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Generate impression based on findings. | Male 60 years old Reason: hx of FL s/p auto SCT f/u evaluation History: hx lymphoma CHEST:LUNGS AND PLEURA: Calcified and noncalcified pulmonary micronodules unchanged.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes are not significantly changed.CHEST WALL: There is no evidence of axillary, subpectoral, cardiophrenic or retrocrural lymphadenopathy on the basis of size criteria.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly and hepatic steatosis unchanged. The degree of hepatic steatosis limits the sensitivity to detect hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Left paraaortic reference lymph node now measures 1.0 x 1.6 cm (image 14, series 3), previously 1.0 x 1.7 cm. Additional scattered retroperitoneal lymph nodes do not appear significantly changed in size from the prior exam.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: There is no evidence of pelvic lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There are degenerative changes of the pubic symphysis. Multilevel degenerative changes of the thoracolumbar spine are again identified. | 1.Stable small retroperitoneal lymph nodes without new lymphadenopathy identified. 2.Hepatomegaly and hepatic steatosis unchanged. |
Generate impression based on findings. | Dropped heavy object on toe; has ecchymosis and pain proximal digitVIEWS: Right foot AP, right great toe oblique and lateral There is a Salter II fracture at the base of the distal phalanx of the great toe with associated soft tissue swelling. The remainder of the examination is normal. | Acute Salter II fracture at the base of the distal phalanx of the great toe. |
Generate impression based on findings. | 70 year-old woman with history of right shoulder pain. Hardware components of a reversed right shoulder arthroplasty device are seen in near anatomic alignment. There is no evidence of complication or periprosthetic fracture. | Reversed right shoulder arthroplasty device without acute fracture or complication. |
Generate impression based on findings. | 10-year-old female with history of T. lymphoblastic lymphoma. Evaluate for progression. There is residual soft tissue density within the anterior mediastinum which is better depicted on same day chest CT. There is no evidence of cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The airway is intact. The visualized intracranial structures are unremarkable. There is an incompletely imaged right chest port with tip extending outside the field-of-view. The visualized lung apices are normal. | No evidence of metastatic disease in the neck. Residual soft tissue density within the anterior mediastinum is better depicted on same day chest CT. |
Generate impression based on findings. | TachypneaVIEW: Chest AP 1/5/15 Cardiothymic silhouette normal. Patchy atelectasis in the perihilar region and left lower lobe. Minimal amount of fluid in the minor fissure. No pleural effusion or pneumothorax. | Minimal patchy atelectasis bilaterally without infection. |
Generate impression based on findings. | FractureVIEWS: Right wrist AP and lateral There is a healing buckle fracture involving the metaphysis of the distal radius with associated soft tissue swelling and in anatomic alignment. The distal ulna is normal. | Healing buckle fracture distal radius as described above. |
Generate impression based on findings. | FractureVIEWS: Right wrist AP and lateral Healing buckle fractures involving the distal radius and ulna are in anatomic alignment. The overlying cast obscures fine bony detail. | Healing buckle fractures distal forearm as described above. |
Generate impression based on findings. | 29-year-old female with palpable right breast lump. History of breast cancer in the patient's grandmother. MAMMOGRAM: Three standard views of both breasts as well as CC and mediolateral spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. A skin marker identifies the site of the patient's palpable abnormality in the right upper outer breast. No underlying mass lesion is evident. Spot compression views show dispersion of normal glandular tissue. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the right axilla.ULTRASOUND: Targeted ultrasound of the right breast was performed at the site of the patient's palpable abnormality. Physical exam demonstrated a soft, mobile, palpable lump in the 10 o'clock radian of the right breast 3 cm from the nipple. Ultrasound of this area showed a focal fat lobule without increased vascular flow. No suspicious mass lesion is present. | Focal fatty lobule corresponding to the site of the patient's palpable abnormality in the right upper outer breast. No mammographic or sonographic evidence of malignancy. Palpable lump should be managed clinically. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended to begin annually once the patient reaches 40 years of age. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 74 years old; Reason: 73 M with metastatic colon cancer, please evaluate for interval change. CHEST:LUNGS AND PLEURA: Visualized lungs without significant change including micronodules, calcified perifissural right middle lobe granuloma and emphysematous disease.MEDIASTINUM AND HILA: Again visualized calcified lymph nodes likely reflecting sequela from prior granulomatous disease.CHEST WALL: Right chest wall port with tip of catheter in distal SVC.ABDOMEN:LIVER, BILIARY TRACT: Decreased hepatic attenuation, may reflect underlying hepatic steatosis, decreasing conspicuity of focal lesions.Multiple enlarging and new bilobar metastatic lesions, with representative lesions as follows:Reference segment 8 lesion measures 2.9 x 2.2 cm, image 90 series 3, previously measured 2.3 x 1.9 cm.Reference segment 7 lesion measures 2.4 x 1.8 cm, image 97 series 3, previously measured 1.9 x 1.8 cm.New lesions also visualized, for example, near hepatic dome, image 83 series 3. Hepatic segment 2/3 lesion measuring 1.9 x 1.5 cm seen in region of left hepatic vein, image 93 series 3, and associated mass effect not entirely excluded. Portal veins patent. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral hypoattenuating lesions in kidneys, without significant change. Dominant 1.9 cm focus in left kidney measures simple fluid, compatible with a cyst, image 127 series 3, majority of lesions too small to characterize.RETROPERITONEUM, LYMPH NODES: Subcentimeter gastrohepatic and upper abdominal lymph nodes. Atherosclerotic abdominal aorta with mural thrombus seen involving infrarenal abdominal aorta and in proximal right common iliac artery, which is ectatic, appearance stable.BOWEL, MESENTERY: Scattered colonic diverticula. Relative underdistention of transverse colon, evaluation of wall thickening suboptimal.PELVIS:PROSTATE, SEMINAL VESICLES: Heterogeneous enlarged prostate gland with relative hypertrophy of median lobe, likely reflecting underlying benign prostatic hypertrophy. BLADDER: Collapsed bladder, making evaluation suboptimal. LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. Multilevel degenerative changes of spine. | 1. Enlarging and new hepatic metastatic lesions.2. Heterogeneous enlarged prostate gland with relative hypertrophy of median lobe, likely due in part to underlying benign prostatic hypertrophy. Additionally, correlation with patient's clinical history and PSA values recommended. |
Generate impression based on findings. | Evaluate position of the chest tubesVIEWS: Chest AP and lateral 1/5/15 ET tube, NG tube and left PICC again noted. There are two right chest tubes with one of the tips anteriorly and the other posteriorly. The moderate size right pneumothorax is unchanged. Patchy atelectasis in the lingula. Cardiothymic silhouette normal. Marked body wall edema. | Right chest tubes with one of the tips anteriorly and the other posteriorly. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast carcinoma in mother diagnosed at the age of 50 and maternal niece diagnosed at the age of 55. Three standard digital views of both breasts and a cleavage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Subcentimeter benign masses and calcifications in both breasts are stable. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable bilateral masses and calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Male 76 years old Reason: concern for lower GI bleed, eval for possible IR embolism History: large bloody bowel movements ANGIOGRAM: There is abnormal enhancement in the region of the cecum (image 72, series 6), but no active extravasation is identified. The celiac axis demonstrates conventional anatomy. There is good peripheral contrast opacification consistent with appropriate blood flow. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypoattenuating lesions is consistent with simple renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Abnormal enhancement in the region of the cecum, but no active extravasation identified. A tagged RBC scan can be considered as clinically indicated as it is a more sensitive examination. No definite bleeding vessel identified. |
Generate impression based on findings. | Reason: s/p 28 cycles of tx for metastatic thyroid ca History: thyroid cancer CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary nodules. No significant change in size or number since the prior exam.Reference right middle lobe nodule (image 51 series 5) is stable measuring 6 mm.Reference left lower lobe nodule (image 39 series 5) is stable measuring 7 mm.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Postsurgical changes in the right breast.Degenerative changes throughout the thoracic spine compatible with DISH.Hemangioma in the T7 vertebrae with anterior wedging unchanged.Expansile lucency involving right 1st sternocostal joint is unchanged (image 13/136) versus recent previous but was not present on more remote studies. This is nonspecific but could be secondary to metastatic disease, post XRT or surgery or degenerative in nature. Continued follow up is recommended. ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cysts unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Stable pulmonary nodules. 2. Abnormality involving right 1st sternocostal joint as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in mother diagnosed at age 76 and sister diagnosed at age 60. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Left chest GSW, known T7-T8 fracture, eval for progression/changeVIEWS: Thoracic spine AP and lateral The patient is known to have T7/T8 fractures in these fractures are not clearly visualized in this exam. The alignment of the thoracic spine appears anatomic. | Alignment of the thoracic spine appears anatomic and the previously described fractures are not clearly identified in this exam. |
Generate impression based on findings. | 54 year old female with chronic breast pain presents for screening mammogram. History of benign biopsies. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Round markers have been placed on multiple skin lesions bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 68 year old female with a history of left breast grade 3 IDC status post modified radical left mastectomy in February of 2007. History of right breast reduction. No current breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: bilateral pulmonary nodules, pt with history of breast and colon cancers History: back pain, palpable lumps in mid back subcutaneous tissue LUNGS AND PLEURA: Nonspecific bilateral subcentimeter groundglass pulmonary nodules are unchanged with the reference nodule in the left lower lobe measuring 5 mm on image 64/101. Punctate calcified granuloma at right base.MEDIASTINUM AND HILA: Dual lead pacemaker.CHEST WALL: Status post bilateral breast reconstruction. The left sided prosthesis appears to have two separate components. Correlate with surgical history and dedicated breast imaging.Hemangioma in T11. Right sided dual lead pacemaker.Small lipoma in subcutaneous tissues of left back near T5-6.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Right renal cyst only partially visualized. Status post cholecystectomy with trace biliary ductal dilatation. | 1. Stable small subcentimeter subsolid pulmonary nodules. These are nonspecific but not necessarily metastatic as inflammatory nodules can appear similarly.2. Small lipoma in subcutaneous tissues of left back near T5-6. |
Generate impression based on findings. | 69-year-old male with persistent left hip pain, new since the surgery Lumbar spine: Severe degenerative disease affects L5/S1. Additional anterior osteophytes are noted along the lower thoracic and lumbar spine. Mild loss of height of the L1 vertebral body appears similar to the prior exam.Pelvis and hip: Alignment is within normal limits. No fracture is visualized. Mild degenerative changes affect each hip. | Degenerative arthritic changes as detailed above. |
Generate impression based on findings. | 83-year-old with history of left breast carcinoma status post mastectomy in 1992 followed by chemotherapy. No current breast related complaints. Three standard views of the right breast along with a repeat MLO view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Note is made of stable benign calcifications. Benign appearing lymph nodes are projected over the right axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 56 years old; Reason: hx nec pancreatitis with worsening lactic acid level concerning bowel necrosis vs worsening sepsis History: blood in FMS rising lactic acid level increases wbc ABDOMEN:LUNG BASES: Bibasilar atelectasis/consolidation. Small bilateral pleural effusions.LIVER, BILIARY TRACT: Liver is normal in morphology. Persistent gas within the gallbladder.The hepatic and portal veins are patent.SPLEEN: Small areas of non-enhancement in the spleen likely represent small infarctions.PANCREAS: The pancreas is necrotic. The collection in the pancreatic bed measures 20 x 7 cm (image 98/series 3) previously, 21 x 6.4 cm.A new drain has been placed in the collection.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Heterogeneous enhancement of the kidneys. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Right retroperitoneal fluid collection is drained by a catheter is also decreased in size.BOWEL, MESENTERY: Diffuse thickening and hyperenhancement of the small bowel. The transverse colon has a thickened enhancing wall with extensive wall edema about the hepatic flexure. There are pockets of gas in the mesentery which may be from the drain placement however, bowel perforation is not excluded.BONES, SOFT TISSUES: Diffuse body wall anasarcaOTHER: Diffuse pockets of fluid within the upper abdomen and pelvis.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Abnormal wall thickening of the colon and small bowel.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Pelvic fluid collection now contains increasing pockets of gas.Right common femoral venous deep venous thrombosis. | 1.Abnormal CT with extensive bowel wall thickening especially of the transverse colon near the hepatic flexure. Ischemia of the small bowel and colon are not excluded.2.New increasing pockets of gas within the pelvis may represent changes from recent catheter placement however, bowel perforation is not excluded.3.Persistent gas within the gallbladder.4.Pockets of gas within the abdominal pelvic collections may be postprocedural however, infection is not excluded. |
Generate impression based on findings. | 50 year-old female with pain in left foot and ankle There is moderate diffuse soft tissue swelling about the ankle. No fracture is visualized. Note is made of an os trigonum and os peroneum. A small calcaneal spur is present. No foot fracture or malalignment. | Soft tissue swelling about the ankle without fracture evident. |
Generate impression based on findings. | 47-year-old male with right wrist pain There is mild narrowing of the radiocarpal joint. Coalition of the capitate and hamate is again noted. No acute fracture or malalignment. | Osteoarthritic changes and coalition of the capitate and hamate appearing similar to the prior exam. |
Generate impression based on findings. | 39 year-old female, assess for middle phalanx fracture instability There is an oblique fracture of the mid diaphysis of the middle phalanx of the index finger with approximate 5 mm impaction and mild volar angulation of the distal fragment | Middle phalanx fracture as described above. |
Generate impression based on findings. | 21-year-old male with pain and prosthesis, evaluate left hand and index finger Hand: Alignment is anatomic. No fracture or other specific abnormality is noted to account for the patient's symptoms.Left ankle: A plate and screws affix the distal fibula in near-anatomic alignment without evidence of hardware complication. | 1. No specific findings to account for the patient's hand pain.2. Distal fibula fracture fixation without evidence of complication. |
Generate impression based on findings. | 46-year-old female with right hip pain Alignment of the right hip is normal limits. There is mild to prominence of the femoral head- neck junction. A lucency with sclerotic margins at the femoral head-neck junction is consistent with a synovial cyst. An IUD is noted in the uterus. | Synovial cyst and mild prominence of the head, neck junction, which has been associated with femoral acetabular impingement. |
Generate impression based on findings. | 34-year-old male with left knee pain Alignment is within normal limits. No fracture or other specific findings to account for patient's pain. | No specific findings to account for the patient's left knee pain. |
Generate impression based on findings. | 80 year-old female with elbow pain Interval removal of cast. There is deformity of the medial and lateral condyles and a transcondylar fracture line which is indistinct indicating some interval healing. | Healing medial and lateral condylar fracture as detailed above. |
Generate impression based on findings. | DesaturationVIEW: Chest AP 1/5/15 ET tube tip immediately above the carina. NG tube tip in the stomach. Right upper extremity PICC with tip in the right subclavian vein. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally increased from prior study. No pleural effusion or pneumothorax. | Diffuse atelectasis bilaterally increased from prior study. |
Generate impression based on findings. | 54-year-old man with history of multiple myeloma, evaluate for myelomatous lesions. SKULL: There are no discrete myelomatous deposits. Multiple dental fillings are noted.CERVICAL SPINE: There are no discrete myelomatous deposits. Mild degenerative disc disease affects the lower cervical spine. Cervical spine alignment is within normal limits.THORACIC SPINE: There are no discrete myelomatous deposits. LUMBAR SPINE: There are no discrete myelomatous deposits. Small anterior osteophytes are seen along the L2, L3, and L4 vertebral bodies with disc space narrowing at L1/L2 and L2/L3 indicating mild degenerative disc disease. Lumbar spine alignment is within normal limits.RIBS: No discrete myelomatous deposits. A right-sided port catheter is noted.PELVIS: No discrete myelomatous deposits. Mild osteoarthritis affects the hips bilaterally.UPPER EXTREMITIES: There are no discrete myelomatous deposits.LOWER EXTREMITIES: There are no discrete myelomatous deposits. Two round, well marginated lesions of the left femoral neck with sclerotic margins likely represent synovial herniation pits and are unchanged from the prior examination. Mild osteoarthritis affects the knees bilaterally. | No discrete myelomatous lesions or significant interval change from the prior examination. |
Generate impression based on findings. | FractureVIEWS: Left foot AP and lateral There is a healing fracture involving the base of the first metatarsal. There is sclerosis reflecting interval healing. Alignment is anatomic. | Healing fracture involving the base of the first metatarsal. |
Generate impression based on findings. | FractureVIEWS: Right knee AP, oblique and lateral Cast has been removed in the interval. The two screws in the distal femur are again visualized. Alignment remains anatomic. Minimal periosteal reaction along the distal femur. | Healing distal femur fracture as described above. |
Generate impression based on findings. | Reason: 50F with AIH, cirrhosis undergoing tx w/u; liver MRI with dysplastic nodule; ? mets History: none Focus of increased activity in the anterolateral right fifth rib is likely post-traumatic. No other abnormal foci of activity seen. | Probable post-traumatic increased focus of activity in the anterolateral fifth rib. No definite evidence of metastatic disease. |
Generate impression based on findings. | Reason: eval for PE History: cp, elevated dimer PULMONARY ARTERIES: No significant abnormality noted.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | History of olfactory neuroblastoma. There are postsurgical changes within the right ethmoid sinus from prior sinonasal tumor resection. There is persistent moderate mucosal thickening of the right maxillary sinus. There is mucosal thickening of the remaining paranasal sinuses with increased mucosal thickening of the left maxillary sinus with questionable air-fluid levels. There is enhancing soft tissue along the right anterior cranial fossa along the defect in the region of the right fovea ethmoidale, which appears to have decreased in size slightly over the course of approximately one year, given differences in modality. There is no significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The airways are patent. There are mild cervical degenerative changes. The imaged portions of the lungs are clear. | 1. Postsurgical findings related to sinonasal tumor resection without definite sinonasal mass lesion.2. A small amount of enhancing soft tissue along the right anterior cranial fossa appears to have slightly decreased in size and is likely treatment related. Please also refer to concurrent MRI report for additional details. 3. Persistent mucosal thickening of the right maxillary sinus. Increased mucosal thickening of the left maxillary sinus with an air-fluid level may represent acute sinusitis in the appropriate clinical setting.4. No significant cervical lymphadenopathy by CT size criteria. |
Generate impression based on findings. | FractureVIEWS: Left humerus AP and lateral There is a healing proximal humeral fracture with posterior and medial angulation. There is periosteal reaction reflecting interval healing. | Healing humeral fracture as described above. |
Generate impression based on findings. | 54-year-old male status post Dobbhoff tube placement. Note that the pelvis was not included in the exam. Nonobstructive bowel gas pattern. The Dobbhoff tube tip is within a right inferior bronchus. | The Dobbhoff tube tip is within a right inferior bronchus. Results were discussed with Dr. Vanessa Alonso of the primary service by Dr. Josh Finkle of the Radiology service at 11:44 am on 1/5/14. |
Generate impression based on findings. | Reason: h/o olfactory neuroblastoma and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged since 2012 and likely benign. No evidence of pulmonary metastases.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Interval removal of port catheter.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypodensity in right lobe of liver is too small to characterize but stable and presumably benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Very small hyperdensities noted in the kidneys are presumably early contrast excretion rather than nonobstructive stones.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | 23-year-old man with history of scaphoid fracture. There has been interval fixation of a transversely oriented scaphoid fracture with a cannulated, headless screw. The fracture line is indistinct, alignment is near anatomic, and there is no evidence of nonunion. There is no evidence of hardware complication. | Orthopedic fixation of scaphoid fracture without evidence of complication or nonunion. |
Generate impression based on findings. | There are no fractures. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. There is no abnormal enhancement.Please see CT abdomen/pelvis dictation from 12/6/2014 for discussion of abdominal contents.Disc desiccation is present at L3/4 L4/5, and L5/S1. Mild disc height loss is noted at L3/4 and L5/S1 with severe disc right loss at L4/5. A prominent Schmorl's node is present involving the posterior aspect of the S1 superior endplate.Trace retrolisthesis is noted of L4 on L5 with trace anterolisthesis of L5 on S1.T12/L1: UnremarkableL1/2: UnremarkableL2/3: UnremarkableL3/4: Mild disc bulge without stenosisL4/5: There is a broad-based central to left paracentral disc extrusion which extends below the disc level causing mild central, mild to moderate left lateral recess, and mild right lateral recess stenosis. There is also superimposed diffuse annular disc. There is no significant neural foraminal stenosis.L5/S1: Central disc protrusion which abuts bilateral S1 nerve root sheath origins without flattening or displacement. | 1.L4/5: There is a broad-based central to left paracentral disc extrusion which extends below the disc level causing mild central, mild to moderate left lateral recess, and mild right lateral recess stenosis.2.L5/S1: Central disc protrusion which abuts bilateral S1 nerve root sheath origins without flattening or displacement. |
Generate impression based on findings. | Male 72 years old; Reason: eval for progression History: prostate cancer, rising PSA CHEST:LUNGS AND PLEURA: Left basal bronchiectasis. Subcentimeter pulmonary micronodules are nonspecific.MEDIASTINUM AND HILA: Severe coronary artery calcification. Moderate thoracic aorta and branch vessel arteriosclerosis. Subcentimeter mediastinal and hilar lymph nodes, some of which are calcified, suggestive of prior granulomatous process.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable appearance of two right adrenal fat attenuation lesions consistent with myelolipomas. The largest measures 5.3 x 4.9 cm (series 3, image 87). Stable appearance of fat-containing left adrenal lesion, previously characterized as a benign adenoma.KIDNEYS, URETERS: Complex cystic lesion in the right upper pole with thick hyperdense mural nodules and most compatible with renal cell carcinoma. This is stable in size and measures 3.3 x 3.2 cm (series 3, image 94), previously 3.3 x 3.2 cm.Additional smaller indeterminate attenuation lesions in the bilateral kidneys are too small characterize. These may represent additional renal cell carcinomas versus complex cysts. Overall the appearance of these is not significantly changed compared to prior study.RETROPERITONEUM, LYMPH NODES: Moderate calcific arteriosclerosis of the abdominal aorta and branch vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Abnormal soft tissue no arising in the right rectus musculature. This is of unclear etiology but demonstrates an increase in findings. It measures 3.0 x 2.0 cm (series 3, image 175). Extensive osseous metastatic disease throughout the bones of the chest, abdomen and pelvis. Nuclear medicine bone study is more sensitive for assessment of disease extent and activity.OTHER: Incompletely imaged fluid in the perineal region likely relating to dependent fluid within a hydrocele. | 1.Stable appearance of right superior pole renal mass consistent with renal cell carcinoma. Additional indeterminate attenuation lesions in both kidneys may reflect smaller renal cell carcinomas versus complex cysts. These are unchanged compared to prior study.2.Extensive sclerotic osseous metastatic disease. Nuclear medicine bone scan is more sensitive for assessment of disease extent and activity.3.Right adrenal myolipomas and left adrenal adenoma are unchanged.4.Right rectus muscle nodule is of unclear etiology but demonstrates an interval increase in size compared to prior studies. |
Generate impression based on findings. | 71 year-old female who is status post stent-assisted coiling of a right posterior communicating artery aneurysm. History of lung cancer. 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.The patient is status post embolic coil occlusion of a right posterior communicating artery aneurysm. The right to posterior communicating artery is not clearly identified. There is a small remnant at the neck of the aneurysm measuring approximately 2 mm in size. This remnant was present on previous exams as well. A stent is identified coursing from the right supraclinoid internal carotid artery into the midportion of the right middle cerebral artery. Please note that the signal within the right internal carotid artery and right middle cerebral artery is diminished .There is a left posterior communicating artery aneurysm present measuring 4 mm x3.5mm in axial dimensions which is unchanged since the prior exam . This aneurysm is lobulated and directed posteriorly and medially. The left thalamotuberal artery appears to originate from the medial aspect of this aneurysm dome. Adjacent to this aneurysm is a second posterior communicating artery aneurysm measuring 3 mm in diameter directed laterally and inferiorly which is proximal to the left anterior choroidal artery. This aneurysm is also stable. These two small aneurysms can be considered as one since they are adjacent to each other.Along the left P1 segment there is a small forme fruste aneurysm present measuring 1 mm in size. It is located approximately 6 mm from the origin of the left posterior cerebral artery. It is directed posteriorly.There is a 2-mm aneurysm along the horizontal portion of the right internal carotid artery directed inferiorly.The anterior communicating artery is identified and is medium size. The right posterior communicating artery is relatively small but can be identified. The left posterior cerebral artery has fetal origin. The vertebral arteries are similar in size. | 1.Status post stent-assisted coiling of right posterior communicating artery are somewhat small remnant which is stable. Signal within the distal right internal carotid artery and proximal right middle cerebral artery is diminished probably related to artifact from the stent. 2.Left posterior communicating artery double aneurysm complex as described above which is also stable since the previous exam. The combined diameter is between the two components is 7 mm although this could be considered to be two adjacent aneurysms measuring 4 mm and 3 mm each . The left thalamotuberal artery appears to originate from the more proximal aneurysm.3.Small forme fruste aneurysm measuring 1 mm in size off the left posterior cerebral artery. This may be associated with a perforating artery.4.Small right cavernous segment 2-mm wide neck aneurysm. This is stable since the prior scan |
Generate impression based on findings. | Female, 56 years old. Status post abdominal hysterectomy. Study performed due to elevated BMI. No suspicion for retained foreign object. Nasoenteric tube is incompletely imaged. Surgical clip projected over the left femoral neck. No evidence of retained foreign object. Bowel gas pattern within normal limits. | No evidence of retained radiopaque foreign object. Discussed by myself Dr. Ward with Dr. Tenney at ext 69414 01/05/15 12:20 p.m.. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of endometrial cancer diagnosed at age 55. History of breast cancer in paternal aunt diagnosed at age 55. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Stable focal asymmetry is present in the right upper outer quadrant. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable right focal asymmetry. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. History of breast cancer in mother diagnosed in her 80s and maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying both breasts. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Metastatic thyroid cancer. Neck: There are postoperative findings related to thyroidectomy and left vocal cord augmentation prosthesis insertion. There is interval increase in size of a heterogeneous infiltrative mass anterior to the left internal jugular vein at the level of the thyroidectomy bed, now measuring 27 x 26 mm, previously 23 x 21 mm, with invasion of the esophagus. There is interval increase in size of the upper left thyroidectomy bed lesion, which measures 23 x 20 mm, previously 22 x 20 mm. There is interval increase in size of a heterogeneously enhancing mass inferior to left thyroidectomy bed, extending into the superior mediastinum, which now measures 54 x 41 mm, previously 48 x 46 mm, with partial encasement of the left proximal common carotid artery, resulting in mild stenosis. There is interval increase in size of a hyperattenuating mass in the midline subcutaneous tissues anterior and superior to the manubrium, which measures 26 x 21 mm, previously 22 x 19 mm. There is interval increase in size of the soft tissue mass anterior to the prosthesis, which now measures 23 x 20 mm in thickness, previously 22 x 19 mm. The partially imaged upper mediastinal lymphadenopathy appears to also have increased in size. The airways are patent. The salivary glands appear unchanged. There is unchanged mild multilevel degenerative spondylosis. There are a few micronodules within the partially imaged lungs.Head: There is no evidence of intracranial mass or abnormal intracranial enhancement. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is mild scattered paranasal sinus opacification. There is a left frontal sinus osteoma. The mastoid air cells are clear. The skull appears unremarkable. | 1. Slight overall interval progression of extensive neck and partially imaged mediastinal tumors.2. No evidence of intracranial metastases, although CT is less sensitive than MRI for the detection of metastases. |
Generate impression based on findings. | Male 68 years old; Reason: Pt is a 68 y/o male with metastatic melanoma, evaluate for progression History: Metastatic melanoma CHEST:LUNGS AND PLEURA: MEDIASTINUM AND HILA: Enlarging right hilar lymph node, measuring 2.6 x 2.4 cm, image 53 series 3, associated luminal narrowing of adjacent right pulmonary arterial segments seen. Left paraesophageal lymph node, mildly more prominent, measuring 6 x 5 mm on image 75 series 3, previously measured 5 x 4 mm. Mild to moderate calcified coronary artery disease.CHEST WALL: Left-sided mastectomy, left-sided chest wall and axillary surgical clips, right axillary surgical clips. Rim enhancing walled lesion in left chest/axillary area, may represent postoperative seroma, structure measures 1.9 x 1.1 cm, image 54 series 3, given differences in technique, no significant change.ABDOMEN:LIVER, BILIARY TRACT: Stable hypoattenuating hepatic lesions, larger of which measure simple fluid compatible with cysts.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: Aortobiiliac atherosclerotic disease. Minimal interval decrease in size of reference left paraaortic lymph node, measuring 1.9 x 1.3 cm, image 136 series 3, previously measured 1.9 x 1.6 cm.BOWEL, MESENTERY: Left-sided colon diverticulosis. Proximal ascending colonic area of thickening versus underdistention, measuring 4 cm in length, coronal image 84.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate gland, measuring 5.4 cm, containing coarse calcifications.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. Multilevel degenerative changes of spine. Fat containing right inguinal hernia. | 1. Enlarging right hilar adenopathy. 2. Stable to minimal interval decrease in size of reference left paraaortic lymph node. |
Generate impression based on findings. | 10 years old Female with a history of t-lymphoblastic lymphoma s/p induction therapy. This study was performed for restaging RADIOPHARMACEUTICAL: 2.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 52 mg/dL. Today's CT portion grossly demonstrates interval resolution of the right pleural effusion and pericardial effusion. There is interval decrease of the anterior mediastinal mass. The tip of the Port-A-Cath is in the right atrium.Today's PET examination demonstrates interval near complete resolution of FDG avid tumor in the anterior mediastinal regions. There is interval resolution of the tumor in the right upper and lower lobe pleura. However, minimally and metabolically active tumor is present on the periphery of the resolving anterior mediastinal mass with SUVmax of 0.92 (it was 1.2 on prior study).Brown fat activity is noted in the pericardial fat and in the upper abdomen, which may limit the evaluation the tumor activity. Extensive muscle activity is also noted in the chest, abdomen and lower extremities.No evidence of FDG avid tumor is identified. Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Interval near complete resolution of FDG avid tumor in the chest. Minimal FDG avid tumor is present in the right anterior mediastinum.2.No evidence of new FDG avid tumor. |
Generate impression based on findings. | Male 50 years old; Reason: evaluate for acute abdominal infection History: abdominal pain, ALL, fever ABDOMEN:LUNGS BASES: Small bibasilar atelectasis.LIVER, BILIARY TRACT: Hypoattenuated appearance of liver likely reflecting underlying hepatic steatosis/parenchymal dysfunction. Small periportal edema. Patent portal veins, patent splenic vein and SMV.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Heterogeneous renal parenchymal enhancement with suggestion of striated nephrograms. No radiopaque obstructing calculus seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderate to marked thickening with underlying mucosal enhancement of proximal colon, primarily the ascending colon, hepatic flexure and proximal third of transverse colon. Involvement of distal ileum also seen, measuring approximately 12 cm in length. Mild prominence of small bowel proximally, measuring up to 2 cm in fluid containing. Sigmoid colon diverticulosis without evidence of acute diverticulitis. PELVIS:PROSTATE/SEMINAL VESICLES: Prostate gland measures 4.7 cm. Prostatic calcifications. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes of spine. | 1. Findings compatible with acute enterocolitis as described, etiology may be postinfectious or inflammatory, ischemic etiology not entirely excluded. 2. Heterogeneous renal parenchymal enhancement with suggestion of striated nephrograms, appearance suspicious for bilateral pyelonephritis. Correlation with patient's clinical history and urinalysis recommended.3. Hepatic steatosis. |
Generate impression based on findings. | Male 59 years old; Reason: eval liver lesions S/P TACE/RFA 12/10/14 History: HCC, cirrhosis ABDOMEN:LUNG BASES: Unchanged bilateral pulmonary nodules.LIVER, BILIARY TRACT: Segment 8 hypodense mildly heterogenous ablation zone measures 4.3 x 4.1 cm with a rim of hyperdensity on noncontrast scan, and no demonstrable abnormal enhancement. No other suspicious focal hepatic lesions are seen. Cirrhotic liver morphology. Replaced right hepatic artery from the SMA. Cholelithiasis. Recannulized umbilical vein. Splenorenal collaterals.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: No significant abnormality noted.BONES, SOFT TISSUES: Non-FDG avid lucent lesion with sclerotic rim in the L2 vertebral body, stable.OTHER: No significant abnormality noted. | 1.Segment 8 ablation cavity as described above without suspicious features. No new hepatic lesions. Cirrhosis with portal hypertension.2.Unchanged bilateral pulmonary nodules, nonspecific. |
Generate impression based on findings. | Supine evaluation. Multiple myeloma Baseline exam SKULL: No significant abnormality noted.CERVICAL SPINE: No significant abnormality noted.THORACIC SPINE: Questionable minimal wedge deformity of what appears to be T7. Mild scattered degenerative changes in midthoracic spine with relative sparing both proximally and distally. No specific discrete focal lesions to suggest myelomatous involvement, however axial imaging however may increase sensitivity LUMBAR SPINE: Mild osteoarthritis of the upper lumbar spineRIBS: No significant abnormality noted.PELVIS: Enthesopathies without additional radiographic abnormalityUPPER EXTREMITY: Focal cortical thickening and deformity involving the proximal left humeral diaphysis without a discrete well-differentiated lytic lesion. Comparison with prior imaging would be helpful if available and comparison with prior potential history of a old healed fracture or cortical defect.LOWER EXTREMITY: No significant abnormality noted. | No definite superimposed focal changes to suggest myeloma. Minimal mid thoracic degenerative changes and focal solitary deformity of the proximal left femur. This latter finding is nonspecific and not characteristic of a myelomatous lesion, however with the absence of a historical old injury, a myelomatous lesion cannot entirely be excluded |
Generate impression based on findings. | CoughVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Female 65 years old; Reason: Metastatic cholangiocarcinoma please compare to previous scan and provide index lesion measurements for RECIST CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall port with tip near cavoatrial junction. Previously seen clot alongside catheter are no longer visualized.ABDOMEN:LIVER, BILIARY TRACT: Scattered hypoattenuating liver lesions without significant change. Peripherally enhancing heterogeneous mass in inferior right liver lobe, image 108 series 3, demonstrates stable to minimal interval decrease in size, measuring 7.9 x 4.1 cm, image 108 series 3, previously measured 7.7 x 4.6 cm, lesion demonstrates progressive "fill in" on delayed imaging. Bilateral biliary stents in place without significant biliary dilatation, tips seen in region of duodenum, small pneumobilia.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: Large stool burden. No bowel obstruction.PELVIS:UTERUS, ADNEXA: Presumed hysterectomy. Stable right adnexal/presacral hypoattenuating lesion, measuring 5 x 4.3 cm, image 165 series 3.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. Multilevel degenerative changes of spine, intervertebral disk space narrowing most pronounced at L2/3 level. Grade 1 anterolisthesis of L4 on L5, stable. | Stable to mild interval decrease in size of reference mass in liver as above.Stable presacral/adnexal lesion.Large stool burden, no bowel obstruction, correlate clinically for history of constipation. |
Generate impression based on findings. | PainVIEWS: Left knee AP, oblique and lateral No acute fracture or dislocation. No knee joint effusion. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of basal cell carcinoma. Two standard digital views of both breasts and an additional left MLO view were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying the right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Pain Right total leg evaluation demonstrates two degrees of valgus angulation with underlying moderate degenerative of the knee. More mild osteoarthritic changes of the hip and ankle otherwise observed | Right knee osteoarthritis with minimal valgus deformity |
Generate impression based on findings. | Foot pain evaluate for foreign bodyVIEWS: Right foot AP, oblique and lateral There is a linear radiopaque density measuring approximately 7 mm in the subcutaneous tissue at the plantar aspect of the calcaneus. No acute fracture or dislocation. | Radiopaque foreign body in the subcutaneous tissue at the plantar aspect of the calcaneus. |
Generate impression based on findings. | The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. Myelination pattern is mature. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The mastoid air cells are clear. | Negative noncontrast brain MRI. Specifically, there are no MRI findings to explain the patient's symptomatology. |
Generate impression based on findings. | 68 years old male with metastatic melanoma, s/p 4 cycles of Ipilimumab. Please assess response to therapy and compare to previous stdudy. RADIOPHARMACEUTICAL: 14.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 109 mg/dL. Today's CT portion grossly again demonstrates surgical clips in both axillae and postsurgical changes of the left anterolateral chest wall. Enlarged right hilar lymph node, similar to prior study. Hypoattenuating lesions in the liver likely represent cysts which is stable. Enlarged left periaortic lymph node, not significantly changed compared to prior study. Extensive calcifications are seen in the coronary arteries.Today's PET examination demonstrates interval increase in size and metabolic activity of the right hilar lymph node with SUV Max of 15.2 (it was 10.9). Small right paratracheal lymph node with mildly increased activity with SUV Max of 2.8 (it was 2.3 on prior study) is stable. There is a minimal FDG uptake in a small retroperitoneal lymph node, which is consistent with posttherapy change.Two new tiny foci of mildly increased activity are noted in the floor of the pelvis on the right side with SUV Max of 2.6 in the posterior focus and 2.5 in anterior focus. There is no definite CT correlation for these findings.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Interval increased metabolic activity in the right hilar and mediastinal lymph nodes.2.Two new nonspecific foci of increased activity in the floor of the pelvis. |
Generate impression based on findings. | Pain fallVIEWS: Right foot AP, oblique and lateral There are acute fractures involving the second, third and fourth metatarsals necks visualized in the oblique radiograph. There is associated soft tissue swelling at the dorsal aspect of the foot. | Acute fractures second through fourth metatarsals as described above. |
Generate impression based on findings. | Pain Ankle: Small minimal chip deformity again representing a dorsal navicular fracture, currently less well visualized , representing continued interval healing. Alignment preservedFoot: No additional radiographic abnormality | Healing navicular fracture |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her maternal grandmother. Two standard digital views of both breasts and an additional left MLO view, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable bilateral calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the perihilar region and right lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her mother at age 55. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Left chest port in place. Cardiothymic silhouette normal. Minimal patchy atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis bilaterally without infection. |
Generate impression based on findings. | Pain Knee: Right total knee arthroplasty appears unchanged with severe degenerative changes largely involving the medial compartment on the left. Joint space narrowing , sclerosis and osteophytes. No discrete effusion.Left leg length study demonstrates 12 degrees of varus angulation. Mild to moderate over ankle degenerative changes incompletely visualized | Severe osteoarthritis of the knee with varus angulation |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of lung carcinoma diagnosed at age 73. Two standard digital views of both breasts, with additional bilateral MLO views, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral axillary sebaceous cysts. Family history of breast carcinoma in her maternal grandmother at age 65. Two standard digital views of both breasts, with additional bilateral CC and MLO views, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered benign calcifications are present. There is redemonstration of circumscribed right breast masses, unchanged. Additionally, circumscribed masses are present in both axillary regions, unchanged. Round markers have been placed on cutaneous lesions in both axillary regions.No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable circumscribed right breast masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Prior aspiration.EXAMINATION: Oropharyngeal motility study 1/5/15 Julia Ecclestone, speech and language therapist, supervised the examination.111 seconds of fluoroscopy was used.Liquids were administered via a fast flow nipple. Nectar thick liquids were administered via a fast flow nipple. Stage 2 puree, soft solids, and solids were administered by spoon.Oral deficits included decreased oral control, decreased mastication, positive oral spread and stasis, and positive spillage to the hypopharynx.Pharyngeal deficits included decreased epiglottic deflection and slight nasopharyngeal regurgitation. Trace penetration was observed with thin liquids, which cleared completely with swallow. No aspiration was identified. | Trace penetration without aspiration.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, with additional bilateral MLO and CC views, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | FractureVIEWS: Left great toe AP/lateral (2 views) 1/5/15 A Salter Harris type II fracture extends through the great toe distal phalanx base. No joint malalignment is present. | Great toe distal phalanx Salter Harris type II fracture. |
Generate impression based on findings. | Male 63 years old; Reason: HCC screening History: ETOH cirrhosis s/p TIPS ABDOMEN:LUNG BASES: Unchanged fibrotic changes in the posterior lung bases and right middle lobe dating back to 2011.LIVER, BILIARY TRACT: Status post TIPS, patent.SPLEEN: Splenomegaly, measuring up to 14.5 cm, previously as high as 16.5 cm on 1/29/2015PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic plaque and calcification of the aorta and its branches. Esophageal varices.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Cirrhotic liver morphology with no suspicious focal liver lesion. Patent TIPS. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There continues to be a small mucosal retention cyst or polyp in the left maxillary sinus, with trace scattered mucosal thickening. There is mild mucosal thickening along the floor of the right maxillary sinus which appears similar. The ostiomeatal units are clear.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: There is no interval development of minimally aerated secretions in the medial left sphenoid sinus, although the previous tiny mucosal retention cyst has resolved. The right sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is no significant nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric.Postoperative changes from previous right pterional craniotomy are again noted, relating to partial right temporal lobectomy. There is ex vacuo dilatation of the posterior right lateral ventricle. Mild scattered atherosclerotic calcification is seen along the carotid bifurcations. | Redemonstration of mild scattered sinus inflammatory changes with interval development of minimally aerated secretions in the left sphenoid sinus. Ostiomeatal units remain patent. |
Generate impression based on findings. | AML, fever of unknown origin, and pre SCT work-up. The paranasal sinuses are clear. The nasal cavity is also clear. There is no nasal septal deviation towards the right. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, and orbits appear to be unremarkable. There are partially-imaged postoperative findings in the right occipital region. There is prominence of the partially-imaged ventricular system, which appears to be unchanged. | No evidence of sinusitis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy in 1970. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A linear marker has been placed on a scar overlying the lower central right breast. Round markers were placed on skin lesions overlying both breasts. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Left great toe fracture shoulder pain No significant interval change in the avulsed interarticular base of the first phalanx fracture along the medial margin. Alignment unchanged. Associated deformity of the lateral distal first phalanx is also similar without significant and evidence of interval change or to healingShoulder: Nondisplaced tuberosity comminuted fracture is observed with indistinct fracture edges compatible with subacute timing. | Right tuberosity fracture and unchanged two fractures of the left first toe |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in a paternal aunt at age 60. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Bilateral breast pain. Rule out abscess. Skin over the area of pain is marked by Dr. Jaskowiak. Focused ultrasound is performed for the marked areas.In the left breast, 6 - 8 o'clock position near the nipple is marked. The skin of this area appears red. There is a skin thickening with increased blood flow. Just behind the nipple, there is a hypoechoic lesion measuring 6 x 5 mm, likely an area of cellulitis. Increased blood flow is also present at the retroareolar region. No fluid collection is seen in the left breast.In the right breast, 1 - 3 o'clock position near the nipple is marked. The skin of this area appears red. There is a skin thickening with some hypoechoic area in the skin, associated with increased blood flow. There is no increased blood flow within the breast tissue. No fluid collection is seen in the right breast. | Findings consistent with left breast cellulitis, and skin inflammation of right breast. No evidence of abscess formation. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, and an additional right MLO view, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Left total knee arthroplasty Left total knee arthroplasty appears well aligned with longstem components both proximally and distally. No definite effusion. Minimal heterotopic bone is observed along the medial and lateral aspects, specifically curvilinear focus is observed adjacent to the tibial plateau and possibly old and long-standing. Comparison with prior outside imaging if available would be helpful | Left total knee arthroplasty, see description provided |
Generate impression based on findings. | Postoperative changes are again seen from right parietal temporal craniotomy as well as a left frontal craniectomy. There is extensive streak artifact from scattered aneurysm clips. There are also additional smaller surgical clips in the right temporal occipital region relating to previous AVM resection, with underlying encephalomalacia and ex vacuo dilatation of the right occipital horn. The ventricles overall remain somewhat prominent in size but unchanged. The left frontal temporal extra-axial/extracranial collection has significantly decreased in size, now measuring up to 10 mm in greatest thickness compared to previous 20 mm at its mid section. The hypodense subdural collection along the left frontal parietal convexity is unchanged, again measuring 13 mm in greatest thickness, with mild-moderate mass effect upon the adjacent parenchyma. Midline shift to the right remeasured at 5 mm is also unchanged.There is no intracranial hemorrhage. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | 1. Significant decrease in size of hypodense left frontotemporal extracranial fluid collection.2. Stable left frontal parietal convexity hypodense subdural fluid collection with mild-moderate mass effect.3. Stable minimal midline shift. |
Generate impression based on findings. | Female 73 years old; Reason: 73 year old female with pancreatic neuroendocrine tumor on therapy. Monitor disease response. History: bloating CHEST:LUNGS AND PLEURA: Scattered subcentimeter pulmonary nodules are unchanged.The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Right right cardiophrenic lymph node measures 3.2 x 2.4 cm (image 70/series 7) previously, 3.2 x 2.6 cm.CHEST WALL: Scattered sclerotic foci within the thoracic spine unchanged.ABDOMEN:LIVER, BILIARY TRACT: Large liver lesion straddling the left and right hepatic lobes measures 8.6 x 7.2 cm (image 84/series 7) previously, 7.8 x 5.5 cm. Other hepatic hypodensities are unchanged. The left hepatic vein is occluded. The portal vein remains patent.SPLEEN: No significant abnormality noted.PANCREAS: Stable nonspecific pancreatic hypodensities. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Peripancreatic bilobed mass measures 3.9 x 3.1 cm (image 90/series 7) previously, 3.7 x 3.3 cm.Reference left para-aortic lymph node measures 2.3 x 1.6 cm (image 108/series 7) previously, 2.2 x 1.2 cm.BOWEL, MESENTERY: Small bowel is normal in caliber. The extensive peritoneal and omental carcinomatosis there is extensive upper abdominal and pelvic ascites the volume of which is nearly stable.Right lower abdominal ostomy with enhancement of the wall and thickening suspicious for disease.Large omental mass measures 11.8 x 4.7 cm (image 133/series 7) previously, 13.2 x 5.6 cm.BONES, SOFT TISSUES: Diffuse body wall anasarca.Scattered sclerotic foci in the lumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enhancing soft tissue at the apex of the vagina in the pelvis suspicious for pelvic disease, unchanged subjectively.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scattered pelvic sclerotic foci.OTHER: Pelvic ascites. | 1.Near stable size measurements of the reference lesions. There is slight increase and slight decrease in some of the lesions as detailed above. |
Generate impression based on findings. | 56 year old female with history of shortness of breath and new right pleuritic chest pain. Evaluate for PE versus infection. Additional history of breast cancer. PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Severe emphysema, unchanged. New foci of nodular opacities, right greater than left, with the largest region noted medially at the right lung base with internal areas of necrosis. A small associated right pleural effusion. Scattered pulmonary micronodules, unchanged.MEDIASTINUM AND HILA: No significant cardial effusion. Heterogeneous thyroid, unchanged. Scattered slightly enlarged mediastinal and hilar lymph nodes are again seen.CHEST WALL: Single lumen right chest IJ Port-A-Cath with tip in the SVC.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple hepatic hemangiomas are again seen, similar to prior. Stable right adrenal nodule. | No pulmonary embolus. New foci of nodular opacities, right greater than left, concerning for progression of metastatic disease, although atypical infection cannot be excluded.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, with additional bilateral MLO views, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers have been placed on cutaneous lesions overlying the right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 36 years old Reason: r/o PE, chest pain and history of PE 18mo ago. History: chest pain pleuritic PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Minimal bibasilar atelectasis and nonspecific bronchial wall thickening. No focal consolidation, pleural effusion or pneumothorax.MEDIASTINUM AND HILA: No adenopathy. No pericardial effusion. Scattered foci of air related to power injection. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of PE.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 36 year old with palpable abnormalities in both breasts. Nontender lump in left breast has been present for multiple years. A palpable abnormality in the right breast has been present for one year. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A skin marker overlies right upper inner breast identifying the site of the patient's palpable abnormality. Within the right upper inner inner breast mid-depth there is a partially circumscribed mass. Within the left lower inner breast there is an additional mass with partially obscured and partially circumscribed margins. No suspicious microcalcifications or architectural distortion. ULTRASOUND: Targeted ultrasound was performed of both breasts at the site of the mammographic abnormalities. Within the right breast one o'clock radian 2 cm from the nipple there is a round, solid, near isoechoic mass with macrolobulated margins which measures 2.4 x 1.9 x 2.2 cm. There is mild internal vascularity. Within the left breast 4 o'clock radian 3 cm from the nipple there is an ovoid parallel oriented hypoechoic mass with circumscribed margins and mildly increased through transmission which measures 1.9 x 1.1 x 1.0 cm. This also contains minimal internal vascularity. | The more recently developed palpable abnormality in the right upper inner breast corresponds to a solid mass lesion as described. While this may represent a fibroadenoma, given the size and a more recent development, ultrasound guided biopsy is recommended for further evaluation. Additional lesion in the left lower outer breast as described compatible with a fibroadenoma.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Pain Persistent lucency surrounding both fixation screws traversing the first MTP articulation again concerning for loosening. Specifically the threads distally do not appear engaged. Additionally the articulation does not appear fused and demonstrate a new small punctate calcification along the dorsal aspect, possibly a new chip avulsion fracture.Post surgical removal of the trapezium and scattered surgical staples overlying the radial lip and soft tissues | Persistent concern for loosening of first MCP screws with questionable new small chip fracture |
Generate impression based on findings. | B-cell lymphoma with cough evaluate for pneumoniaVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Minimal atelectasis right lower lobe without pneumonia. No pleural effusion or pneumothorax. | No evidence of pneumonia. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history breast carcinoma in her sister at age 67. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | SI joint pain SI joints: Detail obscured by overlying extensive gas and stool. SI joints appear grossly intact with mild degenerative changes yet patent.L-spine: Mild scattered degenerative changes more pronounced involving L1 through L3 with relative sparing distally. Facet sclerosis at preservation of vertebral body heights and alignment observed throughout. Moderate atherosclerotic disease | Mild osteoarthritis observed in both SI joints and lumbar spine. See detail provided |
Generate impression based on findings. | Chronic wrist pain Questionable ulnar plus variant without additional distinct abnormality. Soft tissues unremarkable | Suspected ulnar plus variant raise the patient's risk for a TFCC abnormality |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her mother. Two standard digital views of both breasts, with an additional left MLO view, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female 77 years old Reason: assess HCC progression; need triple phase scan History: abdominal pain CHEST:LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema. Cluster of groundglass nodules in the right middle lobe may be related to aspirationMEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphadenopathy on the basis of size criteria. There are severe atherosclerotic calcifications of the coronary arteries. There is a moderate hiatal hernia.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology the liver.Hepatic segment 7 TACE defect now measures 2.2 cm (image 26, series 10), unchanged. Adjacent arterially enhancing lesion in the superior aspect of the the described defect demonstrates washout and measures 1.6 x 1.8 cm (image 49, series 8070), previously 1.8 x 2.3 cm. This lesion is consistent with a HCC.The arterially enhancing lesion with washout in the hepatic dome now measures 1.4 x 1.8 cm (image 15, series 10), previously measuring 1.2 x 1.5 cm. This lesion is consistent with a HCC.Additional arterial enhancing lesion with washout in the inferior right hepatic lobe now measures 1.1 x 1.0 cm (image 30, series 10), previously 0.8 x 0.6 cmAdditional arterial enhancing lesion without washout appears slightly larger, now measuring 1.2 x 1.2 cm (image 18, series 10), previously 1.0 x 1.0 cm.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate hypodensities in the right kidney are too small to characterize.RETROPERITONEUM, LYMPH NODES: Aortoiliac stent and infrarenal abdominal aortic aneurysm again identified, which appears sightly smaller in size now measuring up to 3.2 cm in maximal diameter.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis. Enhancement in the distal esophagus and proximal stomach compatible with varices and enhancement in the rectum consistent with hemorrhoids.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: There is colonic diverticulosis without evidence of diverticulitis. Enhancement in the distal esophagus and proximal stomach compatible with varices and enhancement in the rectum consistent with hemorrhoids.BONES, SOFT TISSUES: Fluid collection in the subcutaneous fat superficial to the right femoral artery is likely postprocedural in etiology.OTHER: No significant abnormality noted. | 1.Interval increase in size of most the arterial enhancing lesions with washout consistent with HCC, as detailed above.2.Cirrhotic morphology of the liver with findings compatible with portal hypertension. |
Generate impression based on findings. | 47-year-old female with intermittent vomiting and diarrhea and abdominal pain. Assess for small bowel abnormality. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 45 minutes. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no ulcers, sinus tracts, fistulae, or adhesions. The terminal ileum and ileocecal valve were normal in appearance. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 3 minutes and 58 seconds. | Normal examination of the small bowel and proximal colon. |
Generate impression based on findings. | Female 75 years old Reason: Evaluate for PE, chest pain and desaturations Motion artifact limits the sensitivity of this examination.PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Large bilateral, partially loculated due to pleural adhesions, pleural effusions. Compressive basilar atelectasis. 3-mm nonspecific right upper lobe pulmonary nodule (image 88 series 10) unchanged and presumably benign. Emphysema.MEDIASTINUM AND HILA: No ascites.CHEST WALL: Degenerative changes in the spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Ascites is incompletely visualized. Right hepatic lobe hypoattenuating lesion is too small to characterize measuring 0.7 cm, unchanged from prior exam. | 1.No PE. 2.Large bilateral partially loculated pleural effusions. 3.Ascites.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. Contrast Extravasation Description:Supervising radiologist: Judy Wu, M.D.Minor or major extravasation: MinorContrast type: Omnipaque 350 were administered.Amount extravasated: 20 ccLocation of extravasation: left forearmSigns and symptoms: patient denies pain, numbness or tingling.Treatment given: warm compressDischarge instructions given: Yes |
Generate impression based on findings. | Right hip pain with lateral movement Moderate bilateral hip osteoarthritis with sclerosis and bulky osteophytes and subchondral cysts, more pronounced on the left. Minimal degenerative changes both SI joints but incompletely severe changes of the lumbar spine, consider dedicated imaging. Calcified fibroidsHips: Proximal femurs are otherwise intact with preserved femoral head shapes bilaterally | Moderate osteoarthritis of both hips, detail provided |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of uterine carcinoma. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear markers have been placed on scars overlying the left axilla. A possible new subcentimeter mass is present in the right lower inner quadrant. Scattered benign calcifications are present. No suspicious microcalcifications or areas of architectural distortion are present. | Possible new mass in the right breast. Spot compression imaging and ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 82-year-old female with chronic kidney disease. Evaluate kidneys. RIGHT KIDNEY: The right kidney measures 10 centimeters in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. There is mild loss of corticomedullary differentiation.LEFT KIDNEY: The left kidney measures 10.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. There is mild loss of corticomedullary differentiation.URINARY BLADDER: A normally distended urinary bladder is present.OTHER: There is prominence of the presumed uterus measuring 4.7 x 5.7 in cross-section. | 1. Findings compatible with medical renal disease. No hydronephrosis.2. Prominent presumed uterus may be further evaluated with dedicated ultrasound if clinically warranted. |
Generate impression based on findings. | Tenderness and swelling over fifth metatarsal No radiographic abnormality. Dr. Asbury contacted | Normal |
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