itsanmolgupta/mimic-cxr-dataset-cleaned · Datasets at Hugging Face

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The heart is mild to moderately enlarged. The mediastinal and hilar contours appear unchanged including unfolding of the thoracic aorta. The lungs appear clear. There are no pleural effusions or pneumothorax.	No evidence of acute disease.	15,213
A portable frontal chest radiograph again demonstrates low lung volumes. Asymmetric increased opacity of the right hemithorax is again seen but overall less prominent, most likely representing improving pulmonary edema. There is bibasilar atelectasis. Bilateral pleural effusions appear more prominent. The visualized portion of the cardiomediastinum is unchanged, as is a right central catheter.	Bilateral pleural effusions appear more prominent. Improving pulmonary edema.	10,630
Single upright view of the chest provided. There are multi focal patchy opacities, including in the bilateral perihilar and left lower lung regions. There are small bilateral pleural effusions. There is no pneumothorax. Cardiomegaly is mild to moderate. The mediastinum is not widened. Imaged osseous structures are intact. There is mild dextroscoliosis of the thoracic spine. There is a left chest cardiac device with lead tip projecting over the right ventricle. No free air below the right hemidiaphragm is seen.	Multifocal pneumonia. Follow-up after treatment is recommended.	12,246
Cardiac size is top normal. Mild pulmonary edema is grossly unchanged. Bibasilar atelectasis larger on the right have minimally improved on the left. Right IJ catheter tip is in the cavoatrial junction. . There is no pneumothorax or pleural effusion.	Mild pulmonary edema.	60
An orogastric tube courses into the stomach. Its sidehole marker projects over the expected site of the gastroesophageal junction. The lungs appear clear. There no pleural effusions or pneumothorax. The cardiac, mediastinal and hilar contours are unremarkable.	Status post endotracheal intubation. Sidehole marker of orogastric tube projecting at the gastroesophageal junction. If clinically indicated, advancing the tube somewhat may be appropriate. No evidence of acute cardiopulmonary disease.	9,931
Portable AP chest radiograph demonstrates no focal consolidation, pleural effusion, pulmonary vascular engorgement, or pneumothorax. Multiple vascular stents are noted in the right upper extremity, superior mediastinum, and mid left upper extremity. The aorta is tortuous. The cardiomediastinal silhouette is otherwise normal.	No acute cardiopulmonary process.	7,649
Single AP upright portable view of the chest was obtained. Enteric tube is seen terminating in the region of the midline of the chest, most likely within the mid esophagus, does not fully project over the airway; however, airway involvement is not entirely excluded. There is a large area of opacity projecting over the right mid-to-lower lung as well as left retrocardiac lucency consistent with patient's known large hiatal hernia. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac silhouette is top normal to mildly enlarged. The aortic knob is calcified.	Enteric tube terminates in the mid hemithorax in the midline, may be in the mid esophagus; however, airway involvement is not excluded, although felt unlikely. Recommend repositioning so that it terminates within the stomach if possible. Large area of basilar opacity involving the right mid-to-lower hemithorax as well as left base retrocardiac lucency consistent with patient's known large hiatal hernia.	8,394
Normal cardiomediastinal and hilar contours. New, bibasilar, mild atelectasis that may reflect early, mild pulmonary edema.	New, bibasilar, mild atelectasis. Possible mild pulmonary edema.	15,414
AP portable upright view of the chest provided. Diffuse bilateral ground glass pulmonary opacities are noted. There is relative increased opacity additionally in the left mid to lower lung. The possibility of pulmonary edema with a superimposed left mid to lower lung pneumonia is raised. No large effusion is seen. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are diffusely sclerotic consistent with renal osteodystrophy.	Diffuse pulmonary edema. Possible pneumonia in the left lower lung.	15,592
Right IJ catheter is unchanged. Heart size is mildly enlarged, as before. Bilateral perihilar hazy interstitial opacities indicative of pulmonary edema have slightly improved. No pleural effusion or pneumothorax.	Slight improvement in pulmonary edema, now moderate. No pleural effusions.	14,199
AP portable upright view of the chest. Port-A-Cath again seen residing over the right chest wall with tip extending to the region of the SVC. There has been interval thoracentesis with decreased right pleural effusion. No pneumothorax. Otherwise no change.	Interval decrease in right pleural effusion. Otherwise unchanged.	17,475
Enteric tube courses below the left hemidiaphragm into the stomach and off the inferior borders of the film. Heart size is mildly enlarged. Mediastinal and hilar contours are unremarkable. Bibasilar airspace opacities, more severe on the left, may reflect areas of atelectasis though aspiration or infection cannot be completely excluded. Small left pleural effusion also may be present. There is no pneumothorax. No pulmonary vascular congestion is demonstrated.	Standard positioning of endotracheal and enteric tubes. Bibasilar opacities, more pronounced on the left, which could reflect areas of atelectasis though infection or aspiration are additional possibilities. A small left pleural effusion may be present.	11,112
Single AP portable view of the chest was obtained. The extreme left lateral costophrenic angle is not fully included on the image. Given this, no focal consolidation, pleural effusion, or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen.	No acute cardiopulmonary process.	6,830
The remainder of the exam is unchanged, demonstrating mild cardiomegaly and low lung volumes.	Interval placement of a nasogastric tube, with the tip in the stomach.	18,177
An enteric tube is noted looped within the stomach, with the tip coursing off the inferior borders of the film. Low lung volumes are present. The heart size is mildly enlarged. Superior mediastinal contours are widened, and there is crowding of the bronchovascular structures. No overt pulmonary edema is seen. Bibasilar patchy opacities are nonspecific, possibly reflective of atelectasis but infection or aspiration cannot be excluded. There is no pleural effusion or pneumothorax. No acute osseous abnormalities are seen.	Standard position of the endotracheal and enteric tubes. Widening of the superior mediastinum. Further assessment with chest CTA is recommended. Bibasilar patchy opacities may reflect atelectasis in the setting of low lung volumes, but infection or aspiration cannot be completely excluded.	9,136
The heart is normal in size. The mediastinal and hilar contours appear unchanged. There is cephalization of the pulmonary vascularity, suggesting pulmonary venous hypertension or mild vascular congestion, also supported by peribronchial cuffing. There is no pleural effusion or pneumothorax.	Findings suggesting mild fluid overload.	7,746
Low lung volumes. Heart size is at the upper limits of normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Cervical spinal hardware is incompletely imaged.	No acute cardiopulmonary abnormality.	8,010
The PICC has been pulled back and is now within the mid SVC. Improved aeration with minimal subsegmental atelectasis in the lung bases. The heart is not enlarged. No pneumothorax or significant effusions.	The PICC is now in the mid SVC. No pneumothorax. Minimal persistent subsegmental atelectasis in the lung bases.	14,230
The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. Unchanged appearance of the paraspinal mediastinal clips.	No acute intrathoracic abnormalities identified. No subdiaphragmatic free air.	18,289
Cardiac size is top normal. Bibasilar atelectasis larger on the right have minimally increased. There are low lung volumes. There is no pneumothorax or pleural effusion.	Bibasilar atelectases no pneumothorax.	17,512
Single frontal of the chest. Left IJ central venous catheter terminates at the origin of the SVC. A NG tube passes into the stomach and terminates beyond the limits of the film. The heart remains severely enlarged. Upper mediastinal contours are stable. Widespread bilateral pulmonary opacities are consistent with severe pulmonary edema. Bibasilar consolidations are unchanged.	Stable severe cardiomegaly, pulmonary edema, and bibasilar consolidations.	3,878
The patient is status post left lower lobectomy with a left-sided chest tube and mediastinal clips noted. There is a small to moderate left apical pneumothorax. There is no right-sided pneumothorax. A right IJ introduction sheath is noted in the the origin of the SVC. An epidural catheter is in place. There is no focal consolidation or pleural effusion. The cardiomediastinal silhouette is within normal limits.	Small to moderate left apical pneumothorax.	8,701
The cardiomediastinal silhouettes are normal. The trachea is midline. The hila are unremarkable. The lungs are clear. There is no pulmonary vascular congestion. There is no pneumothorax. There is no right pleural effusion. Poor visualization of the lateral left CP angle may relate to overlying soft tissues, however, a small left pleural effusion would be difficult to exclude. There is mild dextroscoliosis of the mid thoracic spine.	No acute cardiopulmonary process.	12,351
Portable upright chest radiograph was obtained. The lungs are well expanded. Left basal opacity has progressed and could reflect a focus of aspiration or pneumonia. Additional focal opacities in the lateral right mid lung and medial right lower lung could reflect additional sites of infection or aspiration. Interstitial prominence is greater than on the prior and a component of pulmonary edema superimposed upon existing chronic lung disease is suspected. No pneumothorax is seen with perhaps trace bilateral pleural effusions. Cardiomediastinal contours are unchanged.	Likely multifocal pneumonia, either aspiration or infectious, with presumed pulmonary edema superimposed on a background of chronic lung disease.	19,890
A frontal upright view of the chest was obtained portably. There has been interval removal of the right internal jugular catheter. A PICC ends in the lower SVC. There is no focal consolidation or pneumothorax. Mild left basilar opacity has improved and is likely atelectasis and small pleural effusion as seen on chest CT. There is no pulmonary edema. Cardiac and mediastinal silhouettes are stable.	Left basilar atelectasis and small effusion. No pneumonia.	10,600
Interval decrease in bilateral apical pneumothoraces which are now small. No evidence of tension. Subcutaneous emphysema on the left chest wall has decreased. Right PICC in ET tube are in good position. Basilar opacities have slightly improved, likely improving pneumonia.	Interval decrease in bilateral apical pneumothoraces.	11,962
The more superior and smaller of the two pleural pigtail catheters has been removed in the interim. Additionally, the more inferior and larger pleural pigtail catheter has been nearly entirely withdrawn, with more than % of its sideholes projecting outside the thoracic cage. There is no pneumothorax. Moderate-sized, loculated left pleural effusion is similar to . Pulmonary vascular engorgement and pulmonary edema is similar. Right pleural effusion is slightly increased. Dense retrocardiac and right base atelectasis is unchanged. The cardiac silhouette and mediastinal contours remain indistinct, in this patient following aortic graft repair.	Pleural pigtail catheter pulled back to an abnormal position largely outside the thoracic cage. Left loculated pleural effusion is unchanged, right pleural effusion is slightly increased. No pneumothorax.	17,198
Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle. Moderate enlargement of the cardiac silhouette is present. The mediastinal contours are unremarkable. Diffuse alveolar opacities in a perihilar distribution are compatible with moderate pulmonary edema. There is likely a trace left pleural effusion. No pneumothorax is identified. There are no acute osseous abnormalities.	Moderate pulmonary edema and probable trace left pleural effusion.	16,625
Single portable view of the chest. Low lung volumes are noted. Within limitation of overlying trauma board, the lungs are grossly clear. The cardiomediastinal silhouette is within normal limits. No displaced fractures are identified.	No definite acute cardiopulmonary process.	7,540
Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.	No acute cardiopulmonary abnormality ET tube in appropriate position .	18,715
AP portable upright view of the chest. Low lung volumes somewhat limit assessment. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is unchanged with mild to moderate cardiomegaly. Imaged osseous structures are intact.	Cardiomegaly, otherwise unremarkable.	9,113
Again noted is a right-sided chest tube. A right pneumothorax is slightly smaller in size than previous exam. No other acute abnormalities are identified.	Persistent, small right-sided pneumothorax status post right chest tube adjustment.	11,951
Tiny left apical pneumothorax. Given for differences in position, right pleural effusion and adjacent atelectasis may have marginally increased. Mild pulmonary vascular congestion. Moderate cardiomegaly. Innumerable sclerotic metastases related to known prostate cancer.	Tiny left apical pneumothorax. Substantial decrease and left-sided effusion.	12,061
Two frontal images of the chest demonstrate a Dobbhoff tube with the tip in the stomach. The lungs are well expanded and are clear, although the apices are not included on this image. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Visualized osseous structures are unremarkable.	Dobbhoff tube in appropriate position within the stomach, otherwise unremarkable chest radiograph.	6,860
The tip of the right PICC line extends to the cavoatrial junction. There has been interval removal of the feeding tube. Unchanged retrocardiac opacity as well as an opacity in the left mid lung zone. There are small bilateral pleural effusions. No pneumothorax identified. The size and appearance of the cardiomediastinal silhouette is unchanged.	Unchanged retrocardiac opacity as well as an opacity in the left mid lung zone which may reflect atelectasis or consolidation. Small bilateral pleural effusions, greater on the left.	4,169
AP portable supine view of the chest. Lungs appear clear without focal consolidation, or supine evidence for an effusion or pneumothorax. There is opacity at the left costophrenic angle which could represent atelectasis. Please refer to CT torso performed subsequently. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.	No acute findings. Please refer to subsequent CT torso for further details.	14,033
A frontal upright view of the chest was obtained portably. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is within normal limits. Mediastinal silhouette and hilar contours are normal aside from aortic knob calcifications. No upper abdominal or osseous abnormality is identified.	No pneumonia, edema or effusion.	11,572
Study is limited due to patient rotation. Heart size is likely mildly enlarged. Mediastinal contours are difficult to assess given patient rotation. There is no pulmonary vascular congestion. Mild streaky left basilar opacity likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormality is seen.	Minimal left basilar atelectasis.	15,536
AP portable upright chest radiograph provided. Right CP angle is partially excluded. Previously noted right IJ central venous catheter has been removed. Lungs appear clear without definite signs of pneumonia, edema, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact.	No acute findings in the chest.	555
The heart appears mildly enlarged, even accounting for technique. Increased opacities at the right lung base could reflect atelectasis, however in the appropriate clinical setting an early infectious process or aspiration cannot be entirely excluded. There is mild pulmonary vascular congestion. No pneumothorax is identified.	Mild cardiomegaly,. Mild pulmonary vascular congestion. Increased density at the right lung base could reflect atelectasis, however in the appropriate clinical setting an early infectious process or aspiration cannot be entirely excluded.	9,395
The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are hypoinflated but without focal consolidation. Pulmonary vascularity is within normal limits.	No acute cardiopulmonary process.	4,010
Low lung volumes. Small bilateral pleural effusions. No focal consolidation, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. Apparent widening of the mediastinum is secondary to lack of full inspiration. No subdiaphragmatic intra-abdominal free air.	Small bilateral pleural effusions.	628
Left internal jugular catheter is unchanged in position, and terminates in the low SVC. Right lower lobe pneumonia continues to improve. There is streaky atelectasis at the left lung base. No other consolidation. Right pleural effusion is small, if any. No pneumothorax. There is no pulmonary edema. Cardiomediastinal contours are normal.	Continued improvement in right lower lobe pneumonia, without radiographic evidence of heart failure.	3,105
Fluid has been removed from the right pleural space. The large pleural effusion remains. This obliterates the right heart border. Mediastinal structures are noted longer shifted to the left. Bronchovascular markings are prominent on the left but there is no focal consolidation. A feeding tube remains in place.	Interval decrease in right pleural effusion. Mediastinal structures are no longer shifted significantly to the left.	11,877
There has been interval removal of a right-sided chest tube. There is no pneumothorax. Bilateral Lung fields are unchanged. Cardiomediastinal silhouette is unchanged.	No pneumothorax status post chest tube removal.	739
AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.	No acute intrathoracic process	19,223
There is a small residual right apical pneumothorax. No focal consolidation, pleural effusion or pulmonary edema is seen. The heart is normal size and the previously noted mediastinal shift has resolved.	Interval expansion of the right lung following catheter placement with small residual right apical pneumothorax. Previously noted mediastinal shift has resolved.	13,585
Mild scarring in the left mid lung is similar to prior studies. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is stable.	No acute cardiopulmonary process.	19,604
Low lung volumes are noted. Right IJ central venous catheter tip projects over the mid to lower SVC. Low lung volumes are seen with secondary crowding of the bronchovascular markings. Bilateral parenchymal opacities are noted, left greater than right. No visualized pneumothorax on this supine film. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.	Right central venous catheter seen with tip projecting over the mid to lower SVC. No visualized pneumothorax. Low lung volumes with parenchymal process potentially in part due to atelectasis although superimposed infection or edema is possible.	2,356
The lungs are clear. The cardiomediastinal silhouette is within normal limits. Chronic posttraumatic changes noted at the right shoulder.	No acute cardiopulmonary process.	5,551
There is partial re-expansion of the left lung particularly the right upper lobe. Persistent left lower lobe collapse and small effusion. Right lung is clear.	Partial re-expansion of left lung	11,604
No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is normal. Mediastinal contours are normal. No acute bony abnormality is detected.	No radiographic evidence for acute cardiopulmonary process.	1,296
Heart size is normal. Rim calcified convexity at the AP window is concerning for a pseudoaneurysm. The aorta is otherwise diffusely calcified. Hilar contours are unremarkable. Vascular indistinctness with perihilar haziness suggests mild pulmonary edema. Additional ill-defined nodular opacities are noted within the right lung, which could reflect infection or aspiration. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities detected.	Abnormal left mediastinal contour with rim calcified convexity at the AP window suggestive of a pseudoaneurysm arising from the aorta. Further assessment with chest CTA is recommended. Mild pulmonary edema. Ill-defined nodular opacities within the right lung may reflect multifocal pneumonia or aspiration. This can also be assessed at the time of chest CT.	10,272
A portable frontal chest radiograph demonstrates a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable.	No acute cardiopulmonary process. No obvious hilar adenopathy.	8,435
No focal consolidation, pleural effusion or pneumothorax identified. The size the cardiac silhouette is enlarged.	Enlarged cardiac silhouette.	6,490
AP portable upright view of the chest. Interval placement of a right pigtail chest tube without re-expansion of the right lung suggests malpositioned chest tube. There is a persistent moderate in size right pneumothorax with associated partial collapse of the right lung. Mediastinum is not shifted. Left lung remains clear.	Persistent moderate right pneumothorax despite the presence of a chest tubes suggests improper chest tube placement.	15,006
Single portable view of the chest. Relatively lower lung volumes seen on the current exam. The lungs however are clear of consolidation, large effusion, or pulmonary vascular congestion. Linear bibasilar opacities may be due to atelectasis. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected.	No acute cardiopulmonary process.	10,369
Cardiac and mediastinal silhouettes are stable. There is mild right base atelectasis without definite focal consolidation. No large pleural effusion or pneumothorax is seen. Gastrostomy tube is noted overlying the left abdomen. Surgical clips are again seen overlying the left lung apex.	Mild right base atelectasis without definite focal consolidation.	16,873
There is no new consolidation or pleural effusion. Multiple subcentimeter nodules are better seen on the recent chest CT. There is no pneumothorax. The heart and mediastinum are within normal limits despite the projection.	No significant interval change.	2,449
There continues to be interval improvement in aeration of the left lung however, there is continued left lower lobe collapse. Mediastinal contour has now normalized. Cardiac silhouette is normal. Right lung remains clear.	Improvement of left lung aeration with continued lower lobe collapse. Mediastinal contour has normalized.	8,963
Single portable supine AP image of the chest. The right IJ central line has been pulled back in the interval, but still terminates in the right atrium. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable.	Right IJ central line terminates in the right atrium. No acute cardiopulmonary process.	18,356
The heart is mildly enlarged, and there is mild pulmonary vascular congestion. There is no pleural effusion, pneumothorax or focal consolidation.	Cardiomegaly with mild pulmonary vascular congestion.	5,350
The enteric tube terminates within the proximal stomach with the side port at approximately the level of the GE junction. Evaluation of the pulmonary parenchyma is limited by exclusion of the left chest from the field of view. The visualized lungs are clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is stable.	Enteric tube tip in the proximal stomach. No acute cardiopulmonary process.	5,596
Portable frontal radiograph of the chest demonstrates a new left PICC ending in the upper to mid SVC. Otherwise there is stable appearance of the chest with normal cardiac size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax.	Left PICC ends in the upper to mid SVC.	702
AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.	No acute intrathoracic process	18,591
Right IJ catheter tip now projects in the cavoatrial junction. There is no pneumothorax. Extensive bilateral lung opacities are unchanged. Cardiomediastinal contours are unchanged	Right IJ catheter tip now projects in the cavoatrial junction	1,228
NG tube with tip in the proximal stomach and is shifted leftwards from a large central paraseptal bullae as is seen on CT chest. Vascular clips are noted, and the sternotomy wires are intact. Stable bibasilar atelectasis, left greater than right. No additional focal opacity or pleural effusions. Lung apices are not imaged on this film, however no large pneumothorax. The aorta is tortuous and dilated, and is unchanged. Heart size is top normal and right hilus is normal.	NG tube enters into the esophagus with tip in the proximal stomach. Stable bibasilar atelectasis, left greater than right.	18,844
The cardiac, mediastinal and hilar contours appear stable. There is no definite pleural effusion or pneumothorax. Streaky opacities at the right lung base suggest minor atelectasis. Partly visualized abdomen shows gastric distention as well as dilatation of small and large bowel. No free air is identified.	Right basilar opacity suggesting atelectasis with low lung volumes. No free air identified. Gastric and bowel distention, incompletely assessed.	5,402
The heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.	No acute cardiopulmonary process.	14,136
Portable supine chest radiograph obtained. The heart is markedly enlarged. There is no definite sign of pneumonia or overt CHF. No large pleural effusion or pneumothorax is seen. The mediastinal contour is stable with atherosclerotic calcification along the aortic knob. Bony structures are intact.	Cardiomegaly, unchanged, no definite sign of pneumonia or overt CHF.	12,107
Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. Moderate bilateral pleural effusions with adjacent atelectasis are stable. There has been interval improvement in aeration of the bilateral upper lungs, consistent with improved pulmonary edema. Cardiomediastinal and hilar contours are unchanged. The right-sided central line ends in the right atrium, in unchanged position.	Moderate bilateral pleural effusions with adjacent atelectasis are stable. Interval improvement of pulmonary edema.	8,397
Single portable view of the chest. Bibasilar opacities are compatible with pleural effusions and likely associated atelectasis. Superiorly the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected.	Bilateral pleural effusions with associated atelectasis noting that infection cannot be excluded.	5,338
The appearance of the left retrocardiac opacity has significantly improved, likely due to improved aeration on the current exam. Right lung is clear. No pleural effusion or pneumothorax. Hilar structures and cardiomediastinal silhouette is normal. There are chronic resorptive changes in the distal right clavicle.	Significant improvement in left basilar opacity, likely due the improved aeration on the current exam. Residual left basilar opacity may be atelectasis, although infection cannot be ruled out.	5,320
Moderate sized left pleural effusion is similar to with left base atelectasis. Small right base atelectasis. Multiple pulmonary nodules previously seen on better appreciated on CT. No new consolidation, large mass, pneumothorax. Heart size is normal.	Moderate-sized left pleural effusion, similar to , with bibasilar atelectasis. Previously seen pulmonary nodules are better appreciated via CT.	13,967
AP portable view of the chest. A right pigtail catheter is in place in the right pleural space. There is decrease in right hydropneumothorax. A small right pleural effusion persists. The left lung is clear. Sternotomy wires and mediastinal clips are seen. Additional opacities in the right lower lobe may represent pneumonia or atelectasis.	Interval placement of right pigtail catheter in right pleural space with decrease in right-sided hydropneumothorax.	7,533
Nasogastric tube now turns at the GE junction with tip in the upper esophagus. Otherwise, unchanged exam.	NG tube coiled within the esophagus. Recommend fluoroscopic-guided placement.	9,723
The endotracheal tube and enteric tube are in standard position. Left internal jugular central line projects over the upper right atrium, and appears to have been advanced, however the apparent position could be secondary to lower inspiratory level. Lung volumes are low and there is persistent left lower lobe collapse. Mild pulmonary edema is unchanged. Upper lung parenchymal opacities are more readily recognized than in the lower lobes. Moderate cardiomegaly is stable.	Lower lung volumes with stable mild pulmonary edema and left lower lobe collapse. Stable support lines and tubes.	18,731
Lung volumes are low. Heart is mildly enlarged though this appears stable. Subtle lower lung opacity is most attributable to the bronchovascular crowding in the setting of low lung volumes. There is no definite signs of pneumonia or CHF. No large effusion or pneumothorax is seen. Mediastinal contour is normal. Imaged osseous structures are intact.	No acute findings in the chest. Stable cardiomegaly.	8,734
Single frontal view of the chest demonstrates intact median sternotomy wires and interval removal of an enteric tube and right chest tube and, with minimal subcutaneous emphysema along the right chest wall. There is somewhat similar mild perihilar vascular congestion and stable moderate left pleural effusion and increased small right pleural effusion with associated atelectasis. Coarse calcifications along the aortic arch is unchanged. The upper lungs remain relatively well aerated. Previously seen tiny right apical pneumothorax is no longer appreciable.	Interval removal of right chest tube without discernible pneumothorax.	17,996
Overlying EKG leads are present. The lungs appear clear bilaterally without signs of pneumonia or edema. No large effusion or pneumothorax. Previously noted pulmonary edema and multifocal opacities have cleared in the interval. Cardiomediastinal silhouette appears normal. No free air seen below the right hemidiaphragm.	No acute intrathoracic process.	12,806
There are low lung volumes. There is elevation of the right hemidiaphragm. The cardiac and mediastinal silhouettes are likely accentuated by a low lung volumes. There are perihilar opacities raising concern for mild pulmonary edema. Patchy left basilar opacities most likely relate to edema, however, infectious process not excluded in the appropriate clinical setting. Dedicated PA and lateral views or frontal view within improved inspiration would be helpful for further evaluation. No pleural effusion or pneumothorax is seen.	Low lung volumes. Elevated right hemidiaphragm. Perihilar opacities raising concern for mild pulmonary edema. Patchy basilar opacities most likely relate to edema, however, infectious process not excluded in the appropriate clinical setting. Dedicated PA and lateral views or frontal view within improved inspiration would be helpful for further evaluation.	18,874
There is no focal consolidation, pleural effusion, pulmonary edema or pneumothorax. A left central venous line continues to terminate within the right atrium. The heart and mediastinal contours are normal.	No acute cardiopulmonary process.	18,718
Single AP view of the chest. The lungs are clear of focal consolidation or vascular congestion. There is fullness in the region of the right hilum. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities identified.	Increased size and density projecting over the right hilum for which dedicated PA and lateral is suggested to further characterize when patient is amenable.	10,105
Median sternotomy wires are in place. Heart size is normal. The mediastinal silhouette and hilar contours are normal. There is mild retrocardiac atelectasis. Lungs are otherwise clear. There is no pleural effusion or pneumothorax.	No acute cardiopulmonary abnormality.	15,133
The heart is enlarged. The pulmonary vasculature is within normal limits. No consolidation. No signs of CHF. Dual lead pacemaker again seen with the leads ending in the RA and RV.	Cardiomegaly. No signs of pulmonary edema.	8,054
Cardiomediastinal silhouette is normal. There is linear atelectasis at the right lung base. There is no focal lung consolidation. There is no pleural effusion or pneumothorax.	No evidence of pneumonia.	6,514
Retrocardiac and left lower lobe basilar opacities also slightly worsened. No pulmonary edema. No pneumothorax or substantial effusion.	Worsening right middle and bilateral lower lobe opacities may reflect increasing collapse/atelectasis.	1,741
A single AP radiograph of the chest was acquired. There has been interval placement of a right internal jugular central venous catheter with its tip overlying the right axilla, likely within the right axillary vein or one of its tributaries. There is no pneumothorax. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions.	Newly placed right internal jugular central venous catheter extends into either the right axillary vein or one of its tributaries. m. on reveals interval repositioning of this catheter. Clear lungs.	7,757
There is volume loss at the bases. There is no focal infiltrate. Cardiac mediastinal silhouettes are normal.	No new infiltrate.	3,269
A nasoenteric tube enters the stomach with the tip not visualized. Again seen is moderate cardiomegaly. There is no focal consolidation. There is no pleural effusion or pneumothorax.	Endotracheal tube appropriately positioned.	5,412
The left internal jugular central venous catheter tip terminates in the mid SVC. No pneumothorax is identified. The remaining lines and tubes remain in standard positions. Cardiac and mediastinal contours are similar. There is continued diffuse interstitial and alveolar opacities, perhaps minimally improved in the interval, compatible with mild pulmonary edema. More focal opacities within the right mid lung field and right lung base again could reflect areas of coexistent infection. Hazy opacity in the right lung base likely reflects the presence of a small layering pleural effusion, as seen previously.	Left internal jugular central venous catheter tip terminates in the mid SVC. No pneumothorax. Slight interval improvement in mild pulmonary edema with more focal opacities in the right lung suggestive of coexistent multifocal pneumonia. Small right pleural effusion, probably unchanged.	14,665
Portable AP upright chest radiograph is obtained. The lung volumes are low. The heart is markedly enlarged. There is obscuration of the retrocardiac space, which could reflect technique. The possibility of tiny bilateral pleural effusions is not excluded. While there is no overt pulmonary edema, there may be minimal interstitial edema. The mediastinal contour is stable. Bony structures are intact.	Cardiomegaly with possible mild interstitial edema and tiny pleural effusions. Limited exam due to low lung volumes.	2,620
There is dense opacification of the left lung base with patchy areas of opacification within the right lung. Know interstitial opacities demonstrated opn the previous chest CT are less visible now. Left-sided opacity obscures the cardiac border. There is no pneumothorax. There is likely a left-sided pleural effusion.	Dense opacity at the left lung base with patchy areas of opacity at the right lung, findings concerning for multifocal infectious process with pulmonary edema being less likely. Underlying interstitial lung disease.	17,613
The heart size is mildly enlarged. Aortic knob is calcified. Perihilar haziness and vascular indistinctness is compatible with mild pulmonary edema. More focal patchy opacity in the right lung base may reflect asymmetric pulmonary edema but an area of infection or aspiration is not excluded. No pleural effusion or pneumothorax is seen. Contrast material is noted within the colon.	Mild pulmonary edema. More focal patchy opacity in the right lung base may reflect asymmetric pulmonary edema, but infection or aspiration is not excluded. Continued followup after diuresis is recommended.	13,090
New esophageal ube loops and ends within the thorax, likely within a large hiatal hernia. Otherwise there is no significant change compared with the previous exam. A right sided IJ line ends in the upper to mid SVC. A right-sided PICC ends in the lower SVC. There is no evidence of pneumothorax. No focal opacities concerning for pneumonia identified. No pleural effusion is identified. Previous right costophrenic angle vague opacity has cleared and it was most likely due to positioning. There is no pneumothorax. Cardiomediastinal and hilar contours are unremarkable.	New esophageal tube ends above the diaphragm, likely within a large hiatal hernia. Otherwise unchanged from recent exam. No evidence of pleural effusion or pneumothorax.	19,516
Tracheostomy tube is in standard position. There is no evidence to suggest aspiration or pneumonia or pulmonary edema. Lung volumes are relatively low. There is no evidence of pleural effusion. Stomach is grossly distended with air. Heart size, mediastinal and hilar contours are normal.	No evidence of aspiration or pneumonia.	3,111
Portable upright chest radiograph shows an unchanged left subclavian central venous line. The orientation of the tracheostomy is unchanged. There is interval improvement in aeration at the right lung base, with continued atelectasis at the left lung base. Parenchymal opacities in both lungs, predominantly in the upper zones, are unchanged. Left chest tube is in unchanged configuration.	Slight interval improvement in aeration of the right lung base with continued left basilar atelectasis, and unchanged support devices.	18,119
The heart is upper limits normal in size. There is a moderate right pleural effusion, some of which is loculated. There is associated volume loss in the right lower lobe and an underlying infectious infiltrate can't be excluded in this region There is a small left effusion. There is mild pulmonary vascular redistribution no pneumomediastinum is identified	Right-sided effusion and volume loss. An underlying infectious infiltrate can't be excluded.	15,042
Single frontal view of the chest. Heart size is top normal and mediastinal contours are stable. Moderate interstitial edema with probable tiny pleural effusions. Retrocardiac opacity could represent atelectasis or consolidation. No pneumothorax.	Moderate pulmonary edema with retrocardiac opacity that could represent either atelectasis or consolidation.	9,122
Left-sided chest tube appears unchanged. There is persistent unchanged subcutaneous emphysema which has redistributed somewhat. Endobronchial valves appear unchanged along the left hilum. There is persistent extensive atelectasis of the left upper lobe with mild volume loss in the left hemithorax. There is a trace left-sided pleural effusion although not necessarily changed in degree allowing for differences in positioning.	Extensive left upper lobe atelectasis and trace pneumothorax on the left. Left-sided chest tube in place. Widespread subcutaneous emphysema.	543

The heart is mild to moderately enlarged. The mediastinal and hilar contours appear unchanged including unfolding of the thoracic aorta. The lungs appear clear. There are no pleural effusions or pneumothorax.

No evidence of acute disease.

15,213

A portable frontal chest radiograph again demonstrates low lung volumes. Asymmetric increased opacity of the right hemithorax is again seen but overall less prominent, most likely representing improving pulmonary edema. There is bibasilar atelectasis. Bilateral pleural effusions appear more prominent. The visualized portion of the cardiomediastinum is unchanged, as is a right central catheter.

Bilateral pleural effusions appear more prominent. Improving pulmonary edema.

10,630

Single upright view of the chest provided. There are multi focal patchy opacities, including in the bilateral perihilar and left lower lung regions. There are small bilateral pleural effusions. There is no pneumothorax. Cardiomegaly is mild to moderate. The mediastinum is not widened. Imaged osseous structures are intact. There is mild dextroscoliosis of the thoracic spine. There is a left chest cardiac device with lead tip projecting over the right ventricle. No free air below the right hemidiaphragm is seen.

Multifocal pneumonia. Follow-up after treatment is recommended.

12,246

Cardiac size is top normal. Mild pulmonary edema is grossly unchanged. Bibasilar atelectasis larger on the right have minimally improved on the left. Right IJ catheter tip is in the cavoatrial junction. . There is no pneumothorax or pleural effusion.

Mild pulmonary edema.

60

An orogastric tube courses into the stomach. Its sidehole marker projects over the expected site of the gastroesophageal junction. The lungs appear clear. There no pleural effusions or pneumothorax. The cardiac, mediastinal and hilar contours are unremarkable.

Status post endotracheal intubation. Sidehole marker of orogastric tube projecting at the gastroesophageal junction. If clinically indicated, advancing the tube somewhat may be appropriate. No evidence of acute cardiopulmonary disease.

9,931

Portable AP chest radiograph demonstrates no focal consolidation, pleural effusion, pulmonary vascular engorgement, or pneumothorax. Multiple vascular stents are noted in the right upper extremity, superior mediastinum, and mid left upper extremity. The aorta is tortuous. The cardiomediastinal silhouette is otherwise normal.

No acute cardiopulmonary process.

7,649

Single AP upright portable view of the chest was obtained. Enteric tube is seen terminating in the region of the midline of the chest, most likely within the mid esophagus, does not fully project over the airway; however, airway involvement is not entirely excluded. There is a large area of opacity projecting over the right mid-to-lower lung as well as left retrocardiac lucency consistent with patient's known large hiatal hernia. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac silhouette is top normal to mildly enlarged. The aortic knob is calcified.

Enteric tube terminates in the mid hemithorax in the midline, may be in the mid esophagus; however, airway involvement is not excluded, although felt unlikely. Recommend repositioning so that it terminates within the stomach if possible. Large area of basilar opacity involving the right mid-to-lower hemithorax as well as left base retrocardiac lucency consistent with patient's known large hiatal hernia.

8,394

Normal cardiomediastinal and hilar contours. New, bibasilar, mild atelectasis that may reflect early, mild pulmonary edema.

New, bibasilar, mild atelectasis. Possible mild pulmonary edema.

15,414

AP portable upright view of the chest provided. Diffuse bilateral ground glass pulmonary opacities are noted. There is relative increased opacity additionally in the left mid to lower lung. The possibility of pulmonary edema with a superimposed left mid to lower lung pneumonia is raised. No large effusion is seen. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are diffusely sclerotic consistent with renal osteodystrophy.

Diffuse pulmonary edema. Possible pneumonia in the left lower lung.

15,592

Right IJ catheter is unchanged. Heart size is mildly enlarged, as before. Bilateral perihilar hazy interstitial opacities indicative of pulmonary edema have slightly improved. No pleural effusion or pneumothorax.

Slight improvement in pulmonary edema, now moderate. No pleural effusions.

14,199

AP portable upright view of the chest. Port-A-Cath again seen residing over the right chest wall with tip extending to the region of the SVC. There has been interval thoracentesis with decreased right pleural effusion. No pneumothorax. Otherwise no change.

Interval decrease in right pleural effusion. Otherwise unchanged.

17,475

Enteric tube courses below the left hemidiaphragm into the stomach and off the inferior borders of the film. Heart size is mildly enlarged. Mediastinal and hilar contours are unremarkable. Bibasilar airspace opacities, more severe on the left, may reflect areas of atelectasis though aspiration or infection cannot be completely excluded. Small left pleural effusion also may be present. There is no pneumothorax. No pulmonary vascular congestion is demonstrated.

Standard positioning of endotracheal and enteric tubes. Bibasilar opacities, more pronounced on the left, which could reflect areas of atelectasis though infection or aspiration are additional possibilities. A small left pleural effusion may be present.

11,112

Single AP portable view of the chest was obtained. The extreme left lateral costophrenic angle is not fully included on the image. Given this, no focal consolidation, pleural effusion, or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen.

No acute cardiopulmonary process.

6,830

The remainder of the exam is unchanged, demonstrating mild cardiomegaly and low lung volumes.

Interval placement of a nasogastric tube, with the tip in the stomach.

18,177

An enteric tube is noted looped within the stomach, with the tip coursing off the inferior borders of the film. Low lung volumes are present. The heart size is mildly enlarged. Superior mediastinal contours are widened, and there is crowding of the bronchovascular structures. No overt pulmonary edema is seen. Bibasilar patchy opacities are nonspecific, possibly reflective of atelectasis but infection or aspiration cannot be excluded. There is no pleural effusion or pneumothorax. No acute osseous abnormalities are seen.

Standard position of the endotracheal and enteric tubes. Widening of the superior mediastinum. Further assessment with chest CTA is recommended. Bibasilar patchy opacities may reflect atelectasis in the setting of low lung volumes, but infection or aspiration cannot be completely excluded.

9,136

The heart is normal in size. The mediastinal and hilar contours appear unchanged. There is cephalization of the pulmonary vascularity, suggesting pulmonary venous hypertension or mild vascular congestion, also supported by peribronchial cuffing. There is no pleural effusion or pneumothorax.

Findings suggesting mild fluid overload.

7,746

Low lung volumes. Heart size is at the upper limits of normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Cervical spinal hardware is incompletely imaged.

No acute cardiopulmonary abnormality.

8,010

The PICC has been pulled back and is now within the mid SVC. Improved aeration with minimal subsegmental atelectasis in the lung bases. The heart is not enlarged. No pneumothorax or significant effusions.

The PICC is now in the mid SVC. No pneumothorax. Minimal persistent subsegmental atelectasis in the lung bases.

14,230

The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. Unchanged appearance of the paraspinal mediastinal clips.

No acute intrathoracic abnormalities identified. No subdiaphragmatic free air.

18,289

Cardiac size is top normal. Bibasilar atelectasis larger on the right have minimally increased. There are low lung volumes. There is no pneumothorax or pleural effusion.

Bibasilar atelectases no pneumothorax.

17,512

Single frontal of the chest. Left IJ central venous catheter terminates at the origin of the SVC. A NG tube passes into the stomach and terminates beyond the limits of the film. The heart remains severely enlarged. Upper mediastinal contours are stable. Widespread bilateral pulmonary opacities are consistent with severe pulmonary edema. Bibasilar consolidations are unchanged.

Stable severe cardiomegaly, pulmonary edema, and bibasilar consolidations.

3,878

The patient is status post left lower lobectomy with a left-sided chest tube and mediastinal clips noted. There is a small to moderate left apical pneumothorax. There is no right-sided pneumothorax. A right IJ introduction sheath is noted in the the origin of the SVC. An epidural catheter is in place. There is no focal consolidation or pleural effusion. The cardiomediastinal silhouette is within normal limits.

Small to moderate left apical pneumothorax.

8,701

The cardiomediastinal silhouettes are normal. The trachea is midline. The hila are unremarkable. The lungs are clear. There is no pulmonary vascular congestion. There is no pneumothorax. There is no right pleural effusion. Poor visualization of the lateral left CP angle may relate to overlying soft tissues, however, a small left pleural effusion would be difficult to exclude. There is mild dextroscoliosis of the mid thoracic spine.

No acute cardiopulmonary process.

12,351

Portable upright chest radiograph was obtained. The lungs are well expanded. Left basal opacity has progressed and could reflect a focus of aspiration or pneumonia. Additional focal opacities in the lateral right mid lung and medial right lower lung could reflect additional sites of infection or aspiration. Interstitial prominence is greater than on the prior and a component of pulmonary edema superimposed upon existing chronic lung disease is suspected. No pneumothorax is seen with perhaps trace bilateral pleural effusions. Cardiomediastinal contours are unchanged.

Likely multifocal pneumonia, either aspiration or infectious, with presumed pulmonary edema superimposed on a background of chronic lung disease.

19,890

A frontal upright view of the chest was obtained portably. There has been interval removal of the right internal jugular catheter. A PICC ends in the lower SVC. There is no focal consolidation or pneumothorax. Mild left basilar opacity has improved and is likely atelectasis and small pleural effusion as seen on chest CT. There is no pulmonary edema. Cardiac and mediastinal silhouettes are stable.

Left basilar atelectasis and small effusion. No pneumonia.

10,600

Interval decrease in bilateral apical pneumothoraces which are now small. No evidence of tension. Subcutaneous emphysema on the left chest wall has decreased. Right PICC in ET tube are in good position. Basilar opacities have slightly improved, likely improving pneumonia.

Interval decrease in bilateral apical pneumothoraces.

11,962

The more superior and smaller of the two pleural pigtail catheters has been removed in the interim. Additionally, the more inferior and larger pleural pigtail catheter has been nearly entirely withdrawn, with more than % of its sideholes projecting outside the thoracic cage. There is no pneumothorax. Moderate-sized, loculated left pleural effusion is similar to . Pulmonary vascular engorgement and pulmonary edema is similar. Right pleural effusion is slightly increased. Dense retrocardiac and right base atelectasis is unchanged. The cardiac silhouette and mediastinal contours remain indistinct, in this patient following aortic graft repair.

Pleural pigtail catheter pulled back to an abnormal position largely outside the thoracic cage. Left loculated pleural effusion is unchanged, right pleural effusion is slightly increased. No pneumothorax.

17,198

Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle. Moderate enlargement of the cardiac silhouette is present. The mediastinal contours are unremarkable. Diffuse alveolar opacities in a perihilar distribution are compatible with moderate pulmonary edema. There is likely a trace left pleural effusion. No pneumothorax is identified. There are no acute osseous abnormalities.

Moderate pulmonary edema and probable trace left pleural effusion.

16,625

Single portable view of the chest. Low lung volumes are noted. Within limitation of overlying trauma board, the lungs are grossly clear. The cardiomediastinal silhouette is within normal limits. No displaced fractures are identified.

No definite acute cardiopulmonary process.

7,540

Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.

No acute cardiopulmonary abnormality ET tube in appropriate position .

18,715

AP portable upright view of the chest. Low lung volumes somewhat limit assessment. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is unchanged with mild to moderate cardiomegaly. Imaged osseous structures are intact.

Cardiomegaly, otherwise unremarkable.

9,113

Again noted is a right-sided chest tube. A right pneumothorax is slightly smaller in size than previous exam. No other acute abnormalities are identified.

Persistent, small right-sided pneumothorax status post right chest tube adjustment.

11,951

Tiny left apical pneumothorax. Given for differences in position, right pleural effusion and adjacent atelectasis may have marginally increased. Mild pulmonary vascular congestion. Moderate cardiomegaly. Innumerable sclerotic metastases related to known prostate cancer.

Tiny left apical pneumothorax. Substantial decrease and left-sided effusion.

12,061

Two frontal images of the chest demonstrate a Dobbhoff tube with the tip in the stomach. The lungs are well expanded and are clear, although the apices are not included on this image. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Visualized osseous structures are unremarkable.

Dobbhoff tube in appropriate position within the stomach, otherwise unremarkable chest radiograph.

6,860

The tip of the right PICC line extends to the cavoatrial junction. There has been interval removal of the feeding tube. Unchanged retrocardiac opacity as well as an opacity in the left mid lung zone. There are small bilateral pleural effusions. No pneumothorax identified. The size and appearance of the cardiomediastinal silhouette is unchanged.

Unchanged retrocardiac opacity as well as an opacity in the left mid lung zone which may reflect atelectasis or consolidation. Small bilateral pleural effusions, greater on the left.

4,169

AP portable supine view of the chest. Lungs appear clear without focal consolidation, or supine evidence for an effusion or pneumothorax. There is opacity at the left costophrenic angle which could represent atelectasis. Please refer to CT torso performed subsequently. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.

No acute findings. Please refer to subsequent CT torso for further details.

14,033

A frontal upright view of the chest was obtained portably. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is within normal limits. Mediastinal silhouette and hilar contours are normal aside from aortic knob calcifications. No upper abdominal or osseous abnormality is identified.

No pneumonia, edema or effusion.

11,572

Study is limited due to patient rotation. Heart size is likely mildly enlarged. Mediastinal contours are difficult to assess given patient rotation. There is no pulmonary vascular congestion. Mild streaky left basilar opacity likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormality is seen.

Minimal left basilar atelectasis.

15,536

AP portable upright chest radiograph provided. Right CP angle is partially excluded. Previously noted right IJ central venous catheter has been removed. Lungs appear clear without definite signs of pneumonia, edema, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact.

No acute findings in the chest.

555

The heart appears mildly enlarged, even accounting for technique. Increased opacities at the right lung base could reflect atelectasis, however in the appropriate clinical setting an early infectious process or aspiration cannot be entirely excluded. There is mild pulmonary vascular congestion. No pneumothorax is identified.

Mild cardiomegaly,. Mild pulmonary vascular congestion. Increased density at the right lung base could reflect atelectasis, however in the appropriate clinical setting an early infectious process or aspiration cannot be entirely excluded.

9,395

The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are hypoinflated but without focal consolidation. Pulmonary vascularity is within normal limits.

No acute cardiopulmonary process.

4,010

Low lung volumes. Small bilateral pleural effusions. No focal consolidation, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. Apparent widening of the mediastinum is secondary to lack of full inspiration. No subdiaphragmatic intra-abdominal free air.

Small bilateral pleural effusions.

628

Left internal jugular catheter is unchanged in position, and terminates in the low SVC. Right lower lobe pneumonia continues to improve. There is streaky atelectasis at the left lung base. No other consolidation. Right pleural effusion is small, if any. No pneumothorax. There is no pulmonary edema. Cardiomediastinal contours are normal.

Continued improvement in right lower lobe pneumonia, without radiographic evidence of heart failure.

3,105

Fluid has been removed from the right pleural space. The large pleural effusion remains. This obliterates the right heart border. Mediastinal structures are noted longer shifted to the left. Bronchovascular markings are prominent on the left but there is no focal consolidation. A feeding tube remains in place.

Interval decrease in right pleural effusion. Mediastinal structures are no longer shifted significantly to the left.

11,877

There has been interval removal of a right-sided chest tube. There is no pneumothorax. Bilateral Lung fields are unchanged. Cardiomediastinal silhouette is unchanged.

No pneumothorax status post chest tube removal.

739

AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.

No acute intrathoracic process

19,223

There is a small residual right apical pneumothorax. No focal consolidation, pleural effusion or pulmonary edema is seen. The heart is normal size and the previously noted mediastinal shift has resolved.

Interval expansion of the right lung following catheter placement with small residual right apical pneumothorax. Previously noted mediastinal shift has resolved.

13,585

Mild scarring in the left mid lung is similar to prior studies. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is stable.

No acute cardiopulmonary process.

19,604

Low lung volumes are noted. Right IJ central venous catheter tip projects over the mid to lower SVC. Low lung volumes are seen with secondary crowding of the bronchovascular markings. Bilateral parenchymal opacities are noted, left greater than right. No visualized pneumothorax on this supine film. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.

Right central venous catheter seen with tip projecting over the mid to lower SVC. No visualized pneumothorax. Low lung volumes with parenchymal process potentially in part due to atelectasis although superimposed infection or edema is possible.

2,356

The lungs are clear. The cardiomediastinal silhouette is within normal limits. Chronic posttraumatic changes noted at the right shoulder.

No acute cardiopulmonary process.

5,551

There is partial re-expansion of the left lung particularly the right upper lobe. Persistent left lower lobe collapse and small effusion. Right lung is clear.

Partial re-expansion of left lung

11,604

No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is normal. Mediastinal contours are normal. No acute bony abnormality is detected.

No radiographic evidence for acute cardiopulmonary process.

1,296

Heart size is normal. Rim calcified convexity at the AP window is concerning for a pseudoaneurysm. The aorta is otherwise diffusely calcified. Hilar contours are unremarkable. Vascular indistinctness with perihilar haziness suggests mild pulmonary edema. Additional ill-defined nodular opacities are noted within the right lung, which could reflect infection or aspiration. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities detected.

Abnormal left mediastinal contour with rim calcified convexity at the AP window suggestive of a pseudoaneurysm arising from the aorta. Further assessment with chest CTA is recommended. Mild pulmonary edema. Ill-defined nodular opacities within the right lung may reflect multifocal pneumonia or aspiration. This can also be assessed at the time of chest CT.

10,272

A portable frontal chest radiograph demonstrates a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable.

No acute cardiopulmonary process. No obvious hilar adenopathy.

8,435

No focal consolidation, pleural effusion or pneumothorax identified. The size the cardiac silhouette is enlarged.

Enlarged cardiac silhouette.

6,490

AP portable upright view of the chest. Interval placement of a right pigtail chest tube without re-expansion of the right lung suggests malpositioned chest tube. There is a persistent moderate in size right pneumothorax with associated partial collapse of the right lung. Mediastinum is not shifted. Left lung remains clear.

Persistent moderate right pneumothorax despite the presence of a chest tubes suggests improper chest tube placement.

15,006

Single portable view of the chest. Relatively lower lung volumes seen on the current exam. The lungs however are clear of consolidation, large effusion, or pulmonary vascular congestion. Linear bibasilar opacities may be due to atelectasis. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected.

No acute cardiopulmonary process.

10,369

Cardiac and mediastinal silhouettes are stable. There is mild right base atelectasis without definite focal consolidation. No large pleural effusion or pneumothorax is seen. Gastrostomy tube is noted overlying the left abdomen. Surgical clips are again seen overlying the left lung apex.

Mild right base atelectasis without definite focal consolidation.

16,873

There is no new consolidation or pleural effusion. Multiple subcentimeter nodules are better seen on the recent chest CT. There is no pneumothorax. The heart and mediastinum are within normal limits despite the projection.

No significant interval change.

2,449

There continues to be interval improvement in aeration of the left lung however, there is continued left lower lobe collapse. Mediastinal contour has now normalized. Cardiac silhouette is normal. Right lung remains clear.

Improvement of left lung aeration with continued lower lobe collapse. Mediastinal contour has normalized.

8,963

Single portable supine AP image of the chest. The right IJ central line has been pulled back in the interval, but still terminates in the right atrium. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable.

Right IJ central line terminates in the right atrium. No acute cardiopulmonary process.

18,356

The heart is mildly enlarged, and there is mild pulmonary vascular congestion. There is no pleural effusion, pneumothorax or focal consolidation.

Cardiomegaly with mild pulmonary vascular congestion.

5,350

The enteric tube terminates within the proximal stomach with the side port at approximately the level of the GE junction. Evaluation of the pulmonary parenchyma is limited by exclusion of the left chest from the field of view. The visualized lungs are clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is stable.

Enteric tube tip in the proximal stomach. No acute cardiopulmonary process.

5,596

Portable frontal radiograph of the chest demonstrates a new left PICC ending in the upper to mid SVC. Otherwise there is stable appearance of the chest with normal cardiac size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax.

Left PICC ends in the upper to mid SVC.

702

AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact.

No acute intrathoracic process

18,591

Right IJ catheter tip now projects in the cavoatrial junction. There is no pneumothorax. Extensive bilateral lung opacities are unchanged. Cardiomediastinal contours are unchanged

Right IJ catheter tip now projects in the cavoatrial junction

1,228

NG tube with tip in the proximal stomach and is shifted leftwards from a large central paraseptal bullae as is seen on CT chest. Vascular clips are noted, and the sternotomy wires are intact. Stable bibasilar atelectasis, left greater than right. No additional focal opacity or pleural effusions. Lung apices are not imaged on this film, however no large pneumothorax. The aorta is tortuous and dilated, and is unchanged. Heart size is top normal and right hilus is normal.

NG tube enters into the esophagus with tip in the proximal stomach. Stable bibasilar atelectasis, left greater than right.

18,844

The cardiac, mediastinal and hilar contours appear stable. There is no definite pleural effusion or pneumothorax. Streaky opacities at the right lung base suggest minor atelectasis. Partly visualized abdomen shows gastric distention as well as dilatation of small and large bowel. No free air is identified.

Right basilar opacity suggesting atelectasis with low lung volumes. No free air identified. Gastric and bowel distention, incompletely assessed.

5,402

The heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.

No acute cardiopulmonary process.

14,136

Portable supine chest radiograph obtained. The heart is markedly enlarged. There is no definite sign of pneumonia or overt CHF. No large pleural effusion or pneumothorax is seen. The mediastinal contour is stable with atherosclerotic calcification along the aortic knob. Bony structures are intact.

Cardiomegaly, unchanged, no definite sign of pneumonia or overt CHF.

12,107

Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. Moderate bilateral pleural effusions with adjacent atelectasis are stable. There has been interval improvement in aeration of the bilateral upper lungs, consistent with improved pulmonary edema. Cardiomediastinal and hilar contours are unchanged. The right-sided central line ends in the right atrium, in unchanged position.

Moderate bilateral pleural effusions with adjacent atelectasis are stable. Interval improvement of pulmonary edema.

8,397

Single portable view of the chest. Bibasilar opacities are compatible with pleural effusions and likely associated atelectasis. Superiorly the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected.

Bilateral pleural effusions with associated atelectasis noting that infection cannot be excluded.

5,338

The appearance of the left retrocardiac opacity has significantly improved, likely due to improved aeration on the current exam. Right lung is clear. No pleural effusion or pneumothorax. Hilar structures and cardiomediastinal silhouette is normal. There are chronic resorptive changes in the distal right clavicle.

Significant improvement in left basilar opacity, likely due the improved aeration on the current exam. Residual left basilar opacity may be atelectasis, although infection cannot be ruled out.

5,320

Moderate sized left pleural effusion is similar to with left base atelectasis. Small right base atelectasis. Multiple pulmonary nodules previously seen on better appreciated on CT. No new consolidation, large mass, pneumothorax. Heart size is normal.

Moderate-sized left pleural effusion, similar to , with bibasilar atelectasis. Previously seen pulmonary nodules are better appreciated via CT.

13,967

AP portable view of the chest. A right pigtail catheter is in place in the right pleural space. There is decrease in right hydropneumothorax. A small right pleural effusion persists. The left lung is clear. Sternotomy wires and mediastinal clips are seen. Additional opacities in the right lower lobe may represent pneumonia or atelectasis.

Interval placement of right pigtail catheter in right pleural space with decrease in right-sided hydropneumothorax.

7,533

Nasogastric tube now turns at the GE junction with tip in the upper esophagus. Otherwise, unchanged exam.

NG tube coiled within the esophagus. Recommend fluoroscopic-guided placement.

9,723

The endotracheal tube and enteric tube are in standard position. Left internal jugular central line projects over the upper right atrium, and appears to have been advanced, however the apparent position could be secondary to lower inspiratory level. Lung volumes are low and there is persistent left lower lobe collapse. Mild pulmonary edema is unchanged. Upper lung parenchymal opacities are more readily recognized than in the lower lobes. Moderate cardiomegaly is stable.

Lower lung volumes with stable mild pulmonary edema and left lower lobe collapse. Stable support lines and tubes.

18,731

Lung volumes are low. Heart is mildly enlarged though this appears stable. Subtle lower lung opacity is most attributable to the bronchovascular crowding in the setting of low lung volumes. There is no definite signs of pneumonia or CHF. No large effusion or pneumothorax is seen. Mediastinal contour is normal. Imaged osseous structures are intact.

No acute findings in the chest. Stable cardiomegaly.

8,734

Single frontal view of the chest demonstrates intact median sternotomy wires and interval removal of an enteric tube and right chest tube and, with minimal subcutaneous emphysema along the right chest wall. There is somewhat similar mild perihilar vascular congestion and stable moderate left pleural effusion and increased small right pleural effusion with associated atelectasis. Coarse calcifications along the aortic arch is unchanged. The upper lungs remain relatively well aerated. Previously seen tiny right apical pneumothorax is no longer appreciable.

Interval removal of right chest tube without discernible pneumothorax.

17,996

Overlying EKG leads are present. The lungs appear clear bilaterally without signs of pneumonia or edema. No large effusion or pneumothorax. Previously noted pulmonary edema and multifocal opacities have cleared in the interval. Cardiomediastinal silhouette appears normal. No free air seen below the right hemidiaphragm.

No acute intrathoracic process.

12,806

There are low lung volumes. There is elevation of the right hemidiaphragm. The cardiac and mediastinal silhouettes are likely accentuated by a low lung volumes. There are perihilar opacities raising concern for mild pulmonary edema. Patchy left basilar opacities most likely relate to edema, however, infectious process not excluded in the appropriate clinical setting. Dedicated PA and lateral views or frontal view within improved inspiration would be helpful for further evaluation. No pleural effusion or pneumothorax is seen.

Low lung volumes. Elevated right hemidiaphragm. Perihilar opacities raising concern for mild pulmonary edema. Patchy basilar opacities most likely relate to edema, however, infectious process not excluded in the appropriate clinical setting. Dedicated PA and lateral views or frontal view within improved inspiration would be helpful for further evaluation.

18,874

There is no focal consolidation, pleural effusion, pulmonary edema or pneumothorax. A left central venous line continues to terminate within the right atrium. The heart and mediastinal contours are normal.

No acute cardiopulmonary process.

18,718

Single AP view of the chest. The lungs are clear of focal consolidation or vascular congestion. There is fullness in the region of the right hilum. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities identified.

Increased size and density projecting over the right hilum for which dedicated PA and lateral is suggested to further characterize when patient is amenable.

10,105

Median sternotomy wires are in place. Heart size is normal. The mediastinal silhouette and hilar contours are normal. There is mild retrocardiac atelectasis. Lungs are otherwise clear. There is no pleural effusion or pneumothorax.

No acute cardiopulmonary abnormality.

15,133

The heart is enlarged. The pulmonary vasculature is within normal limits. No consolidation. No signs of CHF. Dual lead pacemaker again seen with the leads ending in the RA and RV.

Cardiomegaly. No signs of pulmonary edema.

8,054

Cardiomediastinal silhouette is normal. There is linear atelectasis at the right lung base. There is no focal lung consolidation. There is no pleural effusion or pneumothorax.

No evidence of pneumonia.

6,514

Retrocardiac and left lower lobe basilar opacities also slightly worsened. No pulmonary edema. No pneumothorax or substantial effusion.

Worsening right middle and bilateral lower lobe opacities may reflect increasing collapse/atelectasis.

1,741

A single AP radiograph of the chest was acquired. There has been interval placement of a right internal jugular central venous catheter with its tip overlying the right axilla, likely within the right axillary vein or one of its tributaries. There is no pneumothorax. The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions.

Newly placed right internal jugular central venous catheter extends into either the right axillary vein or one of its tributaries. m. on reveals interval repositioning of this catheter. Clear lungs.

7,757

There is volume loss at the bases. There is no focal infiltrate. Cardiac mediastinal silhouettes are normal.

No new infiltrate.

3,269

A nasoenteric tube enters the stomach with the tip not visualized. Again seen is moderate cardiomegaly. There is no focal consolidation. There is no pleural effusion or pneumothorax.

Endotracheal tube appropriately positioned.

5,412

The left internal jugular central venous catheter tip terminates in the mid SVC. No pneumothorax is identified. The remaining lines and tubes remain in standard positions. Cardiac and mediastinal contours are similar. There is continued diffuse interstitial and alveolar opacities, perhaps minimally improved in the interval, compatible with mild pulmonary edema. More focal opacities within the right mid lung field and right lung base again could reflect areas of coexistent infection. Hazy opacity in the right lung base likely reflects the presence of a small layering pleural effusion, as seen previously.

Left internal jugular central venous catheter tip terminates in the mid SVC. No pneumothorax. Slight interval improvement in mild pulmonary edema with more focal opacities in the right lung suggestive of coexistent multifocal pneumonia. Small right pleural effusion, probably unchanged.

14,665

Portable AP upright chest radiograph is obtained. The lung volumes are low. The heart is markedly enlarged. There is obscuration of the retrocardiac space, which could reflect technique. The possibility of tiny bilateral pleural effusions is not excluded. While there is no overt pulmonary edema, there may be minimal interstitial edema. The mediastinal contour is stable. Bony structures are intact.

Cardiomegaly with possible mild interstitial edema and tiny pleural effusions. Limited exam due to low lung volumes.

2,620

There is dense opacification of the left lung base with patchy areas of opacification within the right lung. Know interstitial opacities demonstrated opn the previous chest CT are less visible now. Left-sided opacity obscures the cardiac border. There is no pneumothorax. There is likely a left-sided pleural effusion.

Dense opacity at the left lung base with patchy areas of opacity at the right lung, findings concerning for multifocal infectious process with pulmonary edema being less likely. Underlying interstitial lung disease.

17,613

The heart size is mildly enlarged. Aortic knob is calcified. Perihilar haziness and vascular indistinctness is compatible with mild pulmonary edema. More focal patchy opacity in the right lung base may reflect asymmetric pulmonary edema but an area of infection or aspiration is not excluded. No pleural effusion or pneumothorax is seen. Contrast material is noted within the colon.

Mild pulmonary edema. More focal patchy opacity in the right lung base may reflect asymmetric pulmonary edema, but infection or aspiration is not excluded. Continued followup after diuresis is recommended.

13,090

New esophageal ube loops and ends within the thorax, likely within a large hiatal hernia. Otherwise there is no significant change compared with the previous exam. A right sided IJ line ends in the upper to mid SVC. A right-sided PICC ends in the lower SVC. There is no evidence of pneumothorax. No focal opacities concerning for pneumonia identified. No pleural effusion is identified. Previous right costophrenic angle vague opacity has cleared and it was most likely due to positioning. There is no pneumothorax. Cardiomediastinal and hilar contours are unremarkable.

New esophageal tube ends above the diaphragm, likely within a large hiatal hernia. Otherwise unchanged from recent exam. No evidence of pleural effusion or pneumothorax.

19,516

Tracheostomy tube is in standard position. There is no evidence to suggest aspiration or pneumonia or pulmonary edema. Lung volumes are relatively low. There is no evidence of pleural effusion. Stomach is grossly distended with air. Heart size, mediastinal and hilar contours are normal.

No evidence of aspiration or pneumonia.

3,111

Portable upright chest radiograph shows an unchanged left subclavian central venous line. The orientation of the tracheostomy is unchanged. There is interval improvement in aeration at the right lung base, with continued atelectasis at the left lung base. Parenchymal opacities in both lungs, predominantly in the upper zones, are unchanged. Left chest tube is in unchanged configuration.

Slight interval improvement in aeration of the right lung base with continued left basilar atelectasis, and unchanged support devices.

18,119

The heart is upper limits normal in size. There is a moderate right pleural effusion, some of which is loculated. There is associated volume loss in the right lower lobe and an underlying infectious infiltrate can't be excluded in this region There is a small left effusion. There is mild pulmonary vascular redistribution no pneumomediastinum is identified

Right-sided effusion and volume loss. An underlying infectious infiltrate can't be excluded.

15,042

Single frontal view of the chest. Heart size is top normal and mediastinal contours are stable. Moderate interstitial edema with probable tiny pleural effusions. Retrocardiac opacity could represent atelectasis or consolidation. No pneumothorax.

Moderate pulmonary edema with retrocardiac opacity that could represent either atelectasis or consolidation.

9,122

Left-sided chest tube appears unchanged. There is persistent unchanged subcutaneous emphysema which has redistributed somewhat. Endobronchial valves appear unchanged along the left hilum. There is persistent extensive atelectasis of the left upper lobe with mild volume loss in the left hemithorax. There is a trace left-sided pleural effusion although not necessarily changed in degree allowing for differences in positioning.

Extensive left upper lobe atelectasis and trace pneumothorax on the left. Left-sided chest tube in place. Widespread subcutaneous emphysema.

543