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Generate impression based on findings. | 54 years old, Female, Reason: follow-up toxic mng History: increasing thyroid size RIGHT LOBE MEASUREMENTS: 4.6 x 1.6 x 1.3 cmLEFT LOBE MEASUREMENTS: 8.1 x 2.4 x 1.7 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: The gland is diffusely heterogeneous. Subcentimeter hypoechoic focus in the right lower lobe is unchanged measuring 0.4 x 2.2 x 0.4 cm.LEFT LOBE: The gland is diffusely heterogeneous. Subcentimeter hypoechoic focus in the mid left thyroid lobe is unchanged in appearance. There is a dominant solid left lower thyroid lobe nodule is slightly smaller in size measuring 2.8 x 1.2 x 1.6 cm which is amenable to biopsy.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Solid dominant left lower pole thyroid nodule measures slightly smaller in size and is amenable to biopsy. 2.Multiple other subcentimeter hypoechoic foci within the bilateral thyroid lobes appear unchanged. |
Generate impression based on findings. | 66 years old, Male, Reason: r/o cholecystitis History: abd pain LIVER: The liver is enlarged measuring 21.1 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is gallbladder sludge without evidence of gallbladder wall thickening or pericholecystic fluid. Sonographic Murphy's sign could not be assessed due to patient's clinical status. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 12.5 cm in length. RIGHT KIDNEY: Kidney measures 10.4 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted. | 1.Gallbladder sludge without evidence of acute cholecystitis.2.Hepatomegaly. |
Generate impression based on findings. | 44-year-old female with history of kidney stones and hydronephrosis. RIGHT KIDNEY: The right kidney measures approximately 11.9 cm, and again shows mild hydronephrosis. An approximately 1 cm calculus in the inferior pole, and approximately 8mm renal calculus in the midpole, are again seen.LEFT KIDNEY: The left kidney measures approximately 11.6 cm, and has mild hydronephrosis, unchanged. Left renal stone in the inferior pole measures approximately 1 cm, similar to prior.OTHER: The bladder is collapsed, and not clearly visualized. | Bilateral mild hydronephrosis and renal stones, without significant interval change. |
Generate impression based on findings. | 69-year-old male with history of angiomyolipoma and renal cysts. RIGHT KIDNEY: The right kidney measures approximately 12 cm in length, and demonstrates an approximately 7.6 x 6 x 5.2 cm simple cyst in the lower pole. Additional smaller cysts are seen.LEFT KIDNEY: The left kidney measures approximately 14 cm in length, and has an approximately 5 x 7.6 x 5.8 cm lower pole simple cyst with a single septation. The previously seen hyperechoic area in the superior pole, consistent with angiomyolipoma, is unchanged in size measuring approximately 2.6 x 3 x 2 cm.URINARY BLADDER: The bladder is with normal limits, with a small amount of adjacent free fluid.OTHER: No significant abnormalities noted. | 1.Left renal angiomyolipoma is not significantly changed.2.Multiple bilateral renal cysts.3.Small amount of pelvic free fluid. |
Generate impression based on findings. | 85 years old, Female, Reason: thyroid nodules seen on 9/2013 ultrasound - please check for progression History: none RIGHT LOBE MEASUREMENTS: 4.7 x 2.2 x 2.4 cmLEFT LOBE MEASUREMENTS: 4.3 x 2.2 x 1.5 centimeters ISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Complex cystic nodule in the right inferior thyroid lobe is not significantly changed size measuring 1.8 x 1.3 x 1.3 cm.LEFT LOBE: Previously noted cystic nodule on the left is not significantly changed in size. There is a newly identified subcentimeter simple cystic nodule in the left lower lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Complex cystic nodule in the right inferior thyroid lobe is not significantly changed.2.Two subcentimeter simple appearing cysts in the left lower lobe. |
Generate impression based on findings. | 58 years old, Female, Reason: rule out thyroid cancer History: none RIGHT LOBE: Patient is status post thyroidectomy. No evidence of recurrent mass.LEFT LOBE: Patient is status post thyroidectomy. No evidence of recurrent mass.ISTHMUS: Patient is status post thyroidectomy. No evidence of recurrent mass.LYMPH NODES: Several bilateral subcentimeter benign appearing lymph nodes are noted.OTHER: No significant abnormality noted. | No evidence of recurrent disease or lymphadenopathy. |
Generate impression based on findings. | Hyperthyroidism RIGHT LOBE MEASUREMENTS: 5.5 x 3.1 x 3 cmLEFT LOBE MEASUREMENTS: 5.3 x 2.7 x 2.4 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Diffusely heterogeneous gland without discrete nodule. Borderline increased vascularityLEFT LOBE: Diffusely heterogeneous gland without discrete nodule. Borderline increased vascularityISTHMUS: Diffusely heterogeneous gland without discrete nodule. Borderline increased vascularityPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous mildly enlarged gland without discrete nodule. Borderline increased vascularity. Findings favor thyroiditis slightly over Graves disease; cannot assess for acute component. |
Generate impression based on findings. | 75 years old, Female, Reason: rule out thyroid nodules History: none RIGHT LOBE MEASUREMENTS: 4.3 x 1.4 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.2 x 2.0 by 2.4 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Multiple nodules on the right some of which are calcified. The lower calcified nodule measures 1.0 x 0.6 x 0.7 cm.LEFT LOBE: Multiple nodules on the left. Inferior medial solid appearing nodule along the left isthmus measures 2.1 x 1.3 x 1.7 cm and is amenable to biopsy. Another left thyroid nodule is mixed cystic and solid in appearance measuring 1.5 x 1.2 cm and is also amenable to biopsy.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Multiple subcentimeter right thyroid nodules, some of which are calcified.2.Multiple left thyroid nodules which are amenable to biopsy. |
Generate impression based on findings. | 31 years old, Female, Reason: Left Thyroid nodule FNA positive PTC. Please perform lymph node mapping. RIGHT LOBE MEASUREMENTS: 5.2 x 2.2 x 1.4 centimetersLEFT LOBE MEASUREMENTS: 5.2 x 2.3 x 2.1 cmISTHMUS MEASUREMENTS: 0.3 centimetersRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Single solid-appearing left thyroid nodule measures 2.7 x 1.8 x 2.0 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Enlarged left level 1b lymph node near the submandibular gland most likely reflects a reactive lymph node however special attention to this area should be paid on future surveillance scans.OTHER: No significant abnormality noted. | 1.Solid thyroid nodule consistent with known history of papillar thyroid cancer.2.No significant lymphadenopathy. Enlarged left level 1b lymph node near the submandibular gland is favored to represent a reactive lymph node, however special attention to this area should be paid on future surveillance scans. |
Generate impression based on findings. | 5-month-old female with hip dysplasia.VIEWS: Pelvis AP (one views) 01/20/15 Faint ossification of the femoral epiphysis bilaterally. The femurs are symmetric and appear to be well seated in the acetabula. | Normal examination. |
Generate impression based on findings. | 67 years old, Female, Reason: status of MNG History: "food gets stuck occasionally" RIGHT LOBE MEASUREMENTS: History of right thyroidectomy.LEFT LOBE MEASUREMENTS: 5.3 x 1.9 x 1.8 cm.ISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Status post right thyroidectomy.LEFT LOBE: Multiple left thyroid nodules. The largest left thyroid nodule has a spongiform appearance and is slightly increased size from prior study measuring 2.9 x 2.3 x 2.0 cm. A second smaller cystic nodule measures 1.4 x 0.6 x 0.9 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple left thyroid nodules of varying appearance the largest of which measures slightly increased in size and is amenable to biopsy. |
Generate impression based on findings. | 50 year-old female with a history of bilateral breast lumps and fibrocystic disease. She has a history of bilateral benign breast biopsies and cyst aspirations. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Bilateral waxing and waning masses are present. Scattered benign calcifications are unchanged in both breasts.Whole bilateral ultrasound was performed. Multiple simple and complicated cysts are present in both breasts. The largest cyst is a complicated cyst, measuring 18 x 14 mm at 12 o'clock position in the left breast. | No mammographic evidence of malignancy. Multiple simple and complicated cysts in both breasts. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Hyperparathyroidism RIGHT LOBE MEASUREMENTS: 5.1 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 5.4 x 1.2 x 1.6 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant change in multiple subcentimeter predominantly cystic nodules. The largest nodule is within the superior pole measuring 0.8 x 0.5 x 0.6 cm.LEFT LOBE: Relatively stable upper pole isoechoic nodule measuring 1 x 0.9 x 1 cm.ISTHMUS: Stable subcentimeter hypoechoic nodules.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral thyroid nodules. No convincing extrathyroidal focus identifiable as a parathyroid lesion. |
Generate impression based on findings. | 45 years old, Female, Reason: 45 yo female with h/o htn and GFR 60's. Please eval for obstruction History: ckd RIGHT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.Bladder: Nondistended | No significant abnormality seen on this ultrasound evaluation of the kidneys. No evidence of hydronephrosis as clinically questioned. |
Generate impression based on findings. | 63 years old, Female, Reason: right upper quadrant pain with radiation to back, eval for gallstones History: see above LIVER: The liver measures 13 cm in length. Increased echogenicity of the liver is consistent with fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 7.5 cm in length. RIGHT KIDNEY: Kidney measures 10 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.5 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.2.Increased echogenicity of the liver is consistent with fatty infiltration. |
Generate impression based on findings. | 65 years old, Male, Reason: pt with aki; please eval for obstuction History: Aki RIGHT KIDNEY: Kidney measures 11.4 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.8 cm in length. Increased echogenicity of the kidney is consistent with medical renal disease. No hydronephrosis, shadowing calculus or mass.Bladder: Bladder nondistended | 1.Increased echogenicity of the kidneys consistent with medical renal disease. 2.No evidence of hydronephrosis as clinically questioned. |
Generate impression based on findings. | 59 years old, Female, Reason: HBV, eval for HCC History: HBV LIVER: The liver measures 15.3 cm in length. Coarsened echotexture of the hepatic parenchyma. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: Patient status post cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 7.3 cm in length. RIGHT KIDNEY: Kidney measures 10.7 centimeters and is located within the pelvis, similar to prior exam. Normal echotexture. No hydronephrosis or shadowing calculus. Subcentimeter renal cyst.LEFT KIDNEY: Kidney measures 11.1 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | Coarsened echotexture of the hepatic parenchyma without focal hepatic lesions or evidence of cirrhosis. |
Generate impression based on findings. | 64 years old, Male, Reason: kidney stones History: stones RIGHT KIDNEY: Kidney measures 9.3 cm in length. Normal echotexture. Nohydronephrosis. Shadowing nonobstructing calculi in the lower pole appearing similar to prior exam.LEFT KIDNEY: Kidney measures 9.2 cm in length. Normal echotexture. Nohydronephrosis. Shadowing nonobstructing calculi in the lower pole appearing similar to prior exam.Bladder: The bladder is nondistended. | Nonobstructing renal calculi in the lower poles of each kidney. No evidence of hydronephrosis. |
Generate impression based on findings. | 24 years old, Male, Reason: evaluate for cholelithiasis History: post prandial abdominal pain, nausea LIVER: The liver measures 16.4 cm in length. The liver parenchyma is normal in echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s. Small subcentimeter calcification within the left lobe of the liver is indeterminate and may represent a granuloma.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.5 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.5 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.2.Subcentimeter calcification in the left hepatic lobe is indeterminate and may represent a granuloma. |
Generate impression based on findings. | 33 years old, Female, Reason: hx of PTC History: for routine surveilillance RIGHT LOBE MEASUREMENTS: Patient status post thyroidectomyLEFT LOBE MEASUREMENTS: Patient status post thyroidectomyISTHMUS MEASUREMENTS: Patient status post thyroidectomyRIGHT LOBE: No definite evidence of recurrence.LEFT LOBE: Small subcentimeter hypoechoic areas in the left thyroid bed without vascular flow likely represent postsurgical changes. Continued follow-up is recommended for confirmation of stability. No definite evidence of recurrence.ISTHMUS: No definite evidence of recurrence.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral subcentimeter benign-appearing level 3 lymph nodes.OTHER: No significant abnormality noted. | 1.No evidence of recurrent disease or lymphadenopathy.2.Subcentimeter hypoechoic areas in the left thyroid bed are favored to represent postsurgical changes. Continued follow-up is recommended for confirmation of stability. |
Generate impression based on findings. | 31 years old, Female, Reason: RUQ US to evaluate gallbladder History: RUQ pain and vomiting LIVER: The liver measures 15 cm in length. Mildly increased hepatic parenchymal echogenicity suggestive of fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.5 cm in length. RIGHT KIDNEY: Kidney measures 10 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.6 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.2.Mildly increased hepatic parenchymal echogenicity is suggestive of fatty infiltration. |
Generate impression based on findings. | 79 years old, Female, Reason: NASH evaluate for HCC History: NASH LIVER: The liver measures 12 cm in length. Increased hepatic echogenicity is consistent with fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s. Anechoic subcentimeter focus in the right hepatic lobe likely representing a cyst is not significantly in size measuring 0.8 x 0.9 x 1.1 cm.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 5.4 cm in length. RIGHT KIDNEY: Kidney measures 10.1 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.6 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Increased hepatic echogenicity with unchanged anechoic focus favored to represent a cyst.2.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 51 years old, Male, Reason: Assess for cirrhosis, PH? History: HepC, ascites, lower extremity edema LIVER: The liver measures 17 cm in length. Mildly increased hepatic parenchymal echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s. No nodularity or widening of the fissures to suggest cirrhosis.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. Mild prominence of intrahepatic biliary ductal system. No extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.3 cm in length. RIGHT KIDNEY: Kidney measures 9.3 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No evidence of ascites. | 1.Mildly increased hepatic parenchymal echogenicity without evidence of focal lesion.2.No parenchymal nodularity or widening of the fissures to suggest cirrhosis. |
Generate impression based on findings. | 41 years old, Female, Reason: R shoulder pain after eating, eval for cholecystitis History: R shoulder pain after eating, AIH LIVER: The liver measures 12.7 cm in length. Hepatic parenchymal echogenicity is within normal limits. Multiple anechoic foci within the liver of varying sizes the largest of which measures 1.9 x 1.4 x 2.0 cm and is located in the right hepatic lobe. These lesions are indeterminate by ultrasound but are favored to represent hepatic cysts. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures two mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.2 cm in length. RIGHT KIDNEY: Kidney measures 9.9 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. Nohydronephrosis. Nonobstructing shadowing calculus in the left kidney measures up to 6 mm.OTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.2.Nonobstructing shadowing calculus in the left kidney measures up to 6 mm.3.Multiple anechoic foci within the hepatic parenchyma are indeterminate on this ultrasound exam although are favored to represent cysts. |
Generate impression based on findings. | Likely lipoma. Need evaluation of soft tissue mass noted in left upper quadrant of the abdomen. At the site of the palpable abnormality left upper quadrant, there is well marginated a 3.7 x 2.7 x 1.0 cm soft tissue nodule with internal vascularity. This is nonspecific on ultrasound although a lipoma would be most likely. This is not a cyst. | Soft tissue nodule at the site of the palpable abnormality. This is nonspecific by ultrasound although a lipoma is favored. |
Generate impression based on findings. | 59 years old, Female, Reason: nodule size and characteristics History: multinodular goiter RIGHT LOBE MEASUREMENTS: 7.8 x 4.5 x 3.4 cmLEFT LOBE MEASUREMENTS: 5.0 x 1.7 x 1.9 cmISTHMUS MEASUREMENTS: 0.18 cmRIGHT LOBE: The right lobe of the thyroid is enlarged and heterogeneous with focal subcentimeter anechoic areas, solid areas in some areas possibly representing colloid.LEFT LOBE: Multiple left thyroid nodules. The most superior nodule is solid in appearance measuring 1.9 x 1.0 x 1.3 cm. The superior solid nodule is indeterminate on this ultrasound examination and is amenable to biopsy. Another mid left thyroid nodule is solid in appearance measuring 1.0 x 0.9 x 0.8 cm. The most inferior nodule is predominantly cystic in appearance measuring 1.2 x 1.0 x 1.0 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Findings consistent with multinodular goiter.2.Diffusely enlarged heterogeneous right thyroid lobe.3.Multiple left thyroid nodules, the largest of which is amenable to biopsy if clinically indicated. |
Generate impression based on findings. | 75 years old, Female, Reason: Renal Failure History: AS CAD LOW EF Rising Creatinine RIGHT KIDNEY: Kidney measures 10.0 cm in length. Right kidney is echogenic consistent with medical renal disease. No hydronephrosis or shadowing calculus. Multiple anechoic foci in the right kidney most likely represent cysts, however some which are too small to characterize. The largest cyst measures 2.0 x 1.8 x 1.6 cm.LEFT KIDNEY: The left kidney is difficult to visualize. Kidney measures 9.7 cm in length. The left kidney is slightly echogenic consistent with medical renal disease. No definite hydronephrosis or shadowing calculus. Anechoic foci consistent with renal cysts are noted.Bladder: Not well visualized on this exam. | 1.Bilateral echogenic kidneys consistent with medical renal disease.2.No evidence of hydronephrosis.3.Bilateral anechoic lesions are favored to represent cysts, however some are too small to characterize. |
Generate impression based on findings. | 53 years old, Male, Reason: cirrhosis? in 53M with AML and new diagnosis of hep C; bedside US if possible History: hep C active LIVER: The liver is mildly enlarged measuring 18.4 cm in length. The hepatic parenchyma is normal in echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s. No definite nodularity of the liver contours to suggest cirrhosis.BILIARY TRACT: There is gallbladder sludge without evidence of gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.6 cm in length. RIGHT KIDNEY: Kidney measures 11.7 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No evidence of ascites. | 1.No nodularity of the liver to suggest cirrhosis. No focal hepatic lesions.2.Gallbladder sludge without evidence of cholecystitis. |
Generate impression based on findings. | 65 years old, Male, Reason: evalaute for obstruction History: AKI RIGHT KIDNEY: Kidney measures 13.5 cm in length. Increased echogenicity of the right kidney consistent with medical renal disease. Right upper pole renal cyst measuring 2.4 x 2.6 by 2.1 cm. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 13.8 cm in length. Increased echogenicity of the left kidneys consistent with medical renal disease. No hydronephrosis, shadowing calculus or mass.Bladder: There is a Foley within the bladder. | 1.No evidence of hydronephrosis as clinically questioned.2.Increased echogenicity of the kidneys bilaterally consistent with medical renal disease.3.Right upper pole simple appearing renal cyst. |
Generate impression based on findings. | 42 years old, Female, Reason: 42F with ARDS, oliguria and Hx of ARF History: oliguria RIGHT KIDNEY: Kidney measures 12.4 cm in length. Increased echogenicity is right kidney consistent medical renal disease. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Limited evaluation of the left kidney. Kidney measures 10.2 cm in length. Increased echogenicity the left kidney consistent medical renal disease. No definite evidence of hydronephrosis.Bladder: The bladder is decompressed with a Foley. | 1.Bilaterally increased echogenicity of the kidneys consistent with medical renal disease.2.No evidence of hydronephrosis. |
Generate impression based on findings. | Ms. Lebeau is a 54 year old female with a known history of right breast cancer. She presents today for skin marking prior to surgery. Targeted right breast ultrasound was performed at the location of the known right breast cancer. No sonographic correlate was seen for the known right breast cancer nor was any sonographic correlate seen for the biopsy clip placed within the cancer. Thus, a decision to proceed with mammographically guided localization was made.DIAGNOSTIC MAMMOGRAPHIC | Successful localization of the clip at the site of known malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 88 years old, Male, Reason: CKD - cysts on CT History: see above RIGHT KIDNEY: Kidney measures 10.3 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No evidence of hydronephrosis. No shadowing renal calculus. Complex right renal cyst with echogenic septum which is likely calcified measuring up to 4.6 cm appearing similar to recent abdominal CT exam.LEFT KIDNEY: Kidney measures 10.9 cm in length. Increased echogenicity of the kidney is consistent with known medical renal disease. No hydronephrosis, shadowing calculus or mass.Bladder: The bladder is markedly distended. | 1.Increased echogenicity of the kidneys bilaterally is consistent with known medical renal disease.2.Complex right renal cyst with calcified septum measuring up to 4.6 cm appearing similar to recent CT examination. |
Generate impression based on findings. | 64 years old, Male, Reason: eval for hydronephrosis History: AKI, elevated Cr RIGHT KIDNEY: Kidney measures 9.8 cm in length. Increased echogenicity of the kidney consistent with medical renal disease. No hydronephrosis or shadowing calculus. Simple appearing right renal cyst measures 3.5 x 2.4 x 2.4 cm.LEFT KIDNEY: Kidney measures 8.7 cm in length. Increased echogenicity of the kidney. No hydronephrosis, shadowing calculus or mass.Bladder: There is a Foley within the bladder. | 1.Increased echogenicity of the kidneys bilaterally is consistent with medical renal disease.2.Simple appearing right renal cyst. |
Generate impression based on findings. | 18 years old, Male, Reason: of liver History: abnl lts LIVER: The liver measures 15.0 cm in length. The liver parenchymal echogenicity is normal in appearance. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures two mm in diameter. There is a very small gallbladder polyp measuring up to 2 mm.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.5 cm in length. RIGHT KIDNEY: Kidney measures 10.4 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Very small polyp in the gallbladder without evidence of cholelithiasis or cholecystitis.2.The hepatic parenchyma is normal in echogenicity without evidence of focal hepatic lesion. |
Generate impression based on findings. | 67 years old, Female, Reason: Eval for cirrhotic morphology of liver History: Low VItamin K LIVER: The liver measures 14.4 cm in length. The liver is echogenic consistent with a fatty infiltration. Multiple focal hepatic lesions are indeterminate on this ultrasound exam. Largest hypoechoic lesion in the right hepatic lobe measures 1.2 x 1.1 x 0.9cm. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: The gallbladder is nondistended. There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: The spleen is not well-visualized on this exam.RIGHT KIDNEY: Kidney measures 9.0 cm in length. Normal echotexture. No hydronephrosis. Shadowing catheter was present within the right kidney.LEFT KIDNEY: Kidney measures 9.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1. The liver is echogenic consistent with fatty infiltration.2. No nodularity to suggest cirrhosis.3. Multiple hypoechoic lesions within the liver which are indeterminate on this exam. Dedicated liver follow-up imaging is recommended.Findings discussed with Dr. Minic at time of dictation. |
Generate impression based on findings. | Ms. Taylor is a 23-year-old female presenting with a palpable abnormality left axilla. She states that she initially felt this abnormality for the past one month, but has progressively gotten smaller in size. Last week, she noted some yellowish discharge from the area. Upon physical exam at the patient's area of concern, a small pimple-like area is noted in the central left axillary region. No discharge is able to be extruded.A targeted left ultrasound was performed for the patient’s area of concern. In the central left axillary region, there is a superficial hypoechoic lesion measuring 0.9 x 0.4 x 1.3 cm. There is no suspicious solid or cystic mass identified. | Benign epidermal inclusion cyst in the left axillary region. No sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted. All results and recommendations were relayed to the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 60 years old, Male, Reason: HCV screen for HCC and assess liver contour History: HCV LIVER: The liver measures 15.6 cm in length. There is coarsened echogenicity of the liver. There is a nodular contour of the liver consistent with cirrhosis. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures two mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.9 cm in length. RIGHT KIDNEY: Kidney measures 12.9 cm in length. Severe hydronephrosis with thinned cortex may be chronic in etiology. No evidence of shadowing calculus. LEFT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. No evidence of hydronephrosis. Anechoic minimally complex cyst with a septation measures 1.9 x 1.8 x 1.5 cm. Another smaller anechoic lesion favored to represent a cyst near the lower pole of the left kidney measures 1.0 x 1.0 x 1.0 cm.OTHER: No significant abnormalities noted. | 1.Nodular contour of the liver is consistent with cirrhosis.2.Severe hydronephrosis in the right kidney with thin cortex may be chronic in etiology. No visualized obstructing calculus or mass. |
Generate impression based on findings. | 71 years old, Female, Reason: 71F with history of thyroid nodule History: no symptoms RIGHT LOBE MEASUREMENTS: 3.6 by 0.7 x 1.3 cmLEFT LOBE MEASUREMENTS: 3.7 x 1.2 x 0.8 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Heterogeneous right thyroid lobe with multiple subcentimeter hypoechoic foci. No dominant lesion is identified.LEFT LOBE: Heterogeneous left thyroid lobe. No focal nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous thyroid bilaterally with multiple subcentimeter hypoechoic foci in the right thyroid lobe which are indeterminate on this exam but are favored to represent benign colloid cysts. No dominant lesion is identified. |
Generate impression based on findings. | 72 years old, Female, Reason: R/o gallstones or Ulcer History: abdominal pain LIVER: The liver is slightly enlarged measuring 18 cm in length. The liver parenchyma is normal in appearance. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Normal appearing gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 60 years old, Male, Reason: 60 yo M hx with bilirubin, liver enzyme elevation. Pls eval for gallbladder stones, mass, or liver abnormality. History: asymptomatic now, but one episode of abdominal pain last month LIVER: The liver is enlarged measuring 20.5 cm cm in length. The echogenicity of the liver mildly increased suggesting fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: The gallbladder is not well visualized due to wall echo shadow sign consistent with a gallstone filled gallbladder. If further evaluation of the gallbladder is clinically warranted CT is recommended. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 7 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: A small splenule is present. The spleen measures 13.4 cm in length. RIGHT KIDNEY: Kidney measures 13.4 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 13.4 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Wall echo shadow sign consistent with gallstone filled gallbladder, less likely porcelain gallbladder. No definite evidence of cholecystitis. If further evaluation of the gallbladder is clinically warranted CT is recommended.2.Increased echogenicity of the liver consistent with fatty infiltration. |
Generate impression based on findings. | 63 years old, Male, Reason: urinary retention, place intraop SP tube History: urinary retention Ultrasound guidance was performed for intraoperative placement of suprapubic catheter. | Ultrasound guidance performed for intraoperative placement of suprapubic catheter. |
Generate impression based on findings. | Assuming 12 rib bearing vertebrae, there appear to be 4 truly lumbar appearing vertebrae. There is suggestion of a segmentation anomaly at L5-S1 without evidence of intervening disk, although there are two sets of posterior elements. For the purposes of this exam, the last fully formed disk is at S1-S2.The lumbar spine is in normal alignment, with significant straightening of the normal lumbar lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is abnormal ventral T2 hyperintensity within the distal cord with axial confirmation to the lower T12 level from the tip of the conus, although sagittal images suggest additional abnormality extending cranially although not well delineated. This measures up to 3 x 2 mm at the T12-L1 level. The distal spinal cord and conus are otherwise within normal limits with the conus terminating at the L3-L4 level. There is no evidence of fat signal intensity along the distal thecal sac. On prone imaging, there does appear to be some degree of ventral movement of the distal cord and conus. Under within the thecal sac.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the lumbar spine. | 1. Transitional spinal anatomy, incompletely assessed as the counting sequence is not available. For the purposes of this exam, the last fully formed disk is at S1-S2. If surgery is to be contemplated, correlation with imaging of the entire spine is recommended.2. Segmentation anomaly of L5-S1 without intervening disk although with separate posterior elements.3. Utilizing the above counting convention, conus termination is abnormally low at L3-L4 without evidence of a fatty filum. Some degree of ventral motion of the distal cord and conus are noted on the images. Please correlate clinically for tethered cord.4. Small caliber syringohydromyelia within the visualized distal cord extending at least to the lower T12 level is confirmed on axial imaging, although likely also involving additional lower thoracic cord which extends out of the field-of-view. Consider dedicated MRI cervical and thoracic spine as clinically indicated. |
Generate impression based on findings. | Abdominal pain and increased LFTs LIVER: Normal echogenicity without mass. Liver length 14.6 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.2 cm in lengthOTHER: Left kidney 12 cm in length. Spleen 10.3 cm in length. No ascites. | Negative right upper quadrant ultrasound. No hepatobiliary abnormality. |
Generate impression based on findings. | 70 years old, Male, Reason: HCC screening History: ETOH cirrhosis LIVER: The liver measures 20 cm in length. Coarse echogenicity of the liver. No definite nodularity to suggest cirrhosis. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.4 m/s.BILIARY TRACT: Cholelithiasis without gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.1 cm in length. RIGHT KIDNEY: Kidney measures 11.5 cm in length. Normal echotexture. Nohydronephrosis. Anechoic focus in the midpole the right kidney measuring up to 1.2 cm is favored to represent a cyst.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal echotexture. Nohydronephrosis. Anechoic focus measuring up to 1.6 cm and the left kidney is favored to represent a cyst.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without evidence of cholecystitis.2.Coarsened echogenicity of the hepatic parenchyma without nodularity to suggest cirrhosis. |
Generate impression based on findings. | 54 years old, Male, Reason: neutropenic stem cell transplant patient w/ complaints of dysuria and elevated Cr. History: dysuria, Cr trending up over last couple days. Cr today 2.9 RIGHT KIDNEY: Kidney measures 11.8 cm in length. Mildly increased echogenicity consistent with medical renal disease. No evidence of hydronephrosis.LEFT KIDNEY: Kidney measures 11.4 cm in length. Mildly increased echogenicity consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus.Bladder: The bladder is at least moderately distended and concentrically thick walled which is nonspecific but may be secondary to cystitis. Other: Partially visualized liver parenchyma is increased in echogenicity consistent with fatty infiltration. | 1.Mildly increased echogenicity bilaterally consistent with medical renal disease. No evidence of hydronephrosis.2.The bladder wall is concentrically thickened, nonspecific but may be seen in setting of cystitis, correlation with patient's clinical history and urinalysis recommended.3.Partially visualized liver parenchyma is increased in echogenicity consistent with fatty infiltration. |
Generate impression based on findings. | 57 years old, Male, Reason: 57 male with lung cancer, known liver mets. Worsening RUQ pain, transaminitis. Assess status of liver mets, evaluate for biliary disease History: RUQ pain, transaminitis LIVER: The liver is enlarged measuring 26.7 cm in length. The hepatic parenchyma is extremely heterogeneous consistent with metastatic disease appearing similar to prior exam. The main portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: The gallbladder is contracted and not well visualized. No intrahepatic or extrahepatic biliary ductal dilatation is present, the common bile duct measures 4.5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 11.4 cm in length, no hydronephrosis.LEFT KIDNEY: Kidney measures 11.3 cm in length, no hydronephrosis.OTHER: No evidence of ascites. | 1.Suboptimal assessment of gallbladder secondary to contracted state. 2.Hepatomegaly with extremely heterogeneous hepatic parenchyma, consistent with known metastatic disease. |
Generate impression based on findings. | 57 years old, Male, Reason: assess for liver cirrhosis History: hepatitis C positive LIVER: The liver measures 17 cm in length. Majority of the hepatic parenchyma normal limits. A focal hypoechoic area may be posttraumatic or represent focal fatty sparing. No nodularity to suggest cirrhosis. No focal hepatic masses. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 7.5 cm in length. RIGHT KIDNEY: Kidney measures 8.8 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.1 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.No nodularity of the hepatic parenchyma to suggest cirrhosis.2.Anterior hypoechoic region of the liver may be posttraumatic or represent focal fatty sparing. No suspicious focal hepatic masses. |
Generate impression based on findings. | 39 years old, Female, Reason: 39 yo with hx of repaired ventral hernia in 2000; please do ultrasound exam to evaluate for hernia History: abdominal pain No evidence of hernia at rest or with Valsalva maneuver. | No evidence of ventral abdominal hernia. |
Generate impression based on findings. | 75 years old, Female, Reason: pt with cirrhosis, rule out hcc History: rule out hcc LIVER: The liver measures 14.6 cm in length. No significant nodularity or widening of the fissures to suggest cirrhosis. No focal hepatic lesions are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures two mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. No hydronephrosis. Subcentimeter right renal simple appearing cyst measuring up to 0.7 cm.LEFT KIDNEY: Kidney measures 10.6 cm in length. No hydronephrosis. Left renal cyst appearing similar to prior exam measuring up to 3.7 cm.OTHER: No significant ascites. | No sonographic evidence of cirrhosis. No focal hepatic mass. |
Generate impression based on findings. | 53 years old, Male, Reason: r/o obstruction History: r/o obstruction RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. Small right renal cyst measuring up to 1.9 cm.LEFT KIDNEY: Kidney measures 12.2 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus.Bladder: No significant abnormalities noted. | No evidence of hydronephrosis. No emergent findings to explain patient's symptoms. |
Generate impression based on findings. | 41 years old, Female, Reason: RUQ US for rule out stones History: RUQ pain LIVER: The liver measures 18.1 cm in length. Echogenicity of the liver is within normal limits. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: The gallbladder is not visualized, suspect prior cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.5 cm in length. RIGHT KIDNEY: Kidney measures 12.1 cm in length. Normal echotexture. Nohydronephrosis.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal echotexture. Nohydronephrosis.OTHER: No significant abnormalities noted. | 1.The gallbladder is not visualized. Suspect prior surgery.2.The common bile duct is within normal limits. No evidence of choledocholithiasis. |
Generate impression based on findings. | 55-year-old male with history of elevated LFTs. Evaluate for biliary obstruction. LIVER: No intrahepatic or extrahepatic biliary dilatation. The portal vein is tortuous, as seen on prior CT.GALLBLADDER, BILIARY TRACT: Cholelithiasis, without evidence of cholecystitis.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Cholelithiasis, and portal vein tortuosity as above. |
Generate impression based on findings. | 45-year-old male with history of thyroid cancer and resection of previous abnormal nodes. Evaluate.Review of pathology report dated 7/16/2014, patient with interval lymph node dissection with evidence of metastatic papillary thyroid cancer in the left lymph node dissection. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right: There is a benign appearing level 2/3 lymph node measuring 2.7 x 1.2 x 0.4 cm.Left: At the inferior aspect of the left thyroid bed, there is a round hypoechoic focus measuring 1.1 x 0.8 x 0.8 cm with suggestion of fatty hilum; however, the cortex is abnormally thickened.There is benign appearing left level 2/3 lymph node measuring 2.4 x 1.1 x 0.6 cm.OTHER: No significant abnormality noted. | Round hypoechoic focus at the inferior aspect of left thyroid bed with suggestion of a fatty hilum but thickened cortex. In light of history of interval resection with tumor positive lymph nodes, this is worrisome for additional tumor. |
Generate impression based on findings. | 74-year-old male with history of elevated alk phos. Evaluate liver/gallbladder. LIVER: Small amount of perihepatic ascites. Subtle heterogeneity of the liver may represent chronic liver disease versus fatty infiltration.GALLBLADDER, BILIARY TRACT: Gallbladder wall is slightly thickened, which may be related to the patient's ascites.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Splenic granulomata. | Gallbladder wall is slightly thickened, which can be seen in patients with ascites and/or chronic liver disease, however cannot exclude cholecystitis. |
Generate impression based on findings. | 52 year-old male with history of acute injury. Assess for stones or hydronephrosis. RIGHT KIDNEY: Mild cortical thinning, without hydronephrosis or nephrolithiasis. The right kidney measures 10.75 cm.LEFT KIDNEY: Mild cortical thinning, without hydronephrosis or nephrolithiasis. The left kidney measures 11.9 cm.OTHER: Bladder is relatively decompressed. | Mild bilateral cortical thinning, without hydronephrosis or nephrolithiasis, which may represent medical renal disease. |
Generate impression based on findings. | Right breast focal asymmetry seen on outside mammograms. A targeted right ultrasound was performed for the mammographic area of concern. An ill-defined 1.1 x 0.8 x 1.1 cm heterogeneously hypoechoic mass is seen in the 12:30 position of the right breast 6 cm from the nipple with posterior acoustic shadowing. Mild peripheral vascularity is noted. | Suspicious right breast lesion. Ultrasound guided biopsy is recommended for further evaluation. Findings were discussed with the patient. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 62-year-old male with history of right upper quadrant pain and elevated white blood cell count. LIVER: No significant abnormalities noted. GALLBLADDER, BILIARY TRACT: Cholelithiasis, with a small amount of gallbladder wall thickening and subtle mural striation. No intrahepatic or extrahepatic biliary dilatation. Common bile duct measures approximately 8 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Positive Murphy sign. | Given the patient's acute tenderness, gallbladder wall thickening and mural striation, this is most consistent with acute on chronic cholecystitis. |
Generate impression based on findings. | 59 years old, Female, Reason: Acute kidney injury, unclear etiology History: Increased creatinine RIGHT KIDNEY: Patient is status post right nephrectomy.LEFT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. Small left renal cyst in the inferior pole measuring 1.3 x 1.5 cm.Bladder: The bladder is collapsed and not well-visualized. | No evidence of hydronephrosis or shadowing calculus. |
Generate impression based on findings. | 27 years old, Male, Reason: assess for perinephric abscess History: MRSA UTI RIGHT KIDNEY: Kidney measures 12.0 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.3 cm in length. A focal space occupying lesion in the superior anterior portion of the left kidney which appears to extend beyond the expected contours of the kidney. There is blood flow to portions of this space occupying lesion indicating it is at least partially intrarenal with distention of the renal capsule and possible extrarenal extension. This hypoechoic focus measures approximately 4.4 x 2.5 by 7.0 cm and highly suspicious for a renal and perirenal infection given the clinical history. However a malignancy cannot be fully excluded on this ultrasound examination.Bladder: There is echogenic debris in the bladder which is partially mobile when patient's position is changed. There is no significant bladder wall thickening or evidence of emphysematous cystitis. | 1.Hypoechoic space-occupying lesion in the left kidney which likely represents intrarenal infection with possible extrarenal extension. However a malignancy cannot be fully excluded on this ultrasound examination. Dedicated cross-sectional renal imaging is recommended to further characterize if clinically warranted.2.Echogenic debris within the bladder. |
Generate impression based on findings. | 50 year-old female with history of a large thyroid. RIGHT LOBE MEASUREMENTS: 2.9 x 2.2 x 6.2 cmLEFT LOBE MEASUREMENTS: 2.8 x 1.9 x 6.3 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Within the right thyroid lobe has a heterogeneously hypoechoic nodule with several coarse internal calcifications measuring 1.3 x 0.9 x 1.3 cm. The margin is not entirely distinct. Remaining right thyroid lobe is within normal limits.LEFT LOBE: Within the posterior left thyroid lobe is an approximately 1.7 x 1.1 x 1.4 cm nodule that was heterogeneous but isoechoic to thyroid glandular tissue. The margins are distinct. The remaining left thyroid lobe is within normal limits.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules as described above. The right thyroid nodule contains internal calcifications and somewhat indistinct margins - scheduled to undergo biopsy today. |
Generate impression based on findings. | Palpable abnormality noted by patient in the right lateral breast. Bilateral painful breasts, right greater than left. Physical examination revealed a diffusely tender right breast without palpable mass or notable skin changes.A whole right breast ultrasound was performed with special attention paid to the patient’s area of concern. There is no solid or cystic mass identified. There is no sonographic abnormality noted otherwise. | No sonographic abnormality identified. Clinical follow-up is recommended. Results and recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 81 years old, Male, Reason: evaluate L scrotal edema History: L scrotal edema. No testicular tenderness. RIGHT TESTIS: Heterogeneous right testis without focal lesions appearing similar to the prior exam. There is blood flow within the right testis. Right testicle measures 3.9 x 1.9 x 2.7 cm.LEFT TESTIS: Heterogeneous testis without any focal lesions appearing similar to the prior exam. Left testis measures 3.5 x 2 .0 by 2.7 cm.RIGHT EPIDIDYMIS: Small epididymal cyst. The right epididymis is within normal limits. No evidence of hydrocele. LEFT EPIDIDYMIS: The left epididymis appears smaller in size than on the prior study and is not significantly hyperemic.OTHER: No significant abnormalities noted. | 1. Testes are heterogeneous bilaterally appearing similar to the prior exam. 2. Left epididymis appears smaller than on the prior study is not significantly hyperemic. |
Generate impression based on findings. | 75 years old, Male, Reason: ESRD s/p cadaveric transplant in 2003, now with AKI/ATN likely due to contrast nephropathy. assess graft function, obstruction History: AKI Transplanted kidney: No perinephric fluid collections are identified. The transplant kidney measures 11.8 cm in length. No shadowing calculus or suspicious lesions are evident. No evidence of hydronephrosis or hydroureter.Vascular Doppler data: The peak systolic velocity of the iliac artery is 1.0 m/sec. The peak systolic velocity at the anastomosis is 3.5 m/sec with a resistive index of 0.87 appearing similar to prior exam.Peak systolic velocity of the renal artery is 3.5 m/sec at the origin, 1.9 m/sec in the midportion, 1.3 m/sec distally with system indices of 0.88, 0.84, 0 .81 respectively. These peak systolic velocities and resistive indices are similar to prior exam.Resistive indices within parenchymal branches very between 0.7 and 0.8 which are minimally increased compared to the prior exam.Other: Mild to moderate amount of ascites is present. | 1.Increase velocity at the renal artery anastomosis is stable since the prior exam, but significant stenosis at this site cannot be excluded.2.Increased resistive indices in the main renal artery and in the parenchymal arterial branches.3.Mild to moderate ascites is present. |
Generate impression based on findings. | Female 37 years old Reason: Rule out LN's vs. Ganglion Cysts History: Pt has hx of left forearm nodules off/on x 3mos - that gradually decrease in size. Nodules are painful.Additional history obtained in radiology: The patient pointed to several nodules been recently decreasing in size or larger, painful and tender. There is an associated numbness or tingling. High-frequency grayscale and color Doppler imaging showed no discrete measurable lesion over the palpable abnormality. | No visible lesion by ultrasound. |
Generate impression based on findings. | 67 years old, Female, Reason: abnormal lfts need vascular imaging History: abnormal LFTs need vascular imagin to r/o liver thrombosis Ultrasound exam is extremely limited due to patient body habitus.LIVER: The liver measures 19.8 cm in length. Increased hepatic parenchyma echogenicity is consistent with fatty infiltration. No focal hepatic lesions or masses are definitely identified. PORTAL VENOUS: The main portal vein is is not well-visualized with a possible peak systolic flow 1.3 cm/s which is elevated. No definite thrombus is identified.HEPATIC ARTERIES: The hepatic arteries are not well visualized.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. The common bile duct is not well visualized.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: The spleen is not well visualized. No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: No hydronephrosis or shadowing calculus.LEFT KIDNEY: No hydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted. | 1.Exam is limited due to patient body habitus. Within these limitations the portal vein appears patent with an increased peak systolic velocity. No definite thrombus is identified. Recommend dedicated CT to evaluate vascular patency. 2.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 56 years old, Female, Reason: thyroid nodules History: thyroid nodules, pls assess for changes RIGHT LOBE MEASUREMENTS: 6.2 by 3.0 x 2.4 cmLEFT LOBE MEASUREMENTS: 2.9 x 2.3 by 5.9ISTHMUS MEASUREMENTS: 0.3RIGHT LOBE: There is a solid nodule within the right thyroid lobe which is slightly hypoechoic to background tissue measuring 1.7 x 1.4 x 1.4 cm.LEFT LOBE: There is a left predominantly solid nodule with mostly heterogeneously hypoechoic density in the periphery with a 6-mm hypoechoic central area. There is no vascular flow within this nodule. No definite calcifications within this nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a right level 2 lymph node measuring 2.4 x 1.7 x 0.7 cm with a fatty hilum which is not significantly changed from the prior exam.OTHER: No significant abnormality noted. | Bilateral lower pole nodules which are not significantly changed in size and appearance. |
Generate impression based on findings. | 26 years old, Female, Reason: elevated Cr History: elevated Cr Transplanted kidney: Renal transplant is identified in the right iliac fossa. Echogenic renal parenchyma is consistent with medical renal disease. No hydronephrosis is identified. No focal mass or shadowing calculus. No perinephric fluid collection.Doppler exam:Color and spectral Doppler were performed on inflow and outflow vessels. No significant abnormality noted. Peak velocities and resistive indices appear similar to the prior exam.Peak systolic velocities are as follows:Right iliac artery: 1.0 m/sec.Anastomosis: 0.8 m/sec, resistive index of 0.8Renal arteryproximal: 0.6 m/secmid: 0.6 m/secdistal: 0.5 m/secIntrarenal resistive indices measure from 0.5 to 0.68Urinary bladder: No significant abnormalities noted. | 1.Increased parenchymal echogenicity of the kidneys consistent with medical renal disease.2.No evidence of hydronephrosis or evidence of stenosis within the transplant vasculature. |
Generate impression based on findings. | 38 year old female with history of hernia. Evaluate for umbilical hernia. Bowel is noted coursing posteriorly along a shallow defect in the anterior abdominal wall near the umbilicus, however no bowel is seen herniating into the anterior wall. | Intraperitoneal bowel adjacent to a shallow anterior abdominal wall defect, without frank herniation. |
Generate impression based on findings. | 49 years old, Female, Reason: assess for ascites, any intra-abd abnormalities, h/o dermatomyositis + ILD + pulm HTN History: abd distention, volume overload 2/2 right heart failure LIVER: The liver measures 18.7 cm in length. There are regional areas of increased parenchymal echogenicity consistent with focal fatty infiltration. A focal hyperechoic area adjacent to the porta hepatis measuring 1.7 x 1.8 x 1.5 cm most likely represents focal fatty infiltration. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Ringdown artifact from the gallbladder wall suggests cholesterol deposition. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 0.3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 15.9 cm in length. RIGHT KIDNEY: Kidney measures 13.2 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.6 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | Regional areas of hepatic parenchymal fatty infiltration with a more focal hyperechoic focus adjacent to the porta hepatis which likely represents focal fatty infiltration. |
Generate impression based on findings. | 74 years old, Female, Reason: Liver injury from hypotension or other etiology? History: elevated AST, ALT, bili LIVER: The liver measures 14.6 cm in length. Increased hepatic parenchymal echogenicity is consistent with fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.4 m/s. BILIARY TRACT: Patient status post cholecystectomy. Common bile duct measures 3 mm.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 8 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echogenicity. No hydronephrosis.LEFT KIDNEY: Kidney measures 9.0 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No evidence of ascites | 1.Increased hepatic parenchymal echogenicity is consistent with fatty infiltration. 2.No evidence of ascites or splenomegaly. |
Generate impression based on findings. | 35 years old, Male, Reason: 35yo male with ETOH use and low platelets, assess for cirrhosis. History: abnormal LFTs LIVER: The liver is enlarged measuring 20.2 cm in length. Increased hepatic parenchymal echogenicity suggestive of fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s. No nodularity of the hepatic parenchyma to suggest cirrhosis.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 0.2 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.4 cm in length. RIGHT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Hepatomegaly and increased echogenicity of the liver suggestive of fatty infiltration. No nodularity of the liver contours are widening of the fissures to suggest cirrhosis.2.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 76 years old, Female, Reason: 76 yo F, New onset kidney failure History: elevated Cr, lactic acid RIGHT KIDNEY: Kidney measures 10.3 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. There is trace perinephric fluid on the right. Right superior simple-appearing cyst measures 4.5 x 3.0 x 3.6 cm appearing similar to the recent CT study. Right renal stone measures up to 1.3 cm. No evidence of hydronephrosis.LEFT KIDNEY: Kidney measures 8.8 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. Left renal cyst measures 2.6 x 2.9 x 3.4 cm. Nonobstructing left renal stone measures up to 0.7 cm. No evidence of hydronephrosis.OTHER: Trace ascites. | 1.Increased echogenicity of the kidneys bilaterally is consistent with medical renal disease.2.Nonobstructing nephrolithiasis bilaterally.3.Bilateral renal cysts. |
Generate impression based on findings. | 48 years old, Male, Reason: Right Testicular pain History: Right testicular pain. Concern for epidydimitis RIGHT TESTIS: Echotexture of the right testicle is within normal limits. Arterial and venous color Doppler are within normal limits.LEFT TESTIS: Echogenicity and vascular flow in the left testicle is within normal limits.RIGHT EPIDIDYMIS: Right epididymis is not enlarged or hyperemic.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: 1 cm benign appearing lymph node in the right inguinal area. | Normal ultrasound examination of the testicles. No specific finding to account for patient's pain. |
Generate impression based on findings. | 55 years old, Female, Reason: Rule out hydronephrosis RIGHT Native KIDNEY: Kidney measures 10.0 cm in length. The cortex is thinned with moderate to severe hydronephrosis which is likely chronic in etiology. There is a nonobstructing rounded calculus within a calix of the superior pole.LEFT KIDNEY: The left native kidney is not well seen on this examination.Transplanted kidney: The transplanted kidney in the right iliac fossa measures 11.7 cm. There is a simple appearing cyst measuring 1.4 x 1.1 by 1.8 cm. Mild dilatation of the collecting system, appearing similar to the recent abdominal CT. No perinephric fluid collections. No evidence of shadowing calculus, or mass within the transplanted kidney. Pigtail catheter is visualized within the pelvis of the transplanted kidney.Bladder: The bladder is nondistended. | 1.Mild dilatation in the transplanted kidney, unchanged from recent abdominal CT.2.Moderate to severe chronic hydronephrosis in the native right kidney.3.Nonobstructing right renal calculus. |
Generate impression based on findings. | 61 years old, Male, Reason: anisarca, heavy EtOH drinker, check liver History: anisarca LIVER: The liver is enlarged measuring 24.4 cm in length. There is mildly increased echogenicity of the liver parenchyma No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of velocity m/s.BILIARY TRACT: The gallbladder is nondistended. There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: The spleen is difficult to visualize on this ultrasound examination. No significant abnormalities noted. The spleen measures 9.9 cm in length. RIGHT KIDNEY: Kidney measures 11.7 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.OTHER: No definite evidence of ascites in this exam. | 1.Hepatomegaly with mild to moderately increased echogenicity of the liver consistent with fatty infiltration.2.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 73 year old female who was recalled from outside screening mammogram for left breast asymmetry. MAMMOGRAM: An ML view and two spot compression views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Within the left breast, 12 o'clock position, the previously visualized asymmetry partially disperses on spot compression imaging, suggesting superimposition of fibroglandular tissues.Within the right breast, upper outer quadrant, there is a new 0.8-cm mass which persists on spot compression imaging.ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. A dense band of fibroglandular tissue is noted. There is no solid or cystic mass identified.A targeted right ultrasound was subsequently performed for the mammographic area of concern. At the 10 o'clock position of the right breast, 5 cm from the nipple, there is a well-circumscribed anechoic cyst mild posterior acoustic enhancement measuring 0.5 x 0.4 x 0.5 cm, likely corresponding to the finding on mammogram. | Dense fibroglandular tissue in the upper central left breast corresponding to the asymmetry on mammogram. Right simple breast cyst. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 57 year old female who was recalled from screening mammogram for right breast mass. No family history of breast cancer. Right Breast Diagnostic Mammogram: An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Within the medial slightly upper right breast, there is redemonstration of a circumscribed mass measuring approximately 0.4 cm which persists on spot compression imaging.Right Breast Ultrasound: On physical examination, no palpable abnormality is identified.A targeted right ultrasound was performed for the mammographic area of concern. At the two o'clock radian of the right breast, 4 cm from the nipple, there is a clustered cyst measuring 0.5 x 0.4 x 0.9 cm, corresponding to the mass visualized on mammogram. | Clustered cyst at the two o'clock position in the right breast, corresponding to the mass visualized on prior mammogram. Left unilateral diagnostic mammogram and ultrasound is recommended in 6 months to assess stability. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 55 year old female with multiple right breast masses and right axillary adenopathy who was recalled from interpretation of outside examination for left breast asymmetry. History of ovarian cancer in sister diagnosed at age 45. LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: A ML view and 3 spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is redemonstration of a 1 cm mass in the the medial central left breast, which persists on compression imaging.LEFT BREAST ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. At the 9 o'clock position of the left breast, 3 cm from the nipple, there is a benign morphology intramammary lymph node measuring 0.7 cm, with normal color flow, corresponding to the finding on mammogram. At the 3 o'clock position of the left breast, 4 cm from the nipple, there is a 0.4 x 0.4 x 0.2 cm hypoechoic mass with ill-defined margins. | Ill-defined hypoechoic 0.4 cm mass at the 3 o'clock position of the left breast. While this may represent benign lesion, fine-needle aspiration with possible ultrasound guided core needle biopsy is recommended for definitive histologic diagnosis. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Ms. Taylor is a 23-year-old female presenting with a palpable abnormality left axilla. She states that she initially felt this abnormality for the past one month, but has progressively gotten smaller in size. Last week, she noted some yellowish discharge from the area. Upon physical exam at the patient's area of concern, a small pimple-like area is noted in the central left axillary region. No discharge is able to be extruded.A targeted left ultrasound was performed for the patient’s area of concern. In the central left axillary region, there is a superficial hypoechoic lesion measuring 0.9 x 0.4 x 1.3 cm. There is no suspicious solid or cystic mass identified. | Benign epidermal inclusion cyst in the left axillary region. No sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted. All results and recommendations were relayed to the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 56-year-old male with history of thyroid cancer and treated recurrence with possible cystic structure in the thyroid bed. Rule out growth. RIGHT LOBE MEASUREMENTS: Post thyroidectomy changes again seen.LEFT LOBE MEASUREMENTS: Post thyroidectomy changes again seen.ISTHMUS MEASUREMENTS: Post thyroidectomy changes again seen.RIGHT LOBE: No mass is identified.LEFT LOBE: The reference lesion is a hypoechoic, round cystic lesion in the left thyroidectomy bed measures 0.3 x 0.1 x 0 .2 cm, previously 0.2 x 0.3 x 0.3. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal appearing right level 2 cervical lymph node.OTHER: No significant abnormality noted. | No significant interval change in the reference subcentimeter hypoechoic focus left thyroid bed.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 49-year-old male with left upper pole renal mass and prior lumbar spine CT RIGHT KIDNEY: The right kidney measures 10.7 cm in length. There are shadowing calcifications without hydronephrosis which may be due to nonobstructing stones or medullary calcification. No mass identified.LEFT KIDNEY: The left kidney measures 10.8 cm in length. There is an ovoid simple -- appearing cyst arising from the extreme upper pole corresponding to the CT abnormality measuring 1.8 cm in greatest diameter. Presumably this represented a complicated cyst on prior CT. Very small lower pole simple cyst. No hydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted. | Left renal cyst corresponding to CT abnormality. |
Generate impression based on findings. | 67 years old, Male, Reason: Abnormal masses or nodes? History: Thyroid cancer s/p surgery and I131 MEASUREMENTS: Patient status post thyroidectomyRIGHT LOBE AREA: No significant abnormality noted. No evidence of local recurrence.LEFT LOBE AREA: No significant abnormality noted. No evidence of local recurrence.ISTHMUS AREA: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No evidence of lymphadenopathy.OTHER: No significant abnormality noted. | No evidence of local recurrence or lymphadenopathy. |
Generate impression based on findings. | 42 years old, Female, Reason: Abnormal nodes? History: THyrodi cancer s/p surgery MEASUREMENTS: Patient is status post thyroidectomy.RIGHT LOBE AREA: No significant abnormality noted. No evidence of local recurrence.LEFT LOBE AREA: Asymmetry in the area of the left thyroidectomy bed. No focal mass.ISTHMUS AREA: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign appearing left level 2 lymph node with a fatty hilum measuring 0.6 x 0.2 x 0.8 cm.OTHER: No significant abnormality noted. | Asymmetry in the area of the left thyroidectomy bed without focal mass. No definite evidence of recurrence or lymphadenopathy. However follow up imaging of the thyroid is recommended to ensure stability. |
Generate impression based on findings. | 16 year old female with recent laparoscopic cholecystectomy with recurrent biliary pain LIVER: The liver measures 14.9 cm. Normal liver echotexture without focal hepatic lesions. Limited interrogation of the main portal vein demonstrates blood flow towards the liver measuring 22.4 cm/sec.GALLBLADDER, BILIARY TRACT: Gallbladder has been removed. No intrahepatic or extrahepatic biliary ductal dilatation. The common bile duct measures up to 7 mm.PANCREAS: Pancreas body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 11.3 cm.KIDNEYS: The right kidney measures 10.5 cm. The left kidney measures 10.6 cm. No evidence of hydronephrosis.OTHER: No significant abnormalities noted. | Status post cholecystectomy with common bile duct measuring up to 7 mm. |
Generate impression based on findings. | 76 years old, Female, Reason: r/o adenopathy, recurrence History: h/o thyroid cancer MEASUREMENTS: Patient status post thyroidectomy.RIGHT LOBE AREA: Previously noted anechoic focus measuring up to 5 mm in the right thyroid surgical bed is again noted and unchanged in size and appearance.LEFT LOBE AREA: No evidence of local recurrence.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign appearing level 2 lymph node measuring 0.6 x 0.3 x 0.5 cm.OTHER: No significant abnormality noted. | Anechoic 5-mm focus in the right thyroid surgical bed is unchanged in appearance since 2013 exam. Follow-up ultrasound examination is recommended to ensure stability. No definite evidence of local recurrence or lymphadenopathy. |
Generate impression based on findings. | 51 years old, Female, Reason: evaluate for neck mass History: neck mass for past 4 months, freely mobile and nontender RIGHT LOBE MEASUREMENTS: 5.4 x 1.4 x 1.8 centimetersLEFT LOBE MEASUREMENTS: 5.2 x 1.4 x 1.8 cmISTHMUS MEASUREMENTS: 0.7 cmRIGHT LOBE: Hypoechoic spongiform nodule in the inferior right thyroid lobe without peripheral capsule measures 0.6 x 2.5 x 0.4 cm, which is favored to represent colloid nodule. There is no calcification within this nodule.LEFT LOBE: Solid appearing left inferior thyroid lobe nodule has a discontinuous hypoechoic rim measuring 1.0 x 0.7 x 0.4 cm. This nodule is amenable to biopsy. There is no calcification within this nodule.ISTHMUS: There is an anechoic well defined, semi-complex 1.8 x 1.4 x 0.6 centimeter nodule which partially deforms the trachea. There is not significant nodularity within the cystic structure itself. There is thyroid tissue around this entire structure. The structure may represent a minimally complex colloid cyst or less likely a thyroglossal duct cyst.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Midline anechoic cystic structure which minimally deforms the trachea is favored to represent a mildly complex colloid cyst versus less likely a thyroglossal duct cyst.2. Solid appearing left inferior lobe nodule is indeterminate on this exam and is amenable to biopsy.3. Subcentimeter spongiform right thyroid nodule is favored to represent a colloid cyst. |
Generate impression based on findings. | 31-year-old female with nausea and vomiting with abnormal liver function. Prior cholecystectomy. Mild hyperemesis gravidum LIVER: Normal in size and echogenicity. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: The biliary tract is normal in caliber. Patient has had a prior cholecystectomy.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Normal exam post cholecystectomy. |
Generate impression based on findings. | 43-year-old male with proteinuria. Ultrasound guidance was provided for biopsy of right kidney | Ultrasound guidance. |
Generate impression based on findings. | 39 year old female with proteinuria. Ultrasound guidance was provided for biopsy of right kidney | Ultrasound guidance. |
Generate impression based on findings. | 50 year-old female with hepatitis C cirrhosis. For hepatocellular carcinoma. LIVER: Liver is mildly enlarged and coarsely echogenic without significant change. Within the lateral segment left lobe there is again noted a mildly echogenic mass measuring approximately 1 0.2 x 1 at one . 5 cm. Measurements have increased in compared to prior exam.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: Normal in size, contour and echogenicity.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Morphologically normal peripancreatic lymph node. | Mild interval enlargement of left lobe mass. This has been determined on prior CT represent a hemangioma. |
Generate impression based on findings. | 40 year-old female with history of thyroid cancer post surgery. Follow-up nodules left thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: There are again noted somewhat lobulated soft tissue masses in the left thyroid bed with an appearance suggestive of prominent but morphologically normal lymph nodes rather than separate masses. These are unchanged, measuring 0.4 x 0.7 x 0.6 centimeter, 0.6 x 0.7 by 1.3 cm and 0.2 x 0.6 x 1.3 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination. Presumed lymph nodes left thyroid bed. |
Generate impression based on findings. | 36 years old, Female, Reason: r/o adenopathy, recurrence History: h/o thyroid cancer. most recent US suggested benign nodes, but one was slightly larger. This is a 6-month follow-up study MEASUREMENTS: Patient status post thyroidectomyRIGHT LOBE AREA: No evidence of local recurrence.LEFT LOBE AREA: No evidence of local recurrence. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Previously seen level IV right lymph node measures 1.3 x 0.5 x 0.9 cm which is unchanged from prior study. A fatty hilum is not definitely identified within this lymph node.Level 2 benign-appearing left lymph node measures 0.9 x 0.2 by 0.5 cm. OTHER: No significant abnormality noted. | 1. No definite evidence of local recurrence.2. Level 4 right lymph node is unchanged from prior exam. Continued surveillance is recommended. |
Generate impression based on findings. | 50 years old, Female, Reason: r/o adenopathy, recurrence History: h/o thyroid cancer MEASUREMENTS: Patient status post thyroidectomyRIGHT LOBE AREA: Again seen is a very small hypoechoic focus measuring 0.2 x 0.1 x 0.2 cm which is not significant change from prior exam.LEFT LOBE AREA: No evidence of local recurrence.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign appearing right level 3 lymph node measures 0.9 x 0.3 x 0.2 cm. benign appearing left level 3 lymph node measures 1.3 x 0.6 x 0.2 cm.OTHER: No significant abnormality noted. | 1. Stable very small hypoechoic focus in the right thyroid bed.2. No significant lymphadenopathy. |
Generate impression based on findings. | 65 years old, Female, Reason: RUQ US for ?cholelithiasis History: RUQ pain LIVER: The liver measures 17.3 cm in length. Increased echogenicity of the liver is consistent with fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: Pancreas is not well visualized in this examination due to overlying bowel gas. No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculusLEFT KIDNEY: Kidney measures 12.6 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculusOTHER: No significant abnormalities noted. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.2.Increased echogenicity of the hepatic parenchyma compatible with fatty infiltration. |
Generate impression based on findings. | 74 years old, Female, Reason: 74 y/o F with therapy realated MPS now R lateral thigh cellulitis with induration. Please evaluate for drainable fluid collection/abscess History: pain, R thigh cellulitis Skin thickening with increased echogenicity and edema within the soft tissues consistent with cellulitis. No focal fluid collections to suggest abscess. | Cellulitis without evidence of abscess. |
Generate impression based on findings. | 33 years old, Male, Reason: baseline exam as part of evaluation for heart/kidney transplant History: none LIVER: Mildly heterogeneous liver measuring 13.7 cm. No evidence of focal hepatic mass. The portal vein is patent with hepatic pedal flow at 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance without evidence of cholelithiasis. No pericholecystic fluid or gallbladder wall thickening.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 9.2 centers. No significant abnormality noted.KIDNEYS: The right kidney measures 9.6 cm. Increased echogenicity the right kidney is consistent medical renal disease. No evidence of shadowing calculus or hydronephrosis.The left kidney measures approximately 8.6 cm in length. Increased echogenicity of the normal portions of the left kidney is consistent medical renal disease. There is a hypoechoic at least partially exophytic lobulated mass in the mid to inferior portion of the left kidney measuring approximately 6.5 x 3.6 x 4.5 cm, similar to prior exam dated 1/19/15. No gross shadowing calculus or hydronephrosis.ABDOMINAL AORTA: Proximal aorta measures up to 2.2 cm in diameter. The mid abdominal aorta measures up to 1.9 cm in diameter. The distal abdominal aorta measures 1.6 m in diameter. No focal aneurysmal dilation is identified.INFERIOR VENA CAVA: The inferior vena cava is not well-visualized on this exam.OTHER: No significant abnormality noted. | 1. Echogenic renal cortices compatible with medical renal disease.2. Hypoechoic partially exophytic lobulated soft tissue mass in the mid to lower pole of the left kidney appearing similar to prior exam and is concerning for neoplasm. |
Generate impression based on findings. | 74 years old, Male, Reason: history of kidney stones and renal cell cancer History: none RIGHT KIDNEY: Kidney measures 9.5 cm in length. Normal echotexture. No hydronephrosis. Nonobstructing nephrolithiasis. No focal mass to suggest recurrence seen on this examination.LEFT KIDNEY: Kidney measures 11.2 cm in length. Normal echotexture. No hydronephrosis. No definite shadowing calculus. No focal mass.Bladder: The bladder is not distended. | 1.Nonobstructing nephrolithiasis of the right kidney.2.No focal mass to suggest recurrence. |
Generate impression based on findings. | 68 years old, Female, Reason: eval left kidney for hydronephrosis/lesion History: left flank pain, hx pyelonephritis RIGHT KIDNEY: Kidney measures 12.1 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. There is an anechoic simple appearing cyst in the superior pole of the right kidney measuring 1.6 x 1.4 x 1.6 cm.LEFT KIDNEY: Kidney measures 12.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.Bladder: The bladder is not completely distendedOther: Increased echogenicity of the liver is consistent with fatty infiltration. | 1.No evidence of hydronephrosis as clinically questioned. No evidence of shadowing calculus.2.Echogenicity of the renal parenchyma is within normal limits bilaterally.3.Echogenic liver. |
Generate impression based on findings. | 71 years old, Female, Reason: rule out progression in size of nodules - please comment on substernal extension - seen on 7/2012 US but not mentioned on 3/2013 US History: dysphagia RIGHT LOBE MEASUREMENTS: 5.0 x 2.3 x 1.7 centimetersLEFT LOBE MEASUREMENTS: 7.1 x 5.6 x 4.7 cm.ISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Stable right thyroid nodules which are spongiform in appearance and likely represent colloid nodules. The largest spongiform right thyroid nodule measures 1.1 x 0.6 x 0.8 cm, previously measuring 1.1 x 0.8 x 0.7 cm.LEFT LOBE: There are two left thyroid nodules. The more superior medial nodule is spongiform in appearance measuring 1.9 x 1.7 x 1.8 cm. Interval increase in size of dominant solid left thyroid nodule which measures 5.9 x 5.1 x 4 .5 cm, previously measuring 5.4 x 4.6 x 4.07 m. Retrosternal extension of the left thyroid lobe. ISTHMUS: There is a mixed solid-cystic nodule measuring 2.2 x 1.3 x 1.2 cm which is not significantly changed in size.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing right level 2 lymph node measures 1.5 x 1.3 x 0.5 cm. Left level 2 benign-appearing lymph node in measures 0.9 x 0.6 x 0.8 cm.OTHER: No significant abnormality noted. | 1. Dominant solid left thyroid nodule has increased in size and is indeterminate on this examination.2. Stable spongiform thyroid nodules which are likely colloid nodules.3. Stable mixed solid cystic left thyroid nodule. |
Generate impression based on findings. | 44 years old, Male, Reason: 44yo with HTN, new diagnosed hyperthyroidism with new Afib. Requesting thyroid US for eval History: palipations, weakness, insomnia RIGHT LOBE MEASUREMENTS: 5.2 x 2.3 x 2.2 cmLEFT LOBE MEASUREMENTS: 5.7 x 2.2 x 2.2 cmISTHMUS MEASUREMENTS: 2.8 cmRIGHT LOBE: Mosaic echogenicity of the right thyroid lobe without discrete mass.LEFT LOBE: Mosaic echogenicity of the left thyroid lobe. The upper pole the left thyroid lobe is slightly more hypoechoic than the rest of the lobe and we cannot definitely excluded a nodule in this location. ISTHMUS: This this appears heterogeneous.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mosaic echogenicity of the thyroid gland diffusely consistent with thyroiditis. 2.Hypoechoic area in the superior left lower lobe. We cannot definitely exclude a nodule in this area. |