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<s>[INST] tortuous and diffusely dilated thoracic aorta is re- demonstrated, with marked enlargement of the aortic knob compatible with known aortic arch aneurysm, better depicted on the prior chest cta. heart size is top normal. the pulmonary vascularity is not engorged. the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is identified. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] diffusely dilated and tortuous thoracic aorta with unchanged aortic arch aneurysm. no acute cardiopulmonary abnormality otherwise detected. </s>
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<s>[INST] the heart size, mediastinal and hilar contours are within normal limits and without change. moderate-sized left pleural effusion is again demonstrated, and likely has a subpulmonic component. adjacent atelectasis in the left retrocardiac region has partially cleared. known right lower lobe lung nodule is seen to better detail on prior abdominal ct <unk> <unk>.What are the key findings of this report? [/INST] <num>. moderate left pleural effusion with likely subpulmonic component. if warranted clinically, left lateral decubitus radiograph may be helpful to better quantify the amount of pleural fluid. <num>. right lower lobe lung nodule, more fully characterized on recent ct. </s>
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<s>[INST] portal ap chest radiograph demonstrates clear lungs. there is no focal consolidation, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is within normal limits.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] new since the prior radiographs but also since the recent prior ct are opacities in the superior segment of the left lower lobe and also more vague but new right upper lobe opacity, all suggesting development of pneumonia. there is no pleural effusion or pneumothorax. mild to moderate degenerative changes are similar along the thoracic spine.What are the key findings of this report? [/INST] new opacities suggesting pneumonia. </s>
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<s>[INST] pa and lateral views of the chest were obtained. lungs are clear without focal consolidation, effusion, or pneumothorax. heart and mediastinal contours appear normal. bony structures are intact. no free air below the right hemidiaphragm.What are the key findings of this report? [/INST] no signs of pneumonia. </s>
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<s>[INST] compared with prior radiographs on <unk>, there is new free intraperitoneal air under the diaphragm. there is bibasilar atelectasis. no vascular congestion or pulmonary edema. no pneumothorax. cardiomediastinal silhouette is unchanged. median sternotomy wires and mediastinal clips are stable position.What are the key findings of this report? [/INST] new free intraperitoneal air, consistent with history of bso today. no pulmonary edema. </s>
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<s>[INST] mild cardiomegaly is unchanged. there is new mild pulmonary edema, evidenced by peribronchial cuffing and increased interstitial lung markings. no new focal consolidation, pleural effusion, or pneumothorax. lung volumes are slightly lower. enteric tube courses below the left hemidiaphragm and out of view.What are the key findings of this report? [/INST] new mild pulmonary edema, evidenced by peribronchial cuffing and increased interstitial lung markings. no new focal consolidation. </s>
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<s>[INST] the cardiac, mediastinal and hilar contours are normal. subsegmental atelectasis in the left lung base is present. lungs are otherwise clear. no focal consolidation, pleural effusion or pneumothorax is present. partially imaged is a left ureteral stent.What are the key findings of this report? [/INST] subsegmental atelectasis in the left lung base. </s>
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<s>[INST] the lungs are clear. the cardiomediastinal silhouette is within normal limits. slight tortuosity of the descending thoracic aorta is noted. no acute osseous abnormalities. surgical clips overlying the right lateral chest.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] lungs are clear. cardiac size is normal. no pleural effusion, pneumonia or pneumothorax.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the heart size is mildly enlarged but unchanged. a moderate-sized hiatal hernia is re- demonstrated. the mediastinal and hilar contours are unchanged with unfolding of the thoracic aorta again noted with diffuse atherosclerotic calcifications. symmetric widening of the superior mediastinum is also unchanged, and may reflect mediastinal lipomatosis or enlarged thyroid. the pulmonary vascularity is not engorged. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is present. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. moderate size hiatal hernia. persistent widening of the superior mediastinum could reflect mediastinal lipomatosis or an enlarged thyroid gland. consider further evaluation with chest ct. </s>
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<s>[INST] frontal and lateral chest radiographs demonstrate well-expanded lungs. heart is normal in size, and cardiomediastinal contour is unremarkable. lungs are clear. there is no pleural effusion and no pneumothorax. the distal aspect of the right clavicle is excluded from the image. no definite fracture is identified.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. no acute fracture is identified on this non-dedicated examination. </s>
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<s>[INST] since prior, right picc has been repositioned and now ends in the distal right atrium. endotracheal tube and ngt are unchanged in position. the overall appearance of the lungs is unchanged with continued opacification of the right base, likely representing pleural effusion and compressive atelectasis. the cardiomediastinal and hilar contours are stable.What are the key findings of this report? [/INST] right picc ends in the distal right atrium and can be pulled back approximately <num> cm. otherwise, no significant interval change. </s>
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<s>[INST] there is no focal consolidation, pleural effusion or pneumothorax. cardiomediastinal silhouette is within normal limits. there is dextroscoliosis of the upper thoracic spine, and levoconvex scoliosis of the lower thoracic spine. mild loss of height involving several midthoracic vertebral bodies, age indeterminate.What are the key findings of this report? [/INST] <num>. no acute cardiopulmonary process. <num>. mild loss of height in several thoracic vertebral bodies, age indeterminate. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. abandoned pacer wires are again seen projecting over the right upper chest. triple-lead left-sided aicd is again seen, unchanged in position. the cardiac and mediastinal silhouettes are stable with the cardiac silhouette remaining enlarged. no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. there is no overt pulmonary edema. there are degenerative changes at the right shoulder joint. the right humeral head is high riding, which can be seen in rotator cuff disease.What are the key findings of this report? [/INST] no acute cardiopulmonary process. degenerative changes at the right shoulder. </s>
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<s>[INST] the patient has been extubated. low lung volumes. there are sternotomy wires that appear intact and in appropriate alignment. there is a right ij with the tip in the low svc. stable enlargement of the cardiac silhouette. given the changes in inspiration, the lungs appear unchanged.What are the key findings of this report? [/INST] <num>. right ij with tip in the low svc. <num>. status post extubation with low lung volumes, but otherwise unchanged. </s>
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<s>[INST] there is a moderate right pleural effusion with increased haziness in the adjacent right mid to lower lung zone. no pneumothorax identified. pulmonary edema is also present. the size the cardiomediastinal silhouette is mildly enlarged. degenerative changes of both shoulders, greater on the left.What are the key findings of this report? [/INST] new pulmonary edema. bilateral lower lung zone hazy and patchy opacities may be secondary to pulmonary edema however superimposed multifocal pneumonia should also be considered given the provided clinical history. </s>
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<s>[INST] the lungs are well expanded and clear. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary process. </s>
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<s>[INST] cardiac size is normal. the aorta is tortuous. . the lungs are clear. there is no pleural effusion or pneumothorax. there are moderate degenerative changes in the thoracic spineWhat are the key findings of this report? [/INST] no acute intrathoracic abnormality. </s>
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<s>[INST] patient is status post median sternotomy and cabg. mild enlargement of cardiac silhouette is unchanged. the mediastinal and hilar contours are unremarkable. the pulmonary vasculature is not engorged. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is present. no acute osseous abnormalities detected.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] there are relatively low lung volumes and basilar atelectasis. left base opacity may be due to atelectasis however, underlying consolidation due to pneumonia is not excluded in the appropriate clinical setting. no large pleural effusion is seen. there is no pneumothorax. cardiac and mediastinal silhouettes are grossly stable.What are the key findings of this report? [/INST] left base opacity, could be due to atelectasis, but pneumonia may be present in the appropriate clinical setting. </s>
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<s>[INST] the right lower lobe opacities persist and have increased since the prior study. in addition, there are new left lower lobe opacities concerning for atelectasis versus pneumonia. heart size is top normal. no pneumothorax.What are the key findings of this report? [/INST] continued right lower lobe opacities concerning for pneumonia, increased. additional left lower lobe opacities consistent with atelectasis versus pneumonia. </s>
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<s>[INST] pa and lateral chest radiographs were obtained. the lung volumes are slightly low. the lungs are clear. there is no focal consolidation, effusion, or pneumothorax. cardiac and mediastinal contours are normal.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] cardiac, mediastinal and hilar contours are normal. heart size is normal. pulmonary vasculature is not engorged. no focal consolidation, pleural effusion or pneumothorax is visualized. minimal atelectasis is demonstrated in the lung bases. no pleural effusion or pneumothorax is demonstrated. a bb marker is seen indicating the site of the patient's tenderness overlying the region of the left ninth posterior rib. minimal cortical irregularity is seen involving the left ninth and tenth ribs posterolaterally which could reflect nondisplaced fractures.What are the key findings of this report? [/INST] minimal cortical irregularity of the left ninth and tenth ribs posterolaterally which could reflect nondisplaced fractures. no pneumothorax or pleural effusion. minimal bibasilar atelectasis. </s>
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<s>[INST] an endotracheal tube is in-situ, the tip terminates <num> cm above the level of the carina. a nasoenteric tube is seen, the tip is not visualized lies below the level of the stomach. lung volumes are somewhat low. no liver air collapse appreciated. no consolidation, pneumothorax or pleural effusion.What are the key findings of this report? [/INST] no significant interval change when compared to the prior study. </s>
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<s>[INST] a single ap radiograph of the chest was acquired. a right picc ends in the low svc, not significantly changed compared to the prior radiograph from <unk>, although this picc has apparently been exchanged in the interim. there is minimal bilateral lower lung atelectasis/scarring. there is no focal consolidation. the heart size is normal. the mediastinal contours are normal. there are no pleural effusions. no pneumothorax is seen.What are the key findings of this report? [/INST] appropriate positioning of right picc, ending in the low svc. no acute cardiac or pulmonary process. </s>
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<s>[INST] the heart is mildly enlarged but unchanged. the mediastinal and hilar contours are normal. lungs are clear and the pulmonary vascularity is normal. no pleural effusion or pneumothorax is present.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] there is a large region of consolidation involving the left lung, involving the upper lobes, lingula, and possibly the left lower lobe, significantly increased since the prior study. patchy right basilar opacity may represent atelectasis or additional site of consolidation. additional subtle opacity projecting over the right upper lobe, in the region of the posterior right <unk> rib, may be additional site of consolidation. no pleural effusion or pneumothorax is seen. there are relatively low lung volumes. the cardiac and mediastinal silhouettes are stable.What are the key findings of this report? [/INST] large left lung consolidation involving the left upper lobe, lingula, and possibly left lower lobe. possible right lower lobe consolidation versus atelectasis. additional subtle opacity projecting over the right upper lobe, in the region of the posterior right <num>th rib, may be additional site of consolidation. overall findings are most consistent with multifocal pneumonia. </s>
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<s>[INST] there is new right infrahilar opacity obscuring the right heart border, in the middle lobe. additional opacity in the left midlung is obscured on the frontal view by the pacer and is better seen as increased density overlying the right hilar structures on the lateral. mild to moderate cardiomegaly is unchanged. there is no pleural effusion or pneumothorax. there is no pulmonary edema. left chest wall pacemaker -defibrillator has leads terminating in the right atrium and right ventricle. healed right rib fractures are redemonstrated.What are the key findings of this report? [/INST] new multi focal regions of consolidation the right middle lobe and left midlung worrisome for pneumonia. repeat radiographs in <num> weeks after treatment is recommended. </s>
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<s>[INST] cardiomediastinal contours are normal. the lungs are clear. there is no pneumothorax or pleural effusion. cervical spinal hardware is partially imagedWhat are the key findings of this report? [/INST] no acute cardiopulmonary abnormalities </s>
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<s>[INST] the patient has had prior median sternotomy. sternotomy wires are intact and aligned. there is no pneumothorax. a right ij central venous catheter ends in the lower svc. the endotracheal tube ends at the level of the clavicles. bilateral chest tubes and mediastinal drains remain in place. small layering bilateral pleural effusions with associated bibasilar atelectasis are unchanged. mild pulmonary edema is unchanged. the cardiomediastinal silhouette is stable.What are the key findings of this report? [/INST] no significant interval change. </s>
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<s>[INST] frontal and lateral radiographs of the chest demonstrate low lung volumes with bibasilar atelectasis and accentuation of the cardiac and pulmonary vasculature. elevated left hemidiaphragm is again noted. small bilateral pleural effusions. no focal consolidation concerning for pneumonia. no pneumothorax. cardiac and mediastinal contours are grossly normal.What are the key findings of this report? [/INST] bibasilar atelectasis, worse on the left with continued low lung volumes. </s>
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<s>[INST] portable chest radiograph demonstrates stable mild-to-moderate cardiomegaly with unremarkable mediastinal and hilar contours. bibasilar atelectasis is identified. possibly trace bilateral pleural effusions are unchanged. no focal opacifications identified.What are the key findings of this report? [/INST] trace bilateral pleural effusions. no opacification concerning for pneumonia. no overt pulmonary edema. </s>
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<s>[INST] single ap upright portable view of the chest was obtained. there are slightly low lung volumes, accentuate the bronchovascular markings. patchy right lung base opacity may represent confluence of overlapping structures, although underlying consolidation cannot be excluded in the appropriate clinical setting and could be better evaluated with dedicated pa and lateral views. the left lung is clear. no large pleural effusion or pneumothorax. the cardiac silhouette is top normal to mildly enlarged. the aorta remains tortuous.What are the key findings of this report? [/INST] low lung volumes. patchy right base opacity may represent overlapping structures, although underlying consolidation cannot be excluded in the appropriate clinical setting. dedicated pa and lateral views would better evaluate. </s>
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<s>[INST] lung volumes are low. heart size is normal. mediastinal and hilar contours are unremarkable. the pulmonary vascularity is normal. there is minimal atelectasis at the lung bases. no pleural effusion, focal consolidation or pneumothorax is visualized. no acute osseous abnormalities are seen.What are the key findings of this report? [/INST] low lung volumes with mild bibasilar atelectasis. </s>
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<s>[INST] since <unk>, moderate pulmonary congestion and mild interstitial edema is increased, moderate right pleural effusion is new, and moderate left basilar opacities are seen, likely representing atelectasis. moderate cardiomegaly is increased. no pneumothorax. large goiter displacing the trachea to the right and moderately narrowing at at the thoracic inlet is chronic.What are the key findings of this report? [/INST] <num>. moderate pulmonary congestion and mild interstitial edema is increased, moderate right pleural effusion is new, and moderate left basilar atelectasis is increased since <unk>, consistent with acute chf exacerbation. large goiter, unchanged. </s>
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<s>[INST] cardiomediastinal silhouette and hilar contours are unremarkable. lungs are clear. mild right apical pleural thickening may be secondary to radiation therapy. pleural surfaces are otherwise otherwise clear without effusion or pneumothorax. prominent sclerosis of the thoracic cage is compatible with metastatic disease.What are the key findings of this report? [/INST] <num>. no acute cardiopulmonary abnormality. <num>. dense bones compatible with diffuse osseous metastases. </s>
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<s>[INST] no evidence of focal consolidation. stable chronic interstitial densities bilaterally related to emphysema. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] no evidence of pneumonia. no acute cardiopulmonary process. </s>
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<s>[INST] overlying trauma board and external devices limit assessment. heart size is normal. mediastinal and hilar contours are within normal limits. pulmonary vasculature is not engorged. lungs are clear. no focal consolidation, large pleural effusion or pneumothorax is detected on this supine exam. no acutely displaced fractures are grossly visualized.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] a right ij line ends in the region of the proximal svc. the cardiomediastinal silhouette is unremarkable. lung volumes are low. there is no focal pulmonary opacity. there is no pneumothorax.What are the key findings of this report? [/INST] a right ij line ends in the region of the proximal svc. </s>
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<s>[INST] there has been interval placement of a right-sided chest tube with substantial decrease in the right-sided pleural effusion. there is a small amount of loculated air adjacent to the chest tube on the current study and a small amount of fluid tracking superiorly over the right chest wall. no subcutaneous emphysema seen. left lung appears clear.What are the key findings of this report? [/INST] status post chest tube placement. </s>
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<s>[INST] frontal and lateral views of the chest. triple lead left chest wall pacing device is again seen. the lungs remain clear. cardiomediastinal silhouette is stable. hypertrophic changes again noted in the spine.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] cardiomediastinal silhouette is stable. the lungs are essentially clear. there are no pleural effusions or pneumothoraces. cardiac silhouette, hilar and mediastinal contours appear normal.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the lungs are clear and the cardiac and mediastinal contours are accentuated by portable technique, but stable since <unk>. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] pa and lateral chest views were obtained with patient upright position. analysis is performed in direct comparison with the next preceding similar study of <unk>. marked cardiomegaly as before. unchanged position of previously described permanent pacer in left anterior axillary position and dual intracavitary electrode pacing system with position in right atrial appendage and right ventricular apical portion. a third electrode is in typical coronary sinus position terminating in a location compatible with the obtuse marginal vein. the electrodes are in completely unchanged position in comparison with the previous study. the degree of cardiomegaly has not changed significantly, but noticeable is that the left cardiac border is now somewhat more separated from the left chest wall, which would suggest some improvement of the previously described marked cardiomegaly. coinciding is a finding which favors this assumption in as much as the previously present upper zone vascular redistribution pattern in the pulmonary circulation has decreased, which would indicate a slightly lower left atrial filling pressure. there is no evidence of new pulmonary congestion, pleural effusion, or parenchymal infiltrates. no pneumothorax exists in the apical area.What are the key findings of this report? [/INST] radiographically mild degree of improvement with suggestion of slightly diminished cardiomegaly and lesser upper zone redistribution pattern. no evidence of acute infiltrates. </s>
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<s>[INST] as compared to prior examination, there has been minimal interval change. there is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. the heart size is normal. the mediastinal and hilar contours are normal.What are the key findings of this report? [/INST] no radiographic evidence for acute cardiopulmonary process. findings were conveyed by dr. <unk> to dr. <unk> <unk> via telephone at <time>pm on <unk>, <num> minutes after discovery. </s>
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<s>[INST] lungs are clear. heart size is top-normal. no pulmonary edema. no pleural effusion or pneumothorax. densely calcified breast implant.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] mild cardiomegaly again persists as do basilar streaky opacities consistent with atelectasis. the vessels are somewhat indistinct compatible with mild vascular engorgement. there is no overt edema. no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] mild vascular congestion and bibasilar atelectasis. </s>
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<s>[INST] pa and lateral views of the chest provided. suggest infiltrative lung disease. there may also be dilated bronchi bilaterally. there is no suggestion of central adenopathy. cardiomediastinal silhouette is normal. there are no pleural effusions.What are the key findings of this report? [/INST] findings above, including interstitial opacities and perihilar bronchial dilatation, warrant a chest ct for further evaluation. </s>
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<s>[INST] there is a right-sided picc line which terminates in the low svc. the tracheostomy tube terminates <num> cm above the carina. the left apical consolidation and right mid lung consolidation appear stable. there are small bilateral pleural effusions. there is no pneumothorax. the heart size is stable. the hilar and mediastinal contours are unremarkable.What are the key findings of this report? [/INST] et tube terminates <num> cm above the carina. stable left apical and right mid lung consolidation. </s>
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<s>[INST] the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. the heart size and cardiomediastinal contours are normal. the lungs are hyperinflated. interstitial lung markings are increased at the lung bases. no focal consolidation, pleural effusion, or pneumothorax.What are the key findings of this report? [/INST] lower lobe predominant interstitial lung disease. </s>
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<s>[INST] the heart size is normal. the aorta is slightly unfolded. mediastinal and hilar contours are unremarkable. no focal consolidation, pleural effusion or pneumothorax is seen. minimal streaky linear opacity in the left lung base likely reflects atelectasis. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] minimal left basilar atelectasis. </s>
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<s>[INST] lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] a dobhoff tube is present. on view <num>., the tip overlies the distal mediastinum, possibly reaching the ge junction. on view <num>., the tip is not visualized and presumably extends beneath the ge junction. based on this common additional view to include the abdomen would be required to see the radiopaque tip. compared with the prior film, cardiomediastinal silhouette is grossly unchanged. however, there is increased vascular engorgement and mild vascular blurring at the bases, consistent with chf. the possibility of small effusions cannot be excluded. picc line again noted in the mid to distal svc.What are the key findings of this report? [/INST] <num>. on the second film, the radiopaque dobhoff tip tube extends beyond the ge junction, into the abdomen, but is not included on the film. <num>. compared with the prior film, there is now evidence of chf, with vascular engorgement and probable interstitial edema at the bases. possible small bilateral effusions. </s>
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<s>[INST] compared to <unk> at <time>, there may have been slight improvement in the chf findings. otherwise, i doubt significant interval change.What are the key findings of this report? [/INST] as above. </s>
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<s>[INST] the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] left-sided dual-chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle. heart size remains mildly enlarged with a left ventricular predominance. the aorta is unfolded with diffuse atherosclerotic calcifications. pulmonary vasculature is normal. there is minimal atelectasis within the lung bases. no focal consolidation, pleural effusion or pneumothorax is identified. no acute osseous abnormalities seen.What are the key findings of this report? [/INST] minimal bibasilar atelectasis. </s>
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<s>[INST] the moderate right and moderate to large left pleural effusions have slightly increased since <unk> and markedly increased since <unk>. there is bibasilar atelectasis. the upper lungs are clear. there is no pleural effusion or pneumothorax identified. the aortic knob is calcified. the cardiac contours are not well seen.What are the key findings of this report? [/INST] moderate right and moderate to large left pleural effusions have slightly increased since <unk> and markedly increased since <unk>. </s>
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<s>[INST] the patient is rotated which slightly limits assessment. allowing for this, the heart size is grossly normal. mediastinal and hilar contours are grossly unremarkable. no focal consolidation, pleural effusion or pneumothorax is seen. the pulmonary vasculature is normal. lungs are hyperinflated with flattening of the diaphragms compatible with copd. mild compression deformity of a low thoracic vertebral body is unchanged.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. copd. </s>
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<s>[INST] there is no intraperitoneal free air. the lungs are clear without effusion or pneumothorax. the cardiac silhouette is normal in size. the mediastinal contours are normal.What are the key findings of this report? [/INST] normal chest. </s>
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<s>[INST] heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] ap portable upright view of the chest. left chest wall pacer device is seen with pacer leads extending to the right atrium, right ventricle and coronaries sinus as on prior. previously noted effusions have resolved in the interval. a rounded density projecting over the left lung base is likely a nipple shadow. mild blunting persists at the right lung base likely representing residual tiny effusion. no convincing evidence for pneumonia or edema. no pneumothorax is seen. bony structures are intact.What are the key findings of this report? [/INST] tiny residual right pleural effusion. </s>
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<s>[INST] ap upright and lateral views of the chest are provided. there is mild left basilar atelectasis. there is no focal consolidation to suggest the presence of pneumonia. no pleural effusion or pneumothorax. cardiomediastinal silhouette appears normal. bony structures are intact.What are the key findings of this report? [/INST] mild left basilar atelectasis. otherwise normal. </s>
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<s>[INST] an endotracheal tube has been placed that terminates approximately <num> cm above the carina. a orogastric tube passes into the stomach, its distal course not imaged. lung volumes are low. the cardiac, mediastinal and hilar contours appear unchanged. there is persistent mild elevation of the right hemidiaphragm with effacement of the right costophrenic sulcus and mild pleural thickening, apparently chronic in nature. likewise, blunting of the left costophrenic sulcus appears unchanged. there is no pneumothorax.What are the key findings of this report? [/INST] status post endotracheal intubation. stable appearance of the chest. </s>
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<s>[INST] the patient is status post median sternotomy and cabg. endotracheal tube tip terminates approximately <num> cm from the carina and the orogastric tube tip is within the stomach. the heart size is normal. the aorta is slightly unfolded. there is crowding of the bronchovascular structures due to low lung volumes. streaky opacities within the lung bases likely reflect atelectasis. no large pneumothorax is identified on this supine study. a possible trace right pleural effusion may be present as the right costophrenic angle is slightly indistinct. no acute osseous abnormalities seen.What are the key findings of this report? [/INST] endotracheal and orogastric tube tips are in standard positions. low lung volumes with streaky opacities in the lung bases, likely atelectasis. possible trace right pleural effusion. </s>
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<s>[INST] the heart size is at the upper limits of normal. the mediastinal and hilar contours are normal. the lung volumes are low and mild consolidation at the right base may represent atelectasis or developing pneumonia. there is no pleural effusion or pneumothorax. spine fusion hardware projects over the lower aspect of the imaged lumbar spine.What are the key findings of this report? [/INST] right basal opacity may represent atelectasis or early pneumonia in the appropriate setting. </s>
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<s>[INST] cardiac size is top-normal. the aorta is tortuous. there is a hiatal hernia. there are low lung volumes. the lungs are clear. there is no pneumothorax or pleural effusion. the osseous structures are unremarkable. rounded calcification in the a left breast and probably surgical clips are better evaluated in prior ct.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormalities hiatal hernia </s>
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<s>[INST] there are atelectatic changes extending from the right hilum into the right lower lung field. there is a small right pleural effusion. the cardiomediastinal silhouette and hila are normal. there is no pneumothorax and no suspicious lung consolidation. dish is seen in the thoracic spine. there is no free air.What are the key findings of this report? [/INST] small right pleural effusion. no evidence of pneumonia, pneumothorax or pneumoperitoneum. </s>
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<s>[INST] heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>
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<s>[INST] allowing for limitations in patient positioning, there is minimal left hemidiaphragm elevation, decreased compared to the prior study. otherwise, lungs are fully expanded and clear. heart size is normal. cardiomediastinal hilar silhouettes are normal. no pleural abnormalities.What are the key findings of this report? [/INST] allowing for limitations in patient positioning, left hemidiaphragm elevation is now minimal and decreased compared to prior. </s>
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<s>[INST] frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. lungs are clear. no pleural effusion or pneumothorax evident. no osseous abnormality identified.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>
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<s>[INST] frontal and lateral views of the chest were obtained. there are low lung volumes. there is prominence of the hila and central pulmonary vasculature. over the posterior right eighth rib/anterior right third rib, there is a <num>-mm nodular opacity not clearly seen on prior chest radiograph; however, could potentially represent bone island seen on prior chest ct from <unk>, although on that study it was in the ninth rib. no pleural effusion or pneumothorax is seen.What are the key findings of this report? [/INST] <num>. low lung volumes with likely moderate pulmonary vascular congestion/mild pulmonary edema. <num>-mm nodular opacity projecting over the right mid lung, at the level of the posterior right eighth rib/anterior right third rib, could possibly represent a bone island that was seen in the ninth rib on prior chest ct of <unk>. however, given the uncertainty whether this is the same finding, findings could be further evaluated on chest ct. </s>
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<s>[INST] the left-sided picc has been repositioned, with tip now at the cavoatrial junction. bilateral low opacities, are unchanged in appearance. trace right-sided effusion. the cardio mediastinal silhouette is compatible. no pneumothorax.What are the key findings of this report? [/INST] the right-sided picc line is now in good position. stable basilar opacities, and right small effusion. </s>
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<s>[INST] the lungs are clear. the cardiomediastinal silhouette and hila are normal. there is no pleural effusion and no pneumothorax.What are the key findings of this report? [/INST] no acute cardiothoracic process. </s>
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<s>[INST] a right internal jugular venous catheter terminates in the superior vena cava. the heart is moderately enlarged. there is new moderate pulmonary edema. lung opacification is particularly confluent along the left mid lung. for the latter, since it is more focal than more generalized opacification, the possibility of an additional process such as aspiration could also be considered in the appropriate setting. there may be a trace pleural effusion on the right, none clearly present on the left. the stomach is distended.What are the key findings of this report? [/INST] moderate new pulmonary edema. focal left mid lung opacity; attention and follow-up is suggested. for the latter, in addition to confluent pulmonary edema, an additional process such as developing pneumonia or aspiration pneumonitis could also be considered. </s>
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<s>[INST] bilateral lung volumes are low. in comparison <time> portable chest radiograph, there is mild improvement of the small left pleural effusion and decreased level of opacification of the retrocardiac lung regions suggesting improved ventilation. the right ij is in stable position terminating in mid svc. moderate cardiomegaly and pulmonary vascular congestion are stable and unchanged from prior study. no pneumothorax nor consolidation seen.What are the key findings of this report? [/INST] <num>. since <unk>:<num> chest radiograph, there has been mild improvement of small left pleural effusion and improved ventilation of the retrocardiac lung regions. otherwise, pulmonary vascular congestion and pulmonary edema are relatively unchanged. there is no evidence of pneumonia. <num>. right ij is in stable position in the mid svc </s>
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<s>[INST] as seen on the prior ct there is a very large bochdalek's type hernia containing multiple loops of small and large bowel. this limits assessment of the lung bases. there is a small right pleural effusion. no definite left pleural effusion seen. there is left basilar atelectasis. lung volumes are consequently low. no pneumothorax or consolidation seen.What are the key findings of this report? [/INST] large bochdalek's hernia limits assessment. small right pleural effusion. </s>
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<s>[INST] compared to prior chest x-rays there is improvement of the bilateral opacification especially in the right lung for reduced vascular congestion. ventilation of the left base is improved for reduced atelectasis. there is no pleural effusion or pneumothorax. reticular changes with mild hyperlucency in the upper lobes is for emphysema. cardiac size is normal.What are the key findings of this report? [/INST] reduced pulmonary edema especially on the right with improved left base ventilation for reduced atelectasis. </s>
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<s>[INST] the patient is rotated somewhat to the right. there are bilateral pleural effusions on a background of likely pulmonary edema. right mid lung opacity is worrisome for pneumonia versus possible loculated pleural effusion with overlying collapse, and is new/ increased since the prior study. cardiac silhouette remains enlarged. the aorta is calcified and tortuous.What are the key findings of this report? [/INST] bilateral pleural effusions and pulmonary edema. consolidative opacity in the right mid lung worrisome for pneumonia versus possible loculated pleural effusion with overlying lung collapse. </s>
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<s>[INST] the cardiomediastinal silhouette and pulmonary vasculature are unremarkable. the lungs are grossly clear aside from a nodular opacity in the left midlung. this may represent a vessel, though nodular opacity is not excluded. there is no pleural effusion or pneumothorax. no subdiaphragmatic air is identified.What are the key findings of this report? [/INST] <num>. possible left mid lung nodule. consider obliques views versus nonemergent chest ct to further assess. <num>. otherwise no acute abnormality. </s>
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<s>[INST] the cardiomediastinal and hilar contours are within normal limits. the heart is mildly enlarged but stable. the lungs are clear without focal consolidation, pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] ap upright radiograph of the chest demonstrates clear lungs bilaterally. the mediastinal and hilar contours are within normal limits. there is no pneumothorax or pleural effusion. osseous structure without acute abnormality.What are the key findings of this report? [/INST] no acute intrathoracic abnormality. </s>
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<s>[INST] the lungs are well expanded without lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. previously detected pulmonary nodules are minimally conspicuous. no displaced rib fractures are visualized.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] compared to the prior film, multiple lines and tubes have been removed. the right ij swan-ganz catheter is been converted to right ij sheath, with tip over distal most svc. the two prosthetic valves are noted. the cardiomediastinal silhouette is again noted to be prominent, consistent with recent surgery. although it appears more pronounced than on the prior film, this may relate to technical differences. on today's exam, there is more pronounced vascular plethora, with diffuse vascular blurring, consistent with chf. again seen is patchy retrocardiac opacity. possible small bilateral effusions. no pneumothorax detected.What are the key findings of this report? [/INST] interval removal of multiple lines and tubes. apparent interval increase in chf. patchy retrocardiac opacity similar to prior. </s>
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<s>[INST] there are very low lung volumes, likely accentuating the size of the cardiomediastinal silhouette. hila are not well assessed, likely within normal limits. new since prior exam is a left lower lung opacity with air bronchograms, concerning for pneumonia. patchy right mid lung opacities likely reflect atelectasis. there is no pneumothorax. there is probably a small left pleural effusion. there is no right pleural effusion. surgical clips are seen scattered over the left hemiabdomen.What are the key findings of this report? [/INST] left lower lung pneumonia and a small left parapneumonic pleural effusion. </s>
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<s>[INST] there is no focal consolidation, pleural effusion or pneumothorax. cardiomediastinal silhouette is normal. the imaged upper abdomen is unremarkable, there is no free intraperitoneal air.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] ap upright and lateral views of the chest were provided. lungs are clear without effusion or pneumothorax. cardiomediastinal silhouette appears normal. there is a subtle deformity of the right posterolateral eighth rib, which is unchanged from prior exam. no acute displaced rib fractures are identified. right ac joint arthropathy is again noted. no free air below the right hemidiaphragm. no definite compression fractures are seen within the imaged spine.What are the key findings of this report? [/INST] no injury seen. if strong clinical concern for rib fracture, consider dedicated rib series. </s>
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<s>[INST] pa and lateral views of the chest were obtained. a severe dextroscoliosis of the t-spine is present which somewhat limits the evaluation. there is mild prominence of the left pulmonary hilum with left perihilar linear density likely representing scarring in this patient with prior pneumonia in this region. there is no new consolidation, effusion, or pneumothorax. the heart size is difficult to assess due to severe scoliosis, though appears grossly stable. mediastinal contour is normal. bony structures are intact.What are the key findings of this report? [/INST] left mid lung scarring likely sequelae of old infection. no evidence of pneumonia or chf. dextroscoliotic t-spine. </s>
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<s>[INST] there is a new mass-like appearance to the left hilum worrisome for underlying neoplasm and in addition the left upper mediastinal contours are newly thickened and lobular which raises concern for coinciding lymphadenopathy. there is no pleural effusion or pneumothorax. bony structures are unremarkable.What are the key findings of this report? [/INST] findings worrisome for new left perihilar mass as well as mediastinal lymphadenopathy. chest ct is recommended. </s>
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<s>[INST] frontal and lateral radiographs of the chest show persistent nodular opacities in the right upper lobe and lingula which appear less well defined than on <unk>. a small right pleural effusion is resolved from <unk>. no new focal opacity, pleural effusion or pneumothorax is present. the cardiac silhouette is normal in size. thickening of the right paratracheal stripe is consistent with adenopathy, also seen on ct of the chest from <unk>. the mediastinal and hilar contours are unchanged.What are the key findings of this report? [/INST] <num>. less well defined appearance of right upper lobe and lingular pulmonary nodules from <unk>. <num>. resolved small right pleural effusion from <unk>. <num>. stable right paratracheal adenopathy also seen on ct of <unk>. </s>
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<s>[INST] sequential images of the thorax demonstrate advancement of a dobhoff feeding tube into the gastric body. small bilateral pleural effusions with overlying atelectasis. no pneumothorax identified. the size of the cardiac silhouette is unchanged. multiple metallic coils are seen in the right upper quadrant.What are the key findings of this report? [/INST] sequential images demonstrate advancement of the dobhoff feeding tube into the gastric body. persisting small bilateral pleural effusions with overlying atelectasis. </s>
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<s>[INST] frontal and lateral views of the chest demonstrate low lung volumes without pleural effusion, focal consolidation or pneumothorax. the hilar and mediastinal silhouettes are unremarkable. a mild interstitial pulmonary abnormality could be acute, either edema or interstial pneumonia, but since there is a suggestion of a milder interstitial abnormality in <unk>, this may be the progression or recurrence of a longstanding process. heart is mildly enlarged, including a dilated left atrium both increased since <unk>. partially imaged upper abdomen is unremarkable.What are the key findings of this report? [/INST] mild cardiomegaly and left atrial enlargement. see findings for discussion of interstial pulmonary abnormality--<unk> failure, infection or chronic disease. </s>
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<s>[INST] the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are stable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] frontal and lateral views of the chest. no pleural effusions, pneumothorax or focal airspace consolidation. normal cardiac size, hilar and mediastinal contours. pleural surfaces are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>
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<s>[INST] the lungs are well expanded. there is minimal left basilar atelectasis but no focal opacities concerning for pneumonia. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax. no subdiaphragmatic air is seen.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary process. no evidence of pneumoperitoneum. </s>
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<s>[INST] patient is status post median sternotomy and cabg. inferior-most sternotomy wire appears disrupted. moderate enlargement of the cardiac silhouette is demonstrated. the thoracic aorta demonstrates diffuse atherosclerotic calcifications. the mediastinal and hilar contours are otherwise unremarkable. pulmonary vasculature is not engorged. apart from minimal atelectasis in the lung bases, the lungs are clear without focal consolidation. minimal blunting of the right costophrenic angle suggests a trace right pleural effusion. no pneumothorax is seen. the right hemidiaphragm is mildly elevated, of unknown chronicity. no acute osseous abnormality is visualized. mild degenerative changes are noted in the thoracic spine.What are the key findings of this report? [/INST] moderate cardiomegaly with trace right pleural effusion. no focal consolidation to suggest pneumonia. </s>
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<s>[INST] pa and lateral chest views were obtained with patient in upright position. comparison is made with the next preceding single chest view of <unk>. presently, the heart size is normal. no configurational abnormality is present. thoracic aorta unremarkable. no mediastinal abnormalities are seen. the pulmonary vasculature is normal. no signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. no evidence of pneumomediastinum or pneumothorax. the, on previous examination identified, mediastinal air collections and tissue emphysema in the right lower neck area have normalized.What are the key findings of this report? [/INST] normalization of chest findings. no persistent pneumothorax, mediastinal or chest wall emphysema. </s>
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<s>[INST] right internal jugular central venous catheter is seen terminating in the low svc/ cavoatrial junction without evidence of pneumothorax. dual lead left-sided pacer device is similar in position. there has been interval development of obscuration of the left hemidiaphragm, given short term interval, may be due to atelectasis or aspiration. the cardiac silhouette remains enlarged. mediastinal contours are unremarkable. there is central pulmonary vascular engorgement.What are the key findings of this report? [/INST] interval placement of right ij central venous catheter terminating in the low svc/ cavoatrial junction without evidence of pneumothorax. increased obscuration of the left hemidiaphragm/left base opacity, given short term interval, may be due to atelectasis or aspiration. central pulmonary vascular engorgement. </s>
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<s>[INST] the ett tip ends approximately <num> cm from the carina. the right ij tip ends in the mid svc. median sternotomy wires appear intact and unchanged in position. pleural drains are unchanged in position. the stomach remains distended and filled with air, perhaps more so compared to the prior exam. stable postoperative appearance of the cardiomediastinal silhouette. there is moderate pulmonary edema that appears slightly improved with improved aeration, although lung volumes remain low. probable layering small right pleural effusion is overall unchanged. no pneumothorax.What are the key findings of this report? [/INST] <num>. persistent lower lung volumes and mild-to-moderate pulmonary edema, slightly improved from the prior exam. <num>. ett tip approximately <num>-cm from the carina. <num>. interval increase in stomach distension. </s>
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