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Generate impression based on findings. | Female 58 years old; Reason: r/o diverticulitis History: LLQ pain ABDOMEN:LUNG BASES: Linear parenchymal opacity in the left lung base.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber. No bowel obstruction. Appendix is normal in caliber.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Heterogeneous appearance of the uterus. Right adnexal cystic focus suboptimally evaluated by CTBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No colonic diverticulitis as clinically questioned. No small bowel obstruction. Redundant colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace amount of pelvic free fluid. | 1.Limited study due to motion artifact. No definite CT evidence of acute diverticulitis. Patient has a redundant colon.2.Nonspecific left basilar pulmonary opacities may represent atelectasis, aspiration of possibly pneumonia. Follow up is suggested. |
Generate impression based on findings. | Female 59 years old; Reason: concern for pheochromocytoma History: concern for pheochromocytoma ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. The hepatic and portal veins are patent.SPLEEN: Spleen is normal in size. Small partially calcified splenic artery pseudoaneurysm measures 7 millimetersPANCREAS: Hypodense pancreatic tail mass measures 1.4 x 1.4 cm (image 39/series 6). No significant pancreatic atrophy distal to the lesion. No pancreatic ductal dilatation. The fat planes surrounding the tail of the pancreas are intact.ADRENAL GLANDS: Adrenal glands are normal in morphology. No focal adrenal mass.KIDNEYS, URETERS: No hydronephrosis in either kidney. Complex cyst at the low pole of the left kidney with thin septations. The intrarenal portion which is more complex measures 2.5 centimeters.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy or focal mass.BOWEL, MESENTERY: Small bowel is normal in caliber and course. Colon is not distended. There are few scattered colonic diverticula.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Findings of a 1.4 centimeter pancreatic lesion . Consultation with a pancreaticobiliary specialist and follow up M.R.C.P. are suggested.2.Complex left renal cyst measures 2.5 centimeters, it meets criteria for a Bosniak 2F lesion and follow up is suggested.3.Given the negative exam for the pheochromocytoma, follow up nuclear medicine study for a whole body pheochromocytoma or paraganglioma search is suggested. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage or fluid collection. A focus of encephalomalacia is present along the right periventricular white matter and basal ganglia. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consistent with moderate to severe chronic small vessel ischemic changes. There is no extraaxial fluid collection. Atherosclerotic calcifications of the cavernous carotids are noted. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There are bilateral lens implants. A nasogastic tube is partially imaged. | 1. No intracranial hemorrhage, fluid collection or midline shift. 2. Marked chronic small vessel ischemic changes. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Chronic infarct along the right periventricular white matter and basal ganglia. |
Generate impression based on findings. | Male 67 years old; Reason: s/p NGT History: Distension The nasogastric tube now sharply angulates near the gastroesophageal junction and has its tip in the region of the gastric fundus.Mild gaseous distention of the small bowel with ingested oral contrast now residing within the colon suggestive of an ileus.Catheter type device projects over the pelvis. The are multiple pelvic clips. Bladder catheter projects over the pelvis. | 1.Enteric tube with its tip near the gastric fundus.2.Ileus |
Generate impression based on findings. | Male, 59 years old, with stroke. Hypoattenuation is evident within the inferior right cerebellar hemisphere. The distal right vertebral artery is hyperdense compatible with atherosclerotic disease or thrombosis. Supratentorially, no definite loss of gray-white distention is seen. However, one of the MCA branches within the right Sylvian fissure is hyperdense suggestive of thrombus.No mass effect or midline shift is seen. No intracranial hemorrhage is detected. The ventricles are normal in size and morphology with the exception of mild effacement of the fourth ventricle.The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear. | 1. Hypoattenuation involving the inferior right cerebellar hemisphere compatible with an acute or subacute infarction.2. Hyperdense MCA on the right without definite evidence of loss of gray-white distinction compatible with acute infarction. Please see subsequent CTA for further details. |
Generate impression based on findings. | There is a large, mixed attenuation subdural hematoma along the left frontoparietal convexity measuring up to 1.9 cm in maximum width, contributing to subfalcine herniation and left to right midline shift of approximately 1.3 cm. There is mass effect on the underlying parenchyma and left lateral ventricle. There is entrapment of the right temporal horn. The visualized portions of the paranasal sinuses are grossly clear. There is opacification of a few bilateral mastoid air cells. | Large left subdural collection, measuring up to 1.9 cm in maximum width with midline shift of 1.3 cm to the right. Mass effect on the left lateral ventricle and trapping of the right temporal horn.Findings discussed with Dr. Subeh by radiology resident on call at the completion of the study. |
Generate impression based on findings. | Male 55 years old; Reason: assess stool burden History: constipation, LLQ abd pain Mild gaseous distention of a small bowel loop in the left upper abdomen measuring up to 2.5 centimeters. Extensive vascular calcifications and phleboliths project over the pelvis.No definite intraperitoneal free air. | 1.Mild gaseous distention of the small bowel loop in the left upper abdomen. |
Generate impression based on findings. | There are postoperative findings related to a left frontal and a left parietal burr hole placement. There is a drainage catheter through the left parietal burr hole, with tip in the left subdural fluid collection. There are small foci of pneumocephalus. The subdural collection is low in attenuation with thin layering high attenuation at the dependent portion. There is interval decrease in size of the left subdural collection measuring up to 13 mm in maximum width, previously 19 mm. There is interval improvement in left to right midline shift measuring up to 6 mm, previously 13 mm. There is decreased mass effect on the underlying parenchyma and left lateral ventricle. There is mildly decreased entrapment of the right temporal horn. The visualized portions of the paranasal sinuses are grossly clear. There is opacification of a few bilateral mastoid air cells. | Postoperative findings related to two left-sided burr holes with drainage catheter in the left subdural fluid collection. Interval decrease in size of the left subdural collection measuring up to 13 mm and decreased left to right midline shift of 6 mm. |
Generate impression based on findings. | Female 37 years old; Reason: r/o perforation, ileus History: bloody emesis \T\ BM Extensive patchy parenchymal opacities in the left lung base with a left pleural effusion.Gastrostomy catheter projects over the expected region of the gastric body. Additional intraperitoneal catheter projects over the pelvis. There is slight progression of contrast through the colon. Small bowel gas pattern remains nonobstructive. | 1.No significant change in the bowel gas pattern. If patient has persistent bloody emesis consider CT scan for further evaluation. |
Generate impression based on findings. | Female 65 years old; Reason: r/o microperforation in subclavian +/- obstruction in subclavian and SVC History: R arm swelling s/p OHT LUNGS AND PLEURA: There is a moderate right-sided pleural effusion and a small left-sided pleural effusion with overlying compressive atelectasis. There is no pneumothorax. MEDIASTINUM AND HILA: Lack of IV contrast limits evaluation of the vasculature. There are post-surgical changes of a heart transplant with ascending aorta graft material, median sternotomy hardware and epicardial pacing leads. There is a stranding of the mediastinal fat and small amount of fluid along the ascending aorta which is presumably post-surgical. There is a trace pericardial effusion.A left upper extremity central venous catheter tip is at the confluence of the left subclavian and left internal jugular veins which appear to drain into a duplicated, left SVC. There is aberrant origin of the right subclavian artery which arises off the descending aorta and courses posterior to both the esophagus and trachea. The right internal jugular vein is small in caliber and heavily calcified. CHEST WALL:There are remnants of right-sided ICD leads within the right subclavian vein which terminate within the duplicated, right SVC. Just inferior to the origin of the leads, there is a 3.8 x 1.8 x 6.8 cm fluid-density collection within the right anterior chest wall with surrounding inflammatory changes. An additional small inflammatory collection is identified just inferior to this and may represent infiltrating inflammatory changes within the breast tissue. Median sternotomy hardware without definite evidence of complication.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Right anterior chest wall fluid collection which is likely post-surgical in etiology and may represent a seroma/hematoma. 2. Post-surgical changes of a heart transplant with expected post-surgical changes within the mediastinum. 3. Moderate right and small left pleural effusions with associated compressive atelectasis. 4. Duplicated SVC and aberrant origin of the right subclavian artery. |
Generate impression based on findings. | Female 96 years old; Reason: eval dobhoff placement History: s/p Dobbhoff Enteric tube projects over the region of the gastric body.Bowel gas pattern is unchanged. | 1.Enteric tube terminates in the region of the gastric body |
Generate impression based on findings. | Male 48 years old; Reason: eval g-j placement History: eval g-j placement GJ tube with tip left of midline at the level of the ligament of Treitz. Contrast opacifies the jejunum and duodenum.Postsurgical changes with multiple staples. There are two abdominal drains. | 1.GJ tube with its tip in the region of the ligament of Treitz. |
Generate impression based on findings. | Male, 48 years old.Liver transplant take back, count correct NG tube and surgical catheters placing contrast in the proximal small bowel. There are multiple surgical clips are noted in the upper abdomen. There is free intraperitoneal air.Left basilar pulmonary opacity.No unexpected radiopaque foreign body. | No unexpected radiopaque foreign body.These findings were discussed by telephone with Dr. Renz, the attending surgeon, on 1/3/2015 at 1900 by Dr. Bonham. |
Generate impression based on findings. | Female 62 years old; Reason: r/o obstruction History: severe diffuse abd pain, hx multiple abd surgeries \T\ obstructino 2010 ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. Hypervascular area in segments 5/8 which appears peripheral and wedge-shaped and may represent a portal vein to hepatic vein shunt. Status post cholecystectomy. Common bile duct is mildly dilated measuring up to 11 millimeters in the head of the pancreas. The hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct is mildly dilated measuring up to 5 millimeters. No peripancreatic inflammation. No definite mass.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post resection of the right lower pole renal mass. Left renal cortical cyst has slightly increased in size. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Moderate calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: Small bowel is normal in caliber. Small ventral hernia contains portion of transverse colon without obstruction.Portion of small bowel that enters into the hernia and has a slightly hyperenhancing wall but no evidence of obstruction. Partial entrapment is a possibility.BONES, SOFT TISSUES: Postsurgical changes in anterior abdominal wall.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Atrophic or absentBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the hips.OTHER: No ascites. | 1.No bowel obstruction as clinically questioned. Please see above discussion for ventral hernia.2.if patient's symptoms persist, consider small bowel follow through as an outpatient for further evaluation of bowel transit time.3.Hypervascular right hepatic lobe lesion as detailed above.4.Mildly dilated common bile duct and pancreatic duct. Follow up M.R.C.P. as outpatient is suggested. |
Generate impression based on findings. | There is subtle loss of gray-white matter differentiation of the right inferior and middle frontal gyri, consistent with acute right MCA territory infarct. There is no intracranial hemorrhage. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consistent with mild age-indeterminate small vessel ischemic changes. There are chronic lacunar infarcts in the left external capsule/claustrum and left thalamus. There is no extraaxial fluid collection. There is a small extra-axial lesion at the left vertex, measuring 8 mm in AP dimension (image 22, series 80280), which may represent a meningioma or vascular lesion. Mildly prominent CSF space in the posterior fossa, may represent a mega cisterna magna or retrocerebellar cyst. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There are bilateral lens implants. | 1. Acute right MCA territory infarct. No acute intracranial hemorrhage. 2. Mild age-indeterminate small vessel ischemic changes. 3. Chronic lacunar infarcts in the left external capsule/claustrum and left thalamus.4. 8 mm extra-axial lesion at the left vertex, may represent an incidental meningioma or vascular lesion. Urgent findings discussed with ER by radiology resident on call at the completion of the study. |
Generate impression based on findings. | Female, 68 years old, new diagnosis of non-Hodgkin's lymphoma, initial staging exam. A soft tissue nodule is seen within the right submandibular space measuring 28 x 16 mm (image 95 series 5). This nodule enhances very similarly to the adjacent submandibular gland and is in fact difficult to separate from it as there is no clear intervening fat plane.Two or three smaller discontiguous nodes are seen at levels Ib, II and III in the right neck which enhance similarly to the dominant lesion above.No definite suspicious adenopathy is seen in the contralateral left neck. No mucosal masses are identified. The parotid and left submandibular glands are unremarkable. The thyroid is free of focal lesions. The cervical vessels enhance normally. Lung apices are unremarkable. No destructive osseous lesions are seen. | Right submandibular space adenopathy compatible with the stated history of lymphoma. The dominant lesion is difficult to separate from the adjacent submandibular gland and may have invaded it or arisen from it. Smaller suspicious lymph nodes are evident elsewhere in the upper right neck as above. |
Generate impression based on findings. | Female 67 years old; Reason: eval for free air; possible on OSH report History: see above Enteric tube terminates in the region of the gastric body. Postsurgical changes are noted within the pelvis with a surgical staple line.Bilateral stents are noted in the common iliac vessels.Gas is noted within the colon. Small pockets of gas are noted lateral to the descending colon of unclear etiology. No significant small bowel distention. No free intraperitoneal air.The renal parenchyma are hyperdense possibly from excretion of IV contrast. Heart size is enlarged. Postsurgical changes of median sternotomy. Increased interstitial opacities suggestive of pulmonary edema. | 1.Nonobstructive bowel gas pattern.2.Consider CT for further evaluation. |
Generate impression based on findings. | Female 47 years old; Reason: abdominal pain History: abdominal pain There is gas within the colon and probable oral contrast within the rectum.Scattered small bowel gas without obstruction. | 1.Nonobstructive bowel gas pattern |
Generate impression based on findings. | Male, 64 years old, with history of thyroid cancer, follow-up exam. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Neck:Evidence of total thyroidectomy is redemonstrated. A hyper-attenuating, presumably enhancing mass is redemonstrated in the right aspect of the thyroid bed measuring 36 x 25 mm (image 56 series 7), previously measuring about the same when similar measurements are made. An adjacent right level 6 reference lymph node measures 5 mm in short axis dimension (image 50 series 7), unchanged from prior. Adenopathy in the upper mediastinum is also seen including a nodule in the right paratracheal space which measures approximately 26 x 19 mm (image 69 37), not significantly changed from prior.A destructive lesion involving the left scapula with pathologic fracturing is grossly unchanged as well.No definite evidence of any new lesion is seen. The mucosal tissues are unremarkable. The cervical vessels enhance with evidence of atherosclerotic calcification of the carotid bifurcations right worse than left. Multilevel cervical spondylosis is again seen similar to prior. | 1. Stable disease in the neck.2. No evidence of intracranial metastasis. |
Generate impression based on findings. | Male 67 years old; Reason: NGT in place? History: NGT retracted Enteric tube terminates in the region of the gastroesophageal junction. The bowel gas pattern is nonobstructive.Nasogastric tube is not identifiedHeart size is enlarged. Postsurgical changes of median sternotomy. Vascular catheter projects adjacent to the right heart border. Pulmonary parenchymal opacities are located posterior to the left heart border. | 1.Enteric feeding tube terminates in the region of the gastroesophageal junction and can be advanced.2.Nasogastric tube is not identified. |
Generate impression based on findings. | Female 56 years old; Reason: assess for megacolon History: sepsis Bowel gas pattern is nonobstructive with gas noted within the colon and rectum. The colon is not distended.Right vascular access catheter. | 1.Nonobstructive bowel gas pattern |
Generate impression based on findings. | There is a right parietal approach ventricular shunt catheter with tip in left frontal horn, unchanged in position. There is no significant interval change of ventricular size and configuration, where the right lateral ventricle is nearly completely collapsed and the left frontal horn is collapsed. The imaged radiopaque portions of the shunt catheter appear to be intact. There are stable postoperative findings related to suboccipital craniectomy with an otherwise small posterior fossa and slightly low-lying cerebellar tonsils. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | 1. Right parietal approach ventricular shunt catheter, unchanged in position. Unchanged ventricular size and configuration.2. No intracranial hemorrhage or midline shift. 3. Suboccipital craniectomy with slightly low-lying cerebellar tonsils, unchanged. |
Generate impression based on findings. | Car ran over the left lower extremity one week ago with pain on the medial aspect of the left ankle and lower leg. Evaluate for fracture. Four views of the left knee reveal no acute fracture or malalignment. There is no knee joint effusion. Four views of the left lower leg and ankle reveal a transverse fracture of the medial malleolus with approximately 2 mm of distraction of the medial fracture margin. There is also a minimally displaced comminuted, predominantly oblique fracture of the distal fibular metaphysis, which has a small angulated fracture fragment. The ankle mortise otherwise appears intact. | 1. Medial malleolus fracture.2. Comminuted distal fibular metaphysis fracture. |
Generate impression based on findings. | Left tibia/fibular fracture. Redemonstration of a transverse medial malleolus fracture and comminuted, predominantly oblique distal fibular metaphyseal fracture. There is no widening of the tibiocalcaneal ankle joint with stress. | No specific evidence tibiocalcaneal joint widening with stress. |
Generate impression based on findings. | Injury post fall. Possible dislocation. Question of fracture. There is a minimally displaced oblique fracture of the head of the middle phalanx of the ring finger with suspected extension into the distal interphalangeal joint. There is also a oblique fracture of the ring finger tuft. The partially imaged left fifth digit is deformed, however, this appears chronic. | 1. Oblique fracture of the ring finger middle phalanx with suspected DIP intraarticular extension and tuft fracture.2. Partially imaged deformed fifth digit which appears chronic; if clinically indicated, dedicated radiographs may be obtained for further evaluation. |
Generate impression based on findings. | BRAIN: The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consistent with stable mild chronic small vessel ischemic changes. There is no extraaxial fluid collection. There are atherosclerotic calcifications of the cavernous internal carotids arteries. There is mild mucosal thickening of the right maxillary sinus. There is scattered opacification of a few ethmoid air cells. The other visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. Incidentally noted are bilateral tonsilliths. ORBITS: There may be very minimal left scalp swelling in the left supraorbital region. The extraocular muscles and optic nerves are normal in size and density. No mass is seen in the orbits within the limitations of this noncontrast exam. No bone destruction or fracture of the orbital walls is seen. There are bilateral lens implants. | 1. No acute intracranial abnormality. Stable mild chronic small vessel ischemic changes.2. Suggestion of very minimal left scalp swelling in the left supraorbital region. No acute orbital fracture. |
Generate impression based on findings. | Pain/swelling, limited range of motion of the hand and wrist. There is a minimally displaced, acute fracture of the hamate. There is soft tissue swelling of the hand and wrist. There is a comminuted fracture of the index finger tuft with well corticated fracture fragments. | 1. Acute fracture of the hamate; if clinically warranted, CT may be obtained for further characterization.2. Chronic injury of the tuft of the index finger. |
Generate impression based on findings. | Fell with pain in the thumb and medial side of the ankle. Three views of the left hand reveal no acute fracture or malalignment. Three views of the right ankle reveal no acute fracture or malalignment. Multiple well corticated ossicles distal to medial and lateral malleolus may be related old trauma. | No acute fracture or malalignment. |
Generate impression based on findings. | Female 32 years old; Reason: assess LP shunt History: history of fall, hitting side with LP shunt, since x3weeks headaches Shunt Device: Evaluation is limited due to body habitus. The patient did not complete the examination due to inability to lie flat due to pain and difficulty breathing. Shunt tubing is seen overlying the L2-L3 vertebral bodies and coursing to the right along the back and right flank outside of the field of view given limitation stated above. The lateral aspect of the shunt tubing is not included within the field of view of this study. The intrathecal extent of the tubing is again not clearly visualized. Abdomen: Contrast is seen within a partially imaged, non-dilated renal collecting system. Non-obstructive bowel gas pattern. | Limited study as described above with suboptimal evaluation of the shunt. |
Generate impression based on findings. | Female, 45 years old, with left face droop, slurring, right upper extremity weakness. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. The bones of the calvarium and skull base are intact. | Within limits of CT, no acute intracranial abnormality. If clinical concern for ischemia persist, consider further evaluation with MRI. |
Generate impression based on findings. | Female, 19 years old, found down, altered mental status. The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. The bones of the calvarium and skull base are intact. | No acute intracranial abnormality. |
Generate impression based on findings. | Pain/swelling. Question of fracture. Severe osteoarthritis affects the left knee with bone on bone apposition of the lateral tibiofemoral compartment. There are prominent osteophytes. There is a moderate knee joint effusion. No acute fracture is seen. | 1. No acute fracture is evident.2. Moderate joint effusion and severe osteoarthritis. |
Generate impression based on findings. | Female, 47 years old, right-sided weakness. No evidence of parenchymal edema or loss of gray-white distinction is seen. There may be mild periventricular hypoattenuation which is nonspecific but could reflect mild age indeterminate small vessel skin disease. No intracranial hemorrhage or abnormal extra-axial fluid is detected. Ventricles are normal in size and morphology.Near complete opacification of the right maxillary sinus is seen with internal hyperattenuating material. Mild mucosal thickening is seen in the left maxillary sinus. Numerous periapical cysts and dental caries are evident. The osseous structures of the skull are otherwise intact. | 1. No definite CT evidence of any acute intracranial abnormality.2. Hyperdense opacification of the right maxillary sinus may reflect inspissated secretions, fungal elements or blood product. |
Generate impression based on findings. | Car accident with pain and left lateral shoulder and elbow. No acute fracture or malalignment of the elbow is seen. No elbow joint effusion is identified.No acute fracture or dislocation of the shoulder is seen. | No fracture or malalignment is evident. |
Generate impression based on findings. | Right knee lateral abscess with worsening pain and history of osteomyelitis. Question of osteomyelitis. No acute fracture or malalignment is evident. No joint effusion is seen. No evidence of cortical destruction. | No specific radiographic evidence of osteomyelitis. |
Generate impression based on findings. | Swelling, bruising, point tenderness to palpation of the fourth metacarpal. Question of fracture. No acute fracture or malalignment is seen. No soft tissue swelling is identified. | No fracture is evident. |
Generate impression based on findings. | Male, 13 years old, altered mental status, concern for intracranial hemorrhage. The cerebral hemispheres and brainstem are normal in attenuation and morphology. The foramen of Magendie appears slightly more prominent than what is typically seen. The CSF space beneath the vermis is perhaps also mildly prominent. Otherwise the cerebellum is unremarkable.No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. The bones of the calvarium and skull base are intact. Soft tissue debris is present within the right external auditory canal | 1. No acute intracranial abnormality.2. Slight prominence of the foramen of Magendie and perhaps of the CSF space beneath the cerebellar vermis are of uncertain significance. An arachnoid cyst may be considered as well as normal variation. Further evaluation with MRI may be helpful. |
Generate impression based on findings. | Right elbow pain for two days without injury. Question of fracture. No acute fracture or malalignment. The elbow fat pads are nondisplaced. | No acute fracture is evident. |
Generate impression based on findings. | Pain after fall against a wall. Question of dislocation. There is no acute fracture or malalignment. | No acute fracture or dislocation is evident. |
Generate impression based on findings. | MVC with airbag deployment and left lower rib pain. Evaluate for rib fracture. No acute rib fracture is seen. The heart size is normal. No focal lung opacity, pleural effusion, or pneumothorax is identified. | No acute rib fracture is evident. |
Generate impression based on findings. | Back pain status post ground level fall. Evaluate for fracture. There are multilevel degenerative changes of the lumbar spine. The lumbar vertebral body heights are maintained. There is no definite fracture. There is anterior wedging of the T11 vertebral body of indeterminate chronicity. | 1. Multilevel degenerative changes of the lumbar spine without definite acute fracture.2. Age indeterminate compression deformity of the T11 vertebral body. |
Generate impression based on findings. | Male, 78 years old, status post fall with head trauma. Hyperattenuating tissue is seen within the suboccipital scalp which may reflect traumatic injury. Mild subcutaneous thickening in the midline frontal scalp likewise may reflect traumatic injury. No underlying skull fracture is seen.No acute intracranial hemorrhage is seen. Periventricular hypoattenuation is a nonspecific finding but most commonly represents age indeterminate small vessel ischemic disease. No loss of gray-white distinction or edema is suspected. There is no evidence of significant parenchymal mass effect. The ventricles are within normal limits for size. The sulci and subarachnoid spaces are mildly prominent compatible with slight parenchymal volume loss. | 1. Age indeterminate small vessel ischemic disease without CT evidence for any acute intracranial abnormality.2. Frontal and suboccipital scalp injury is suspected. No underlying skull fracture is seen. |
Generate impression based on findings. | The patient is kyphotic and osteopenic. Within these limitations, there is no evidence of acute fracture or subluxation. There is mild anterolisthesis of C4 on C5, measuring 2 mm, and minimal anterolisthesis of T1 on T2, likely on a degenerative basis. The vertebral body heights are preserved. There are endplate degenerative changes and loss of disc height, moderate at C5-C6 and mild at C6-C7. There is no significant spinal canal stenosis. There are partially imaged atherosclerotic changes of the aorta. The partially imaged lung apices demonstrate a right apical opacity. C2-C3: Mild disc bulge. No significant spinal canal or foraminal stenosis.C3-C4: Mild disc bulge and bilateral facet degeneration. No significant spinal canal or foraminal stenosis.C4-C5: Moderate bilateral facet degeneration and right uncovertebral spur. No significant spinal canal or foraminal stenosis.C5-C6: Moderate bilateral facet degeneration and right uncovertebral spur contributing to moderate right foraminal stenosis. No significant spinal canal stenosis.C6-C7: Moderate bilateral facet degeneration and right uncovertebral spur contributing to mild right foraminal stenosis. No significant spinal canal stenosis.C7-T1: No significant spinal canal or foraminal stenosis. | 1. No acute fracture or subluxation. 2. Diffuse osteopenia. 3. Multilevel degenerative cervical spondylosis with variable right foraminal stenosis as described. No significant spinal canal stenosis. Mild anterolisthesis of C4 on C5 and T1 on T2, likely degenerative. 4. Partially imaged right apical lung opacity, may be related to infection or aspiration. Follow up as clinically warranted. |
Generate impression based on findings. | Male, 47 years old, with leukocytosis, fever and altered mental status. Assess for signs of infection. Allowing for the minimal mucosal thickening within the maxillary sinuses, the paranasal sinuses are clear. The major sinus ostia are unobstructed. The nasal septum is intact deviating mildly to the right. An NG tube passes through the left nare. Partial opacification of the mastoid air cells is seen. The middle ear cavities are clear. Debris is present in the external auditory canals.No discrete fluid collection or evidence of pathologic adenopathy is detected in the soft tissues of the neck. The aerodigestive mucosa is within normal limits. Lung apices are clear. The glandular tissues are free of focal lesions. No worrisome osseous lesions are identified. Multiple missing and/or carious teeth are demonstrated along with scattered peri-apical lucencies. | 1. No evidence of significant paranasal sinus infection or inflammation. Partial opacification of the mastoid air cells is a nonspecific finding. This can reflect a sterile effusion or inflammatory fluid. No osseous destruction is seen to suggest an aggressive infection. Correlation with local symptomatology is suggested.2. No obvious infectious source is identified in the neck. Evidence of dental and periodontal disease is, however, seen as discussed above. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Incidentally noted is a partially empty sella, which is non-specific. | No acute intracranial abnormality or pathologic enhancement. |
Generate impression based on findings. | Streak artifact from metallic hardware somewhat limits evaluation.CT CERVICAL SPINE: There are postoperative changes related to a posterior spinal fusion at C3 through T1, utilizing bilateral lateral mass screws at C3-C6, pedicle screws at T1 and stabilizing rods. There are decompressive laminectomies at C3 through C7. There is anterior cervical discectomy and fusion at C4-C5. There is no evidence of hardware loosening or fracture. There is resolution in the reversal of cervical lordosis seen on previous MR. There is interval improvement in retrolisthesis at C4-C5, C5-C6, and C6-C7. The vertebral body heights are preserved. There is loss of disc height at C5-C6 and C6-C7. There are multilevel degenerative changes with facet degeneration. There is disc bulge at C3-C4 and variable bilateral foraminal stenoses at C4-C5, C5-C6 and C6-C7. Streak artifact otherwise limits evaluation of spinal canal at the C3-C7 levels. CT NECK SOFT TISSUE: There are post-operative changes to the left neck with a retropharyngeal effusion. There is a small, ill-defined fluid collection and locule of air at the surgical bed at the level of C3, which is well within post-operative limits. There is a surgical catheter in place. The right temporal soft tissues are asymmetrically thicker than the right, of uncertain clinical significance. There is mild mucosal thickening of the right frontal, ethmoid and maxillary sinuses, which is partially imaged.There is no evidence of mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. Atherosclerotic changes of the bilateral internal carotid arteries are noted.The imaged portions of the lungs are clear. Partially imaged is deformity of the right acromion and distal clavicle, which is better assessed on prior MR of the right shoulder dated 11/18/2014. | 1. Post-operative findings related to posterior spinal fusion at C3-T1, decompressive laminectomies at C3-C7, and anterior cervical discectomy and fusion at C4-C5, with interval improvement in cervical spinal alignment.2. Small, ill-defined fluid collection with locule of air in the surgical bed at the level of C3, which is well within normal post-operative limits. No other evidence of a large CSF leak is seen.3. Multilevel degenerative cervical spondylosis with multilevel foraminal stenosis. Streak artifact limits evaluation of spinal canal. 4. Thickening of the right temporal soft tissues, of uncertain clinical significance. |
Generate impression based on findings. | There are post-operative findings related to a suboccipital craniectomy and resection of the posterior arch of C1 for decompression of Chiari malformation. There is evidence of tonsillar cauterization/resection. There remains some crowding of the remaining cerebellar tonsils at the level of the foramen magnum. A fluid collection at the surgical bed measures approximately 10 x 35 x 36 mm (AP x TR x CC) and extends inferiorly to the level of the mid C2 vertebral body. The superior extent is incompletely evaluated on the axial images. This fluid collection follows CSF signal and is compatible with a pseudomeningocele. Enhancing soft tissue surrounds the fluid collection, which is expected in the post-operative period. There is no significant edema around the fluid collection. The dura/duraplasty in the operative bed shows no definite evidence of a defect.There is mild reversal of the normal cervical lordosis. The vertebral body heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber. There is a thin syrinx at the right lateral aspect of the cervical cord, which, along with a prominent central canal of the cord, extends inferiorly to the thoracic region. There is no pathological intrathecal enhancement.There is no significant disc bulge, herniation, spinal canal or foraminal stenosis within the cervical spine. | 1. Post-operative findings related to Chiari decompression. 2. A pseudomeningocele at the surgical bed is seen. Lack of surrounding edema makes infection less likely, though imaging cannot exclude superinfection. 3. Mild syringohydromelia. |
Generate impression based on findings. | Female, 49 years old, history of left retromolar trigone cancer. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Mild mucosal thickening is seen within the ethmoid air cells and the maxillary sinuses.Neck:The left posterior maxillary alveolar ridge is absent. There is a relatively sharp margin at the residual maxillary ridge just posterior to the second premolar. The walls of the overlying maxillary sinus are intact. The osseous defect is filled by soft tissue thickening which is predominantly hypoattenuating but there is a thin apparent rim of enhancement along its lateral margin. This tissue measures 19 x 14 mm (image 49 series 5). Streak artifact obscures this area on the prior examination which makes accurate measurement difficult. The bony defect does, however appear very similar to prior.There may be soft tissue thickening more inferiorly along the buccal space on the left (see image 66 of series 5). Again, this tissue is nonspecific and could be postoperative. Comparison with the prior examination, and to the contralateral side of the present examination, is compromised by extensive streak artifact.No pathologic adenopathy is detected in the neck by size criteria. The mucosal tissues are otherwise unremarkable. The glandular tissues are free of focal lesions. The cervical vessels opacify normally. No concerning osseous lesions are seen. | 1.The left posterior maxillary alveolar ridge is absent with a relatively sharp margin at the posterior edge of the remaining ridge. The osseous defect is filled by largely hypoattenuating tissue although the lateral margin shows a thin rim of enhancement. In the context of prior treatment, this could represent surgical alteration and grafting. Otherwise this would be compatible with the patient's stated retromolar trigone cancer. In either event, comparison to the prior examination is somewhat limited due to extensive streak artifact. However, the osseous defect does appear very similar.2.Possible buccal mucosal thickening is also seen on the left. As above, this finding is nonspecific and its significance is dependent upon the presence or absence of prior treatment.3.No pathologic adenopathy is detected in the neck.4.No evidence of intracranial metastatic disease is seen. |
Generate impression based on findings. | Re-staging of metastatic thyroid cancer . There are stable post-treatment findings in the neck. There is no evidence of locoregional tumor recurrence. There is no significant lymphadenopathy by size criteria. The salivary glands appear unchanged. There is atrophy of the left parotid gland. The airways are patent. The osseous structures are unchanged. There is a very small right vertebral artery, unchanged. There is a 6 mm subcutaneous soft tissue nodule in the right upper back, unchanged. There are multiple pulmonary nodules and partially imaged small right pleural effusion. | 1. No evidence of locoregional tumor recurrence or significant lymphadenopathy.2. Multiple metastases and small right pleural effusion within the partially imaged lungs. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Female, 90 years old, with altered mental status. No evidence of parenchymal edema or loss of gray-white distinction. A few small foci of hypoattenuation are seen within the right basal ganglia which are nonspecific and likely related to age indeterminate small vessel ischemic disease. No intracranial hemorrhage or abnormal extra-axial fluid. The ventricles are normal in size and morphology. The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Female, 79 years old, history of diabetes, hypertension, presenting with acute onset self-limited confusion found to have hypoglycemia. At most, minimal periventricular hypoattenuation is seen, a nonspecific finding. No parenchymal edema or loss of gray-white distinction is detected. No evidence of intracranial hemorrhage or abnormal extra-axial fluid is seen. The ventricles are normal in size and morphology.The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Reason: 44 y/o with aml with continued neutropenic fever. sinus infection History: headache The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated.The frontal sinuses are clear.Maxillary sinuses are clear. Ethmoid air cells demonstrate minor opacities.Sphenoid sinuses are clear. Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits. | 1.No CT evidence for acute sinusitis. Minor opacities in the ethmoid air cells are probably of little clinical significance.2.No paranasal sinus outlet obstruction is appreciated. |
Generate impression based on findings. | 66-year-old male. Reason: Dobbhoff Placement History: As above Dobbhoff tube curled within the stomach, with tip directed superiorly, overlying the distal esophagus.Mildly prominent loops of small and large bowel, likely ileus pattern. Surgical clips in the left upper quadrant. | Dobbhoff tube curled within the stomach, with tip overlying the distal esophagus. Findings discussed by the on call resident with the ordering provider on 1/4/2015 at 12:42 PM. |
Generate impression based on findings. | 77-year-old male with constipation and leaking around the G-tube site. Concern for obstruction. Nonobstructive bowel gas pattern. Average amount of stool. A G-tube overlies the body of the stomach. The tip of a left-sided central venous catheter terminates at the superior cavoatrial junction. Surgical clip visualized in the right upper quadrant. Note is made of small pleural effusions and bibasilar opacities greater on the left which has air bronchograms. This has increased compared to previous exam from two days ago and may represent developing left basilar infection. | Nonobstructive bowel gas pattern. Interval increase in the left basilar consolidation with air bronchograms suspicious for possible developing infection. This can be better evaluated with a chest radiograph. |
Generate impression based on findings. | Reason: evaluate for stroke History: ams, new afib The CSF spaces are appropriate for the patient's stated age with no midline shift. Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.Periventricular and subcortical white matter hypodensities of a mild degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Male 8 years old Reason: s/p closure of cecostomy tube. now distended History: abdominal distentionVIEW: Abdomen AP (one view) 1/4/15 at 1046 hrs. Cecostomy trapdoor was removed, a small catheter appears to be overlying the region now. Increasing in nonspecific bowel distention, no evidence of obstruction. No free air. | Nonspecific bowel distention. |
Generate impression based on findings. | 38-year-old male with nasogastric tube placement. Note that the pelvis was not included in the exam. Nonobstructive bowel gas pattern. Retained contrast is visualized in the colon. A nasogastric tube tip overlies the body of the stomach. IVC filter is in place at the L1-L2 level. | Nasogastric tube tip in the body of the stomach. |
Generate impression based on findings. | Male 24 years old Reason: abdominal pain History: as above ABDOMEN:LUNG BASES: Left sided pleural effusion with associated compressive atelectasis unchanged. Right basilar atelectasis also unchanged. Previously described multifocal airspace opacities not included in the field-of-view.LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Unchanged nonspecific nodularity of the left adrenal gland.KIDNEYS, URETERS: The patient is status post left nephrectomy. There is a right percutaneous nephrostomy tube in place as well as a nephroureteral stent. Poorly defined areas of hypoattenuation in the renal parenchyma are unchanged. Nonobstructing renal stones again seen.RETROPERITONEUM, LYMPH NODES: Stable left retroperitoneal fluid collection now measuring approximately 15.8 x 7.0 cm (image 65, series 3), previously measuring 16.1 x 6.7 cm. There has been interval removal of the pigtail catheter. Numerous prominent retroperitoneal lymph nodes again identified.BOWEL, MESENTERY: Gastrostomy tubes in place, position changed. Multiple dilated loops of small bowel again seen, consistent with chronic ileus.BONES, SOFT TISSUES: Bilateral hip dysplasia and multilevel fusions of the thoracolumbar spine. Unchanged mild/moderate body wall edema.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: Bilateral hip dysplasia and multilevel fusions of the thoracolumbar spine. Unchanged mild/moderate body wall edema. | 1.Stable retroperitoneal hematoma with interval removal of the pigtail catheter.2.Chronic ileus.3.Left pleural effusion and compressive atelectasis unchanged. |
Generate impression based on findings. | Female 17 years old Reason: 17 YO with ankle pain. s/p inversion of right ankle. evaluate for fx History: bony tenderness at lateral malleolus. inability to bear wt or ambulateVIEWS: Right ankle AP, lateral and oblique 1/4/15 (3 views) Soft tissue swelling with no fracture, malalignment or joint effusion. | Soft tissue swelling with no fracture. |
Generate impression based on findings. | Female 85 years old; Reason: 85 yo F w/ pmhx of hypothyroidism, dementia, and hypertension presenting w/ progressive weight loss, severe malnutrition and leukopenia/thrombocytopenia, concerning for malignancy History: evaluate for malignancy d/t weight loss. CHEST:LUNGS AND PLEURA: Mild biapical scarring. Moderate left basal atelectasis.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is atrophic.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Two hypoattenuating lesions within the left kidney. The largest measures 2.2 cm in maximum dimension. This has been previously characterized with ultrasound as a renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is an abrupt caliber change within the distal stomach which is nonspecific and may relate to poor distention.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: The abdominal aorta is tortuous. There is no aortic dissection. Mild aorta and branch vessel arteriosclerosis.PELVIS:UTERUS, ADNEXA: The uterus is atrophic or absent.BLADDER: The bladder is collapsed.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse osteopenia. Degenerative changes of the bilateral hip joints and lumbar spine, most marked at the L5-S1 level.OTHER: No significant abnormality noted. | 1.No specific findings to account for patient's symptoms. |
Generate impression based on findings. | 88 year-old female with abdominal pain. Evaluate for toxic megacolon. Nonobstructive bowel gas pattern. Average amount of stool in the colon. Degenerative changes are noted of the lumbosacral spine and hips bilaterally. | No evidence of toxic megacolon. |
Generate impression based on findings. | 54-year-old male. Reason: s/p Dobbhoff replacement History: Dobbhoff placement The pelvis is excluded from the field of view.Interval adjustment of Dobbhoff tube, now with tip overlying the GE junction.Partially visualized nonobstructive bowel gas pattern. | Dobbhoff tube with tip overlying the GE junction. This tube has been removed on subsequent imaging. |
Generate impression based on findings. | Male 20 months old Reason: evaluate for pneumonia History: course breath sounds. Diminished at left baseVIEWS: Chest AP/lateral (two views) 1/4/15 Cardiac silhouette size is normal. Peribronchial thickening and left normal opacity, likely atelectasis or pneumonia. | Bronchiolitis pattern with right lower lobe opacity. |
Generate impression based on findings. | 30 year-old female. Reason: LUQ pain, air-filled loops on cxr History: eval Redemonstration of diffusely dilated loops of mostly colon. These findings were seen on prior abdominal CT dated 11/10/2014 No definite air in the expected region of the ileal pouch, similar to the prior radiographic study. Suture lines and surgical clips in the right abdomen and anal region. No evidence of pneumatosis or portal venous gas. No large free air seen on supine imaging.Lap band in appropriate position. | Postsurgical changes and redemonstration of diffusely dilated loops of predominantly colon. Findings most likely represent chronically dilated bowel loops. |
Generate impression based on findings. | 25 year-old male with testicular swelling. RIGHT TESTIS: The right testicle is normal in morphology, echogenicity and size, measuring 4.9 x 2.7 x 3.4 cm. Color Doppler demonstrate symmetrical blood flow. Spectral Doppler demonstrates normal waveforms.LEFT TESTIS: The left testicle is normal in morphology, echogenicity and size, measuring 4.3 x 2.2 x 3.6 cm. Color Doppler demonstrates symmetrical blood flow. Spectral Doppler demonstrates normal waveforms.RIGHT EPIDIDYMIS: The right epididymis is normal in morphology, echogenicity and size without abnormal hypervascularity.LEFT EPIDIDYMIS: The left epididymis is increased in size and heterogeneity. It measures 3.0 x 3.5 x 5.3 cm. There is increased blood flow as well. OTHER: There may be a small left varicocele. | Findings most suggestive of left epididymitis, possibly acute on chronic given the large increase in size and heterogeneity of the left epididymis. Possible small left varicocele, as well. Patient was discharged home from the ED with antibiotic treatment for presumptive epididymitis. |
Generate impression based on findings. | Male 10 years old Reason: Evaluate for obstruction History: 6 days of abdominal pain, no BM in 3 days, vomitingVIEW: Abdomen AP (one view) 1/4/15 Normal abdominal gas pattern. No evidence of obstruction or free air. No ascites. | Normal abdominal gas pattern. |
Generate impression based on findings. | Syncope, seizure activity, transient. Evaluate for the etiology of possible seizure activity. Question of stroke versus mass. There is no evidence of intracranial hemorrhage. The grey-white matter differentiation appears to be intact. There is mild periventricular and subcortical white matter hypoattenuation which is nonspecific but may represent small vessel ischemic disease. 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. | 1. No evidence of intracranial hemorrhage.2. Age-indeterminate small vessel ischemic disease; CT is insensitive for the detection of non-hemorrhagic, acute ischemic infarcts. If concern for ischemia persists, MRI may be obtained for further evaluation. |
Generate impression based on findings. | Female 10 years old Reason: collapse or infiltrate History: intubated , status epilepticus.VIEW: Chest AP (one view) 1/5/15 at 206 hours. ET tube, central line and misplaced NG tube unchanged. Cardiac silhouette size is normal. Interval development of bibasilar opacities, likely atelectasis. | Interval development of bibasilar opacities, likely atelectasis. |
Generate impression based on findings. | 71-year-old male. Reason: Dobbhoff tube clogged - removed and replaced with new History: new Dobbhoff Dobbhoff tube with tip overlying the proximal fourth portion of the duodenum.Nonobstructive bowel gas pattern. LVAD device. | Dobbhoff tube with tip overlying the proximal fourth portion of the duodenum. |
Generate impression based on findings. | Subcutaneous soft tissue swelling with small associated hematoma is noted in the subcutaneous tissues overlying the left frontal bone without underlying calvarial fracture or associated intracranial abnormality. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Foci of mucosal thickening can be found throughout the sinuses without air-fluid levels. The Visualized mastoid air cells are clear. | Subcutaneous soft tissue swelling with small associated hematoma is noted in the subcutaneous tissues overlying the left frontal bone without underlying calvarial fracture or associated intracranial abnormality. |
Generate impression based on findings. | 36 year old female with right lower quadrant abdominal pain and vomiting. ABDOMEN:LUNG BASES: Minimal basilar subsegmental atelectasis. No pleural effusions.LIVER, BILIARY TRACT: Geographic focus of low-attenuation adjacent to the falciform ligament is compatible with focal fatty infiltration. Otherwise morphologically normal liver with patent vasculature and no biliary ductal dilatation. Normally distended gallbladder. Normal common bile duct caliber.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter right renal hypodensity is too small to characterize, but statistically likely a benign renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The small bowel is normal in appearance, given the limitation of no oral contrast. Although, the appendix is difficult to identify there are no secondary inflammatory changes to suggest acute appendicitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Trace amount of endometrial fluid is within physiologic limits. 2.6 x 2.3 cm simple fluid attenuating left adnexal lesion is within physiologic limits. Trace amount of pelvic fluid measuring simple fluid attenuation is noted.BLADDER: Normally distended bladder.LYMPH NODES: Moderately prominent bilateral inguinal lymph nodes are non-specific but may be reactive.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Although the appendix is not well-visualized there are no secondary inflammatory changes in the right lower quadrant to suggest acute appendicitis.2. 2.6-cm left adnexal cystic lesion is within physiologic limits.3. Moderate non-specific bilateral inguinal lymph node enlargement. |
Generate impression based on findings. | Female 16 years old Reason: assess LP shunt History: pain and swelling at shunt siteVIEWS: Abdomen AP and lateral 1/5/15 (two views) An LP shunt is present. Intraperitoneal catheter terminates in the lower pelvis. Intraspinal portion of the catheter tip not visualized. Codman Hakim valve setting is 100 mm of water. Normal abdominal gas pattern. No evidence of obstruction or free air. | LP shunt setting as described. |
Generate impression based on findings. | 47-year-old male status post lumbar instrumentation with back pain Posterior rods and screws affix L1, L2, L4, and L5 in near anatomic alignment without evidence of hardware complication. The L3 vertebral body has been removed and replaced with a metallic spacer. Moderate degenerative disk disease affects L5/S1.An IVC filter is noted. | Lumbar spinal fixation as detailed above without evidence of complication. |
Generate impression based on findings. | There is no acute intracranial hemorrhage. There is CT evidence of large vascular distribution infarct. There is no extraaxial fluid collection. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no calvarial fracture. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial abnormality, and no significant interval change. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion |
Generate impression based on findings. | Male 55 years old Reason: evaluate for diverticulitis or other causes of RLQ and suprapubic abdominal pain History: constipation hx, occ loose stools, LLQ pain, sig cardiovascular hx ABDOMEN:LUNG BASES: Trace bibasilar dependent atelectasis.LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The kidneys are atrophic.RETROPERITONEUM, LYMPH NODES: Extensive right-sided body wall venous collateralization results in early filling of the right femoral vein. There are severe atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis. The appendix is identified in the right lower quadrant and is normal in appearance. Appendicolith formation noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Multilevel degenerative changes of the thoracolumbar spine. | 1.Extensive right body wall collateralization.2.Atrophic kidneys consistent with end-stage renal disease.3.No specific finding seen to account for the patient's pain. |
Generate impression based on findings. | Fall, question of ICH. Head: There is no evidence of acute intracranial hemorrhage. There is moderate periventricular and subcortical white matter hypoattenuation which is non-specific but may represent small vessel ischemic disease. The ventricles and cortical sulci are prominent compatible with age-related volume loss. There is no midline shift or herniation. There is mucosal thickening of the imaged paranasal sinuses with a small air-fluid level in the right maxillary sinus. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. There is atherosclerotic calcification of the cavernous portions of the bilateral internal carotid arteries.Cervical Spine: There is no evidence of fracture. The vertebral body heights are preserved. There is trace anterolisthesis of C7 on T1 due to facet hypertrophy. There are multilevel degenerative changes of the cervical spine, most predominately of the lower segment. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. | 1. No acute intracranial hemorrhage.2. Multilevel degenerative changes of the cervical spine without fracture.3. Age-indeterminate small vessel ischemic disease. CT is insensitive for the detection of non-hemorrhagic, acute ischemic infarcts. If concern for ischemia persists, MRI may be obtained. |
Generate impression based on findings. | Increased oxygen requirementVIEW: Chest AP (one view) 1/5/15 0336 Fractured shunt catheter is noted again in the neck. Left PICC tip is in the right atrium.The cardiac silhouette is normal.The right lower lobe opacity persists. Additional bibasilar multifocal pulmonary opacities are increased. | RLL pneumonia with worsening multifocal opacities. |
Generate impression based on findings. | 82 year-old woman with history of pain and swelling after dropping object on foot. Diffuse soft tissue swelling is noted, increased from the prior study. The bones are demineralized. There is no acute fracture or malalignment. Arterial calcifications are noted. | Soft tissue swelling without acute fracture or malalignment. |
Generate impression based on findings. | 34-year-old male with abdominal/flank pain. Evaluate for nephrolithiasis. Please note that lack of intravenous and oral contrast limits evaluation for lymphadenopathy, solid organ, and bowel pathology.ABDOMEN:LUNG BASES: The lung bases are clear. Normal cardiac size without a pericardial effusion.LIVER, BILIARY TRACT: Normal liver morphology without biliary ductal dilatation. Normally distended gallbladder without extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate left interpolar collecting system non-obstructing calculus. No hydroureteronephrosis, ureter or bladder stone is identified.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The bowel is normal caliber. Note is made of residual contrast throughout the small bowel.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: Pelvic phleboliths are noted. | 1. No obstructing calculus or hydroureteronephrosis as clinically questioned.2. No specific findings to account for the patient's pain given the limitations of a noncontrast examination. |
Generate impression based on findings. | 47-year-old female status post fall, question fracture Glenohumeral alignment is maintained. No fracture is evident. Minimal arthritic changes affect the acromioclavicular joint. | No fracture or dislocation. |
Generate impression based on findings. | 46-year-old man with history of fall and swelling. Right foot: There is soft tissue swelling about the dorsum of the foot and the ankle. Areas of serpentine sclerosis are seen in the first metatarsal and calcaneus, compatible with bone infarcts. Distal tibia and fibular fractures are noted, but there are no fractures involving the bones of the foot.Right ankle: There is are comminuted fractures of the distal tibia and fibula with minimal impaction of the distal tibial fragments. There is an ankle joint effusion, but alignment is grossly anatomic. There is serpentine sclerosis of the distal tibia.Right tibia/fibula: The distal tibial and fibular fractures are again noted. In addition to that seen in the distal tibia, there is an area of serpentine sclerosis in the proximal tibia, compatible with bone infarcts. | Comminuted pilon fractures of the distal tibia and fibula. |
Generate impression based on findings. | Male 20 years old Reason: evaluate for stone History: lower quad abdominal pain b/l, b/l low back pain, n/v ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Medullary hyperattenuation likely reflects fluid status/component of dehydration. There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS: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 noted | No specific findings seen to account for the patient's pain, specifically no evidence of radioopaque nephrolithiasis or ureterolithiasis. |
Generate impression based on findings. | Female 29 years old Reason: r/o pe History: ttp along Left lower ribs, cough PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Medial left lower lobe atelectasis/consolidation consistent with pneumonia. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: No adenopathy. No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No PE.2.Left lower lobe pneumonia. |
Generate impression based on findings. | 49 year old female with left chest wall pain and shortness of breath, evaluate for PE PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Minimal dependent atelectasis. No pleural effusion. No pneumothorax. Small cluster of centriloblar and tree in bud nodules in left upper lobe are nonspecific but may be due to infection or aspirate (image 44/143).No consolidation.MEDIASTINUM AND HILA: No significant pericardial effusion or cardiomegaly. No appreciable coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted, particularly no displaced rib fractures.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No pulmonary embolus.Small cluster of centriloblar and tree in bud nodules in left upper lobe are nonspecific but may be due to bronchiolitis.Findings communicated to ED by Dr. Bennett to Dr. Sofija DegesysPULMONARY EMBOLISM: PE: NegativeChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 54 year old with history of right-sided breast carcinoma status post mastectomy (2010) and reconstruction. No current breast related complaints. Family history of breast cancer in mother, maternal grandmother, and maternal aunt. CC and MLO views of left breast along with implant displaced CC and MLO views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the left breast. Retroperitoneal silicone implant is unchanged and without evidence of rupture. Clustered calcifications in the left lower outer breast are unchanged over multiple prior exams. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 37 years old Reason: evaluate for pna, evaluate for toxic megacolon History: C.diff, bloody stool CHEST:LUNGS AND PLEURA: There are new large bilateral pleural effusions left greater than right with associated compressive atelectasis.MEDIASTINUM AND HILA: The esophagus is patulous. There is no pericardial effusion.CHEST WALL: Ventricular peritoneal shunt catheter tubing is seen coursing down the anterior chest wall. There is marked body wall edema.ABDOMEN:LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal parenchymal hypodensities consistent with simple renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There has been marked interval improvement in the patient's stool burden. There is now diffuse mucosal hyperenhancement and wall thickening extending from the rectum proximally (appears to extend to region of presumed redundant sigmoid colon, possibly to level of mid to distal descending colon) compatible with colitis. There is a gastrostomy tube in place, and the bumper appears to be at least partially buried in the abdominal wall.BONES, SOFT TISSUES: Chronic osseous abnormalities of the abdomen and pelvis again identified. There is marked body wall edema.OTHER: New large volume ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See aboveBONES, SOFT TISSUES: Chronic osseous abnormalities of the abdomen and pelvis again identified. There is marked body wall edema.OTHER: New large volume ascites. | 1.Marked bowel wall thickening and mucosal hyperenhancement affecting primarily the rectosigmoid colon compatible with colitis, most likely infectious or inflammatory in etiology, although ischemia cannot be excluded.2.Improved stool burden.3.New large volume ascites, large pleural effusions are marked body wall edema.4.Gastrostomy tube, which appears at least partially buried in the abdominal wall.These findings were discussed with Dr. Farrington at 09:17 on 1/5/2015 |
Generate impression based on findings. | 58-year-old male with poorly defined abdominal pain. Per the EPIC note, the patient's pain is primarily epigastric. ABDOMEN:LUNG BASES: Partial left lung base consolidation/atelectasis. Normal cardiac size without pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No CT evidence of acute pancreatitis as clinically questioned.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal hypodensities, measuring near simple fluid attenuation, compatible with benign cysts. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcification of the abdominal aorta and iliac arteries without aneurysmal dilatation.BOWEL, MESENTERY: There appears to be soft tissue fullness about the gastroesophageal junction which is poorly defined, in part due to the paucity of intra-abdominal fat. This may represent a small hiatal hernia, esophagitis or other pathology; correlation with EGD is recommended as clinically warranted. There is a mild amount of secretions within the duodenum which is non-specific. The small bowel is otherwise normal in caliber and wall thickness, given the limitation of a paucity of abdominal fat.The appendix is not definitively visualized, but there are no secondary inflammatory changes in the right lower quadrant to suggest acute appendicitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Heterogeneously enlarged lobulated prostate particularly of the central gland, correlate with physical examination and PSA. BLADDER: Normally distended bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right iliac sclerotic focus, likely a benign bone island.OTHER: No significant abnormality noted | 1. Soft tissue fullness about the distal esophagus/gastroesophageal junction which is poorly defined, in part due to the paucity of intra-abdominal fat. This may represent a small hiatal hernia, esophagitis or other pathology; correlation with EGD and/or esophagram is recommended as clinically warranted.2. Left lung base focal consolidation and/or atelectasis.3. Mild amount of secretions within the duodenum is non-specific. 4. Heterogeneously enlarged lobulated prostate particularly of the central gland, correlate with physical examination and PSA. Discussed with Dr. Druelinger (ER Physician) at 1033 on 01/04/2015 regarding the additional findings not discussed in the STAT Consult. |
Generate impression based on findings. | There are postoperative findings related to a left frontal and a left parietal burr hole placement. Interval removal of left subdural drain is seen. There are small foci of pneumocephalus. The subdural collection is mixed in attenuation with areas of high and low density. No significant change in size compared to 1/4/2015 measuring 11 mm in the axial plane and 15 mm in the coronal plane Unchanged left to right midline shift measuring up to 6 mm. No uncal herniation. There is unchanged mass effect on the underlying parenchyma and left lateral ventricle. There is unchanged mild entrapment of the right temporal horn. The visualized portions of the paranasal sinuses are grossly clear. There is minimal opacification of the bilateral mastoid air cells. | Compared to 1/4/2015, interval removal of left subdural drain. No significant change in residual mixed density subdural collection along the left cerebral hemisphere. Unchanged mass effect including effacement of the left cerebral sulci and 6-mm rightward midline shift. |
Generate impression based on findings. | 27 year old female with history of nasal fracture, nasal septal deviation, and questionable nasal polyp. There is mild mucosal thickening scattered about the maxillary, ethmoid and sphenoid sinuses. The frontal sinuses are clear. There is a tiny nodular opacity present along the lateral aspect of the right maxillary sinus likely representing a retention cyst. There are bilateral Haller cells. The ostiomeatal complexes and sphenoethmoidal recesses are clear. There is significant leftward deviation of the nasal septum with a prominent spur. The roof of the ethmoids is relatively symmetric. The lamina papyracea are intact. The mastoid air cells are clear. The visualized intracranial structures are unremarkable. | Mild mucosal thickening of the paranasal sinuses as above. |
Generate impression based on findings. | Female 84 years old Reason: r/o pe History: acute onset sob PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Minimal bibasilar dependent atelectasis. No focal lung consolidation no pneumothorax.MEDIASTINUM AND HILA: The main pulmonary artery is mildly enlarged measuring 3.2 cm, suggestive of pulmonary artery hypertension. Cardiomegaly. Severe atherosclerotic calcification of the coronary arteries. Mild reflux of contrast into the hepatic veins, which can be seen in cardiac dysfunction.CHEST WALL: Degenerative changes in the spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis is incompletely visualized. | 1.No PE.2.Mildly enlarged main pulmonary artery suggestive of pulmonary artery hypertension. |
Generate impression based on findings. | A crescentic left paramedian extra-axial collection is noted at the vertex, underlying the anterior fontanelle, which on coronal reconstruction system crosses the midline, possibly involving the superior sagittal sinus. Given this location and appearance, the differential diagnosis includes venous epidural hemorrhage versus subdural hemorrhage.Separately, there is a 24-mm AP by 19-mm transverse by 25-mm craniocaudal collection within the mid falx demonstrating a fluid/level consistent with an intra-falcine subdural hematoma.Subdural hemorrhage is also noted elsewhere involving the falx as well as along bilateral tentorial leaflets. Scattered subarachnoid hemorrhage is also evident.An intracranial pressure monitoring device is been placed via the right frontal bone without evidence of post-procedural complication. Overlying scalp swelling is noted.The ventricles and sulci are normal in size. There is no midline shift. Fluid is present within bilateral middle ear cavities and mastoid air cells. The patient is intubated. | 1.A crescentic left paramedian extra-axial collection is noted at the vertex, underlying the anterior fontanelle, which on coronal reconstruction system crosses the midline, possibly involving the superior sagittal sinus. Given this location and appearance, the differential diagnosis includes venous epidural hemorrhage versus subdural hemorrhage.2.Separately, there is a 24-mm AP by 19-mm transverse by 25-mm craniocaudal collection within the mid falx demonstrating a fluid/level consistent with an intra-falcine subdural hematoma.3.Subdural hemorrhage is also noted elsewhere involving the falx as well as along bilateral tentorial leaflets. Scattered subarachnoid hemorrhage is also evident. |
Generate impression based on findings. | Male 67 years old Reason: 67 yo M w rectal CA POD 5 s/p LAR with rising WBC, distension - c/f abscess ABDOMEN:LUNG BASES: New nodular right basilar opacity suggestive of aspiration. Small bilateral pleural effusions, right greater than left, with associated compressive atelectasis. Reference cardiophrenic node measures 1.2 x 1.6 cm (image 36, series 3), previously 0.6 x 1.1 cm.LIVER, BILIARY TRACT: Hepatic metastases again identified, without significant interval change from the prior exam. Reference hepatic segment 5 lesion now measures 1.3 x 1.6 cm (image 53, series 3), previously 1.3 x 1.6 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: New predominantly right-sided perinephric stranding is most likely postoperative in etiology.RETROPERITONEUM, LYMPH NODES: Multiple slightly prominent retroperitoneal lymph nodes again seen, reference left periaortic node now measures 1.1 x 1.3 cm (image 85, series 3), previously 1.2 x 1.3 cm.BOWEL, MESENTERY: There are postsurgical changes related to low anterior resection with formation of a left lower quadrant colostomy. There is a drain in place in the surgical bed. There is a loculated approximately 4.4 x 4.5 cm fluid collection within the dependent pelvis, which is presumably postoperative in etiology. There is an additional loculated left paracolic fluid collection measuring up to 6.3 x 5.6 cm in cross-sectional dimension. These collections most likely represent postoperative seromas. Small volume pneumoperitoneum, also likely postprocedural.Fat containing left inguinal hernia.BONES, SOFT TISSUES: Midline anterior abdominal/pelvic surgical wound, with cutaneous clips in place inferiorly. Partially imaged right paraspinal mass with internal calcifications, likely represents a lipoma.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: Midline anterior abdominal/pelvic surgical wound, with cutaneous clips in place inferiorly. Partially imaged right paraspinal mass with internal calcifications, likely represents a lipoma. | 1.Post surgical changes related to low anterior resection with loculated fluid collections in the pelvis and left paracolic gutter presumably representing postoperative seromas.2.Index metastatic lesions without significant interval change since the prior exam.3.Nodular right basilar opacity suggestive of aspiration. |
Generate impression based on findings. | Increased oxygen requirement.VIEW: Chest AP (one view) 1/4/15 1055 Fractured shunt catheter is noted again in the neck. Left PICC tip is in the right atrium.The cardiac silhouette is normal.The right lower lobe opacity persists. Additional bibasilar multifocal pulmonary opacities are increased. | RLL pneumonia with worsening multifocal opacities. |
Generate impression based on findings. | Bilateral consolidation on CTVIEW: Chest AP 1/5/15 Tracheostomy tube tip immediately above the carina. Marked scoliosis of the thoracic spine. Cardiothymic silhouette normal. Patchy atelectasis right lower lobe. No pleural effusion or pneumothorax. | Patchy atelectasis right lower lobe. |
Generate impression based on findings. | Female 74 years old; Reason: r/o mass History: 15 lb wt loss, melena ABDOMEN:LUNG BASES: Emphysematous and fibrotic changes of the lung bases with reticular opacities are representing atelectasis or scarring. Evaluation somewhat limited by motion. Coronary artery calcifications. LIVER, BILIARY TRACT: Prominence of the common bile duct and pancreatic duct, similar to prior CT.SPLEEN: Unchanged likely splenic granuloma. Mild heterogeneity likely perfusional.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Ectatic calcified abdominal aorta and its branches, grossly unchanged, including involvement of the celiac artery, SMA, splenic artery, and renal arteries. The celiac artery and SMA are patent.Redemonstrated eccentric intramural plaque, producing mild stenosis, grossly unchanged (3:38).BOWEL, MESENTERY: Moderate circumferential bowel wall thickening of the ascending colon and cecum with mucosal hyperenhancement and surrounding fatty stranding, most compatible with colitis, nonspecific. No pneumatosis or portal venous gas. Colonic diverticulosis. No obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Atrophic/not well visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of free fluid in the pelvis is likely reactive.BONES, SOFT TISSUES: Multilevel degenerative changes of the spine and pelvis.OTHER: Redemonstrated extensive atherosclerotic calcification of the iliac vasculature. Patency is difficult to evaluate given this and as this exam is not protocol for an angiogram. | 1.Ascending colitis, further described above, is nonspecific, and underlying infectious, inflammatory or ischemic etiology is not excluded. |
Generate impression based on findings. | Female 67 years old; Reason: metastatic thyroid cancer, restaging CHEST:LUNGS AND PLEURA: Innumerable lung and pleural metastases. New small right pleural effusion, sequela from prior left-sided wedge resection seen superiorly.Reference left apical mass demonstrates interval decrease in size, measuring 2.8 x 1.6 cm, image 15 series 5, previously measured 3 x 2.6 cm. Decreased size of right middle lobe reference nodule also noted, measures 1.4 x 1.3 cm, image 56 series 5, previously measured 1.7 x 1.6 cm. No significant change with respect to reference right lower lobe nodule, measuring 8 x 6 mm on image 79 series 5.An additional right upper lobe lesion (necrotic in appearance) has increased in size, measuring 1.6 x 1.4 cm, image 34 series 5, previously measured 1.1 x 1 cm.MEDIASTINUM AND HILA: Status post thyroidectomy. Mild mediastinal and hilar lymphadenopathy. Lymph nodes are stable to slightly less pronounced. A left hilar lymph node demonstrates interval increased central hypoattenuation, likely reflecting necrosis, image 43 series 3, node measures 1.2 x 1.1 cm. Heart borderline in size.CHEST WALL: Left breast and axillary surgical clips, correlate with patient's procedural history. Slight interval decrease in size of left subpectoral lymph node, measuring 5 mm, previously measured 8 mm in short axis dimension.ABDOMEN:LIVER, BILIARY TRACT: Visualized liver without significant change, unchanged reference right hepatic focus, measuring 1.1 x 0.9 cm, image 130 series 3. Mild intrahepatic biliary duct prominence and prominence of proximal common bile duct, without significant change. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable appearance of kidneys including relatively higher density hypoattenuation in left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Heterogeneous uterus with left adnexal prominence and accounting for differences in technique, without appreciable change, left adnexal area measures 3.6 x 2.9 cm on image 177 series 3, may reflect a subserosal/exophytic fibroid but follow-up with dedicated pelvic imaging recommended.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures similar to prior study, areas of lucency, examples include in T7, T9 and T10 vertebral bodies, indeterminant and metastatic disease among differential considerations although lesions demonstrate no significant interval change. Multilevel degenerative changes of spine. | 1. New small right pleural effusion. Pulmonary and pleural metastatic disease. Mixed response noted with many lung nodules stable to mildly decreased in size, but at least one nodule (right lower lobe nodule submitted for reference) demonstrating interval increase in size. 2. Heterogeneous uterus with left adnexal prominence and accounting for differences in technique, without appreciable change, area measures 3.6 x 2.9 cm, may reflect a subserosal/exophytic fibroid but follow-up with dedicated pelvic sonographic imaging recommended to exclude neoplastic involvement.3. Stable right hepatic lesion. |
Generate impression based on findings. | No evidence of intracranial hemorrhage. There is no extraaxial fluid collection. Patchy hypoattenuation throughout the periventricular and subcortical white matter is nonspecific but most compatible with chronic small vessel ischemic disease, not significantly changed from prior. The ventricles and sulci are within normal limits for age. There is no midline shift or mass effect. Again seen is increased density within the left parietal scalp, this is unchanged and likely represents scar tissue. There is mild mucosal thickening within the ethmoid air cells and left maxillary sinus. Changes of right intraocular lens replacement. | No evidence of an acute intracranial abnormality. Please note that CT is insensitive for the detection of early nonhemorrhagic stroke. If clinical concern remains high, further evaluation with MRI is recommended. |
Generate impression based on findings. | 66-year-old with history of right breast DCIS status post lumpectomy (2011) and radiation. History of MRI guided biopsy of the right breast demonstrating ALH. No family history of breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A surgical scar marker overlies the right lower central breast. There is architectural distortion, surgical clips and volume loss in the right breast related to prior lumpectomy. A percutaneous biopsy clip in the 3 o'clock position in the right breast is unchanged. Stable benign calcifications are present in the anterior right breast. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Increasing oxygen requirementVIEW: Chest AP and abdomen AP NG tube tip in the stomach. The umbilical venous catheter tip in the left hepatic vein. There is contrast in the esophagus, stomach and small bowel from the upper GI study. Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. Multiple dilated bowel loops without pneumatosis or pneumoperitoneum. | Patchy atelectasis left lower lobe. |
Generate impression based on findings. | History of recurrent right ear squamous cell carcinoma, status post surgery on 12/8/2014 with PNI and margins, admitted for C1/5 TFHX, post-op evaluation. There are post-operative findings related to right lateral temporal bone resection extending to the middle ear, near total auriculectomy, partial parotidectomy and selective right neck dissection. There is reconstruction with flap placement.The right ossicles are resected. There is near complete opacification of the remaining right mastoid air cells and partial opacification of the left mastoid air cells. The right inner ear structures are intact. Fat within the stylomastoid foramen is preserved; MR would be more sensitive for evaluation of perineural tumor spread if clinically indicated. The left ossicles and inner ear structures are intact. There is no significant lymphadenopathy in the neck. The thyroid gland is unremarkable. There is mild atherosclerotic plaque in the region of the carotid bifurcations. There appears to be right uncinectomy and moderate mucosal thickening within the right maxillary sinus. There is multilevel degenerative spondylosis. There is a 8 mm diameter subcutaneous nodule in the left posterior neck, which likely represents an inclusion cyst. The imaged intracranial structures are grossly unremarkable. There are bilateral lens implants. There is a subcentimeter right apical lung nodule. | 1. Post-operative findings related to right lateral temporal bone resection extending to the middle ear, near total auriculectomy, partial parotidectomy and selective right neck dissection with flap reconstruction. Soft tissue in the surgical bed may represent postsurgical change. No definite evidence of residual tumor. This study can serve as a postoperative baseline. 2. No significant cervical lymphadenopathy.3. A subcentimeter right apical lung nodule again seen. Please refer to the separate chest CT report for additional details. |