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Generate impression based on findings. | Metastatic follicular carcinoma of the thyroid (metastatic to the lungs) and invasive ductal carcinoma of the breast T1cN0M0. History of thyroid resection and chemotherapy. There is a heterogenously enhancing soft tissue mass within the inferior right thyroid resection bed, which extends inferiorly into the mediastinum and measures approximately 27 x 29 x 50 mm. There is associated bilateral cervical lymphadenopathy. The largest lymph node in the neck is in the right level 4 station, measures 23 x 25 mm, and appears to be necrotic or cystic. The inferior right jugular vein is narrowed by the surrounding lymphadenopathy. Additional lymphadenopathy is partially imaged in the mediastinum. The airways are patent. There is asymmetric fatty atrophy of the right parotid gland. The other major salivary glands are unremarkable. There is an extra-axial mass along the planum sphenoidale that measures up to 17 mm with adjacent pneumosinus dilatans and mild sclerosis of the right sphenoid roof. There is a subcentimeter focus of hypoattenuation in the posterior right basal ganglia. The mastoid air cells and paranasal sinuses are grossly clear. There are multiple right upper lobe cavitary lesions, a left upper lobe pulmonary nodule, and left upper lobe peripheral opacities. | 1. A mass within the inferior right thyroidectomy bed extending into the mediastinum is compatible with recurrent follicular thyroid cancer associated with metastatic disease in the adjacent bilateral cervical and partially-imaged mediastinal lymph nodes. 2. Right upper lobe cavitary lesions and a left upper lobe pulmonary nodule are also compatible with metastatic disease. Please refer to CT chest report for additional details. 3. A mass along the planum sphenoidale likely represents a meningioma versus less likely a metastatic lesion. MRI of the brain with contrast may be considered for further evaluation. 4. A subcentimeter focus of hypoattenuation in the right basal ganglia is non-specific but may represent a lacunar infarct of indeterminate age. A brain MRI may also be useful for further characterization. |
Generate impression based on findings. | Reason: hemangioendothelioma of the lung. Compare to last CT \T\ measure 1) LUL lesion, 2) prevascular lymph node, 3) hepatic met History: post 3 cycles of chemo CHEST:LUNGS AND PLEURA: Numerous pulmonary nodules throughout the lungs, not significantly changed in size and number.Reference left upper lobe nodule (series 5/27) 18 x 20 3 mm, not significantly changed.Small amount of loculated pleural fluid or pleural thickening of the right base.MEDIASTINUM AND HILA: Enlarged prevascular/para-aortic lymph node measuring 15 mm in short axis diameter, not significantly changed.Left hilar lymphadenopathy also unchanged.Minimal coronary artery calcification. No pericardial effusion.CHEST WALL: Expansile mixed sclerotic and lytic left fourth and fifth posterior rib lesions appear similar compared to prior examination, possibly posttraumatic.Small sclerotic focus at the T5 vertebral body, likely a bone island, unchanged.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Focal hypodensity in the right lobe adjacent to the gallbladder (series 3/92) measuring approximately 12 mm, not significantly changed since at least 2/8/2013. Additional small nonspecific hypodensity (series 3/77) measures 9 mm, also unchanged.SPLEEN: Small peripheral hypodensity, unchanged, likely benign.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral cysts.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. | Stable disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in two maternal aunts. 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 new partially obscured 2 cm mass is present at the 12 o'clock position of the right breast. Benign calcifications are present. No suspicious microcalcifications or areas of architectural distortion are present. | New right breast mass. Spot compression imaging and ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 68-year-old female. Evaluate for pleural mesothelioma. CHEST:LUNGS AND PLEURA: Small left pleural effusion with underlying atelectasis/consolidation. Pleural thickening along the anterior aspect of the left upper lobe at the 12 o'clock position measures 6 mm in diameter (18; series 3). There is pleural thickening along the medial aspect of the left lower lobe, measuring 6 mm in diameter (78; series 3). There are scattered bilateral pulmonary nodules. There is a 12-mm ground glass nodule in the right upper lobe (37; series 5) with an apparent solid component measuring less then 2 mm. There are multiple additional nodules with irregular margins in the right lower lobe which are nonspecific, but moderately suspicious for synchronous primary adenocarcinomas in situ (images 65 and 69 of series 5).MEDIASTINUM AND HILA: Prominent left cardiophrenic lymph node. No evidence of pericardial effusion. Mild coronary artery calcifications. Small hiatal hernia.CHEST WALL: Dense breast tissue and left breast calcifications, poorly characterized on CT examination. Multilevel degenerative changes affect the thoracic spine. There is surgical fixation of the right glenoid. There is marked degenerative changes affecting the right glenohumeral joint with bone on bone apposition.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypodensity in the right lobe of the liver is too small to characterize, but likely represents a simple cyst.SPLEEN: Small splenule.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypodensities in the left kidney are too small to characterize, but may represent simple cysts. Bilateral extrarenal pelvises.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Prominent retroperitoneal lymph nodes, without evidence of lymphadenopathy.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. | 1. Multifocal left-sided pleural thickening, with measurements provided above, consistent with the known history of biopsy proven mesothelioma. Small left pleural effusion.2. 12-mm sub-solid nodule in the left upper lobe, which is suspicious for adenocarcinoma in situ or minimally invasive adenocarcinoma. There are multiple additional nodules with irregular margins in the right lower lobe which are nonspecific, but are moderately suspicious for synchronous primary carcinomas, and further follow-up is recommended. |
Generate impression based on findings. | The lowermost level containing definite ribs is presumed to be T12. With this numbering nomenclature, a rudimentary disc is present at S1/2.There is levorotoscoliosis with its apex centered at approximately L3. There are no fractures. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.Disc desiccation is present throughout and there is mild disc height loss at L5/S1.T12/L1: UnremarkableL1/2: There is a tiny left paracentral disc protrusion with prominent annular tear without associated significant mass effect. There is also slight ligamentum flavum thickening and mild left hypertrophy. There is no central or neural foraminal stenosis.L2/3: Mild disc bulge containing a posterior central annular fissure, ligamentum flavum thickening, and mild bilateral facet hypertrophy. There are no significant stenoses.L3/4: Left foraminal/lateral broad-based disc extrusion which causes moderate to severe left neural foraminal stenosis with deformation of the adjacent L3 nerve roots. There is also superimposed diffuse annular disc bulge containing a small posterior central annular fissure, ligamentum flavum thickening, and mild to moderate bilateral facet hypertrophy. There is no central stenosis, however there is mild right neural frontal stenosis.L4/5: Right foraminal/lateral disc protrusion, superimposed diffuse annular disc bulge, ligamentum flavum thickening, moderate left facet hypertrophy, and moderate to severe right facet hypertrophy. There is no central stenosis, however there is mild to moderate left neural foraminal and moderate right neural foraminal stenosisL5/S1: Asymmetric bulge to the left and mild bilateral facet hypertrophy. There is mild left neural foraminal stenosis. | 1.L1/2: There is a tiny left paracentral disc protrusion with prominent annular tear without associated significant mass effect or stenosis.2.L2/3: Mild disc bulge containing a posterior central annular fissure without stenoses.3.L3/4: Left foraminal/lateral broad-based disc extrusion which causes moderate to severe left neural foraminal stenosis with deformation of the adjacent L3 nerve roots. There is also mild right neural frontal stenosis.4.L4/5: Right foraminal/lateral disc protrusion. There is no central stenosis, however there is mild to moderate left neural foraminal and moderate right neural foraminal stenosis5.L5/S1: Mild left neural foraminal stenosis. |
Generate impression based on findings. | 54-year-old with history of calcifications in the right upper outer breast. No current breast related complaints. 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing coarse calcifications in the right upper outer breast, are not significantly changed since 8/26/2011. Benign appearing lymph nodes are projected over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: myasthenia gravis, evaluate for possible thymectomy History: see above LUNGS AND PLEURA: Minimal dependent atelectasis.MEDIASTINUM AND HILA: The heart size is within normal limits, no significant pericardial effusion. No visible coronary artery calcifications.Right jugular catheter tip at the cavoatrial junction.No significant hilar/mediastinal lymphadenopathy.Ill-defined soft tissue density in the anterior mediastinum, compatible with residual thymic tissue. No evidence of discrete mass formation, necrosis, or associated lymphadenopathy.CHEST WALL: Mild degenerative disease of the spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Ill-defined anterior mediastinal soft tissue density, compatible with residual thymic tissue. |
Generate impression based on findings. | Bony lesion within left femur; assess for primary tumor CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Vena cava filter.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enlarged heterogeneous uterus with punctate calcification suggestive of fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in sclerosis and cortical disruption involving left intertrochanteric region of the proximal left femurOTHER: No significant abnormality noted. | Interval increase in sclerosis and cortical disruption involving left intertrochanteric region of the proximal left femur; a malignant etiology cannot be excluded.Enlarged heterogeneous uterus with punctate calcifications suggestive for fibroids; would suggest correlation with ultrasound.Otherwise negative for intra-abdominal neoplastic process. |
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 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. | Reason: eval for mediastinal mass History: eval for mediastinal mass LUNGS AND PLEURA: Small pulmonary and subpleural nodules compatible with intrapulmonary lymph nodes, unchanged.No suspicious nodules and no pleural effusions.MEDIASTINUM AND HILA: Diffusely enlarged thymus, not significantly changed from previous scans.No significant lymphadenopathy.No visible coronary artery calcification and no pericardial effusion.CHEST WALL: Mildly enlarged thyroid gland.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Small sliding hiatal hernia with no specific evidence of esophageal abnormality. | Enlarged thymic gland without evidence of a discrete mass or significant interval change. |
Generate impression based on findings. | Aneurysm. Evaluate for bleed. There is no evidence of intracranial hemorrhage. There is a thrombosing fusiform aneurysm of the tortuous mid to distal basilar artery with an internal flow diverter and mass effect upon the brainstem. There is a coil mass within the superior aspect of the basilar artery aneurysm. There has been gradual increase in the size of this aneurysm, which measures 3.1 x 2.3 cm currently, 2.7 x 1.8 cm on 5/19/2014 and 2.5 x 1.3 cm on 10/20/2013. There is encephalomalacia of the right occipital lobe with ex vacuo dilatation of the adjacent ventricle, hypoattenuation in the bilateral cerebellar hemispheres, and hypoattenuation in the right basal ganglia region. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage, within the limits of metal streak artifact.2. Apparent interval increase in size of thrombosing fusiform basilar artery aneurysm that was treated with stent-coiling. Further evaluation with CTA or MRA may be considered.3. Chronic right occipital lobe, bilateral cerebellar, and right basal ganglia infarcts. |
Generate impression based on findings. | Increased work of breathing.VIEW: Chest and abdomen AP (two views) 1/2/15 at 1038 hrs Tracheostomy tube tip is below the thoracic inlet. Left upper extremity central line terminates at the left innominate vein. NG tube tip is at the stomach. Interval decrease in soft tissue edema.Cardiac silhouette size is normal. Interval redevelopment of right upper lobe atelectasis. Decreasing in diffuse lung haziness.Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Redevelopment of right upper lobe atelectasis and decreasing in the haziness and soft tissue edema in the interval.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | Male 67 years old; Reason: evaluAte ivc filter History: ? ivc filter Nonobstructive bowel gas pattern. Multiple clips are project over the pelvis and along the midline and left upper abdomen. An IVC filter is not visualized. | An IVC filter is not visualized. |
Generate impression based on findings. | Metastatic lung carcinoma ABDOMEN:LUNG BASES: Stable bibasilar emphysematous findings and left lung base bullous diseaseLIVER, BILIARY TRACT: Segment 7 right lobe subcentimeter low attenuation focus stable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Obscured by beam hardening artifact.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable negative examination; no evidence for acute, inflammatory, or metastatic process |
Generate impression based on findings. | Female 35 years old; Reason: infertility History: infertility Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine cavity without mucosal irregularity or filling defects in the uterine cavity. Both tubes were freely opacified with free spillage on both sides into the pelvis, indicating tubal patency.TOTAL FLUOROSCOPY TIME: One minute 19 seconds | Normal uterine cavity and patent fallopian tubes. |
Generate impression based on findings. | Male 19 years old Reason: 19yo M with history of HgbSS and new different abdominal pain, eval for free air, SBO, etc VIEW: Abdomen AP supine and upright (two views) 1/2/15 Cholecystectomy clips again noted. Mild amount of fecal accumulation with no evidence of obstruction or free air. No ascites. | Mild fecal accumulation, otherwise normal examination. |
Generate impression based on findings. | Reason: Dx breast Ca History: evaluate disease/check for metastatic disease CHEST:LUNGS AND PLEURA: No significant abnormality noted. No suspicious nodule/mass.MEDIASTINUM AND HILA: The heart size is within normal limits, no significant pericardial effusion. The main pulmonary artery is of normal caliber. Chest port catheter tip at cavoatrial junction.No significant hilar/mediastinal lymphadenopathy.CHEST WALL: Enhancing right axillary lymph nodes measure up to 12 mm in short axis (series 3, image 28), compatible with known axillary metastases.Multiple enhancing nodules in the right breast compatible with known right multicentric breast cancer.Left superior thoracic subcutaneous emphysema likely related to recent procedure. Left chest port catheter terminates at the cavoatrial junction.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Geographic hypoattenuation along the fissure likely relates to focal fat deposition.Subcentimeter hypodensities in the right hepatic lobe are too small to characterize, likely cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter renal hypodensities, likely cysts.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: Mild degenerative disease of the spine. No suspicious lytic/sclerotic osseous lesions.OTHER: No significant abnormality noted. | 1. Enhancing nodules in the right breast and enlarged right axillary lymph nodes are compatible with known right breast cancer with axillary metastases.2. No suspicious nodules/masses in the lungs, visualized osseous structures, left axilla, or upper abdomen. |
Generate impression based on findings. | Evaluation for TAVR Artifacts from spinal fusion hardware at T12-L2 somewhat limit evaluation of the surrounding structures including portions of the aorta and right renal artery.ANGIOGRAM: Please see accompanying cardiac CT report for description of heart and thoracic aorta. There is fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring up to 5.5 x 5.2 centimeters. Moderate atherosclerotic calcifications affect the abdominal aorta and its branches. Mural thrombus is present along the infrarenal abdominal aorta. There is significant tortuosity of the bilateral common iliac arteries. The origins of the great vessels, celiac axis, SMA, and renal arteries are patent. VESSELS:DESCENDING THORACIC AORTA AT LEVEL OF HIATUS: 3.2 X 3.4 cmSUPRARENAL ABDOMINAL AORTA: 2.9 X 2.7 cmINFRARENAL ABDOMINAL AORTA: 5.3 X 4.8 cmRIGHT COMMON ILIAC ARTERY: 16.9 X 16.3 mmRIGHT EXTERNAL ILIAC ARTERY: 11.1 X 11.0 mmRIGHT COMMON FEMORAL ARTERY: 11.0 X 11.1 mmLEFT COMMON ILIAC ARTERY: 16.8 X 16.6 mmLEFT EXTERNAL ILIAC ARTERY: 11.4 X 10.8 mmLEFT COMMON FEMORAL ARTERY: 10.7 X 11.4 mmCHEST:LUNGS AND PLEURA: Scattered atelectasis. MEDIASTINUM AND HILA: See cardiac CT report for details regarding heart and vasculature. Small mediastinal lymph nodes are present.CHEST WALL: Complex deformity of the manubrium appearing similar to prior.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral renal cysts and additional low attenuation lesions too small to characterize.RETROPERITONEUM, LYMPH NODES: See description of the aorta above.BOWEL, MESENTERY: Evaluation of bowel somewhat limited by lack of enteric contrast. No significant abnormality noted. BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine and posterior spinal fusion hardware at T12-L2. Right hip intramedullary rod and screw device with surrounding heterotopic bone formation. Moderate body wall edema.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter is present in the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Evaluation of bowel somewhat limited by lack of enteric contrast. No significant abnormality noted. BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine and posterior spinal fusion hardware at T12-L2. Right hip intramedullary rod and screw device with surrounding heterotopic bone formation. Moderate body wall edema.OTHER: No significant abnormality noted | Fusiform infrarenal abdominal aortic aneurysm measuring up to 5.5 cm with associated mural thrombus. Significant tortuosity of the bilateral common iliac arteries. Additional abdominal aortic measurements as above. Please see chest/cardiac CT from the same day for heart and thoracic aorta findings. |
Generate impression based on findings. | 26 year-old female with dyspnea, lymphadenopathy, and lung nodules in the right upper lobe, seen on previous CT. LUNGS AND PLEURA: Note is made of a cluster of multiple centrilobular nodules in the right upper lobe both anteriorly and medially with associated tree in bud opacity. No pleural effusion or pneumothorax. Numerous additional scattered pulmonary nodules and micronodules are identified bilaterally.MEDIASTINUM AND HILA: Evaluation for mediastinal and hilar lymphadenopathy is limited on this noncontrast examination. There are moderately enlarged mediastinal lymph nodes, and there may be enlarged nodes in the right hilum.CHEST WALL: Prominent right axillary lymph nodes, with normal fatty hila.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hypodensity in the right lobe of the liver is incompletely characterized on this noncontrast examination but likely represents a benign hemangioma. | Multiple clustered small nodules in the right upper lobe are suspicious for granulomatous infection, including TB, atypical mycobacterial or fungal etiologies, such as histoplasmosis. If there is a history of asthma, ABPA (allergic bronchopulmonary aspergillosis) could also be considered. |
Generate impression based on findings. | Reason: History of metastatic breast cancer on treatment. Compare to prior imaging, evaluate for response and extent of disease. History: History of metastatic breast cancer on treatment. Compare to prior imaging, evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Nodular thickening along the right major fissure (series 4/28), increased from previous.Right lower lobe elongated nodular opacity measuring 10 x 15 mm (series 4/63), increased from previous.Left lower lobe infrahilar irregular nodule measuring 16 x 24 mm (series 4/64), increased from 12 x 20 mm previously.Thickened interlobular septi and groundglass opacity in the left lower lobe suggestive of edema secondary to venous and lymphatic obstruction, increased.Right inferior perihilar nodule (series 3/58), increased from previous.MEDIASTINUM AND HILA: Multiple moderately enlarged mediastinal and hilar lymph nodes measuring up to 10 mm in short axis diameter, without significant change.Subcarinal lymph node measuring 11 mm in short axis diameter, not significantly changed when using comparable measurements.No visible coronary arch or calcifications in pericardial effusion.CHEST WALL: Bilateral mastectomies with reconstructions and axillary lymph node dissection.No evidence of axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.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. | Interval increase in size of pulmonary nodules. Stable mediastinal and hilar lymphadenopathy. |
Generate impression based on findings. | 73-year-old female with history of fall and confusion. Evaluate for hemorrhage. No evidence of acute intracranial hemorrhage. There are scattered intracranial vascular calcifications. No midline shift or mass effect. The basal cisterns are unremarkable. Ventricular size is age-appropriate. The visualized paranasal sinuses and mastoid air cells are clear. There is rightward deviation of the nasal septum. | No evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | 76 years old, Male, Reason: restaging cholangiocarinoma on chemotherapy CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are present. Previously noted cluster of right apical pulmonary nodules is no longer present and is likely of infectious or inflammatory etiology. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Severe coronary artery calcifications. Scattered mediastinal and hilar lymph nodes not meeting size criteria for lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Three biliary stents are again seen with expected pneumobilia, not significantly changed. Intrahepatic biliary ductal dilatation is not significantly changed. Segment 5 lesion is very difficult to measure although is approximately 1.7 x 2.6 cm (series 3, image 96). There is adjacent capsular retraction. The anterior branch of the right portal vein is occluded, unchanged. There is differential enhancement of the liver parenchyma likely related to differential vascular flow.SPLEEN: No significant abnormality notedPANCREAS: Scattered punctate parenchymal calcifications unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant change in size of periportal lymph node now measuring 1.7 by 1.0 cm (series 3, image 87), previously measuring 1.8 x 1.0 cm. Scattered retroperitoneal lymphadenopathy unchangedBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Mildly enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Unchanged hepatic segment 5 mass compatible with patient's known cholangiocarcinoma with associated perfusion abnormalities and capsular retraction.2.Unchanged lymphadenopathy.3.Previously noted cluster of right apical pulmonary nodules is no longer visualized. |
Generate impression based on findings. | The patient submitted outside digital mammograms dated 4/24/2014 and 9/13/2013 from Advocate Christ Medical Center in Oak Lawn IL. Submitted outside studies were compared to the current mammogram dated 11/19/2014. The breast parenchyma is heterogeneously dense which may obscure small masses, unchanged in pattern and distribution. Stable benign calcifications are present bilaterally, right greater than left. 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 is unremarkable, annual bilateral screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Gallbladder carcinoma CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter segment 7 lesion best seen on image 78 of series 3 has remained stable measuring 0.7 cm in diameter. Peripheral reference segment 4a lesion best seen on image 86 of series 3 has remained stable measuring 1 cm in diameter. Peripheral benign appearing FNH lesion within segment two best seen on image 80 measures 2.4 x 3.7 cm.Interval appearance of nodularity arising from the gallbladder wall best seen on image 103 of series 3 measuring 1.4 x 1.1 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: New peri-celiac retroperitoneal adenopathy. A representative lymph node best seen on image 106 of series 3 measures 2.1 x 1.4 cm.No significant change in reference portacaval lymph node seen on image 100 of series 3 measuring 1.5 x 1.6 cm.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: No significant abnormality notedOTHER: No significant abnormality noted | New nodularity arising from the gallbladder wall associated with new retroperitoneal adenopathy worrisome for disease progression. |
Generate impression based on findings. | Omphalocele. Feeding intolerance.VIEW: Abdomen AP (one view) 1/2/15 1050 hrs. NG tube terminates in the stomach. Large omphalocele again noted. Nonspecific bowel distention, no evidence of obstruction or free air. No pneumatosis intestinalis or portal venous gas. No ascites. | Nonspecific bowel distention. |
Generate impression based on findings. | ORIFVIEWS: Right elbow AP/oblique/lateral (3 views) 1/2/15 A screw affixes the medial humeral epicondyle in anatomic alignment. No radiographic evidence of hardware complication. The fracture line is no longer visible, indicating healing. No joint effusion is evident. | Healed medial epicondylar fracture. |
Generate impression based on findings. | T4N0 right oral tongue squamous cell carcinoma, status post radiation, 2 cycles of IC with carbo/taxol, and 5/5 cycles of TFHx (completed 12/5/14). There are post-treatment findings in the oral cavity region. There has been interval decrease in size of the oral tongue mass that traverses the midline, which now measures approximately up to 40 mm. The mass contains areas of probable necrosis and calcifications. There is no evidence of significant cervical lymphadenopathy based on size criteria. Indeed, the right level 2A lymph node has further decreased in size, now measuring 3 mm in short axis, previously 8 mm. There is hyperenhancement of the nasopharyngeal mucosa diffusely, which may represent mucositis. The thyroid and major salivary glands are unchanged. There is mild atherosclerotic plaque along the proximal internal carotid arteries bilaterally. There are unchanged bilateral maxillary and mandibular molar extraction cavities with associated soft tissue that may represent granulation tissue. There is a tracheostomy tube in position. The airways are patent. There is minimal mucosal thickening and retention cyst formation in the maxillary sinuses. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. Post-treatment findings in the oral cavity region with interval decrease in size of the oral tongue mass that traverses the midline, which now measures approximately up to 40 mm. 2. No residual significant lymphadenopathy in the neck. |
Generate impression based on findings. | The patient submitted outside digital mammograms dated 4/24/2014 and 9/13/2013 from Advocate Christ Medical Center in Oak Lawn IL. Submitted outside studies were compared to the current mammogram dated 11/19/2014. The breast parenchyma is heterogeneously dense which may obscure small masses, unchanged in pattern and distribution. Stable benign calcifications are present bilaterally, right greater than left. 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 is unremarkable, annual bilateral screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 28 years old; Reason: infertility History: infertility Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine although arcuate appearing cavity without mucosal irregularity or filling defects in the uterine cavity. Both tubes were freely opacified with free spillage on both sides into the pelvis, indicating tubal patency.TOTAL FLUOROSCOPY TIME: 0 minutes and 34 seconds | Probable arcuate uterus with patent fallopian tubes. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. 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 heterogeneously dense, which may obscure small masses , unchanged in pattern and distribution. Stable circumscribed benign masses are present in both breasts. Stable benign calcifications are present. 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: NSC - Screening Mammogram. |
Generate impression based on findings. | Male 52 years old; Reason: eval for PD stent passage. ERCP 12/24/14 History: na Nonobstructive bowel gas pattern. Moderate amount of stool in the abdomen. Biliary stent unchanged. The pancreatic duct stent is no longer visualized. Calcification within the right upper quadrant is unchanged. | The pancreatic duct stent is no longer visualized. |
Generate impression based on findings. | Metastatic breast carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant change in wide spread sclerotic metastatic disease.ABDOMEN:LIVER, BILIARY TRACT: Stable segment 0.2-cm low-attenuation focus.SPLEEN: No significant abnormality noted.PANCREAS: Stable 0.6-cm low-attenuation focus arising from the body of the pancreas best seen on image 11 of series 4.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: Widespread sclerotic metastatic bony disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Widespread sclerotic metastatic bony disease.OTHER: No significant abnormality noted. | Extensive sclerotic bony metastases again noted. No visceral or nodal metastatic process. |
Generate impression based on findings. | 14 year old with right breast lump. There is an area of skin abrasion with white pus coming out. Focused ultrasound is performed in the right breast. Detected is a cystic lesion measuring 16 x 5 mm within the skin at 4 o'clock position, with increased blood flow, consistent with infected sebaceous cyst. | Infected sebaceous cyst at 4 o'clock position in the right breast. Clinical correlation is recommended.Results and recommendations were discussed with the patient and her mother.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: ? worsening pneumothorax History: see above LUNGS AND PLEURA: Large left pneumothorax, markedly increased from previous, with underlying atelectasis and consolidation in the left lung, and a small left pleural effusion.Increase in patchy airspace opacity with underlying groundglass opacity in the right upper lobe.Small anterior right upper lobe cavitary nodule, likely infectious, not significantly changed (series 5/31).Increased right pleural effusion with underlying atelectasis.Underlying nodular pattern, and degraded by motion artifact, suggestive of infectious bronchiolitis.MEDIASTINUM AND HILA: Tracheostomy tube with its tip approximately 6 cm above the carina.Central venous catheters with their tips in the SVC.Enlarged right paratracheal lymph node, unchanged.Hyperattenuating blood pool compatible with anemia.Enteric tube in place.CHEST WALL: Subcutaneous emphysema in the left axillary area.Moderate chest wall edema.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Increased left pneumothorax and bilateral pulmonary consolidation, compatible with infection. |
Generate impression based on findings. | 64-year-old male with GE junction esophageal cancer. Repeat PET imaging per CALGB 80803 requirements.RADIOPHARMACEUTICAL: 13.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 111 mg/dL. Today's CT portion grossly demonstrates chronic-appearing pansinusitis including inflammation of the the bilateral ethmoid and maxillary sinuses. There is a right chest port with tip in the SVC. Extensive atherosclerotic disease is present including coronary arterial calcifications. Diffuse fatty infiltration of the liver is noted.Today's PET examination demonstrates a decrease in size and intensity of the distal esophageal lesion with SUV max = 7.3, which previously measured SUV max = 11.3. There has been complete interval resolution of all of the hypermetabolic hilar and mediastinal lymph nodes seen on the previous study.No new or additional suspicious FDG-avid lesion is identified elsewhere in the neck, chest, abdomen or pelvis. | 1.Significant metabolic response to therapy with complete resolution of mediastinal and hilar activity. Significant reduction in distal esophageal lesion activity. The current distal esophageal activity could represent residual tumor metabolism or post-therapeutic inflammatory changes.2.No new or additional FDG-avid metastases. |
Generate impression based on findings. | Reason: retropharyngeal abscess. History: pain. Neck: There is diffuse prominence of the adenoids and tonsils with mild oropharyngeal airway narrowing. Otherwise, there is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. There are retropharyngeal carotid arteries, but no evidence of retropharyngeal fluid collections. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is a partially-image anterior disc-osteophyte complex at C5-6. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.Maxillofacial: There is mild mucosal thickening within the sphenoid sinuses. The other paranasal sinuses are clear. The nasal cavity is also clear. There is no significant nasal septal deviation. The orbits are unremarkable. Aside from dental amalgam, the dentition appears unremarkable. | 1. Nonspecific diffuse prominence of the adenoids and tonsils with mild oropharyngeal airway narrowing. This may be reactive in nature.2. Retropharyngeal carotid arteries, but no evidence of retropharyngeal abscess. |
Generate impression based on findings. | 79-year-old male on spironolactone presenting with left breast tenderness and firmness. Three standard views of both breasts along with repeat left MLO and left-sided spot compression CC and MLO views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Immediately posterior to the left nipple is a partially circumscribed 2-cm focal asymmetry with feathered posterior margins. No suspicious microcalcifications or architectural distortion. The right breast is unremarkable. A pacemaker generator is noted in the left upper chest wall. | Gynecomastia most likely secondary to the patient's spironolactone treatment. No suspicious features of malignancy. As long as the patient's exam remains stable, no additional imaging is required.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Mesothelioma CHEST:LUNGS AND PLEURA: There is right pleural hemithorax pleural thickening with plaques essentialy similar but with decreased calicifications, possibly representing interval surgical changes. Reference measurements are as follows:1. At the level of the aortic arch (ascending aorta) (image 36 series 3), remains similar at 12 and 10 o'clock, measuring 5 and 6 mm previously 7 mm and 6 mm. Differences most likely differences in gantry angle.2. At the level of the SVC/right atrium (image 51 series 3), measures 11 mmand 0 mm (unmeasureable) previously 11 and 3 mm. The latter representing old calcification from pleural disease and not measureable disease.3. At the level of the left atrium (image 54 series 3 and previously tracked - though not separated from the measurement above by standard slice difference), measures 10 mm and 4mm unchanged.The underlying right lung is significant for patchy partial consolidation and changes essentially in the lower right lobe; probable atelectasis yet aspiration and or even infection cannot be excluded.Left lung demonstrates pleural plaques unchanged. The underlying lung is otherwise unchanged and unremarkable.MEDIASTINUM AND HILA: No distinct lymphadenopathy or measurable disease.Moderate cardiomegaly with extensive pericardial changes along the right margin suggesting possible invasion. No distinct pericardial effusion. Extensive atherosclerotic changes and surgical clips with artifactSmall hiatal herniaCHEST WALL: Unchanged extrathoracic large chest wall mass again when measured similarly remains 12 x 3.5 cm axially (image 102 series 3) with extension through the eighth intercostal space. Coronal measurement also remains approximately 11 cm (image 67 series 8024).ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Extensive bilateral renal cysts. The complex right lower pole cyst again appears similar and 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.No significant abnormality noted.BONES, SOFT TISSUES: Mild scattered degenerative changes involving the lumbar spine unchanged. No new suspicious lytic or blastic lesionsOTHER: No significant abnormality noted. | Scattered mesothelioma changes throughout the right hemithorax with grossly similar measurements given differences in technique. Particular attention was placed in the right chest and abdominal wall focus overlying the lateral right lower ribs. Reference measurements provided |
Generate impression based on findings. | Solitary pulmonary nodule left upper lobe.RADIOPHARMACEUTICAL: 14.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 121 mg/dL. Today's CT portion grossly demonstrates an approximately 11 mm left upper lobe pulmonary nodule, stable. Extensive bilateral groundglass pulmonary opacities are likely inflammatory. There are trace bilateral pleural effusions. Multichamber cardiomegaly is noted. Extensive atherosclerotic including coronary arterial calcifications are seen. Large hypodense right inferior hepatic mass is noted. Several additional more sharply marginated fluid density hepatic lesions are likely cysts. Focal masslike thickening of the cecum is present with an adjacent enlarged right mesenteric lymph node.Today's PET examination demonstrates the small left upper lobe nodule to be mild to moderately hypermetabolic (SUV max = 2.4), very suspicious for malignancy.Multiple small mild to moderately hypermetabolic symmetric bilateral hilar and mediastinal lymph nodes are present (SUV max = 2.7). Given their small size and symmetry, these may reflect benign granulomatous inflammatory lymph nodes although metastatic disease is conceivable.In the right colon in the region of the cecum, curvilinear but fairly focal markedly hypermetabolic activity (SUV max = 10.2) corresponds with regional colonic thickening. This is very suspicious for primary colon carcinoma.An enlarged adjacent significantly hypermetabolic mesenteric lymph node (SUV max = 6.5), is compatible with a regional lymph node metastasis.A large significantly hypermetabolic right inferior hepatic mass (SUV max = 5.5), is compatible with a single hepatic metastasis. | 1.Multiple hypermetabolic abdominal findings most likely represent primary colon cancer at the cecum with an adjacent mesenteric lymph node metastasis and a large right inferior hepatic metastasis.2.Hypermetabolic solitary pulmonary left upper lobe nodule is very suspicious for additional malignancy. This could represent a synchronous small primary lung cancer or a colon cancer metastasis.3.Symmetric mediastinal and hilar small hypermetabolic lymph nodes could represent benign granulomatous inflammation, although metastatic disease is conceivable. |
Generate impression based on findings. | Metastatic lung cancer. LUNGS AND PLEURA: Micronodules and scar like opacities are present with mild emphysema.Right lower lobe subpleural opacity, suggestive of postinfectious scarring and organized pneumonia, unchanged (series 6 /65).Right middle lobe nodule (series 6/49) 3 x 5 mm, decreased from previous.Nonspecific soft tissue thickening in the right hilum measuring 9 x 35 mm (series 4/50) not significantly changed.MEDIASTINUM AND HILA: Reference left paratracheal lymph node (series 4/16), 5 mm in short axis measurement, slightly decreased from 6 mm.Reference right paratracheal lymph node (series 4/24) measuring 8 mm in short axis, not significantly changed.Retrocardiac soft tissue measures 12 mm in thickness, not significantly changed (series 4/56).CHEST WALL: Benign appearing axillary lymph nodes.Degenerative disease in the spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Slightly improved reference measurements and no new sites of disease. |
Generate impression based on findings. | Interbody fusion The patient has undergone multilevel lower lumbar laminectomy. A spacer device is again seen between the L3 and L4 vertebral bodies, with faint bone graft material noted. I see no postoperative complications. Moderate degenerative disk disease affects L1/2. There is slight anterior wedging of the T12 and L1 vertebral bodies which is probably of no clinical significance. | Postoperative changes with interbody spacer device L3/4 as described above. |
Generate impression based on findings. | Female 44 years old; Reason: infertility History: infertility Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine cavity without mucosal irregularity or filling defects in the uterine cavity. Both tubes were freely opacified with free spillage on both sides into the pelvis, indicating tubal patency. Mild intravasation.TOTAL FLUOROSCOPY TIME: 3 minutes and 47 seconds | Normal uterine cavity and patent fallopian tubes. |
Generate impression based on findings. | Pain. Fracture? I see no fracture or other specific findings to account for the patient's shoulder pain. Orthopedic fixation of the thoracic spine is incompletely imaged on this shoulder study. | No fracture evident. No specific findings to account for the patient's pain. |
Generate impression based on findings. | Female 63 years old; Reason: Pt w/ metastatic lung cancer s/p 5 cycles of carbo/paclitaxel, evaluate for progression. History: Pt w/ metastatic lung cancer s/p 5 cycles of carbo/paclitaxel, evaluate for progression. ABDOMEN:LUNGS BASES: Please refer to concomitant CT chest imaging from same day for additional findings. Left apical thrombus visualized, associated small hyperattenuation may reflect underlying calcification, adjacent wall thinning present, probable underlying aneurysm formation, similar to earlier imaging. Findings discussed with Dr. P. Hoffman at 12:20 p.m. on 1/2/15.LIVER, BILIARY TRACT: Common bile duct borderline in size, similar to prior study no radiopaque choledocholithiasis, no significant intrahepatic biliary duct dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable in appearance.KIDNEYS, URETERS: Right kidney stable in appearance, including upper pole renal cyst, lobulated right renal cortex with renocortical thinning also seen, likely reflecting scarring. Near complete left-sided renal cortical atrophy, nonobstructing 4-mm left renal lower pole calculus.RETROPERITONEUM, LYMPH NODES: Moderately atherosclerotic and ectatic, measuring up to 2.5 cm, abdominal aorta with eccentric mural thrombosis seen in distal abdominal aorta.BOWEL, MESENTERY: Large sliding type hiatal hernia. Moderate to large stool burden. Sigmoid and descending colon diverticulosis.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. Both may as you have of your Grover at is aBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Multiple enlarging peripherally enhancing subcutaneous soft tissue foci. For reference, enlarging lesion in upper midline, measuring 4.2 x 3.2 cm, image 22 series 3, previously measured 2.6 x 2.5 cm. Calcified buttock granulomata. Mild nonspecific subcutaneous induration in deep left gluteal area, overlying ischial tuberosity, image 140 series 3. | 1. Multiple enlarging subcutaneous soft tissue foci, suspicious for worsening neoplastic/metastatic disease.2. Please refer to concomitant CT chest exam from same day for additional findings. |
Generate impression based on findings. | Pain. Fracture? Three views of the right ankle are provided. I see no fracture or other specific findings to account for the patient's pain.Three views of the right foot are provided. I see no fracture or other specific findings to account for the patient's pain. | No fracture evident. No specific findings to account for the patient's pain. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy in 1989. Two standard digital views and tomosynthesis of both breasts as well as bilateral ML views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. A linear marker was placed on a scar and a round marker was placed on a skin lesion overlying the left breast. Benign calcifications are present, including arterial calcifications.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. Mammography is most sensitive when evaluating for interval changes. If patient submits outside mammograms, comparison will be made. 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. | Swelling and tenderness. Trauma to left great and second toe. Rule out fracture. There is a nondisplaced fracture of the head of the proximal phalanx of the great toe, best seen on the oblique view. I cannot determine if this fracture extends to the interphalangeal joint. I see no fracture of the remaining toes. There is mild osteoarthritis of the first metatarsophalangeal joint. Mild cortical thickening along the third and fourth metatarsals is of doubtful current clinical significance. Although these are nonweightbearing views, there appears to be a mild cavus deformity of the foot. There is mild deformity of the posterior aspect of the distal tibia which may represent an old healed fracture. Note is made of plantar and posterior calcaneal spurs. | Nondisplaced fracture of the head of the proximal phalanx of the first toe. This was relayed to Dr. Yu at the time of dictation. |
Generate impression based on findings. | 46-year-old female with partially circumscribed subcentimeter mass in the left lower outer quadrant noted on screening mammogram. No family history of breast cancer. MAMMOGRAM: Mediolateral hand spot compression mediolateral and CC views views of the left breast 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. Redemonstration of a partially circumscribed mass in the left lower outer quadrant (4 o'clock radian) that persists on spot compression views. No additional suspicious masses, microcalcifications, or architectural distortion.ULTRASOUND: Targeted ultrasound was performed of the left breast at the site of the mammographic abnormality. Sonographic exam showed a simple cyst in the 4 o'clock radian 5 cm from the nipple measuring 7 x 5 x 6 mm. No suspicious mass lesions are identified. | Simple cyst in the left lower outer breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
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 composed of scattered fibroglandular density. Benign calcifications are present in the right lower inner quadrant. 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 in neck with range of motion. Severe degenerative disk disease affects C4/5, C5/6, and C6/7. Mild to moderate degenerative disk disease affects C2/3. There are minimal anterolistheses of C2 and C3, and a mild retrolisthesis of C5. There is loss of the normal cervical lordosis. There is mild to moderate multilevel facet joint osteoarthritis with neuroforaminal narrowing bilaterally. Calcification to the left of the cervical spine likely resides in the carotid vasculature. There is a slight leftward curvature of the cervicothoracic spine. | Degenerative arthritic changes as described above. |
Generate impression based on findings. | 63 years old, Male, Reason: carcinoid tumor compare to last Ct \T\ measure 1) aortopulmonary node, 2) hepatic dome lesion, 3) right inguinal node and 4) L2 vertebral body lesion History: post 2 cycles of chemo CHEST:LUNGS AND PLEURA: Nonspecific foci of small groundglass attenuation in the right lung apex, measuring 8 mm (series 4, image 27) and left upper lobe (series 4, image 44) appear unchanged compared to prior study.MEDIASTINUM AND HILA: Reference aortopulmonary window lymph node appears to have a fatty hilum and now measures 1.4 x 0.7 cm (series 3, image 42), previously measuring 1.4 x 0.9 cm. Multiple mediastinal surgical clips.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly unchanged. Diffuse hepatic steatosis. Reference anterior hepatic dome lesion is not significantly changed in size measuring 2.5 x 2.2 cm (series 3, image 69), previously measuring 2.5 x 2 cm. There are multiple bilobar hepatic enhancing foci compatible with metastatic disease. The portal veins appear patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable bilateral mild adrenal nodularity.KIDNEYS, URETERS: Left upper pole renal cyst is unchanged in size. There are additional hypoattenuating lesions bilaterally which are too small to characterize. Renal/perirenal soft tissue focus adjacent to the lower pole of the right kidney is slightly enlarged and measures 1.2 by 1.0 cm (series 3, image 135), previously measuring 0.9 x 0.7 cm. This lesion was previously seen to be enhancing and is suspicious for metastasis although RCC cannot be excluded.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy. Aortic and iliac calcifications are present.BOWEL, MESENTERY: Descending and sigmoid colon diverticulosis. No evidence of diverticulitis or obstruction.BONES, SOFT TISSUES: L2 vertebral body lesion is not significant changed in size measuring 1.6 x 2.3 cm (series 3, image 125, previously measuring 2.3 x 1.5 cm. multiple additional sites of osseous metastatic disease are not significantly changed. No definite new sites of sclerotic osseous metastatic disease. Multilevel degenerative changes of the spine without evidence of compression fracture.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Reference right inguinal lymph node measures 1.4 x 0.7 cm (series 3, image 200), previously measuring 1.5 x 0.8 cm.BOWEL, MESENTERY: See abdomen sectionBONES, SOFT TISSUES: See abdomen sectionOTHER: No significant abnormality noted | 1.Innumerable bilobar hepatic metastasis with reference lesion unchanged in size.2.Slight increase in size of the renal/perirenal soft tissue focus, concerning for metastasis although RCC cannot be excluded.3.Unchanged osseous metastatic disease. Please note nuclear medicine bone scan is better to evaluate osseous metastatic disease.4.Lymphadenopathy not significantly changed.5.Nonspecific foci of pulmonary groundglass attenuation not significantly changed. |
Generate impression based on findings. | History of laryngeal squamous cell carcinoma (T4bN3), status post chemoradiation. There are extensive post-treatment findings in the neck, with diffuse pharyngeal mucosal space edema. There is increased heterogeneity and decreased bulk of the ill-defined supraglottic mass, which measures up to approximately 15 mm. There interval decrease in size of the right level 5 necrotic lymph node, measuring approximately 22 x 12 mm, previously 25 x 15 mm in the axial plane. There are postoperative findings related to right lingual artery embolization and right common carotid artery sacrifice. The right internal jugular vein is also absent. There is a partially-imaged left internal jugular venous catheter. There are unchanged bilateral thyroid nodules. The salivary glands appear unchanged. There are retention cysts in the maxillary sinuses. There is mild opacification of the mastoid air cells. There is a tracheostomy tube in position with patent airways inferior to the tube. There is mild to moderate degenerative spondylosis of the cervical spine. There are multiple dental caries. There is a ground glass nodule that measures up to 4 mm in the left upper lobe with a background of emphysema. There are extensive skin calcifications in the cheeks. | 1. Post-treatment findings in the neck with apparent increased necrosis and decreased bulk of the supraglottic mass.2. Interval decrease in size of the necrotic right level V lymphadenopathy. 3. Nonspecific subcentimeter left lung nodule. Please refer to the separate chest CT report for additional details.4. Multiple dental caries. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast cyst aspiration in 2008. History of breast cancer in mother and maternal grandmother. Two 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. If patient submits outside interval mammograms, comparison will be made. 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. Three 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. Prominent axillary fat pads are unchanged. Stable benign lymph nodes project over the axillae. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable prominent bilateral axillary fat pads. 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. | Melanoma status post 4 cycles of chemotherapy. Evaluate treatment response.RADIOPHARMACEUTICAL: 13.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 111 mg/dL. Today's CT portion grossly demonstrates gyriform high with adjacent low density in the right posterior parietal region, similar to previous and suggestive of subacute cerebral infarction on recent MRI. Numerous bilateral pulmonary nodules are present. A small to medium left pleural effusion is seen with left basilar consolidation. Left supraclavicular and left upper mediastinum lymph node masses are seen. Additional mediastinal lymph node enlargement / masses are present most notably in the left lower paratracheal and subcarinal regions. Extensive atherosclerotic including coronary arterial calcifications are noted. Prominence of the right renal pelvis again seen. Large retroperitoneal lymph nodes are present. Masslike enlargement of the right iliopsoas is again present. Multiple surgical clips are seen within the pelvis bilaterally. Orthopedic hardware in the right proximal humerus again seen. Numerous lytic and sclerotic osseous lesions are seen throughout the skeleton with associated collapse of multiple vertebral levels.Today's PET examination demonstrates hypermetabolic pulmonary nodules have increased in size, number, and metabolic activity, consistent with tumor progression. For reference, hypermetabolic left apical nodule has increased in size and activity (SUV max = 2.6 previously, = 5.3 currently) and slightly more inferior a left upper lobe hypermetabolic nodule is new (SUV max = 3.5).Hypermetabolic left supraclavicular lymph node/mass has increased in size and metabolic activity (SUV max = 5.0 previously, = 6.0 currently), consistent with additional disease progression. However, inferior to this, a left upper paratracheal lymph node metastatic mass has decreased somewhat in size and activity (SUV max = 7.7 previously, = 5.7 currently) suggesting improvement in this location.A new hypermetabolic left retrocrural lymph node metastasis is noted (SUV max = 5.0), consistent with additional tumor progression. Several new hypermetabolic retroperitoneal and mesenteric hypermetabolic lymph nodes are also noted (SUV max = 5.2).A hypermetabolic left adrenal gland metastasis has slightly increased in size.The hypermetabolic mass centered in the right iliopsoas has increased in size although the peak uptake is slightly decreased (SUV max = 16.4 previously, = 13.0 currently). It is uncertain whether this is improved with enlargement from necrosis versus tumor progression.Innumerable hypermetabolic osseous metastases are present. While several have decreased such as at the right hip and a sternal lesion, overall there has been significant progression with new, larger, and metabolically more active osseous lesions. For reference, a lesion in the right posterior iliac wing has increased significantly in size and metabolic activity (SUV max = 6.3 previously, = 12.5 currently), and a distal left femoral lesion (SUV max = 8.9) is but one example many new osseous lesions.Right posterior parietal brain demonstrates decreased metabolic activity from previous, suggestive of continued evolution of infarction as seen on recent MRI. | While several lesions have improved, overall there has been significant interval progression of hypermetabolic metastatic disease most notably involving pulmonary and osseous metastases with multiple other areas of progression as described above. |
Generate impression based on findings. | Fell on outstretched hand this morning. Edema, decreased range of motion, pain/tenderness (fourth and fifth digits/metacarpals). Concern for fracture. Mild osteoarthritis affects the distal interphalangeal joints; there are also tiny osteophytes at the second and third metacarpophalangeal joints. I see no definite fracture. Punctate densities adjacent to the DIP joint of the ring finger and the fifth metacarpal head are noted which I suspect represent small foci of capsular calcification rather than tiny fracture fragments. | Degenerative arthritic changes without fracture evident. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 1/31/2012 from Mercy Hospital and Medical Center. Submitted outside study was compared to the current mammogram dated 12/5/2014. Breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Two stable focal asymmetries are present in the left breast. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | Stable left breast focal asymmetries. No mammographic evidence for malignancy. As long as the patient's physical examination is unchanged, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Recent traumatic fracture right hip. Evaluate for current status. Pain in the right hip. Components of a right hip hemiarthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. A fracture involving the proximal femur at the level of the lesser trochanter is slightly less distinct on the current study than on the prior study, suggestive of some interval healing. Again seen is a medially displaced lesser trochanter fracture fragment with a small amount of heterotopic ossification between it and the adjacent femur, also suggesting healing. Evaluation of the pelvis is limited due to enteric contrast. The bones appear demineralized, suggest osteopenia/osteoporosis. | Right hip hemiarthroplasty and healing proximal femur fracture as described above. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 1/31/2012 from Mercy Hospital and Medical Center. Submitted outside study was compared to the current mammogram dated 12/5/2014. Breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Two stable focal asymmetries are present in the left breast. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | Stable left breast focal asymmetries. No mammographic evidence for malignancy. As long as the patient's physical examination is unchanged, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Postop day number 3 status post left total hip arthroplasty. Continued pain. Evaluate for fracture/dislocation. Components of a left total hip arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. I see no fracture or dislocation. Foci of soft tissue gas in the adjacent soft tissues reflects recent surgery. | Total hip arthroplasty without fracture or dislocation. |
Generate impression based on findings. | Thyroid neoplasm. Head and neck cancer CHEST:LUNGS AND PLEURA: Marked interval improvement with decreased size and number of multiple bilateral pulmonary nodules. The reference left lower lobe lobulated nodular mass (image 66 series 4) currently measures 2.3 x 1.8 cm from a prior measurement of 2.7 x 2.2 cm.Biapical scarring is again observed with decreased changes suggesting aspiration bilaterally. No effusions. New new suspicious nodules or masses.MEDIASTINUM AND HILA: Postsurgical changes within the neck with extensive lymphadenopathy previously described. Please correlate the findings above the thoracic inlet with the concomitant neck CTThe reference right paratracheal lymph node above the aortic arch (image 24 series 3) has decreased in size and demonstrates increased hypodensity suggesting necrosis. Short axis measurement currently is 1.8 cm from a prior measurement of 2.8 cm. The reference to subcarinal conglomerate nodal mass demonstrates similar hypodensities in suspected necrosis yet similar measurements of 3.3 x 3.3 cm (image 46 series 3), previously 3.3 x 3.4 cm with more extensive extension inferiorly since resolved.The cardiac and pericardium are within limits.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Gross stability in overall size of the heterogeneous splenic lesion, currently measuring 5.7 x 5.4 cm (image 97 series 3), previously measuring 5.6 x 5.3 cm. Again extensive central necrosis observed with thin and less lobulated margins currently identified.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small suspected renal cysts unchangedPANCREAS: 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: Scattered mild degenerative changes without suspicious new blastic or lytic lesion | Interval considerable improvement with both decreased in reference measurements and suspected necrotic changes of multiple metastatic foci, largely lymphadenopathy observed in the mediastinum and metastatic nodules observed within both lungs. See reference measurements provided |
Generate impression based on findings. | Pain. Rule out fracture. There is perhaps mild soft tissue swelling along the dorsal aspect of the toe, but I see no underlying fracture or dislocation. Mild deformity of the base of the proximal phalanx may represent an old healed fracture, but this is equivocal. | Mild soft tissue swelling without acute fracture evident. |
Generate impression based on findings. | Swelling and pain. Rule out fracture. There is swelling of the soft tissues along the dorsum of the hand as well as at the PIP joint of the little finger. Best seen on the lateral view is a 1-2mm density along the volar aspect of the PIP joint of the middle finger that could conceivably represent a mildly displaced volar plate avulsion fracture, but I am not certain if this is an acute or chronic injury. A small osteophyte is seen along the dorsal aspect of this joint. There is mild deformity of the fifth metacarpal which may represent an old healed fracture. | Soft tissue swelling. Tiny density along the volar aspect of the PIP joint of the middle finger could conceivably represent a minimally displaced volar plate avulsion fracture fragment, but I cannot tell if this is acute or chronic on the basis of this study. If further imaging evaluation is clinically warranted, dedicated radiographs the middle finger could potentially provide additional information. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 5/18/2012 from John H. Stroger Hospital in Chicago IL. Submitted outside study was compared to the current mammogram dated 12/3/2014. 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 is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Lingual cancer CHEST:LUNGS AND PLEURA: Two new focal referral pleural nodular densities in the left lung base along the dependent wall. For reference the more lateral focus measures and 10- millimeters (image 82 series 4) and this finding is associated with mild adjacent tree in bud deformities, concerning for possible aspiration.Right lung is clear. No effusionsMEDIASTINUM AND HILA: No lymphadenopathyThe cardiac and pericardium are within limitsCHEST WALL: Mild scattered degenerative changes without suspicious lytic or blastic lesions. Tracheostomy tube and right chest port, the former appears new since the intervalABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.G-tube well-positionedBONES, SOFT TISSUES: Mild degenerative changes again without suspicious lytic or blastic lesions observedOTHER: No significant abnormality noted. | Interval new left lower lobe dependent appearing nonspecific focal peripheral nodular opacities with tree in bud deformity. Overall appearance most consistent with aspiration or post infectious changes, however small nodular densities cannot be excluded. Serial imaging and comparison with scheduled imaging will be important to confirm. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 5/18/2012 from John H. Stroger Hospital in Chicago IL. Submitted outside study was compared to the current mammogram dated 12/3/2014. 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 is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Swelling, pain, fall. Unable to bear weight. Rule out fracture, dislocation. Three views of the left ankle are provided. There is mild soft tissue swelling but I see no fracture. There may be a small tibiotalar joint effusion, but this is equivocal. There is a screw fragment in the medial cuneiform.Four views of the left knee are provided. I see no fracture or dislocation. I see no large joint effusion. | Mild soft tissue swelling, but no fracture or dislocation. |
Generate impression based on findings. | There are scattered foci of primarily subcortical white matter T2 hyperintensity without associated mass effect, or restricted diffusion. One involving left frontal subcortical white matter is associated with a punctate focus of susceptibility hypointensity. 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. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There has been prior right lens replacement. | There are scattered foci of primarily subcortical white matter T2 hyperintensity without associated mass effect, or restricted diffusion. One involving left frontal subcortical white matter is associated with a punctate focus of susceptibility hypointensity. Given patient age these, are most likely secondary to small vessel disease. The solitary focus associated with susceptibility hypointensity may be secondary to prior trauma. |
Generate impression based on findings. | Pain. No trauma. Diabetic patient with DKA. Evaluate for "osteo". The bones appear demineralized, suggesting osteopenia/osteoporosis. I see no radiographic evidence of osteomyelitis. Although these are nonweightbearing views, there is a hallux valgus deformity. Mild osteoarthritis affects the interphalangeal joints. Moderate osteoarthritis affects the first metatarsophalangeal joint. Mild osteoarthritis affects the midfoot articulations. There are scattered arterial calcifications in the soft tissues. | Degenerative arthritic changes and other findings as described above without radiographic evidence of osteomyelitis. |
Generate impression based on findings. | The patient submitted outside digital mammogram and bilateral breast ultrasound dated 10/5/2010 from St. James Hospital in Olympia Fields IL. Submitted outside studies were compared to the current mammogram dated 12/15/2014. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A stable low lying axillary lymph node is projected over the left pectoralis muscle. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Osteoarthritis? Four views of the right knee are provided. There is narrowing of the medial tibiofemoral compartment and tricompartmental osteophytes indicating moderate osteoarthritis.Four views of the left knee are provided. There is narrowing of the medial tibiofemoral compartment and tricompartmental osteophytes indicating moderate osteoarthritis. A couple of small ossicles overlying the posteromedial aspect of the joint may represent intra-articular loose bodies. | Osteoarthritis. |
Generate impression based on findings. | Lung cancer LUNGS AND PLEURA: Interval progression since prior study. The left upper lobe mass extending from the hilar region has increased in overall size and spiculation, currently measuring 5.0 x 3.8 cm (image 36 series 6), previously 4.2 x 2.4 cm. the mass remains adjacent and abutting the fissure with associated nodularity and extension to the pleural surface with associated pleural thickening. No distinct adjacent satellite lesions, however a new nodular density in the left upper lobe along the anterior aspect (image 19 series 6) is otherwise observed in concerning for a metastatic site.Scattered moderate emphysematous changes without effusions otherwise observed. Large calcified granuloma in the left lung base with scattered micronodules, unchanged.MEDIASTINUM AND HILA: Interval increasing lymphadenopathy. The high right tracheal lymph node currently measures 1.5 cm in short axis (image 21 series 4) from a prior measurement of 1.2 cm. The reference lymph node at the level of the AP window (image 29 series 4) currently measures 2.7 cm, previously 2.5 cm.Small hiatal hernia is not well appreciated but residually observed.The cardiac and pericardium appear unchanged. Of particular note are central filling defects within the proximal SVC and the oracle extending off the right atrium representing persistent thrombus. Current appearance is overall grossly unchanged considering differences in technique, specifically the focus within the SVC appears similar when observed on the coronal projection (image 63 series 80288).CHEST WALL: Increasing multiple peripheral enhancing subcutaneous foci scattered throughout the chest wall bilaterally. The reference and largest lesion overlying the right lower chest and upper abdomen (image 84 series 4) currently measures 4.6 x 3.6 cm, previously 2.6 x 2.5 cm. the reference left breast nodule also appears mildly increased, currently measuring 1.8 x 1.5 cm (image 53 series 4), by reference measurements 1.9 x 1.2 cm.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Incomplete visualization of the kidneys, however the left kidney appears significantly diminished and or non-developed, possible genetic variant. Contour changes of the right kidney are also observed an incompletely identified, yet suggesting possible old remote infarcts with renal cysts. Consider dedicated imaging. | Interval progression of extensive reference measurements provided above. Large left hilar mass with questionable new left upper lobe nodular metastatic disease and interval increasing lymphadenopathy in chest wall lesions. See detail provided |
Generate impression based on findings. | The patient submitted outside digital mammogram and bilateral breast ultrasound dated 10/5/2010 from St. James Hospital in Olympia Fields IL. Submitted outside studies were compared to the current mammogram dated 12/15/2014. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A stable low lying axillary lymph node is projected over the left pectoralis muscle. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram |
Generate impression based on findings. | The patient submitted outside digital mammograms dated 10/3/2013, 9/20/2013 and 7/25/2012 from Mercy Hospital and Medical Center in Chicago, Illinois. Submitted outside studies were compared to the current mammogram dated 12/5/2014. Linear marker was placed on a scar overlying the right breast. Scattered fibroglandular elements are unchanged in pattern and distribution. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 24 years old Reason: 24yo female with Crohn's ileitis on coonoscopy. Now with RLQ pain. Evaluate extent of ileal inflammation History: RLQ pain 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: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Skipped areas of asymmetric wall thickening and dilatation involving approximately 25 cm segment of distal ileum including the terminal ileum. There is increased enhancement of the wall, associated with some striation in the wall. These findings are compatible with acute on chronic changes secondary to Crohn's disease. Proximal to this segment, distal ileal segments are slightly dilated measuring up to 3 cm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Acute on chronic changes secondary to Crohn's disease involving the proximal 25-cm of the distal ileum including the terminal ileum causing mild proximal small bowel dilatation. |
Generate impression based on findings. | The patient submitted outside digital mammograms dated 10/3/2013, 9/20/2013 and 7/25/2012 from Mercy Hospital and Medical Center in Chicago, Illinois. Submitted outside studies were compared to the current mammogram dated 12/5/2014. Linear marker was placed on a scar overlying the right breast. Scattered fibroglandular elements are unchanged in pattern and distribution. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 9/4/2013 from Mount Sinai Hospital in Chicago, Illinois. Submitted outside study was compared to the current mammogram dated 12/12/2014. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign calcifications, including arterial 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 is unremarkable, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.A tiny, thin amount of fat is present within the filum.Disc desiccation is present throughout. Mixed discogenic reactive endplate changes are noted from L1/2 through L5/S1 with Schmorl's nodes involving the endplates at L1/2, L2/3, L3/4, the inferior endplate of L4, and in the inferior endplate of L5.T12/L1: Diffuse annular disc bulge, slight ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is mild bilateral neural foraminal stenosis.L1/2: Diffuse annular disc bulge, slight ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is mild bilateral neural foraminal stenosis.L2/3: Diffuse annular disc bulge, slight ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is mild bilateral neural foraminal stenosis.L3/4: Diffuse annular disc bulge, slight ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is mild bilateral neural foraminal stenosisL4/5: Diffuse annular disc bulge, slight ligamentum flavum thickening, mild left facet hypertrophy, and moderate right facet hypertrophy. There is mild bilateral neural foraminal stenosis.L5/S1: Right paracentral disc protrusion which abuts and flattens the right S1 nerve sheath origin. There is also mild right facet hypertrophy and mild right neural foraminal stenosis. | 1.A tiny, thin amount of fat is present within the filum.2.L1/2 through L4/5: Mild bilateral neural foraminal stenosis.3.L5/S1: Right paracentral disc protrusion which abuts and flattens the right S1 nerve sheath origin. There is also mild right neural foraminal stenosis. |
Generate impression based on findings. | Male 4 days old Reason: Is there evidence of NEC History: Mild distention, refusing feedsVIEW: Abdomen AP (one view) 1/2/15 Normal abdominal gas pattern. No evidence of obstruction or free air. No pneumatosis intestinalis or portal venous gas. No ascites. | Normal examination. |
Generate impression based on findings. | Cough LUNGS AND PLEURA: Motion degrades sensitivityInterval resolution in clearance of the scattered nodular and tree in bud deformity observed bilaterally but greater on the left 7/1/13. Small scattered micronodules without evidence of new or discrete suspicious nodules or masses. No effusions. Mild underlying emphysematous changes.MEDIASTINUM AND HILA: No distinct lymphadenopathy. A borderline and suspected conglomerate right tracheal lymph node with partial calcification again measuring 1.3 cm in short axis is observed (image 36 series 3).The cardiac and pericardium are otherwise within limits.Small hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No discrete new intrapulmonary abnormality and interval changes suggesting resolution or absence of repeated aspiration. Partially calcified lymph node suggest probable old granulomatous disease exposure, all unchanged and stable in appearance. See detail provided |
Generate impression based on findings. | History of hyperaldosteronism, evaluate for adrenal hyperplasia or adrenal tumor. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Several small low attenuation hepatic lesions too small to characterize, favor benign. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Questionable subcentimeter nodule just inferior to limb of the left adrenal gland (series 6, 42) measuring 5 x 7 mm which does not demonstrate the typical characteristics of an adenoma but is too small to characterize and could conceivably represent a small adrenal lesion. Right adrenal gland unremarkable.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Enlarged, heterogenous lobular uterus probably representing uterine fibroids. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Questionable subcentimeter nodule possibly arising from left adrenal gland which could represent a true adrenal lesion; too small to characterize.2.Probable large uterine fibroids. If there is clinical indication for further characterization, MR may be useful. |
Generate impression based on findings. | 49-year-old male with VF arrest and ICD with possible clot on the lead. Evaluate for pulmonary embolism. The comparison chest radiograph performed on 1/2/2015 demonstrates enlarged cardiomediastinal silhouette retrocardiac density suggestive of pleural effusion and/or consolidation.The ventilation images show a left lower lobe defect consistent with patient's left lower lobe consolidation on single breath imaging. This defect equilibrium on wash in images. There is mild abnormal Xe-133 retention during the wash-out phase in the left lower lobe.The perfusion images show a left lower lobe defect. A right apical defect is noted which corresponds to the metallic artifact related to the patient's ICD. | Triple matched ventilation/perfusion defect in the left lower lobe which meets criteria for intermediate probability for pulmonary embolism. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 9/4/2013 from Mount Sinai Hospital in Chicago, Illinois. Submitted outside study was compared to the current mammogram dated 12/12/2014. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign calcifications, including arterial 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 is unremarkable, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram |
Generate impression based on findings. | Supraglottis Cancer, follow-up CHEST:LUNGS AND PLEURA: Two without change or new suspicious lesions. No effusions. Minimal scattered scarring without interpulmonary abnormality superimposed upon previous the described mild central lobular emphysemaMEDIASTINUM AND HILA: Tracheostomy tube unchanged and interval resolution of tracheal debris. No lymphadenopathy.The cardiac and pericardium are within limitsCHEST WALL: Scattered degenerative changes unchanged. No suspicious lytic or blastic osseous lesions. Left chest portABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Probable hepatic cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Nodularity of the left adrenal gland unchangedKIDNEYS, URETERS: Scattered renal cysts greater on the right, unchangedPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.G-tube observed and well-positioned.BONES, SOFT TISSUES: Scattered mild degenerative changes without suspicious new lesionsOTHER: No significant abnormality noted. | No acute abnormality or findings to suggest interval metastatic disease. |
Generate impression based on findings. | Progression of intracranial stenosis? New pulsatile tinnitus. There is paucity of flow-related enhancement throughout the intracranial right internal carotid artery, with reconstitution at the circle of Willis. There is also lack of flow-related enhancement throughout the bilateral intracranial vertebral arteries, with collateral flow derived from a prominent anterior spinal artery. In addition, there is high-grade narrowing of the mid basilar artery, which appears to be new since 2005. There is a wide-neck outpouching along the inferolateral aspect of the left cavernous carotid artery that measures up to approximately 5 mm. There is also irregularity along the left carotid siphon, which may be related to the presence of vascular calcifications. The bilateral anterior, middle, and posterior cerebral arteries are grossly patent. There is encephalomalacia in the right parieto-occipital region. | 1. Occlusions of the right internal carotid artery and bilateral vertebral arteries related to proximal occlusion appear to be unchanged since 2005, a high-grade stenosis of the basilar artery appears to be new since 2005.2. A wide-neck outpouching along the inferolateral aspect of the left cavernous carotid artery that measures up to approximately 5 mm likely represents an aneurysm. 3. Chronic right parieto-occipital region infarct. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 3/7/2013 from St. Bernard Hospital in Chicago IL. Submitted outside study was compared to the current mammogram dated 12/5/2014. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable circumscribed mass is present in the anterior depth of the right upper outer quadrant. Focal asymmetry in the posterior central right breast is also unchanged. Scattered benign calcifications are stable. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | Stable right breast mass and asymmetry. No mammographic evidence for malignancy. If patient's physical examination is unremarkable, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 53 years old; Reason: h/o Hodgkin please restage History: h/o Hodgkin lymphoma CHEST:LUNGS AND PLEURA: Visualized lung fields stable in appearance with scattered micronodules (majority appear calcified/sequela of prior granulomatous disease) and cystic changes. No pleural effusion.MEDIASTINUM AND HILA: Heart borderline in size. Stable air-containing outpouching seen near diaphragmatic hiatus, may represent small epiphrenic/juxtraphrenic diverticulum. Again seen mildly prominent mediastinal lymph nodes, stable to mild interval decrease in size demonstrated. Reference right paratracheal lymph node measures 1.4 x 0.9 cm, image 27 series 3, previously measured 1.4 x 1.2 cm. CHEST WALL: Right-sided chest wall port with tip near cavoatrial junction. ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic hypoattenuating lesions without significant change, largest of these measure simple fluid and are most likely benign in etiology, additional lesions too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: Pancreas stable in appearance with cystic lesions in regions of the head and tail, may be sidebranch intraductal papillary mucinous neoplasms.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable appearance with hypoattenuating foci, most likely cysts.RETROPERITONEUM, LYMPH NODES: Again seen interval decrease in size of reference portacaval lymph node, measuring 1.1 x 0.5 cm, image 101 series 3, previously measured 1.5 x 0.6 cm.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:Evaluation of pelvic structures suboptimal due to beam hardening artifact from patient's left hip postsurgical hardware. UTERUS, ADNEXA: Status post hysterectomy. Small air seen in residual vaginal cuff. Essentially stable soft tissue prominence in bilateral adnexal areas, image 166 series 3, presumably patient's normal ovaries. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: 1.5-cm fat containing umbilical hernia. Evaluation of pelvic structures suboptimal due to beam hardening artifact from patient's left hip postsurgical hardware. Small nonspecific subcutaneous induration in anterior left lower extremity area. Enthesophyte formation seen in region of right ischial tuberosity, hip, acromioclavicular and spinal degenerative disease. | 1. Mild interval decrease in size of reference lymph nodes as above. |
Generate impression based on findings. | Reason: evaluate pulm nodule History: same LUNGS AND PLEURA: Markedly increased and bilateral pleural effusions with associated basilar atelectasis.Bilateral apical nodules with a component of cavitation on the right, have not significantly changed allowing for adjacent atelectasis secondary to increased pleural effusions.New air space and groundglass opacity in the right upper lobe may be due to infection or hemorrhage.New focal subsegmental atelectasis in the lingula anterior to the major fissure.MEDIASTINUM AND HILA: Moderate diffuse mediastinal lymphadenopathy, slightly increased compared to previous with associated edema of the soft tissues.Severe coronary artery calcification.CHEST WALL: Moderately enlarged bilateral axillary lymph nodes, slightly increased.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Very limited evaluation with no gross abnormalities. | Increased bilateral pleural effusions and new air space and groundglass opacity in the right upper lobe suggestive of infection or hemorrhage. Previously described apical nodules are partially obscured but not grossly changed, although further follow-up is recommended. The differential diagnosis includes infection, and less likely neoplasm. |
Generate impression based on findings. | The patient submitted outside digital mammogram dated 3/7/2013 from St. Bernard Hospital in Chicago IL. Submitted outside study was compared to the current mammogram dated 12/5/2014. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable circumscribed mass is present in the anterior depth of the right upper outer quadrant. Focal asymmetry in the posterior central right breast is also unchanged. Scattered benign calcifications are stable. No new masses, suspicious microcalcifications or areas of architectural distortion are present. | Stable right breast mass and asymmetry. No mammographic evidence for malignancy. If patient's physical examination is unremarkable, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis 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 stable benign intramammary lymph node is present in the left upper outer quadrant.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. | 64 year-old female with a history of lung nodule. LUNGS AND PLEURA: Note is made of bilateral pulmonary micronodules. No suspicious nodules or masses are identified. No pleural effusion or pneumothorax. Left apical scarring/atelectasis.MEDIASTINUM AND HILA: Vascular calcifications of the aorta and its branches. No visible coronary artery calcifications. No pericardial effusion.CHEST WALL: There are bilateral retropectoral saline breast implants. Multiple surgical clips are identified in the overlying soft tissues. Incidental note is made of a severe pectus excavatum deformity with left lateral cardiac displacement. The Haller index is 5.7. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Punctate left renal calculus, incompletely visualized. Hypodensity in the dome of the liver is incompletely characterized, but most consistent with a benign simple cyst. | 1. Bilateral pulmonary micronodules which are likely post infectious. No suspicious pulmonary nodules or masses are identified. The previously described pulmonary nodule seen on prior chest radiograph, in 2010, likely corresponds to costochondral calcification.2. Incompletely visualized punctate left renal calculus. |
Generate impression based on findings. | pT4N0 squamous cell carcinoma of the right lower alveolus status post treatment. Neck: There are post-operative findings related to partial right mandibulectomy with graft reconstruction, whereby a screw penetrates into the soft tissues deep to the medial margin of the fibular graft. There is interval appearance of an ill-defined heterogeneous mass within the right infratemporal fossa, centered within the pterygoid muscles, with extension along the right trigeminal nerve trunk into the cavernous sinus via a widened foramen ovale. Overall, the tumor measures up to approximately 6 cm. There is no significant lymphadenopathy in the neck. There is mild asymmetric prominence of the right parotid duct, but no radioattenuating calculi. The thyroid gland appears unchanged. There is a right internal jugular venous catheter. There is no significant narrowing of the major vessels in the neck. The airways are patent. There is multilevel degenerative spondylosis of the cervical spine. There is a partially-imaged right posterior lung opacity.Head: Aside from the tumor in the right cavernous sinus region with mild mass effect upon the right medial temporal lobe associated with extension of the mass from the infratemporal fossa via the right foramen ovale. In addition, the tumor appears to extend into the right Meckel cave and protrudes into the right prepontine cistern. There is no evidence of enhancing lesions within the brain parenchyma. There is no midline shift or herniation. The ventricles are normal in size and configuration. There is a small amount of fluid within the right mastoid air cells. The imaged paranasal sinuses are clear. The skull and scalp soft tissues are unremarkable. | 1. Interval appearance of an infiltrative mass within the right infratemporal fossa is compatible with tumor recurrence with perineural spread along the right trigeminal nerve into the cavernous sinus, Meckel cave, and prepontine cistern. MRI of this region may be useful for further characterization, if there are no contraindications for this modality. 2. A small amount of fluid within the right mastoid air cells is non-specific.3. Partially-imaged right posterior lung opacity. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 2 y/o M with neuroblastoma, increased LDH, eval for disease CHEST:LUNGS AND PLEURA: Dependent subsegmental atelectasis. No focal pulmonary opacities or suspicious pulmonary nodules. No pleural effusions.MEDIASTINUM AND HILA: Normal sized heart or pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. Right internal jugular catheter tip in the SVC. Left PICC tip in the right atrium.ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in appearance without focal hepatic lesion. The portal vein is patent. The gallbladder is normal in appearance.SPLEEN: Normal in appearance.PANCREAS: Normal in appearance.ADRENAL GLANDS: The partially calcified left adrenal mass is significantly larger. The mass is lobulated and extends caudally along the medial aspect of the left renal fossa. It measures 4.1 x 3.4 cm at its largest point on axial plane, and extends in total over approximately 8 cm in craniocaudal dimension. The mass displaced the kidney laterally and the left renal artery anteriorly. The splenic artery and left renal artery are not encased. The right adrenal gland is normal in appearance.KIDNEYS, URETERS: Left kidney is lobulated in appearance and smaller than the right, similar to the prior study. No evidence of hydronephrosis. Normal appearance of the right kidney. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: Normal in appearance.BONES, SOFT TISSUES: No osseous lesions evident.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No osseous lesions evident. | Marked enlargement of the left adrenal mass, without vascular encasement. |
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. Stable 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. | Pain, stiffness. Synovitis. Rule out arthritis. Three views of the left hand are provided. The bones appear slightly demineralized. Mild osteoarthritis affects the interphalangeal joint of the thumb and the distal interphalangeal joint of the fifth finger, as well as the first carpometacarpal joint. I see no definite erosions.Three views of the right hand are provided. The bones appear slightly demineralized. Mild osteoarthritis affects the interphalangeal joint of the thumb and the distal interphalangeal joint of the fifth finger. There is perhaps mild soft tissue swelling dorsal to the metacarpal heads, but I see no erosions.Three views of the left shoulder are provided. The bones appear slightly demineralized. Mild osteoarthritis affects the shoulder. I see no erosions.Three views of the right shoulder are provided. The bones appear slightly demineralized. Mild osteoarthritis affects the shoulder. Mild degenerative arthritic changes also affect the visualized thoracic spine. | Mild osteoarthritic changes of the hands and shoulders as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign bilateral breast biopsies. 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. A linear marker was placed on a scar overlying the left breast. Percutaneously placed clip is present in the left upper outer quadrant. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. Mammography is most sensitive when assessing for interval changes. If patient submits outside mammogram, comparison 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. | Metastatic ovarian carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Left perihilar referenced lymph node no longer measurable.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable left hepatic cystSPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable reference portacaval lymph node best seen on image 82 of series 3 measuring 0.7 x 0.8 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus absent or atrophicBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Reference left perihilar lymph node no longer measurable. Stable portacaval reference lymph node. No new adenopathy or new metastatic focus. |
Generate impression based on findings. | 65-year-old male with relapsed refractory myeloma SKULL: A couple of subcentimeter lucencies near the midline may represent venous lakes, unchanged from the prior exam.CERVICAL SPINE: The lower cervical spine is not well seen due to overlying anatomy. The facets of C2/C3 appear fused. A lucency within the inferior articulating process of C2 may represent a myelomatous deposit, but this is equivocal and unchanged from the prior exam. Degenerative arthritic changes appear similar to the prior study.THORACIC SPINE: The bones appear demineralized, which may represent diffuse myelomatous involvement. There is slight loss of height of multiple vertebral bodies, consistent with chronic compression fractures, appearing similar to the prior exam. There is also mild to moderate multilevel degenerative disk disease.LUMBAR SPINE: The bones appear demineralized, which may represent diffuse myelomatous involvement. Multiple endplate depressions appear similar to the prior exam. Degenerative arthritic changes also appear similar to the previous study.RIBS: The bones appear demineralized, which may represent diffuse myelomatous involvement. Multiple healed rib fractures are present bilaterally.PELVIS: The bones appear demineralized, with small punched out lucencies which may represent myelomatous deposits, appearing similar to the prior exam.UPPER EXTREMITY: Right humerus: Again seen is a large lytic lesion within the distal humerus, extending to articular surface and measuring 4 to 5 cm in greatest dimension. Additional tiny diaphyseal lucencies may represent myelomatous deposits. The bones are diffusely demineralized. Osteoarthritis affects the shoulder.Left humerus: Several small lucencies within the humeral diaphysis likely represent myelomatous deposits. Osteoarthritis affects the shoulder.Right and left forearm: Tiny lucencies within the bones of the forearm bilaterally may represent myelomatous deposits, although this is equivocal and appears similar to the prior exam. Degenerative arthritic changes affect the wrists.LOWER EXTREMITY: Right femur: Again seen is an intramedullary rod and screw device affixing the femur in near-anatomic alignment and traversing a lucent lesion at the level of the lesser trochanter without evidence of complication. Osteoarthritis affects the hip and knee.Left femur: Multiple small lucencies are again seen within the femur compatible with myelomatous deposits, appearing similar to the prior exam. Osteoarthritis affects the hip and knee.Right tibia and fibula: Small lucency in the proximal fibula may represent a myelomatous deposit.Left tibia and fibula: No discrete myelomatous lesions. | Findings compatible with multiple myeloma as detailed above, appearing similar to the prior exam. |
Generate impression based on findings. | Female 9 months old Reason: Check position of DHT History: s/p DHTVIEW: Abdomen AP (one view) 1/2/15 Feeding tube terminates at the stomach fundus. Normal abdomen the gas pattern. No evidence of obstruction or free air. No ascites. | Feeding tube positioning as described. |
Generate impression based on findings. | 2-year-old male patient with neuroblastoma, increased LDH. Evaluate for an intracranial disease process. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of intracranial hemorrhage, mass, or cerebral edema. |