instruction
stringclasses 1
value | input
stringlengths 36
4k
| output
stringlengths 4
1.33k
|
|---|---|---|
Generate impression based on medical findings. | History of pancreatic and peribiliary cysts. Stomach and back pain. ABDOMEN:LUNG BASES: Dilated pulmonary artery redemonstrated, suggestive of pulmonary arterial hypertension.LIVER, BILIARY TRACT: Numerous peribiliary cysts are redemonstrated. They appear slightly increased in number, particularly centrally, and there has been growth of a now 3.0 cm central cyst. This cyst compresses the central ducts, and there is increased intrahepatic biliary ductal dilatation. However extrahepatic biliary ductal dilatation is new or increased, with the common duct measuring up to 9 mm.SPLEEN: No significant abnormality noted.PANCREAS: Multiple cystic lesions of the pancreas are redemonstrated, some of which have increased in size. The reference, largest lesion in the distal body measures 1.8 cm (series 1001, image 20), previously 1.4 cm.ADRENAL GLANDS: Bilateral adrenal thickening unchanged.KIDNEYS, URETERS: Bilateral renal cysts, slightly larger from the prior exam.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.Increased size of multiple pancreatic cystic lesions, likely representing branch-type IPMNs.2.Increased intra and extrahepatic biliary ductal dilatation. Intrahepatic dilatation may at least in part relate to increased size of a central peribiliary cyst. However, there is also a new or increased dilation of the common duct up to 9 mm, which may reflect benign biliary stricture |
Generate impression based on medical findings. | 3 months of dry cough remote history of cigarettes quit in 1984. Normal heart size. Tortuous thoracic aorta unchanged. No visible lymphadenopathy. Plain film technique. No pleural fluid or pneumothorax. No visible pulmonary nodules or masses. Mild degenerative changes of the spine. Right upper quadrant calcifications unchanged. | No acute pulmonary abnormality. |
Generate impression based on medical findings. | Male, 63 years old.Reason: Pre-Kidney evaluation, end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: Pre-Kidney Transplant Suture line and mild volume loss in the right lower lung.Small loculated right pleural effusion versus pleural thickening, improved from prior radiograph and unchanged from CT.No focal pulmonary opacity or pneumothorax.Unremarkable cardiomediastinal silhouette. | Right pleural effusion versus pleural thickening. No specific evidence of infection. |
Generate impression based on medical findings. | Sepsis due to Pseudomonas Mildly improving cardiopulmonary appearance with decreasing edema in the perihilar and basilar distribution, however changes persist with moderate effusions greater on the right. Pericardial and right chest tubes unchanged. Dobbhoff, LVAD, gastric tube and right jugular dialysis catheter otherwise similar | Improving edema pattern with unchanged supportive hardware devices and a right chest tube |
Generate impression based on medical findings. | Female, 56 years old.Reason: r/o rib fx History: fall No acute cardiopulmonary abnormality. Borderline heart size. No evidence of rib fracture or pneumothorax. | No evidence of rib fracture given limits of technique. Borderline heart size |
Generate impression based on medical findings. | Male, 34 years old.Reason: endotracheal tube placed History: endotracheal tube placed Small lung volumes with nonspecific right basilar opacity suggestive of aspiration or localized edema.ET tube tip approximately 5 cm above the carina.A VP shunt courses over the right side of the chest. | Right basilar opacity suggestive of localized edema or aspiration. ET tube tip approximately 5 cm above the carina. |
Generate impression based on medical findings. | 65 year old female with shortness of breath. History of congestive heart failure status post LVAD. Evaluate for effusions or pneumonia. Interval removal of right IJ central catheter. ICD leads and LVAD are unchanged in position. Cardiomegaly unchanged. Median sternotomy wires, surgical clips and fixation hardware project over the mediastinum. Surgical clips in the left axilla.Interval improvement in bilateral pleural effusions. No focal opacities. | Interval improvement in bilateral pleural effusions. No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | 58 year old female with history of lung cancer presenting with shortness of breath. Evaluate for PE. PULMONARY VASCULATURE: No pulmonary embolus. Technically diagnostic study.LUNGS AND PLEURA: Stable diffuse paraseptal and centrilobular emphysema. Previously seen, poorly marginated mass in the superior segment of left lower lobe has decreased in size slightly, measuring approximately 5.1 cm on series 5, image 124 (previously 5.6 cm).MEDIASTINUM AND HILA: Ill-defined subcarinal and AP window adenopathy as before.CHEST WALL: Right Port-A-Cath with tip in SVC.UPPER ABDOMEN: No significant abnormality noted. | 1. No pulmonary embolus. 2. Slight interval decrease in previously seen left lower lobe mass.3. Stable diffuse mixed emphysema. |
Generate impression based on medical findings. | Male, 44 years old.Reason: 44yo M w/ resp failure, assess for effusion History: as above Stable positions of support devices.Moderate left and small right pleural effusions with associated atelectasis unchanged. No interval pneumothorax. | Stable moderate left and small right pleural effusions. |
Generate impression based on medical findings. | Reason: 89 yo M with h/o NSCLC s/p hypofractionated RT to left lung and h/o CVA. Decreased BS R base with subjective increased in SOB. Please assess for acute changes History: DOE Moderate cardiomegaly with a tortuous aorta, unchanged.Increased air space and interstitial opacity in the left lower lung, compatible with tumor and possibly associated infection or hemorrhage.Increased right upper posterior chest wall mass with associated rib destruction, as shown on the previous CT scan.Right basilar opacity compatible with atelectasis and a small pleural effusion. | Tumor progression with possible superimposed process such as infection in the lingula and left lower lobe. |
Generate impression based on medical findings. | Chest pain and shortness of breath past week. Rule-out PE. PULMONARY ARTERY: No evidence of pulmonary embolus.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Dextroscoliosis of the thoracic spine.UPPER ABDOMEN: No significant abnormality noted. | No evidence of pulmonary embolus or other pulmonary abnormality. |
Generate impression based on medical findings. | 63 years Female (DOB:5/27/1953)Reason: stroke syndrome History: 2198PROVIDER/ATTENDING NAME: THOMAS F SPIEGEL KOUROSH A REZANIA There is a area of diffusion restriction present which involves the lateral aspect of the right postcentral gyrus and extends into the right centrum semiovale. There is also involvement of the posterior aspect of the right some central lobule as well as the posterior aspect of the right insular cortex. There is associated T2 and FLAIR signal hyperintensity.A couple punctate foci of T2 and FLAIR signal hyperintensity are present within the thalami bilaterallyThere is a focus of loss of signal on susceptibility imaging within the right dentate nucleus of the cerebellum.There is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Additional T2 and FLAIR MRI signal hyperintense foci are present in the cerebellar hemispheres and brainstem.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. | 1.Findings are compatible with acute infarction involving the lateral aspect of the right postcentral gyrus and adjacent centrum semiovale and insular cortex2.Small hemorrhagic lesion is present in the dentate nucleus of the right cerebellar hemisphere3.Findings are compatible with the old lacunar infarcts involving the thalami.4.Punctate lesions in the brainstem and cerebellum are most likely vascular related at this age.5.Periventricular and subcortical white matter lesions of a moderate degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on medical findings. | Left pleural effusionVIEW: Chest AP 2/6/15 Cardiothymic silhouette normal. Left chest tube in place. There is a moderate size left pleural effusion not significantly changed. Bilateral lung opacities in the right lower lobe and left lower lobe. There is a small left apical pneumothorax. | Moderate size left pleural effusion not significantly change with a small left apical pneumothorax. |
Generate impression based on medical findings. | Reason: evaluate lung fields History: s/p VAD Cardiopulmonary monitoring and support devices, unchanged.Nonspecific basilar opacity consistent with atelectasis, consolidation and effusions.No pneumothorax or other acute change. | Edema, atelectasis and small effusions with no acute change. |
Generate impression based on medical findings. | Male, 48 years old.Reason: pneumothorax History: trauma, mid thoracic back pain, vehicle lifted 10 feet in the air and dropped violently. No pleural effusion or pneumothorax. No focal pulmonary opacities. Widening of the aortic knob is suspicious for aortic injury. | Questionable widening of the aortic knob. Correlation with CT is recommended for further evaluation. |
Generate impression based on medical findings. | Ms. Johnican is a 43 year old female with known left breast cancer status post neoadjuvant chemotherapy and disease positive left axillary lymph node. Personal history of benign left breast biopsies for tubular adenoma and fibroadenoma and benign right axillary lymph node biopsy. There is heterogeneous amount of fibroglandular tissue in both breasts. Mild parenchymal enhancement is noted bilaterally.LEFT BREAST: In the left superior breast, at site of known malignancy, there is revisualization of an irregular enhancing mass measuring 2.3 x 1.7 x 1.9 cm (AP x ML x SI), previously measuring 2.1 x 2.3 x 2.1 cm. Biopsy marker clip is located centrally within this malignancy. There is associated minimal skin dimpling seen anteriorly.Biopsy-proven tubular adenoma and biopsy-proven fibroadenoma of the left breast measure 1.5 x 1.0 x 1.2 cm and 0.8 cm respectively, not significantly changed in size and appearance when compared to prior examination.RIGHT BREAST:There is no abnormal enhancement seen in the right breast.AXILLA: There has been an interval decrease in size of previously enlarged left axillary lymph nodes, two of which contain biopsy marker clips. The two biopsied left axillary lymph nodes now measure 1.7 x 0.7 cm and 1.1 x 0.5 cm respectively. Previously enlarged right axillary lymph nodes have also decreased in size when compared to prior examination, the larger one of which contains a Hydromark biopsy clip. | (1) Interval decrease in size of left breast index malignancy and left axillary lymph nodes.(2) No MR evidence of malignancy in the right breast.(3) Stable biopsy-proven tubular adenoma and fibroadenoma of the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | Adenocarcinoma, follow-up Postsurgical changes mild volume loss on the right with elevated hemidiaphragm and scarring in the right lung base unchanged. Scattered suture material overlying the right hilar region also unchanged. No focal plain film findings to suggest recurrence or interval changeLeft lung remains clear other than minimal atelectasis in the baseThe cardiac and mediastinal contours are within limits | Postsurgical changes in the right hemithorax without evidence of tumor recurrence |
Generate impression based on medical findings. | Female, 56 years old.Reason: ARDS s/p intubation, eval bilateral opacities and hardware placement History: as above ET tube approximately 4 cm above the carina.Diffuse nonspecific airspace opacities compatible with the clinical diagnosis of ARDS, is unchanged. Line position stable. No pneumothorax. | Lines in adequate position. No significant change in the appearance of ARDS. |
Generate impression based on medical findings. | Renal transplant. Question of pyelonephritis. Patient with weakness. The right iliac fossa transplant kidney measures 10 cm in length without shadowing nephrolithiasis. No peritransplant fluid collection. Color Doppler demonstrates symmetric blood flow. Note is made of a 1.3 cm simple cyst. There is mild pelviectasis.Normally distended urinary bladder. | Mild pelviectasis. No specific evidence of pyelonephritis as clinically questioned however ultrasound is very limited for making this diagnosis. |
Generate impression based on medical findings. | Female, 25 years old.Reason: pna? History: AMS Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities. | No significant abnormality. No specific evidence of infection. |
Generate impression based on medical findings. | Female, 61 years old.Reason: febrile neutropenia - c/f pneumonia History: chest pain The right port remains accessed.Small bilateral pleural effusions are new since the prior study. No focal consolidation or interval pneumothorax. Cardiac contour appears enlarged when compared to 3/20/2015, possibly from pericardial fluid. | New small pleural effusions. |
Generate impression based on medical findings. | Likely CLL assess for lymphadenopathy. CHEST:LUNGS AND PLEURA: Two small nodules posteriorly in both lower lobes, on the left about 6 mm in diameter image 53/130 and on the right smaller, image 66/130.MEDIASTINUM AND HILA: One or two upper normal sized mediastinal lymph nodes but no extensive intrathoracic lymphadenopathy.CHEST WALL: Extensive bilateral axillary lymphadenopathy is present. A representative left axillary lymph node is about 3.3 x 1.9 cm image 21/163.ABDOMEN:LIVER, BILIARY TRACT: Less than 5-mm hepatic cyst like hypodensity in the dome of the liver, and the patient has undergone cholecystectomy.SPLEEN: The spleen may be slightly large.KIDNEYS, URETERS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedPANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal and mesenteric lymphadenopathy.BOWEL, MESENTERY: Extensive mesenteric lymphadenopathy noted above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1 Extensive axillary, mesenteric and retroperitoneal lymphadenopathy, sparing the mediastinum and hila; this is consistent with the provided diagnosis of CLL.2. Two small pulmonary nodules discussed above, for which a one year follow up is recommended or follow-up as part of the patient's other treatment. |
Generate impression based on medical findings. | A patient submitted outside study for review. Submitted for review are a bilateral mammogram and ultrasound from 7/23/2015 and performed at the WomanCare P.C. Breast and Bone Density Center, Arlington IL . Two standard views of both breasts and ML and two spot compression views of left breast were obtained. The breast parenchyma is extremely dense. A BB marker in the left breast upper outer quadrant corresponds to a palpable abnormality/thickening. There is extensive bilateral scattered calcifications noted. Most of the calcifications layer on the ML view suggestive of milk of calcium. No obvious mass is noted on spot compression views.Ultrasound: In the right breast are multiple cysts most of which demonstrate calcifications, especially the cyst in the 9:00 position. Clustered cyst is noted in the right breast 12:00 position which measure 1.0 x 0.4 cm. In the left breast are multiple simple, septated cysts containing hyperechoic calcifications in the left upper outer quadrant and the largest septated cyst in the left breast 1:00 position measures 10 x 7 mm. | 1.The area of thickening/palpable in the left breast upper outer quadrant most likely corresponds to fibrocystic changes. 2.Bilateral scattered breast calcifications and multiple, septated and clustered cysts in both breasts. 3.Given the absence of prior mammograms for comparison, a six-month follow-up mammogram is recommended to demonstrate stability of the calcifications. 4.A right breast ultrasound is also recommended in the right breast to demonstrate stability of the clustered cyst.BIRADS: 3 - Probably benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | Age: 56 yearsGender: MaleReason for Study: Reason: trending effusion History: sob Left PICC line is tip in the SVC.IABP marker in the proximal descending aorta.Nupulse device and she did leads unchanged.Stable cardiomediastinal silhouette.Right basilar opacity compatible with pleural effusion and atelectasis similar to the prior exam.No new pulmonary opacities identified. | No interval change in the right pleural effusion and right basilar atelectasis. |
Generate impression based on medical findings. | Male, 58 years old.Reason: S/p pericardiectomy, pleurectomy, CT in place History: asx Left-sided chest tube again noted. Diffuse pulmonary opacities again noted. Unchanged cardiomegaly. No pneumothorax. Small pleural effusions. | Diffuse pulmonary opacities again noted most consistent with pulmonary edema. Small pleural effusions, as before. Unchanged heart size. |
Generate impression based on medical findings. | Pain of the left shoulder ROTATOR CUFF: There is increased signal intensity of the anteriormost fibers of the supraspinatus tendon proximal to its insertion at the greater tuberosity. This likely represents anterior edge fraying. There is an additional focus of intermediate signal intensity in the supraspinatus at its attachment to the greater tuberosity, which may represent focal tendinosis. We see no fluid-filled full-thickness rotator cuff tear. There is no significant supraspinatus muscle atrophy. Infraspinatus, subscapularis, and teres minor tendons and muscles appear normal.SUPRASPINATUS OUTLET: Mild to moderate osteoarthritis affects the AC joint. GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is within normal limits. There is mild degenerative cyst formation in the humeral head. Within the limitation of non-arthrogram study, the labrum appears normal.BICEPS TENDON: No significant abnormality noted. | 1. Mild to moderate osteoarthritis of the AC joint appearing similar to prior study.2. Mild fraying of the anterior surface of the supraspinatus tendon as it courses along the rotator interval, but no full-thickness rotator cuff tear is present. |
Generate impression based on medical findings. | 24-year-old female with abdominal pain. Evaluate for placenta accreta and cesarean section scar. PELVIS:UTERUS, ADNEXA: Intrauterine gestation is present. Mild subchorionic hemorrhage is present. Findings of placenta accreta and probable increta located anteriorly along the lower uterine body, likely in site of prior cesarean section scar. No evidence of placenta percreta.Myometrial contractions make evaluation of the uterus difficult, but within this limitation, there is ill-defined low T2 signal anteriorly within the myometrium of the mid uterine body, for which adenomyosis is a consideration.BLADDER: No significant abnormality noted.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.Findings of placenta accreta and probable increta as above. No evidence of placenta percreta.2.Mild subchorionic hemorrhage is present.3.Possible adenomyosis of the mid uterine body. |
Generate impression based on medical findings. | Male, 68 years old.Reason: 68yo M w/ hx heart/kidney transplant, PTLD, assess for causes of hypoxia History: as above New port catheter terminates near the cavoatrial junction. New diffuse pulmonary opacities with more focal left basilar opacity. Question of small pleural effusions. Unchanged cardiomegaly. No pneumothorax. | New Port-A-Cath terminates near the cavoatrial junction. New diffuse pulmonary opacities most consistent with pulmonary edema. |
Generate impression based on medical findings. | Clinical question: History of brain surgery 9 years ago for subdural hematoma. Signs and symptoms: Memory loss. Nonenhanced brain MRI:No acute intracranial process and negative diffusion weighted series.Examination demonstrate expected chronic postoperative changes of a right parietal small craniotomy.Mild scattered patchy foci of FLAIR/T2 hyperintensity are present only in the subcortical and periventricular white matter of bilateral cerebral hemispheres. Although nonspecific considering patient's stated age of 88 this appearance is highly suggestive of chronic microvascular ischemic changes of mild degree. The signal intensity of brain parenchyma is otherwise within normal on all MRI sequences.There is generalized symmetrical bilateral prominence of cortical sulci which could be within normal range for patient's stated age. Ventricular system are normal and with maintained midline. CSF spaces remain patent and unremarkable.The signal void of major intracranial arterial branches are present.Images through the orbits, paranasal sinuses, mastoid air cells and calvarium are unremarkable. | 1.No acute intracranial process and negative diffusion weighted series.2.Findings suggestive of mild chronic nonhemorrhagic small vessel ischemic strokes only in the subcortical and periventricular white matter.3.Essentially unremarkable nonenhanced brain MRI otherwise for patient's stated age of 88. Please see above comments. |
Generate impression based on medical findings. | Male, 59 years old.Reason: lung eval History: lung eval Support devices are unchanged.Persistent low lung volumes with stable pleural effusions, basilar consolidation and atelectasis. No significant pneumothorax. | No change in the basilar opacities and pleural effusions. |
Generate impression based on medical findings. | BRAIN: There is no evidence of restricted diffusion to suggest acute ischemic infarction. There is a small focus of chronic encephalomalacia within the right cerebellar hemisphere appearing similar to 2013 CT. Punctate and confluent foci of increased T2/FLAIR signal within the supratentorial white matter are nonspecific but favored to represent mild-moderate chronic small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration for age. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable. Postcontrast images do not demonstrate any abnormal parenchymal enhancement.MRA HEAD: 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 posterior cerebral arteries are normal in course and caliber. The right P-comm is not definitively visualized. The left P-comm is diminutive. There is no evidence of flow-limiting stenosis or aneurysm. | 1.No acute ischemic infarction.2.Chronic mild-moderate small vessel ischemic changes.3.Small chronic infarction in the right cerebellar hemisphere.4.MRA without evidence of flow-limiting stenosis or aneurysm. |
Generate impression based on medical findings. | Female, 48 years old.Reason: et tube placement, change in LLL opacity History: intubated, bacteremic Improved aeration left lower lobe but persistent partial opacification on the left and right basilar consolidation.ET tube tip approximately 2 cm above the carina.An NG tube extends below the lower margin of the image. | ET tube tip approximately 2 cm above the carina. Improvement in left lower lobe opacity but still consistent with pneumonia. |
Generate impression based on medical findings. | Male, 70 years old.Reason: s/p esophagectomy History: s/p esophagectomy 2 right chest tubes no pneumothorax.Mild basilar opacities improved on the left.An NG tube traverses gastric pull-up. | No significant pneumothorax. |
Generate impression based on medical findings. | The large right intraparenchymal temporoparietal hematoma is not significantly changed along with areas of low and high T2 signal and predominantly low T2 signal and surrounding vasogenic edema. There is no discernible underlying nodule enhancement. There is persistent partial effacement of the right lateral ventricle, right uncal medialization, as well as approximately 5 mm of midline shift to the left. There is minimal right parietal subarachnoid hemorrhage and intraventricular hemorrhage. There are no new areas of intracranial hemorrhage or hydrocephalus. There are periventricular and subcortical T2 hyperintensities, which are nonspecific, but most compatible with chronic microvascular ischemic disease. However, there is no acute territorial infarct. There is mildly prominent leptomeningeal enhancement diffuse in the right cerebral hemisphere diffusely, which may be due to altered hemodynamics. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA HEAD | 1.Redemonstration of large right intraparenchymal temporoparietal hematoma, with adjacent vasogenic edema and effacement of the right lateral ventricle. There is no midline shift or herniation.2.Unchanged minimal right parietal subarachnoid and intraventricular hemorrhage.No evidence of vascular malformation, aneurysm or significant steno-occlusive lesions within the limits of MRA. |
Generate impression based on medical findings. | 73 year-old female with mediastinal adenocarcinoma of lymph nodes. Restaging examination. CHEST:LUNGS AND PLEURA: Severe centrilobular emphysema.A reference right lower lobe spiculated nodule is partially obscured by motion artifact which makes accurate measurement difficult. An estimated measurement of 1.6 x 1.2 cm on image 70, series 5, is likely unchanged to slightly smaller given the above limitations.A reference left upper lobe nodule is unchanged measuring 6 x 8 mm on axial image 26, series 5. An additional spiculated nodule in the left upper lobe (image 28, series 5) is also unchanged.Groundglass opacity in the left lower lobe is unchanged and may reflect aspiration or atelectasis. No pleural fluid.MEDIASTINUM AND HILA: A reference precarinal lymph node measures 2.1 x 1.4 cm on axial image 29, series 4, and is unchanged. Additional superior mediastinal, prevascular, subcarinal and hilar lymphadenopathy is unchanged.The cardiac size is mildly enlarged. Aortic and coronary artery atherosclerotic calcifications are noted. No pericardial effusion.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: A left adrenal nodule measures 1.5 x 1.8 cm on axial image 79, series 4, and has not significantly changed.KIDNEYS, URETERS: Cystic lesion in the superior pole of the left kidney is unchanged and probably benign.RETROPERITONEUM, LYMPH NODES: Aortic atherosclerotic calcification and mural thrombus with a mild aneurysmal dilatation of the aorta superior to the bifurcation, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild thoracolumbar dextroscoliosis and degenerative disease. 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: No significant abnormality noted.BONES, SOFT TISSUES: Dystrophic calcification in the gluteal soft tissues may reflect prior trauma and is unchanged.OTHER: No significant abnormality noted. | Stable disease in the chest with no evidence of metastatic disease in the abdomen or pelvis. |
Generate impression based on medical findings. | Female, 81 years old.Shortness of breath. Large lung volumes with flattening the diaphragms consistent with COPD/emphysema. Mild bronchial wall thickening. Atelectasis and bronchial wall thickening in the left lower lobe retrocardiac region may be the result of recent aspiration, nonspecific. | Chronic abnormalities consistent with COPD/emphysema with nonspecific bronchial wall thickening which could be the result of chronic bronchitis however asymmetry in the left lower lobe is suspicious for superimposed acute process such as aspiration. If symptoms worsen, follow-up PA and lateral chest radiographs would be suggested. |
Generate impression based on medical findings. | Male 66 years old Reason: HCV evaluate for HCC History: HCV LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 16.1 cm in length. The parenchyma is mildly coarse and echogenic. No focal hepatic lesion is identified.BILIARY TRACT: Hydropic gallbladder with 1.8 cm echogenic calculi with posterior acoustic shadowing. Wall measures 1 mm in thickness. The common hepatic duct measures 3 mm. Murphy's sign is negative.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 10.9 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. Right lower pole cyst measures 2.4 x 2.4 x 2.4 cm.The left kidney measures 11.9 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. No suspicious lesion identified.SPLEEN: The spleen measures 8.0 cm in length.OTHER: No significant abnormalities noted. | 1.Hydropic gallbladder with cholelithiasis, without secondary signs of acute cholecystitis.2.Mildly coarse and echogenic liver, may represent nonspecific fatty infiltration/parenchymal dysfunction. No focal hepatic lesion identified. |
Generate impression based on medical findings. | Female, 26 years old.Reason: Routine screening, post OHT, HX of cough History: as above Median sternotomy, heart size normal.No significant pulmonary or pleural abnormality. | No significant abnormality following heart transplant. |
Generate impression based on medical findings. | Low back pain [M54.5], Reason for Study: ^Reason: assess for stenosis History: BL LE weakness (proximal worse than distal, R > L) and suppressed reflexes at right knee and ankle. History of prostate cancer. Thoracic MRI:Postoperative (colpectomy and external fixation) between T10-L1 and kyphoplasty at L2.Multiple metastatic lesions on cervical, thoracic and lumbar vertebral bodies as well as ribs. The extent of involvement appears to be unchanged since Dec 1 2015 but progressed since Mar 26 2015.Multifocal various degreed height loss (compression fractures) of thoracic vertebral bodies are again seen, no change since Dec 1 2015.Thoracic spinal cord signal intensity is normal.Lumbar spine:Redemonstration of multiple metastatic lesions on lumbar vertebral bodies, sacrum and bilateral ilium, no change since prior scan.Previously noted undulating shape epidural lesion appears to be stable in size and configuration.Spinal cord signal intensity appears to be normal.The conus medullaris terminates at the L1 level. Degenerative changes are specified by the intervertebral level as follows: T12-L1: external fixation using screw is seen, no neuroforaminal narrowing or spinal stenosis. L1-L2: about 20-30% height reduction with bone cement within the vertebral body indicating post kyphoplasty status, no neuroforaminal narrowing or spinal stenosis. About 2 mm thickness intrathecal lesion on the right posterolateral aspect of the thecal sac.L2-L3: about 3mm thickness intrathecal lesion on the left posterolateral aspect of the thecal sac with subtle mass effect toward spinal cord. No neuroforaminal narrowing or spinal stenosis. L3-L4: diffuse bulging of disc with bilateral ligamentum flavum thickening result mild spinal canal stenosis, there is about 2mm thickness intrathecal lesion midline posterior aspect of the thecal sac. No neuroforaminal narrowing or spinal stenosis. L4-L5: diffuse bulging of disc with central broad based disc protrusion result moderate to severe spinal canal stenosis, no neuroforaminal narrowing or spinal stenosis. L5-S1: there is curvilinear intrathecal lesion on the right posterolateral aspect of the thecal sac with mild mass effects toward spinal cord, no neuroforaminal narrowing or spinal stenosis. | 1. No change of multifocal metastatic lesions on thoracic spine, lumbar spine, ribs, sacrum and bilateral ilium.2. Intra thecal fluid collecting lesions likely represent subdural space along lumbar spine with various degree mass effects toward spinal cord as described above, no change in extent, size and configuration since prior scan.3. Degenerative changes of lumbar spine especially at the level of L45, there is moderate to severe spinal canal stenosis. |
Generate impression based on medical findings. | 83-year-old male with prostate cancer. Staging. CHEST:LUNGS AND PLEURA: Upper lobe predominant centrilobular emphysema. Scattered micronodules, many of which are calcified. No suspicious nodules, masses, or pleural effusion. Central bronchial wall thickening.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Coronary artery calcifications.CHEST WALL: Left chest ICD with leads in expected locations. Sternal wires.Degenerative changes of the spine.ABDOMEN: LIVER, BILIARY TRACT: Three peripherally-calcified lesions in the hepatic dome (series 3, image 87) are atypical in appearance for malignancy and possibly represent complex cysts. For reference, a rim calcified lesion measures 2.2 x 1.8 cm.Two other nonspecific hypoattenuating lesions are seen in the right hepatic lobe (series 3, images 96 and 114). The largest measures 2.4 x 2.8 cm.Two small, well marginated hypoattenuating lesions in the hepatic dome (series 3, image 89) likely represent benign cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple hypoattenuating lesions bilaterally are compatible with simple cysts.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications of the descending aorta with elongated ectasia. At the level of the celiac artery, the aorta is approximate 3.3 cm in caliber. At the level of the renal arteries, the aorta measures 4 cm in caliber with more focal aneurysm also seen at the origin of the left renal artery. Just proximal to its bifurcation, the aorta measures 3.3 cm.Ectasia of the left common iliac artery, measuring 1.5 cm in caliber (series 80216, coronal image 50).BOWEL, MESENTERY: Two ventral abdominal wall hernias containing nonobstructed transverse colon as well as a segment of small bowel. No evidence of bowel wall thickening or fluid in the hernia sac.BONES, SOFT TISSUES: Degenerative changes of the spine.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: Bladder wall thickening, which may in part be due to incomplete distention.LYMPH NODES: No pelvic lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Left hip prosthesis. Degenerative changes of the spine. | 1. Multiple liver lesions as detailed above. Several lesions near the hepatic dome appear to be a combination of simple and complex cysts. Two less well defined lesions in the right hepatic lobe are nonspecific and given the lack of IV contrast they are not well characterized. The largest lesion may be amenable to ultrasound-guided biopsy.2. Ectatic aorta as above.3. Nonspecific bladder wall thickening. |
Generate impression based on medical findings. | Male, 67 years old.Reason: hypoxic respiratory failure. History: hypoxia Unchanged position of left ICD.Multifocal interstitial and airspace opacities not significantly changed relative to prior exam. Airspace opacities appear more confluent at the lung bases.Probable small pleural effusions. No pneumothorax.Right fifth rib pathologic fracture is better demonstrated on the current study. | Unchanged multifocal interstitial and airspace opacities.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Female, 60 years old.Reason: hx of lung cancer, History: increased sob New loculated moderately large right pleural effusion.Right basilar atelectasis.Emphysema redemonstrated.Minimal scattered scarring.Stable cardiomediastinal silhouette. | New loculated moderately large right pleural effusion. |
Generate impression based on medical findings. | There is straightening of cervical spine. The osseous marrow signal is within normal limits for patient age. The cord signal is within normal limits.There is mild congenital narrowing of the cervical spine with mild superimposed degenerative findings as described below. C2-3: Minimal disk/endplate degenerative changes with no significant spinal canal or neural foramina stenosis. C3-4: Minimal disk/endplate degenerative changes with no significant spinal canal or neural foramina stenosis. C4-5: Mild bilateral facet arthropathy with no significant spinal canal or neural foramina stenosis. C5-6: Small disk osteophyte complex with no significant spinal canal or neural foramina stenosis. C6-7: Disk osteophyte complex with effacement of ventral CSF and no significant significant spinal canal or neural foramina stenosis. C7-T1: 2 mm anterolisthesis of C7 on T1 with uncovering of the disk and ventral CSF effacement with no significant spinal canal or neural foramina stenosis. | Mild congenital narrowing of the cervical spinal canal with minimal degenerative changes as detailed above. No focal high grade spinal canal stenosis at any level. No significant neural foraminal stenosis. |
Generate impression based on medical findings. | Age: 58 yearsGender: MaleReason for Study: Reason: S/P LVAD. Eval for pneumonia History: fever Left-sided ICD and LVAD unchanged.Stable cardiac enlargement.The lungs are clear.No pleural effusions.Median sternotomy is intact. | No acute cardiopulmonary abnormalities identified without interval change. No specific evidence of infection. |
Generate impression based on medical findings. | Female, 44 years old.Reason: Pre-Kidney evaluation, end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: Pre-Kidney Transplant Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Mild cardiomegaly. Small amount of pneumoperitoneum almost assuredly related to peritoneal dialysis. | Clear lungs. Mild cardiomegaly. |
Generate impression based on medical findings. | Female, 49 years old.Reason: pt with ards. please compare to prior History: ards Support devices are unchanged.Coarse air space opacities of ARDS or edema unchanged. Increasing retrocardiac consolidation and atelectasis. No interval pneumothorax. | Increasing retrocardiac consolidation in the setting of ARDS. |
Generate impression based on medical findings. | Female, 66 years old.Reason: 66F w/ hypoxic failure - eval ETT History: - Interval removal of right IJ Swan-Ganz catheter with sheath remaining in place. Other life-support devices remain unchanged.Stable cardiomediastinal silhouette.No significant change in bilateral lung aeration with redemonstration a loculated pleural effusion/hematoma and prominence of the aortic knob region status post aortic aneurysm repair. No pneumothorax. | No significant change in bilateral lung aeration status post aortic aneurysm repair. |
Generate impression based on medical findings. | Prior pneumonia. Right upper lobe infiltrate concern No cardiopulmonary abnormality. Specifically the previously described right upper lobe opacity has resolved | Improvement with resolution of the right upper lobe focal opacity concerning for pneumonia |
Generate impression based on medical findings. | 11-year-old male presents with a first time seizure, evaluate for structural abnormality. There is no evidence of a mass or acute infarct. There is a focus of encephalomalacia in the left posterior occipital lobe with cortical hemosiderin deposition causing blooming artifact on susceptibility weighted images. No additional hemorrhagic foci are identified. There is no associated vasogenic edema. The ventricles and basal cisterns are normal in size and configuration. The mesial temporal lobes are normal in configuration and signal intensity. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. | 1. Single focus of encephalomalacia in the left occipital lobe with cortical hemosiderin deposition. Differential considerations include chronic focal cortical prior hemorrhage from other causes such as cortical venous thrombosis and conceivably an underlying vascular malformation. Acute process is unlikely since there is no evidence of surrounding brain parenchymal edema.Underlying neoplasm is considered less likely given the lack of mass effect. 2. No additional hemorrhagic foci are identified. For further characterization, post-contrast sequences are recommended. |
Generate impression based on medical findings. | 79-year-old male with acute kidney injury and decreased urine output status post right partial nephrectomy RIGHT KIDNEY: Status post right partial nephrectomy. The right kidney measures 10.9 cm. The cortex is of normal echogenicity. No shadowing calculi or hydronephrosis is present.LEFT KIDNEY: The left kidney measures 10.2 cm. The cortex is of normal echogenicity. No shadowing calculi or hydronephrosis is present.OTHER: Bladder is not well-visualized. Portion of Foley is noted. | No sonographic evidence of hydronephrosis or perinephric fluid collection. |
Generate impression based on medical findings. | Male, 58 years old.Reason: aspiration pneumonia History: aspiration pneumonia New linear opacity overlying the aortic arch, likely iatrogenic; this may be overlying the patient. Lines and tubes are unchanged. No new focal pleural parenchymal opacity. Right-sided subcutaneous emphysema again noted. Unchanged heart size. | New linear opacity overlying the aortic arch, likely iatrogenic; this may be overlying the patient. No acute cardiopulmonary process on radiography. |
Generate impression based on medical findings. | Male, 3 years old. Reason: ETT placement. Bilateral pleural effusionsVIEW: Chest AP (one view) 10/28/2015, 0504 hrs. ET tube tip at the profound thoracic inlet and above the carina. Right chest tube, tip at the right apex.The cardiothymic silhouette is obscured.Bilateral pleural effusions, unchanged from prior.Persistent bilateral pulmonary opacities and right middle and lower lobes and left lung base are unchanged from prior. No pneumothorax. | Unchanged basilar consolidation and pleural effusions. |
Generate impression based on medical findings. | Male, 69 years old.Reason: possible RUL pneumothorax? History: respiratory failure The previously suspected pneumothorax is not visualized.There is no change in the right pleural effusion and basilar opacity.Support devices are unchanged.Progression of left basilar opacity. | The previously suspected pneumothorax is not visualized. Remaining findings are otherwise essentially stable. |
Generate impression based on medical findings. | 58-year-old male with frothy sputum. Evaluate for edema. Interval removal of enteric tube.Other support devices remain unchanged in position.Stable cardiomediastinal silhouette.Low lung volumes with basilar opacities compatible with atelectasis/edema.No new pulmonary opacities are identified. | Persistent basilar opacities compatible with atelectasis/edema. |
Generate impression based on medical findings. | Female, 34 years old.Chest pain, cough and fever. Normal heart size. No focal pulmonary opacities, pleural fluid or pneumothorax. | No acute cardiac pulmonary abnormality. Normal chest. |
Generate impression based on medical findings. | Female, 83 years old.Reason: pulmonary edema/pneumonia History: leg swelling/sob Large lungs consistent with COPD.Moderate cardiomegaly.No specific evidence of infection or edema. | Cardiomegaly and COPD, otherwise unremarkable |
Generate impression based on medical findings. | Patient is a 22 yr old female with history of AML with prior s/p anthracycline containing chemotherapy and stem cell transplant presenting for evaluation of left ventricular function. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 62 %, the LV end diastolic volume index is 74 ml/m2 (normal range: 65+/-11), the LVEDV is 115 ml (normal range 109+/-23), the LV end systolic volume index is 28 ml/m2 (normal range 18+/-5), the LVESV is 43 ml (normal range 31+/-10). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 52 %, the RV end diastolic volume index is 78 ml/m2 (normal range 69+/-14), the RVEDV is 121 ml (normal range 110+/-24), the RV end systolic volume index is 37 ml/m2 (normal range 22+/-8), and the RVESV is 58 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant 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.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.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 drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.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. The left ventricle is normal in size and systolic function (LVEF 62%)2. The right ventricle is normal in size and systolic function (RVEF 52%)3. No evidence for delayed enhancement. |
Generate impression based on medical findings. | Weakness [R53.1], Reason for Study: ^Reason: r/o ischemic stroke History: right arm weakness and slurred speech Brain MRI:There is a focal high signal intensity on the left parietal operculum which shows high signal intensity on diffusion-weighted imaging with equivocal restricted diffusion on ADC map, the lesion shows mild increased signal intensity on T2 weighted image, best seen on coronal T2-weighted image series #7 image #24. This lesion indicate either late subacute or early chronic ischemic infarct.There are linear and nodular susceptibility artifacts on the right frontal lobe indicating hemosiderin differentiation possibility due to prior localized subarachnoid hemorrhage.Underlying brain shows multiple patchy high signal intensity FLAIR lesions on bilateral periventricular white matter and centrum semiovale indicating nonspecific small vessel ischemic disease.Otherwise there is no evidence of new acute ischemic or hemorrhagic lesion on the scan.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA:3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate less than 50% focal luminal narrowing on the left MCA distal M1 segment.There are multifocal intracranial arterial luminal narrowings on bilateral distal MCAs and PCAs indicating intracranial atherosclerosis without evidence of significant (more than 50%) luminal stenosis.The right ACA A1 segment and distal left vertebral artery are hypoplastic.There is no intracranial arterial aneurysm. | 1. Equivocal restricted diffusion with slightly increased T2 signal intensity on the left parietal operculum indicate late subacute or early chronic ischemic infarction without hemorrhagic transformation. 2. Nonspecific small vessel ischemic disease.3. Focal but less than 50% of luminal narrowing on the left MCA distal M1 segment.4. Intracranial atherosclerosis as described above without evidence of significant luminal stenosis. |
Generate impression based on medical findings. | Female, 52 years old.Reason: ett placement, eval for opacities or effusion History: s/p tracheostomy on vent Left IJ sheath is no longer visible. The remaining support devices are unchanged in position.Stable cardiomegaly. Decreasing opacities of edema. Small pleural effusions. Persistent retrocardiac atelectasis. | No pneumothorax following left IJ sheath removal. |
Generate impression based on medical findings. | Male, 34 years old.Reason: SOB, PNA? History: SOB? Cardiac leads/device again noted. Stable cardiomegaly noted. No focal lung consolidation. No pleural effusion or pneumothorax. | No acute cardiopulmonary findings with no specific evidence of infection. |
Generate impression based on medical findings. | Anaplastic astrocytoma status post chemotherapy and radiation treatment. Headache and increasing weakness. Again seen are areas of intrinsic T1 shortening as well as heterogeneous nodular enhancement in the right frontal, parietal, and temporal lobes predominantly in the periventricular regions related to known tumor. Enhancement extending across the corpus callosum is again seen including at the levels of genu, body, and splenium. Enhancing nodules in the left frontal lobe are stable to minimally larger. For example the more anterior enhancing left frontal lobe nodule measures up to 6 x 9 x 10 mm, previously previously 6 x 7 x 9 mm. Subtle differences in measurement may relate to contrast timing and technique with the current study performed at 3 Tesla and previously at 1.5 Tesla. Restricted diffusion is again noted in these areas. Extensive masslike FLAIR signal abnormality in the right cerebral hemisphere extending across the corpus callosum into the left cerebral hemisphere as well as extending inferiorly into the brainstem is again seen and not significantly changed since 10/7/2016. Mass effect with partial effacement of the lateral ventricles is not significantly changed. No significant change in size of the ventricles. There is no significant midline shift or uncal herniation. Compared to 7/29/2016, areas of enhancement and masslike FLAIR signal abnormality are clearly progressed however.Prior postsurgical changes including right temporoparietal craniotomy and right anterior parietal burr hole again seen. A focus of susceptibility along the right precentral gyrus likely represents a biopsy marker. Hemosiderin deposition the surgical bed is similar to prior examination. No findings to suggest acute ischemia, new hemorrhage or new mass effect. Mild to moderate mucosal thickening involving the anterior ethmoid air cells and frontal sinuses is similar to prior. | Allowing for slight differences in technique, there is no significant change since 10/7/2016. Compared to 7/29/2016, however, there appears to have been significant progression with increased tumor involvement of the right frontal lobe, corpus callosum, and extension into the left cerebral hemisphere. |
Generate impression based on medical findings. | Non suppressible leg shaking, change in sensation and subsequent numbness occurring at night several times a month. There is perhaps mild volume loss and T2 hyperintensity in the left hippocampus. There is no evidence of intracranial hemorrhage, mass, or acute infarct. 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. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is scattered paranasal sinus mucosal thickening. | Possible left medial temporal sclerosis. |
Generate impression based on medical findings. | 60 years old Male. Reason: f/u R pneumothorax History: cough. Tiny small loculated pneumothorax is still present in the right apex, which has been improved as compared with the prior study. Diffuse the right pleural thickening and streaky opacities in the right lung. Consolidation is seen in the right lower lobe with elevation of the right hemidiaphragm. | Interval improvement of the small loculated right pneumothorax. Consolidation in the right lower lung, which can be due to atelectasis. However infection cannot be excluded. |
Generate impression based on medical findings. | 66-year-old male with history of pancreas mass ABDOMEN:LIVER, BILIARY TRACT: Bone T2 hyperintense lesions scattered throughout the liver some of which are bigger and at least one which is new in segment 5/6.SPLEEN: Splenomegaly measuring up to 18 cm, increased. PANCREAS: Redemonstrated is a 3.7 x 2.9 cm mass in the tail of the pancreas, previously 3.1 x 2.5 cm which follows signal and contrast enhancement of splenic tissue on all sequences.Redemonstrated is a cystic lesion in the body of the pancreas measuring 9 x 6 mm, previously 11 x 7 mm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Mild periportal, aorta caval and mid mesenteric lymphadenopathy, more prominent when compared to the prior exam.BOWEL, MESENTERY: Moderate to large size hiatal hernia. No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Slight interval increase in pancreatic tail mass as described above compatible with intrapancreatic spleen. 2.Mild periportal, aorta caval and mid mesenteric lymphadenopathy, more prominent when compared to the prior exam. Increased splenomegaly. Findings could represent worsening lymphoma. 3.No significant change in pacreatic body cystic lesion may represent sidebranch IPMN.4.Moderate sized hiatal hernia. |
Generate impression based on medical findings. | Reason: assess for pneumo (line placement yesterday) vs. pulmonary edema History: as above Left jugular catheter with its tip in the SVC, directed laterally.Severe cardiomegaly.Interval removal of a right jugular catheter. ICD lead unchanged.Cardiomegaly with bilateral opacities, most obvious at the left apex, recently characterized by CT scan, suggestive of infection. | Interval removal of right jugular catheter with no pneumothorax or other acute change. |
Generate impression based on medical findings. | Male, 57 years old.Reason: reeval questionable opacity History: as above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities. | No significant abnormality. Questioned opacity on and earlier radiographs is not confirmed. |
Generate impression based on medical findings. | Male, 57 years old.Reason: eval for stool burden in patient with constipation History: nausea, abdominal pain, constipation Cardiomediastinal silhouette is unremarkable. There is mildly increased lung volumes.Slightly greater than average stool burden. No evidence of free air or bowel obstruction. | Slightly greater than average stool burden. |
Generate impression based on medical findings. | Cough and right lung egophony. Chronic biapical scarring and posterior costophrenic angle blunting. Cardiothoracic ratio progressively increasing, now upper normal. Unfolding of the thoracic aorta with prominence of the ascending segment present previously. No focal airspace opacities or specific signs of pulmonary edema. A faint spherical opacity projecting over the right lower thorax most likely reflects summation artifact, not visualized on the lateral film. | Tortuous thoracic aorta, correlate for systemic hypertension. Cardiothoracic ratio remains within normal limits but is been progressively increasing. No conclusive acute pulmonary abnormalities. Short-term PA and lateral chest radiograph follow-up may be obtained if patient remains symptomatic. |
Generate impression based on medical findings. | 63-year-old male with history of cystectomy with neobladder CHEST:LUNGS AND PLEURA: Subcentimeter nodule image number 51, series number 5 in the left upper lobe, unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST 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: Interval development of mild left hydronephrosis and dilated left ureter. The ureters dilated throughout its course. The etiology is unknown.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: Status post cholecystectomy.BLADDER: Status post cystic is unremarkable.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: A small nonobstructive, ventral midline hernia in the pelvis is stable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination.Interval development of new left sided hydronephrosis and hydroureter. Etiology is unknown. |
Generate impression based on medical findings. | 21 year old man referred for evaluation of pulmonic regurgitation and RV volume/function. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 101 ml/m2 (normal range: 74+/-15), the LVEDV is 181 ml (normal range 142+/-34), the LV end systolic volume index is 46 ml/m2 (normal range 25+/-9), the LVESV is 83 ml (normal range 47+/-19), the LV mass index is 68 g/m2 (normal range 85+/-15), and the LV mass is 121 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 57%, the RV end diastolic volume index is 100 ml/m2 (normal range 82+/-16), the RVEDV is 179 ml (normal range 142+/-31), the RV end systolic volume index is 43 ml/m2 (normal range 31+/-9), and the RVESV is 76 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is trace pulmonic regurgitation. Regurgitation fraction is 2%.Tricuspid ValveThe tricuspid valve opens widely. There is trace tricuspid regurgitation.AortaThere is a left sided aortic arch with a "psuedo-bovine" brachiocephalic branching pattern (normal variant). The aortic root is normal in size.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 drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsResidual thymus tissue. This 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. The left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 54%. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 57%, the RV end diastolic volume index is 100 ml/m2 (normal range 82+/-16), the RVEDV is 179 ml (normal range 142+/-31).3. The pulmonic valve opens widely. There is only mild pulmonic regurgitation based on qualitative visualization of the pulmonic valve, quantitative velocity encoded imaging, and also based on absence of left ventricular and right ventricular stroke volume differences. Additionally RV volumes and ejection fraction are within normal limits.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Male, 37 years old.Reason: Eval for infection History: Neutropenic fever, cough Right IJ tunnel central venous catheter remains unchanged.Stable cardiac silhouette.Interval improvement in bilateral lung volumes and bibasilar opacities with residual left basilar bandlike atelectasis/scarring. Redemonstration of interstitial prominence probably representing component of edema. | Interval improvement in bilateral lung volumes and bibasilar opacities with residual left basilar bandlike atelectasis/scarring. |
Generate impression based on medical findings. | 76-year-old male status post head injury; evaluate for ICH There is no evidence of acute intracranial hemorrhage, mass or edema. Extensive areas of nonspecific patchy and confluent hypoattenuation are seen in the periventricular and subcortical white matter, likely representing small vessel ischemic disease of indeterminant age.There is an extra-axial soft tissue density in the interhemispheric fissure measuring 7 x 8 mm (image 11, series 3) and 11 mm in height on the sagittal images. The soft tissue density appears to be connected to the left internal carotid artery and may represent an anterior communicating artery aneurysm. Recommend MRI/MRA for further evaluation. The ventricles and basal cisterns are normal in size and configuration.Soft tissue swelling is seen overlying the left frontal region. The calvaria and skull base are radiographically normal without evidence of fracture. The visualized paranasal sinuses, middle ear cavities and mastoid air cells are normally pneumatized. | 1. No acute intracranial hemorrhage. Extensive small vessel ischemic disease of indeterminate age. 2. Left frontal soft tissue swelling without underlying fracture. 3. Soft tissue density in the interhemispheric fissure as described above suspicious for ACOM aneurysm. Recommend MRI/MRA for further evaluation.These findings were discussed with the emergency room (#56807) at the time of dictation. |
Generate impression based on medical findings. | Age: 56 yearsGender: MaleReason for Study: Reason: h/o HNC and CRT, History: pneumothorax per CT 1/6, reassess The cardiomediastinal silhouette is unremarkable.There are increased lung volumes compatible with COPD. No focal air space opacities noted.Left apical pleural thickening.Probable small left apical pneumothorax. | No acute cardiopulmonary abnormalites identified without interval change. No significant pneumothorax identified. |
Generate impression based on medical findings. | 31 year old female with rising liver function tests, evaluate for mass. LIVER: Enlarged measuring 22.1 cm in length. Increased echogenicity consistent with diffuse fatty infiltration. Focal fatty sparing noted adjacent to the gallbladder fossa. No discrete hepatic lesions identified. BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Hepatomegaly and increased echogenicity consistent with hepatic steatosis. No discrete liver masses or biliary ductal dilation. |
Generate impression based on medical findings. | Female, 64 years old.Shortness of breath. Evaluate for fluid overload. Interval improvement in basilar opacities. No new focal pulmonary opacities. No pleural effusions, or pneumothorax.Unchanged cardiomegaly.Interval removal of right IJ central catheter. | Interval improvement in basilar opacities, without evidence of fluid overload. |
Generate impression based on medical findings. | Sustained an injury six weeks ago. Persistent pain in left shoulder. Rule out labral tear of the left shoulder. ROTATOR CUFF: There is perhaps minimal undersurface tearing of the supraspinatus tendon, but otherwise the tendon and muscle appear normal. The infraspinatus tendon and muscle appear normal. The teres minor muscle and tendon appear normal. The subscapularis tendon is intact. There is a small amount of contrast infiltrating the subscapularis muscle, likely iatrogenic.SUPRASPINATUS OUTLET: Tiny acromioclavicular joint osteophytes suggest minimal osteoarthritis. I see no frank impression upon the superior fibers of the supraspinatus.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is normal. Articular cartilage of the glenohumeral joint appears normal. There is detachment of the superior labrum and anterosuperior labrum from the underlying glenoid from approximately the 11:00 position to the 3:00 position. While it is possible that this could represent an unusually prominent sublabral sulcus combined with a normal variant sublabral foramen, I suspect that it represents a true labral tear. The inferior labrum appears intact.BICEPS TENDON: The tendon of the long head of the biceps appears normal. ADDITIONAL | Detachment of the superior and anterosuperior labrum from the underlying glenoid as described above. While it is possible that this could represent an unusually prominent sublabral sulcus coupled with a normal variant sublabral foramen, I suspect that it represents a true labral tear. |
Generate impression based on medical findings. | There is no evidence of intracranial hemorrhage, mass, or acute infarct. High T2 signal and encephalomalacia are again seen in the left frontal lobe, right parietal lobe, right occipital lobe and right inferior cerebellar hemisphere. Since the previous exam there has been progression of the abnormal T2 signal in the right parietal lobe and left frontal lobe. There are also a few patchy areas of new high T2 signal in the right frontal lobe and left occipital lobe with no associated diffusion restriction. There is susceptibility artifact in the chronic right frontal lobe infarct and left frontal lobe infract compatible with hemosiderin staining.The midline structures and craniocervical junction are within normal limits. There is mild ex vacuo dilatation of the right lateral ventricle. The ventricles and basal cisterns are otherwise normal in size and configuration. There is no midline shift or herniation. No abnormal extra-axial fluid collection is identified. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA HEAD | 1.No acute infarct, intracranial hemorrhage or mass.2.Interval progression of chronic ischemic disease in the regions and territories previously affected by ischemia.3.Stable MRA of the brain with multifocal high-grade stenosis in the anterior and posterior circulation.4.In the neck there is no significant stenosis in the carotid arteries. The cervical vertebral arteries are patent although there is thready opacification on the right. |
Generate impression based on medical findings. | 52 year old female with a history of pancreatitis being treated for autoimmune pancreatitis with prednisone. MRI MRCP to evaluate biliary system, and pancreas. ABDOMEN:LIVER, BILIARY TRACT: Incidental note is made of pacreatic divisum. No evidence of intra-or extrahepatic biliary ductal dilation. There is stenosis/narrowing of the distal 2 cm of the common bile duct. No focal mass lesions are identified. No gallstones. No common duct stones are identified. SPLEEN: No significant abnormality noted.PANCREAS: Note is made of pancreatic divisum. There is a normal response to secretin augmentation. There is faint peripheral enhancement along the margins of the pancreas, which is nonspecific, however, correlation with IgG4 levels recommended to exclude the possibility of autoimmune pancreatitis. There is a focus on T1 and T2 prolongation in the uncinate process with associated patchy restricted diffusion and faint enhancement on post contrast images which is suspicious for focal evolving pancreatitis although a focal mass lesion is not entirely excluded. 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.There is questionable faint peripheral enhancement along the margins of the pancreas as well as narrowing of the distal common bile duct, which is nonspecific, but can be seen in autoimmune pancreatitis. Correlation with IgG4 levels could be considered if clinically indicated. 2.Focus of enhancing signal abnormality affecting an enlarged uncinate process of the pancreas is nonspecific. While an evolving focal pancreatitis is favored, a follow up examination in 6-12 months is recommended to establish resolution.3.Pancreatic divisum. |
Generate impression based on medical findings. | Female, 37 years old.Reason: post op, eval lung fields History: s/p MVR on 5/5/15 Patient is status post sternotomy. Right IJ Swan-Ganz catheter tip in the right main pulmonary artery. Mediastinal drain/chest tube in place. ET tube tip 2.5 cm from the carina.Stable cardiomegaly. Improvement of RUL aeration with residual bilateral atelectasis and probable aspiration bronchiolitis. No large pleural effusions or significant pneumothorax. | Expected postoperative changes with support devices. Improvement of RUL aeration. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Clinical question: Schwannoma, 3 months follow up lumbar tumor resection. Signs and symptoms: As above. Pre-and post-enhanced lumbar MRI:Since prior exam there is significant decreased enhancement of cauda equina at L1 -- L2 surgical site compared to prior study. Posteriorly at the L2 level within the cauda equina there is a small focus of solid enhancement measuring approximately 2.5 x 3-mm in transaxial dimensions (axial post enhanced series 901 image 37 sagittal post enhanced series 801 image 7) highly suggestive of a small schwannoma.Tiny focus of enhancement at the T10 -- T11 disk level identified only on sagittal series and measuring approximately 9 mm in cranial cephalad access and as well suspected of additional schwannoma. This region was not included on prior exam.Multiple small additional intradural enhancing lesions consistent with patient's known schwannomas are again identified and without change. The largest of these lesions is at lower L5 level and measuring a maximum of 10.7-mm in size very similar to prior study. | 1.Significant to near complete resolution of enhancement at the surgical site at L1 -- L2 level since prior study.2.Tiny solidly enhancing schwannoma measuring at 2.5 x 3 mm within the cauda equina at L2 level is identified.3.Multiple additional schwannomas are again identified without interval change.4.A small schwannoma at T10 -- T11 disk level within the spinal canal was not included in the field of prior study. |
Generate impression based on medical findings. | 87-year-old male with history of bladder cancer with lymph node involvement Dense annular mitral valve calcification. Mild left basilar scarring. No abnormal pulmonary opacities identified. | No interval pulmonary nodules. |
Generate impression based on medical findings. | Female, 57 years old.Reason: assess for acute process - R chest pain History: assess for acute process - R chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities. | No significant abnormality. |
Generate impression based on medical findings. | Male, 63 years old.Reason: sob History: sob Innumerable surgical clips again seen in the neck and upper thorax.Cardiomediastinal silhouette.Calcified granulomas are unchanged.Mild blunting at the left cardiophrenic angle likely represents scarring versus small effusion.No focal consolidation or significant pneumothorax. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Positive sputum culture. Diminished lung sounds, check for pneumonia Interval removal of left and mediastinal chest tube as well as a right jugular sheath. The LVAD and, ICD are otherwise unchanged.Decreasing. Persistent mild to moderate nonspecific cardiomegaly with diminishing cardiopulmonary changes suggesting resolving basilar edema. Small effusions | Partial resolution of previously observed suspected CHF with overall improved aeration, specifically left lower lobe. Chest tubes and right jugular catheter removed |
Generate impression based on medical findings. | 56-year-old male with colon cancer status post chemotherapy. CHEST:LUNGS AND PLEURA: Multiple subcentimeter nodules in the right upper and middle lobes and left upper and lower lobes. Nodules in the right upper lobe (series 4, image 44, 45, 56, 62) appears slightly larger. There is a new left lower lobe nodule (Series 4, image 80). The left lower lobe nodule seen previously now measures 8mm, previously 6mm. MEDIASTINUM AND HILA: Coronary artery and aortic arch atherosclerotic calcifications are present.CHEST WALL: The left chest wall port is in place with its tip at the SVC/RA junction.ABDOMEN:LIVER, BILIARY TRACT: Interval progression of hepatic metastases. Reference lesion near the gallbladder fossa measures 5.4 x 7.2 cm (series 3, image 99), previously measuring 4.5 x 6.0 cm. A second reference lesion in segment 7 near the dome measures 7.3 x 10.1 cm (series 3, image 94), previously measuring 6.3 x 5.0 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst.RETROPERITONEUM, LYMPH NODES: Enlarging portacaval lymphadenopathy.BOWEL, MESENTERY: Low anterior resection with colostomy in left lower quadrant. There is herniation of small bowel loops adjacent to the stoma compatible with parastomal hernia. No evidence of bowel obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prosthetic calcifications.BLADDER: No significant abnormality notedLYMPH NODES: Reference right external iliac lymph node measures 1.4 x 2.0 cm (series 3, image 175), previously measuring 1.4 x 2.0 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval progression of lung metastases, hepatic metastases and portacaval lymphadenopathy. |
Generate impression based on medical findings. | Male, 60 years old.History of MI, CHF, and AICD, now with lightheadedness. Defibrillator and pacer leads in place.The cardiomediastinal silhouette is normal.There is subsegmental basilar atelectasis with trace left pleural effusion.Lumbar osteophyte noted. | Basilar atelectasis with trace left pleural effusion. |
Generate impression based on medical findings. | Male, 31 years old.Reason: ? pna History: r chest pain No acute cardiopulmonary abnormality. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Reason: persistent cough History: persistent cough Unremarkable cardiac and mediastinal silhouette.Mild basilar scarring.No significant pulmonary or pleural disease. | No significant abnormalities. |
Generate impression based on medical findings. | Acute left-sided numbness. Please evaluate for infarct. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are scattered punctate and confluent areas of abnormal T2/Flair hypertensity in the periventricular and subcortical white matter, consistent with mild small vessel ischemic changes. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. Left maxillary sinus mucous retention cyst or polyp is seen. | 1.No evidence of acute intracranial hemorrhage, mass, or acute infarct.2.Findings compatible with mild chronic small vessel ischemic disease. |
Generate impression based on medical findings. | Female, 87 years old.Reason: eval for edema/inf, and defib placement History: chest pain Mild to moderate cardiomegaly.No specific evidence of infection or edema.Left subclavian pacemaker, leads unchanged in position. | No specific evidence of infection or edema. |
Generate impression based on medical findings. | Bilateral upper extremity weakness and hyperreflexia, status post MVA Cervical: Craniovertebral junction appears within normal limits. There is evidence of osseous fusion involving the C5-C7 vertebral bodies which is postsurgical. The cervical vertebral bodies are appropriate in height. Alignment is grossly maintained aside from mild loss of cervical lordosis. Bone marrow signal is benign with T1 hyperintense lesion involving the C7 vertebral body compatible with a hemangioma..The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There is mild right neural foraminal narrowing related to uncovertebral hypertrophy and facet arthropathy. No significant compromise to the spinal canal or left neural foramen.C4-5: Disc osteophyte complex and prominent uncovertebral hypertrophy on the left. There is partial effacement of the ventral thecal sac without significant spinal canal stenosis at this level overall. There is moderate left and mild right neural foraminal stenosis.C5-6: No significant compromise to the spinal canal or neural foramina. There is mild effacement of the ventral thecal sac.C6-7: No significant compromise to the spinal canal or neural foramina. There is mild effacement of the ventral thecal sac.C7-T1: There is mild left neural foraminal stenosis related to facet arthropathy. No significant compromise to the spinal canal or right neural foramen.Small perineural cysts incidentally noted at C6-C7 and C7-T1. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Thoracic: Thoracic vertebral body heights are maintained. Alignment is maintained. There is trace prominence of the central canal/tiny syrinx involving the lower thoracic cord, measures 1.3 mm in the AP dimension, and is of doubtful significance. Thoracic cord signal is otherwise unremarkable. Bone marrow signal is benign with no suspicious lesions. Scattered foci of T1 hyperintensity are compatible with hemangiomas and focal fat.No significant spinal canal stenosis is seen. Degenerative changes include partial effacement of the dorsal thecal sac at the T9-T10 level related to ligamentum flavum thickening and facet arthropathy. There is mild right T1-T2 neural foraminal stenosis. There is also mild neural foraminal stenosis at the T5-T6 and T6-7 levels. Small multiple Schmorl's nodes are noted in the lower thoracic spine.T2 hyperintense lesion is partially imaged involving the right hepatic lobe. Small left renal cyst is also noted. | 1. Evidence of remote anterior cervical fusion involving the C5 to C7 vertebral bodies. There is no evidence of high-grade spinal canal stenosis at any level in the cervical spine or evidence of cervical cord signal abnormality.2. Adjacent segment disease with degenerative changes at C4-C5, where there is moderate left and mild right neural foraminal stenosis. There is also partial effacement of the ventral thecal sac at the C4-C5, C5-C6, and C6-C7 levels. Additional levels as detailed above.3. Mild degenerative changes in the thoracic spine without significant spinal canal stenosis at any level. There is trace prominence of the central canal in the distal thoracic cord which is of doubtful clinical significance. Thoracic cord signal is otherwise unremarkable. |
Generate impression based on medical findings. | Female, 72 years old.With history of metastatic leiomyosarcoma status post chest wall resection. Interval removal of mediastinal drain. The cardiomediastinal silhouette is mildly enlarged. Large lung volumes suggestive of obstructive disease. Right moderate layering pleural effusion with adjacent atelectasis. Persistent septal thickening consistent with edema. Tiny left pleural effusion. | Moderate layering right pleural effusion and tiny left pleural effusion with adjacent atelectasis. Septal thickening remains, reflecting a component of edema. |
Generate impression based on medical findings. | Age: 42 yearsGender: FemaleReason for Study: Reason: Non resolving infiltrate without a clear diagnosis History: cough, sweats, chills Stable cardiac mediastinal silhouette.Interval improvement in the ill-defined right basilar opacity.No new pulmonary opacities identified.No pleural effusion. | Right lower lobe airspace opacity improved from the prior exam. Continued follow-up imaging is recommended. |
Generate impression based on medical findings. | Age: 78 yearsGender: FemaleReason for Study: Reason: fluid overload History: SVT Mildly decreased lung volumes.The cardiac mediastinal silhouette is unremarkable.Blunting the costophrenic angles may represent pleural thickening.No focal airspace opacities.Severe degenerative joint disease involving the glenohumeral joints bilaterally. | No acute cardiopulmonary abnormalities are identified. No specific evidence of infection or edema. |
Generate impression based on medical findings. | Reason: AM CXR History: AM CXR Perforation of the esophagus. Interval removal of a right chest tube with a probable skin fold at the right apex which could be confirmed on subsequent radiographs. Left chest tube, venous catheter and esophageal stent, unchanged.Small bilateral pleural effusions with a skin fold at the right apex but no significant pneumothorax.Mild basilar atelectasis, unchanged. | Small pleural effusions and basilar atelectasis with no acute change. Probable skin fold at the right apex which could be reevaluated on subsequent radiographs. |
Generate impression based on medical findings. | Male, 21 years old.Leukocytosis, sickle cell disease. No focal airspace opacities or visible pleural fluid.Unchanged heart size.Right upper quadrant surgical clips. | No acute pulmonary abnormalities. |
Generate impression based on medical findings. | Male 63 years old; Reason: AKI on CKD History: above RIGHT KIDNEY: The right kidney measures 10.0 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. LEFT KIDNEY: The left kidney measures 9.5 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. URINARY BLADDER: No significant abnormality notedOTHER: Hepatic parenchyma is severely echogenic. | 1.Echogenic renal cortices. No sonographic findings of nephrolithiasis or hydronephrosis.2.Echogenic hepatic parenchyma possibly due to fatty infiltration. |
Generate impression based on medical findings. | Female, 96 years old.Reason: infiltrates History: dyspnea Dobbhoff tube tip projects over the proximal duodenum.Lungs are better expanded. Chronic nonspecific interstitial opacities unchanged. Probable mitral annulus calcification. Unchanged apical scarring. | Improved lung inflation. Chronic appearing nonspecific interstitial changes but no acute abnormalities. |
Generate impression based on medical findings. | Female, 23 years old.Reason: r/o acute chest History: hx of sickle cell disease Heart size is enlarged. Low lung volumes with basilar opacities favoring atelectasis. Pleural spaces are clear. Osseous changes reflect sickle cell disease. | Cardiomegaly without edema. |
Generate impression based on medical findings. | Female, 63 years old, with metastatic disease to the brain status post radiosurgery. An enhancing lesion within the left occipital lobe is slightly smaller, now measuring 6 x 3 mm, previously 7 x 4 mm, with reduced edema.A small enhancing lesion within the right inferior cerebellum measures 7 x 6 mm, previously 8 x 6 mm, with minimal if any associated edema.A small focus of enhancement along the inferior vermis is unchanged. An adjacent focus of enhancement within the inferior left cerebellar hemisphere is slightly more conspicuous than on prior (see image 33, series 1301).A 5-mm focus of enhancement within the high right superior frontal gyrus is new. A 3-mm focus of enhancement within the left frontal operculum is new. A 2-mm focus of enhancement within the right superior temporal gyrus is also new. A questionable focus of enhancement along the margin of the left precentral gyrus is unchanged.No evidence of significant brain parenchymal edema or mass effect is seen. No significant intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricles remain normal in size and morphology. | 1.Lesions within the left occipital lobe and right cerebellum are stable to smaller.2.Two additional small lesions within the cerebellum are stable to minimally more prominent.3.Lesions within the right superior frontal gyrus, left frontal operculum and right superior temporal gyrus are new. |