No reliable evidence of interstitial edema or infection.Tortuous aorta. | Cardiomegaly and small bilateral pleural effusions compatible with CHF. |
Generate impression based on medical findings. | Female, 42 years old.Reason: r/o pneumonia History: chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No specific evidence of infection. | No significant abnormality. |
Generate impression based on medical findings. | Female, 48 years old.Evaluate Swan-Ganz catheter position. Stable cardiomegaly. No specific evidence of infection or edema at this time. Left jugular Swan-Ganz catheter, with the tip in the right main pulmonary artery. Unchanged left subclavian single chamber ICD projects in expected position. Right upper quadrant surgical clips. | Unchanged cardiomegaly. Swan-Ganz catheter tip appears similar to prior, in the right main pulmonary artery |
Generate impression based on medical findings. | Male, 38 years old.History of pneumothorax and shortness of breath Left chest tube and bronchial valves are unchanged. Left apical pneumothorax is slightly increased in size from prior. Cardiomediastinal silhouette is unchanged. Pulmonary cavitary lesions are again seen. | Slightly increased size of left pneumothorax, without additional acute abnormality. |
Generate impression based on medical findings. | Reason: evaluate for pna History: elevated WBC Normal heart size with surgical clips compatible with previous CABG surgery.Mild patchy airspace and interstitial opacities compatible with infection superimposed on severe emphysema, as shown on recent CT scan.Focal left upper lobe airspace opacity has resolved since the previous chest radiograph however. | Severe emphysema with mild patchy opacities suggestive of superimposed infection. |
Generate impression based on medical findings. | Enteric tube adjustment Enteric tube now seen looped once at level of gastric fundus with tip in gastric body. Nonobstructive bowel gas pattern. | Improved positioning of enteric tube as described above. |
Generate impression based on medical findings. | Reason: eval for effusions History: shortness of breath Normal heart size with evidence of previous median sternotomy.Small lung volumes with no specific evidence of pulmonary edema or infection.No visible pleural effusions. | No acute abnormalities. |
Generate impression based on medical findings. | Male, 78 years old.SOB and chest pain. Diffuse bilateral edema-like opacity, left greater than right. Lung volumes in cardiothoracic ratio similar to remote prior study. Atherosclerotic calcification of the aortic arch. No pneumothorax. | Diffuse asymmetric pulmonary opacity may reflect acute edema, asymmetry may be the result of hypoperfusion from causes such as pulmonary embolus. Diffuse pulmonary hemorrhage is not excluded. |
Generate impression based on medical findings. | Male, 89 years old.Reason: s/p extraction History: s/p extraction Prior left subclavian ICD leads removed, with a single temporary pacemaker lead extending to the RV apex.No pneumothorax although there is mild left basilar atelectasis.Moderate cardiomegaly. | No pneumothorax following pacemaker/ICD lead extraction. |
Generate impression based on medical findings. | Male, 69 years old.Reason: 7days s/p auto stem cell transplant with 1st neutropenic fever Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. Unchanged port catheter. Left IJ line terminates just above the cavoatrial junction. | No acute cardiopulmonary process on radiography. |
Generate impression based on medical findings. | Male, 48 years old.Reason: eval lung fields History: LVAD LVAD, enteric tube, tracheostomy tube, median sternotomy hardware, and left ICD are unchanged.Cardiomegaly is unchanged. Interstitial opacities consistent with edema are not significantly changed. Bilateral pleural effusions also not significantly changed. | Pulmonary edema and bilateral effusions are not significantly changed. |
Generate impression based on medical findings. | Female, 45 years old.Reason: eval for infection History: fever Lower lung volumes.Heart size normal.No reliable evidence of infection or edema. | Low lung volumes with no reliable evidence of infection or edema. If clinically warranted, a CT could be more sensitive in a patient of this size. |
Generate impression based on medical findings. | Cardiac surgeryVIEW: Chest AP Cardiac apex and aorta are right-sided. Cardiothymic silhouette is mildly enlarged. Endotracheal tube tip is below thoracic inlet. Right internal jugular line tip is in a right-sided superior vena cava. Epicardial pacer leads and atrial line are again visualized. Multiple surgical clips in the mediastinum. Right chest tube has been removed with no evidence of pneumothorax. Feeding tube tip is in gastric antrum of left-sided stomach. | Right chest tube removal without pneumothorax. |
Generate impression based on medical findings. | Male, 56 years old. Reason: malignant neoplasm of upper lobe of right lung History: malignant neoplasm of upper lobe of right lung/ 1 week s/p resection Interval removal of right-sided chest tubes. Small right apical hydropneumothorax is noted. Improvement in right-sided subcutaneous emphysema. Left lung is now clear. Unchanged heart size. | Small right apical hydropneumothorax. |
Generate impression based on medical findings. | Shoulder pain. Four views of the right shoulder reveal no acute fracture or dislocation. There is interval widening of the acromioclavicular joint with resorption of the distal end of the clavicle. | Widening of the AC joint and resorption of the distal clavicle compatible with osteolysis, similar in appearance to a recent MRI. |
Generate impression based on medical findings. | Female, 68 years old.Chest pain. Mild cardiomegaly, unchanged. Normal lung volumes. Small nodule at the right costophrenic angle. No acute pulmonary abnormality. | No acute pulmonary abnormality. |
Generate impression based on medical findings. | Reason: acute pneumonia? History: T=104 with cough Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease. | No significant abnormalities. |
Generate impression based on medical findings. | Female, 73 years old.Retained foreign body fragments, unspecified material. Bulldog clamp. Intraoperative film with open sternotomy and surgical hardware.Bulldog clamp overlying the left heart border likely within the thorax.Esophageal pH probe looped in the hypopharynx with tip overlying the cervical portion of esophagus. Swan-Ganz catheter tip in right main pulmonary artery. Enteric tube projects over the left upper abdomen. Bilateral chest tubes, two on the left and one on the right. Endotracheal tube tip 3.5 cm above the carina. Expected intraoperative changes including bibasilar/dependent atelectasis and a left pleural fluid collection. | Foreign body noted overlying left heart border (Bulldog clamp). Spoke to surgical attending Dr. Onsager, this foreign body has been removed prior to the time of the dictation of this study. Lines and tubes as above.These findings were discussed by telephone with Dr. Onsager, the attending surgeon, on 7/29/2016 at 1:58 PM. |
Generate impression based on medical findings. | Male, 65 years old.Increasing productive cough, hemodynamic changes, evaluate for pneumonia Right PICC catheter tip in the SVC. Single lead left chest wall ICD is unchanged. Cardiac silhouette is unchanged. Basilar opacities and bilateral pleural effusions are improved compared to 11/8/2015. | Improved basilar opacities and effusions compared to 11/8/2015 |
Generate impression based on medical findings. | Male, 63 years old.Reason: Patient with long h/o smoking. Intermittent SOB and decreased RLL breath sounds. Chronic non-productive cough. Thanks History: Dr. Eton Hyperexpansion consistent with COPD.No specific evidence of infection or edema.Heart size normal. | Moderate to severe, but no acute abnormality. |
Generate impression based on medical findings. | A 51 year old male with history of hypertension, hyperlipidemia, atrial fibrillation. Patient with possible ventricular arrhythmia noted during stress test. Referred to stress cardiac MRI for further evaluation of ischemia and infiltrative disease.MEDICATIONS: Aspirin, Atorvastatin, Atenolol, Flecainide First Pass PerfusionDuring hyperemia, no perfusion defects were present. A mild dark ring artifact is noted.Viability/ Myocardial ScarThere was no late gadolinium enhancement noted suggesting that there is no prior myocardial infarction, fibrosis, inflammation, or infiltration. The entire myocardium is viable.Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 66%, the LV end diastolic volume index is 83 ml/m2 (normal range: 74+/-15), the LVEDV is 168 ml (normal range 142+/-34), the LV end systolic volume index is 28 ml/m2 (normal range 25+/-9), the LVESV is 57 ml (normal range 47+/-19), the LV mass index is 50 g/m2, and the LV mass is 101 g. There are no regional wall motion abnormalities present. Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 55%, the RV end diastolic volume index is 95 ml/m2 (normal range 82+/-16), the RVEDV is 193 ml (normal range 142+/-31), the RV end systolic volume index is 42 ml/m2 (normal range 31+/-9), and the RVESV is 86 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is a trace pericardial effusion.Extracardiac FindingsThis study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered. | 1. No perfusion defects/ "ischemia" present during hyperemia.2. No prior myocardial infarction. The entire myocardium is viable.3. Normal LV size and systolic function (LVEF 66%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.4. Normal RV size and systolic function (RVEF 55%).5. There is mild mitral regurgitation.6. Mild biatrial dilation. |
Generate impression based on medical findings. | There is exaggerated lordosis of the lumbar spine. There is a minimal anterolisthesis of L5 on S1. Otherwise, the alignment of the lumbar spine is within normal limits. The vertebral body heights are preserved. There is no evidence of acute fracture. Bilateral L5 pars defects are present without associated edema, and are chronic. There are no other areas of edema-type signal to suggest a stress reaction. No evidence of spinal canal stenosis or neural foraminal narrowing at any level. The conus is normal in signal and morphology and terminates at L1. The visualized intra-abdominal and paraspinal contents are unremarkable. | 1. Chronic bilateral L5 pars defects with minimal anterolisthesis of L5 on S1.2. No evidence of acute fracture, spinal canal stenosis, or neural foraminal narrowing. |
Generate impression based on medical findings. | Reason: PNA History: SOB Tracheostomy tube and ICD in the unchanged.Bilateral basilar opacity, greater on the left, consistent with atelectasis and consolidation, likely secondary to aspirated secretions. No new findings. | Nonspecific basilar consolidation and atelectasis without significant change. |
Generate impression based on medical findings. | 35-year-old female with colorectal cancer on chemotherapy CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: The right-sided port terminates in the right atrium. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant diverting ileostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colo-anal anastomosis with expected postoperative presacral changes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastatic disease or obstruction. |
Generate impression based on medical findings. | Male, 70 years old.Reason: post LVAD, eval for effusions or opacities History: post cardiac surgery No change in cardiomegaly and basilar opacities with small pleural effusions.Unchanged support devices, except for removal of a Dobbhoff. | Unchanged cardiomegaly with basilar opacities and small pleural effusions. |
Generate impression based on medical findings. | Female, 89 years old.Reason: eval ETT, lung fields History: s/p CABG, AVR Interval placement of a bioprosthetic aortic valve. The patient is intubated with the endotracheal tube 1 cm above the carina; this has been removed on subsequent radiograph. Right IJ Swan-Ganz catheter is positioned in the central right pulmonary artery. Bilateral basilar chest tubes and mediastinal drains have been placed. Sternal wires are well aligned with subxiphoid skin staples in place.Mid to lower zone subsegmental atelectasis without significant pleural effusion or interval pneumothorax. Heart size is normal. | No evidence of complication following bioprosthetic aortic valve placement with coronary bypass. |
Generate impression based on medical findings. | Thoracentesis Interval new complete opacification of the right hemithorax with underlying suspected collapsible right lung. Left lung is similar with scattered nodular metastatic foci. No immediate postprocedural complications observed other than mild right to left mediastinal shift likely secondary to the presumed large effusion. However, if this is thought to be post procedural, serial follow-up imaging is needed | New opacification of the right hemithorax, thought to represent a large compressive effusion |
Generate impression based on medical findings. | Male, 23 years old.Reason: assess ETT position, pulm opacities History: CF, T1/2RF ET tube tip 4 cm above carina. NG tube tip in stomach.Extensive findings of cystic fibrosis with areas of bronchial wall thickening, mucoid impaction, and bronchiectasis. Previously noted left midlung focal opacity is slightly improved. | ET tube tip 4 cm above carina. Previously noted left midlung focal opacity is slightly improved. |
Generate impression based on medical findings. | 40 years, Female, Reason: assess pancreas History: abdominal pain and elevated lipase. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: 0.9-cm (13/44) segment 8 hyperenhancing lesion which is bright on T2 likely represents a flash filling hemangioma.SPLEEN: Mild splenomegaly. Subcentimeter hyperenhancing lesion the spleen likely represents a hemangioma.PANCREAS: Nonspecific cystic foci involving the head of the pancreas, 7 mm (7/46) and tail, 6 mm (7/69) which do not appear to indicate but the pancreatic duct. Normal enhancement throughout the pancreas. There is normal ductal morphology without evidence of divisum.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Nonspecific subcentimeter cysts within the pancreas. Follow-up is recommended.2.Small hemangiomas in the liver and spleen. |
Generate impression based on medical findings. | Female 65 years old Reason: cause of acute kidney injury History: elevated creatinine RIGHT KIDNEY: The right kidney measures 11.2 cm. No shadowing calculi or hydronephrosis is present. The renal cortex is increased echogenicity.LEFT KIDNEY: The left kidney measures 10.3 cm. No shadowing calculi or hydronephrosis is present. The renal cortex is increased in echogenicity.BLADDER: OTHER: No significant abnormalities noted. | No hydronephrosis or shadowing renal calculus. Bilateral increased renal cortical echogenicity is compatible with medical renal disease. |
Generate impression based on medical findings. | Female, 56 years old.Acute bronchitis and cough. Moderate to severe bronchial wall thickening consistent with asthma or chronic bronchitis.No evidence of pneumonia.Unremarkable mediastinal contours and cardiac silhouette.Calcified granuloma left lower lobe. | Moderate to severe bronchial wall thickening consistent with asthma or chronic bronchitis. |
Generate impression based on medical findings. | Female, 60 years old.Fever, tachycardia, bodyaches Right lower lobe airspace opacity new from previous.Right hilar calcified lymph nodes and a granuloma abutting the right minor fissure are most consistent with healed granulomatous disease.Normal heart size. | Subtle airspace opacity, suspicious for infection. Follow-up PA and lateral radiographs may be obtained in 6 weeks to ensure resolution and exclude alternate pathology. |
Generate impression based on medical findings. | 35 year old with proven right breast cancer (IDC grade 3) presents for MRI for I-SPY #1. There is extreme amount of fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally.The right breast shows diffuse abnormal enhancement, measuring 71 x 97 x 72 mm (AP x LR x CC), consistent with biopsy proven carcinoma. Diffuse skin thickening is also present in the right breast.There are at least five abnormal lymph nodes showing cortical thickening in the right axilla.No abnormal enhancement is seen in left breast. No abnormal axillary lymph nodes are identified in left axillary region. | 1. Right proven carcinoma shows diffuse enhancement, almost whole breast, with skin thickening.2. Multiple abnormal lymph nodes in the right axilla3. No abnormal enhancement in left breast. No abnormal axillary lymph nodes in left axillary regionBIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | Male, 70 years old.Reason: s/p minimally invasive esophagectomy History: s/p minimally invasive esophagectomy Two right chest tubes with no pneumothorax following gastric pull-up.Basilar atelectasis and small pleural effusions noted.An NG tube traverses a gastric pull-up, the side port at the hemidiaphragm level. | No pneumothorax following gastric pull-up, with nonspecific basilar atelectasis and small pleural effusions. |
Generate impression based on medical findings. | Male, 74 years old.Reason: 74 y/o man w/ pneumothorax Left-sided chest tube with tip directed medially towards the apex. Moderate left and small right pleural effusions with associated atelectasis. Tiny apical left pneumothorax. Multiple skin folds. | Small left apical pneumothorax. |
Generate impression based on medical findings. | Female, 91 years old.Reason: ? PNA History: weakness Small lung volumes with streaky basilar atelectasis or edema.Heart size normal.No reliable evidence of infection. | Streaky basilar opacities which could be edema or aspiration related. No reliable evidence of pneumonia, however. |
Generate impression based on medical findings. | Pleural effusion status post thoracentesis. Interval decrease in right pleural fluid volume. Left pleural fluid volume remains large. Low lung volumes. Compressive atelectasis at the bases. Previously seen right middle lobe opacity is now favored to represent atelectasis. Left basal atelectasis/consolidation is more pronounced. No pneumothorax. | No pneumothorax. |
Generate impression based on medical findings. | Male, 78 years old.Reason: s/p MVR/ CABG History: SOB Feeding tube extends inferiorly off the field of view. Left-sided PICC terminates in the left brachiocephalic vein. Unchanged cardiomegaly. Slight increase in bibasilar opacities. No pneumothorax. | Increased bibasilar probable atelectasis. Unchanged cardiomegaly. |
Generate impression based on medical findings. | Female, 27 years old.Reason: hx of chest pain History: chest pain, Mild to moderate lower lung zone edema with a minimal left pleural effusionConsistent with CHF. Mild cardiomegaly.Right jugular catheter tip at right atrial level.Renal osteodystrophy noted in the spine. | CHF/hypervolemia without infection. |
Generate impression based on medical findings. | Female, 48 years old.Reason: s/p MVR, Chest Tubes pulled History: s/p MVR, Chest Tubes pulled Interval progression of small basilar opacities. Cardiomediastinal silhouette and vasculature are unchanged. The mid and upper lung zones are clear of air space and interstitial opacities. No pneumothorax. | Interval development of small bilateral basilar opacities. |
Generate impression based on medical findings. | Female, 67 years old.Reason: pain in right chest History: pain in chest Unremarkable mediastinal and cardiac silhouette other than a tortuous aorta consistent with age.No significant pulmonary or pleural abnormalities. | No significant abnormality. |
Generate impression based on medical findings. | Supraumbilical hernia Possible very small suprapubic fascial defect with very small fat-containing hernia. No bowel involvement. | Possible very small suprapubic fascial defect with very small fat-containing hernia. No bowel involvement. |
Generate impression based on medical findings. | Male, 24 years old.Hypoxia status post bilateral lung transplant. Right jugular catheters terminate at the SVC/artery junction. Normal heart size. Diffuse interstitial and airspace opacities with atelectasis/consolidation.Volume of pleural fluid on the right about the same, extending over the apex and into the fissures.The sideholes of the upper chest tubes project over the bony thorax, unchanged.Other hardware unchanged.Previously noted tubular air lucencies projecting horizontally at the level of the clamshell sternotomy are compatible with open chest wall defects. | Diffuse pulmonary opacities and loculated pleural fluid without significant change. |
Generate impression based on medical findings. | Female, 48 years old.Reason: ETT placement History: Type IV respiratory failure Stable position of endotracheal tube.No change in appearance of bilateral pulmonary opacities as previously described. | No interval change in opacities as described. |
Generate impression based on medical findings. | 9-year-old male with history of leukemia receiving treatment now with bilateral hip pain, evaluate for avascular necrosis. Right KneeMENISCI: Medial and lateral menisci are intact.ARTICULAR CARTILAGE AND BONE: Small focus of increased edema is seen within the lateral aspect of the lateral femoral condyle (series 701, image 8 and series 1001, image 12). No additional bone marrow signal abnormalities are identified. The articular cartilage appears to be intact. No acute fracture.LIGAMENTS: PCL, ACL, MCL, and LCL are intact. EXTENSOR MECHANISM: Extensor mechanism is intactADDITIONAL | 1. Left knee: Proximal medial tibial metaphysis focus of low signal on T1 is associated with increased signal on T2. These findings are nonspecific but may reflect tibial metaphyseal edema, infarct, or leukemia infiltration. 2. Right Knee: Increased T2 hyperintensity in the right lateral femoral condyle and left medial femoral condyle without associated T1 low signal. These findings are nonspecific, but may reflect edema. |
Generate impression based on medical findings. | 47-year-old man with shortness of breath and concern for interstitial lung disease. LUNGS AND PLEURA: Examination is limited by significant motion artifact and the lower lung volumes. The upper lung zones are relatively opaque with areas of focal low attenuation. There is also significant pulmonary vascular redistribution and pulmonary arterial hypertension. Mild peribronchial thickening is also seen in the upper lung zones. Focal areas of groundglass opacity are seen in the periphery of the lungs in the lower lobes and appear to be in direct relation with pulmonary vessels.Multiple micronodules, the largest of which measures 3 mm, and granulomas most suggestive of prior granulomatous disease, but too small to characterize.MEDIASTINUM AND HILA: Severe cardiomegaly. Minimal pericardial fluid. Multiple mediastinal lymph nodes the largest of which measures 11x 20 mm, (image 35 of series 5). Proximal esophagus is patulous.Main pulmonary arteries enlarged measuring 3.8-cm, image 36, series 5, compatible with pulmonary arterial hypertension. The serpiginous posterior mediastinal and esophageal vessels suggesting lower esophageal varices.CHEST WALL: Unilateral subcutaneous edema and fluid in the left flank. Bullet fragment adjacent to the left scapula. Borderline right axillary lymph node measures 12 mm, (image 35 series 5). Collateral vasculature noted in the chest wall bilaterally.UPPER ABDOMEN: Evaluation of solid organ pathology and lymphadenopathy is limited secondary to lack of intravenous contrast and motion artifact. Marked amount of intra-abdominal ascites. Multiple surgical clips in left upper quadrant adjacent to atrophic appearing spleen. The spleen is abnormal in shape and has areas of low attenuation which are nonspecific and could represent cysts or infarct. | 1. Limited examination without specific findings of interstitial lung disease as clinically questioned.2. Pulmonary arterial hypertension with findings in the lungs that could reflect sequela of PAH/chronic thromboembolic disease. The presence of an enlarged left atrium and upper lobe vascular redistribution weighs against the diagnosis of pulmonary venoocclusive disease. Correlation with nuclear scintigraphy may be of use.3. Findings in the abdomen and left flank are suggestive of cirrhosis with portal hypertension though not conclusive. Correlate with LFTs. |
Generate impression based on medical findings. | Female, 55 years old.Reason: evaluate for infection/pneumonia History: productive cough Stable cardiomediastinal silhouette.No focal consolidation, sizable effusion or pneumothorax. Mild left retrocardiac opacity likely atelectatic in nature.Surgical clips projecting over the right upper quadrant.Postsurgical changes involving the cervical spine. | No radiographic evidence of acute cardiopulmonary process. |
Generate impression based on medical findings. | Female, 66 years old.Rib and chest pain. History of MVA. Please refer to separately reported rib series for skeletal assessment. Normal heart size. No pneumothorax. No pleural fluid.Low normal lung volumes with blunting of the posterior costophrenic angles. No focal airspace opacities. | No pneumothorax or acute pulmonary abnormality. |
Generate impression based on medical findings. | Age: 79 yearsGender: MaleReason for Study: Reason: ETT History: ETT ET tube unchanged with its tip 2 cm above the carina.Decreased lung volumes with stable cardiomediastinal silhouette.No new pulmonary opacities identified. | ET tube unchanged. No acute cardiopulmonary abnormalities. |
Generate impression based on medical findings. | Female, 79 years old.Reason: cp History: cp Moderate to severe cardiomegaly.Small right pleural effusion and right base streaky subsegmental atelectasis or scarring.Right subclavian dual-chamber ICD, leads in stable position. | Small right pleural effusion with right basilar subsegmental atelectasis. |
Generate impression based on medical findings. | Ms. Herts is a 27-year-old female with a personal history of Crohn's disease on immunosuppressant therapy, complaining of new palpable tender right breast lump. No family history of breast cancer. A targeted right ultrasound was performed for the patient’s area of concern.In the right breast 8:00 location, approximately 2 cm from the nipple, there is a thick-walled unilocular hypoechoic lesion with floating internal debris, posterior acoustic enhancement and peripheral vascularity, measuring approximately 1.3 x 0.8 x 0.9 cm. | Sonographic findings are compatible with a right periareolar abscess. No sonographic evidence of malignancy. Patient should be seen by a breast surgeon for further evaluation and treatment. All results and recommendations were discussed with patient and Dr. Bao at time of dictation. The patient was subsequently seen by Dr. Bao and immediately redirected for a surgical consult.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical findings. | Male, 64 years old, with upper extremity weakness, fasciculations and atrophy, with history of lumbar foraminal stenosis with weakness and hyperreflexia. Also with asymmetric pupils. There is a reversal of the normal cervical lordosis centered at C3. In addition, there is a trace anterolisthesis of C2 relative three, and a trace retrolisthesis of C5 relative to C6, all of which findings are likely degenerative in nature.Edematous endplate signal alteration is seen along the C3-4 disc, likely degenerative. Elsewhere the marrow signal intensity is heterogeneous but without frankly worrisome features. Facet arthropathy with osseous and paraspinal edema is noted at C7-T1 bilaterally.The spinal cord demonstrates normal signal characteristics throughout. Morphology is unremarkable except as discussed by level below. Lobular soft tissue is evident filling the left C7-T1 neural foramen and projecting slightly into the spinal canal with indentation of the adjacent dura. This nodule measures up to 12 x 7 mm. The right vertebral artery flow void is not clearly visualized which may represent slow flow, stenosis or occlusion. The intervertebral discs demonstrate loss of disc height and T2 signal, particularly from C3 through C6. Additional level specific findings are as follows:C2-3: Left facet hypertrophy. No significant spinal canal stenosis. Mild left foraminal narrowing. C3-4: Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild to moderate bilateral foraminal narrowing. C4-5: Mild facet and uncovertebral hypertrophy. No significant spinal canal stenosis. Mild to moderate bilateral foraminal narrowing. C5-6: Mild facet hypertrophy. Disc osteophyte formation. Effacement of ventral thecal sac with slight flattening of the ventral cord but no cord signal abnormality. Moderate left and mild right foraminal narrowing. C6-7: Uncovertebral hypertrophy. No significant spinal canal stenosis. Mild to moderate bilateral foraminal narrowing. C7-T1: Advanced facet arthropathy. Posterior disc-osteophyte complex formation with a small superiorly directed disc herniation. Left foraminal soft tissue nodule as discussed above. Ligamentum flavum thickening. Findings contribute to produce a mild to moderate generalized spinal canal narrowing particularly in the transverse dimension. Mild right foraminal narrowing. Moderate to severe left foraminal narrowing. | 1. Nodular soft tissue is evident within the left neural foramen at C7-T1. The differential for this finding would include a small tumor such as a schwannoma, or perhaps an extruded disc or inflammatory tissue related to the adjacent severe facet arthropathy. Further evaluation with contrast-enhanced MRI images is suggested as this would better assess for the possibility of a tumor.2. Multilevel degenerative findings are seen affecting with the discs and posterior elements. Spinal canal stenosis are seen at C5-6 and at C7-T1. Advanced facet arthropathy is also noted at C7-T1. |
Generate impression based on medical findings. | Male, 25 years old.25-year-old male presenting with cough while on Remicade. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No focal pulmonary opacity. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Female, 64 years old.Burns. Febrile. Mild interstitial edema is stable. Heart is normal in size. No measurable pneumothorax. ET tube has been advanced slightly and is now 1.5 cm above the carina. Dobbhoff tube below the diaphragm. | Stable mild interstitial edema pattern. ET tube 1.5 cm above the carina. |
Generate impression based on medical findings. | Male, 36 years old.Reason: SOB Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. | No acute cardiopulmonary process on radiography. |
Generate impression based on medical findings. | Female, 59 years old.Reason: et tube placement, pneumonia, effusion History: see ct head Right midlung atelectasis may be the result of aspirated secretions or mucous plugging.Heart size normal.ET tube tip approximately 5 cm above the carina.An NG tube terminates in the stomach.Left axillary vascular stent. | Right midlung focal atelectasis which may be the result of aspirated secretions or mucous plugging. |
Generate impression based on medical findings. | 60-year-old male status post placement of right IJ trialysis catheter. Cardiomediastinal silhouette is within normal limits.Redemonstration of multifocal airspace and interstitial opacities, similar to prior. Persistent focal nodular opacity in the left upper lobe. No new pulmonary opacities identified. Interval placement of right IJ trialysis catheter with tip in the SVC. No pneumothorax. | Interval placement of right IJ dialysis catheter with tip in the SVC. No pneumothorax. |
Generate impression based on medical findings. | Diagnosis: Migraine, unspecified, not intractable, with status migrainosusClinical question: carotid/ vertebral stenosisSigns and Symptoms: L sided numbness, headache MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. Incidental note is made of partial empty sella.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified and is very small. The posterior communicating arteries are very small. The vertebral arteries are similar in size.MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries. | 1.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 2.There is no evidence of intracranial aneurysm3.There is no evidence for intracranial or extracranial cerebrovascular occlusive disease. |
Generate impression based on medical findings. | Female, 76 years old.Reason: chest tube in place History: above Unchanged right chest tube terminating at the right apex. Aortic stent graft and surgical staples appear similar to prior study.Unchanged heart and mediastinal silhouette.Interval increase in patchy basilar opacities and increased bilateral pleural effusions, suggestive of edema.No significant pneumothorax. | Interval increase in basilar opacities and bilateral pleural effusions suggestive of hypervolemia. |
Generate impression based on medical findings. | 21-year-old male with history of shortness of breath. Diffuse airspace/interstitial opacities compatible with edema. Stable cardiomegaly. | Cardiomegaly and diffuse airspace/interstitial opacities compatible with edema. |
Generate impression based on medical findings. | Female, 77 years old.Reason: Intubation for angioedema History: Angioedema ET tube tip 2-3 cm above carina. Lungs hypoinflated with basilar edema and atelectasis, not significantly changed. | ET tube tip 2-3 cm above carina. |
Generate impression based on medical findings. | Female, 59 years old.Reason: ADHF History: as above Moderate cardiomegaly.No specific evidence of infection or edema.Left subclavian ICD, leads unchanged in position. | Moderate cardiomegaly without significant edema or pneumonia. |
Generate impression based on medical findings. | Right breast mass, possible fibroadenoma with prior benign biopsy result. Recent mastitis treated effectively, currently asymptomatic. A targeted right ultrasound was performed for the area marked by the clinical service. At the right 9 o'clock position, there is a mixed echogenicity lesion measuring 1.6 x 1.5 cm. This has peripheral blood flow. | 1.6-cm mixed echogenicity lesion near the site of clinical concern. This could represent a recurrent galactocele or less likely an area of fat necrosis. Surgical consultation is recommended and the patient will be seeing Dr. Jaskowiak today.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical findings. | 53-year-old male with sepsis and history of osteomyelitis with a rectal exam concerning for sacral osteomyelitis. The coccyx is absent, presumably related to prior resection. There is ulceration of the soft tissues posterior to the distal sacrum to the left of midline which courses distally along the gluteal crease toward the perineum. There is a thin collection of rim-enhancing fluid along the ulceration which contains gas and may communicate with the skin surface. The inflammation abuts the fifth sacral segment and extends anterior to the S5 segment and also into the spinal canal to the level of S2/S3 as well as along the right S2 and S3 nerve roots. The S5 segment shows low signal intensity on T1-weighted images, increased signal intensity on T2-weighted images, and enhances after contrast administration compatible with the suspected history of osteomyelitis. There is relatively mild signal abnormality and enhancement within the S4 segment that could reflect osteomyelitis or simply reactive edema. The bone marrow signal intensity of the remainder of the sacrum appears normal, as does the signal intensity of the remainder of the bones of the pelvis. Note is made of multiple sinus tracts within the perineum compatible with the patient's history of perineal fistulas related to the patient's known history of Crohn's disease. There is also a linear focus of T2 signal abnormality extending to the bladder concerning for fistula formation. Again seen are postoperative changes of proctectomy with a right lower quadrant colostomy, appearing similar to the prior study. A Foley catheter is in place. A pigtail catheter is identified within the bladder. There is gas density within the pelvis, particularly along the right iliopsoas muscle, better seen on the patient's recent CT examination. There is an ovoid collection of high signal intensity on both T1 and T2-weighted images, posterior to the psoas muscle at the level of the lumbosacral transition, which may represent a small hematoma. There is edema within the subcutaneous fat of the right flank which is nonspecific. Overall the subcutaneous edema has improved when compared to the prior study. There is mild intramuscular edema within the right proximal hip musculature that does not enhance following contrast administration. There is mild nonspecific and nonenhancing edema of the abductor musculature of the left hip. A small amount of fluid is identified within both hips, within normal limits. | 1. Soft tissue ulceration as described above with inflammation extending along the anterior aspect of the lower sacrum as well as into the sacral spinal canal. Signal abnormality and enhancement of the S5 segment is compatible with osteomyelitis with possible osteomyelitis of the S4 segment as well.2. Gas density within the pelvis is better seen on the patient's recent abdomen/pelvis CT examination. Please see the discussion above for additional details. |
Generate impression based on medical findings. | Female, 75 years old.PA catheter position. Interval extubation. Right jugular Swan-Ganz catheter tip at the level of the main pulmonary artery. Other tubes and lines unchanged. Left pleural fluid collection, retrocardiac atelectasis/consolidation unchanged. Pulmonary edema and basal atelectasis on the right unchanged. There may be minimal increase in volume of pleural fluid on the right. Subsegmental atelectasis right middle lobe is new. | Right jugular Swan-Ganz catheter tip at the main pulmonary artery level. Pleural fluid, edema and atelectasis, minimally increased on the right. |
Generate impression based on medical findings. | Reason: Tube placement History: OG tube, ventilator ET tube tip approximately 6 cm above the carina.Orogastric tube extending below the inferior margin of the radiograph.Slightly increased left perihilar opacity may represent aspirated secretions or infection in the superior segment of the left lower lobe.No other significant change. | Slightly increased left perihilar opacity suggestive of aspirated secretions and possibly infection. |
Generate impression based on medical findings. | 59-year-old female patient with history of papillary cancer. RIGHT LOBE: Status post thyroidectomy. There is a new hypoechoic focus within the right thyroid bed measuring 0.2 x 0.2 x 0.4 cm.LEFT LOBE: Status post thyroidectomy without recurrent or residual tissue identified.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a non-descript right level III lymph node measuring 0.8 x 0.4 x 1.5 cm. A benign morphology left level III lymph node measures 0.7 x 0.3 x 1.2 cm. OTHER: No significant abnormality noted. | 1. New hypoechoic focus within the right thyroid bed.2. Non-descript prominent right level III lymph node; this is amenable to biopsy if clinically indicated. |
Generate impression based on medical findings. | Kidney cancer, prostate cancer and lung nodule. Status post radiation treatment CHEST:LUNGS AND PLEURA: Previously mentioned lung nodule in the right lower lobe measures 13 x 9 mm on image number 48/224. No other new nodules are seen.MEDIASTINUM AND HILA: Enlarged mediastinal nodes are grossly unchanged. Previously measured subcarinal lymph node measures 18 x 16 millimeter on image number 36/210 4.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postoperative changes in the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Radiotherapy seeds.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: A prosthetic penile pump. | Enlarged mediastinal nodes, right lower lobe nodule are unchanged. |
Generate impression based on medical findings. | Other pulmonary embolism without acute cor pulmonale [I26.99], Reason for Study: ^Reason: Assess brain lesion History: N/A There is 16.3mm (AP) x 15.5mm (CC) and 13.5mm (RL) sized relatively well circumscribed intra axial mainly cystic lesion at the right frontal operculum (right subcentral lobule) with surrounding edema and irregular rim enhancement. There are also a couple of daughter nodules with peripheral enhancement see on post enhanced images. The content of the lesion does not show restricted diffusion. There is no other abnormal enhancing lesion on this scan. Comparing to prior scan obtained outside institution (Sep 15 2015), although overall size of the lesion appears to be decreased and intra lesional fluid fluid level has been not as conspicuous but the enhancing rim has been thickened, peripheral daughter nodules show interval increase in size and the extent of surrounding edema has been increased comparing to the size of the lesion. There is evidence of right fronto-temporal craniotomy.The ventricles, sulci and cisterns are symmetric and unremarkable. Multifocal patchy high signal intensities on bilateral periventricular white matter, bilateral external capsules on FLAIR/T2 images appear to be stable.The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Minimal mucosal thickenings on ethmoid sinuses. | 1. Interval progression of the thickness of enhancing rim, increased size of enhancing peripheral daughter nodules and the extent of surrounding edema of the right frontal opercular cystic lesion as described above since prior scan (Sep 15 2015).2. No change of high signal intensity lesions on bilateral periventricular white matter and external capsule.3. No acute ischemic or hemorrhagic lesion. No new abnormal enhancing lesion. |