instruction
stringclasses 1
value | input
stringlengths 56
2.58k
| output
stringlengths 11
1.71k
|
|---|---|---|
Generate impression based on findings. | 61 year old female with history of right upper quadrant pain. LIVER: Multiple simple hepatic cysts are seen, with the largest left hepatic cyst measuring 2.8 x 2.1 x 2.7 cm. The largest right hepatic cyst measures 2.8 x 2.7 x 3.0 cm.GALLBLADDER, BILIARY TRACT: No cholelithiasis or gallbladder wall thickening. The biliary tract is not dilated.PANCREAS: Visualized portions unremarkable.RIGHT KIDNEY: The right kidney is within normal limits, and measures 10.1 cm.OTHER: The spleen is within normal limits, and measures 8.1 cm. The left kidney is within normal limits, and measures 9.3 cm. No hydronephrosis. | Several simple hepatic cysts. |
Generate impression based on findings. | Papillary thyroid carcinoma; assess for regional adenopathy RIGHT LOBE MEASUREMENTS: 4.9 x 1.5 x 1.3 cmLEFT LOBE MEASUREMENTS: 5.8 x 3.5 x 3.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 3.9 x 3.1 x 3.4 cm mixed cystic and solid nodule arising from the left thyroid gland. Solid component demonstrates probable internal microcalcifications and other worrisome complexity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.2 x 0.9 x 0.5 cm indeterminate left level 2/3 cervical lymph node. Other left level 2 and right level 2 lymph nodes are mildly enlarged but morphologically favor benign reactive lymph nodes.OTHER: No significant abnormality noted. | Mixed cystic and solid worrisome left thyroid nodule corresponding to known papillary thyroid carcinoma. A mildly enlarged left level 2/3 cervical lymph node is best considered indeterminant. This lymph node should be harvested when the thyroid lesion is resected. |
Generate impression based on findings. | Right upper quadrant abdominal pain, evaluate for gallstones or obstruction LIVER: Hepatomegaly with fatty infiltration. No focal hepatic lesions. No biliary ductal dilation. The portal vein is patent.GALLBLADDER, BILIARY TRACT: Cholelithiasis without pericholecystic fluid or wall thickening.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 13.1 cm. No hydronephrosis.OTHER: The left kidney measures 12.4 cm. The spleen measures 11.4 cm. | 1.Hepatomegaly with fatty infiltration. 2.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | 74-year-old male with hepatitis C, evaluate for ascites Limited 4-quadrant grayscale ultrasound of the abdomen shows no ascites. | Limited exam without ascites. |
Generate impression based on findings. | Chronic kidney disease, evaluate for obstructive uropathy RIGHT KIDNEY: Echogenic kidney measures 10.7 cm. Simple cyst in the midpole measures up to 4 cm. No hydronephrosis.LEFT KIDNEY: Echogenic kidney measures 10.6 cm. No hydronephrosis or mass.OTHER: The bladder is not distended. | Medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Goiter, 5 year follow-up study RIGHT LOBE MEASUREMENTS: 7.2 x 2.7 x 3.3 cm.LEFT LOBE MEASUREMENTS: 7.3 x 2.5 x 3.5 cm.ISTHMUS MEASUREMENTS: 1.8 cm.RIGHT LOBE: Diffusely enlarged and heterogeneous echotexture without discrete mass or nodule.LEFT LOBE: Diffusely enlarged and heterogeneous echotexture without discrete mass or nodule.ISTHMUS: Diffusely enlarged and heterogeneous echotexture without discrete mass or nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely enlarged heterogeneous thyroid gland without discrete mass or nodule, similar in appearance to the prior exam. |
Generate impression based on findings. | Thyroid cancer follow-up RIGHT LOBE MEASUREMENTS: 3.2 x 1.2 x 1.1 cm.LEFT LOBE MEASUREMENTS: Resected.ISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: Hypoechoic nodule in the superior right lobe measures 0.9 x 0.5 x 0 .5 cm, similar in appearance to the prior exam.LEFT LOBE: Resected. A large lipoma is present in the left thyroid bed measuring greater than 4 cm in greatest dimension.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No regional adenopathy.OTHER: No significant abnormality noted. | 1.Postsurgical changes with stable nonspecific right thyroid nodule. 2.No regional adenopathy. 3.Left neck lipoma. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Measures 17.7 cm. Normal parenchymal echotexture without focal mass. No biliary dilation. The portal vein is patent.GALLBLADDER, BILIARY TRACT: Cholelithiasis without gallbladder wall thickening. There is a small focus of fluid anterior to the gallbladder. The common bile duct is normal diameter.PANCREAS: Not evaluated due to overlying bowel gas.RIGHT KIDNEY: Measures 10.4 cm. No hydronephrosis or mass.OTHER: Left kidney measures 10.5 cm in length. The spleen is atrophic and measures 8.5 cm in length. | Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | 63-year-old male with thyroid nodule on MR exam. RIGHT LOBE MEASUREMENTS: 4.9 x 1.8 x 2.3 cmLEFT LOBE MEASUREMENTS: 4.2 by 2 x 1.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Homogeneous in echotexture. LEFT LOBE: Homogeneous in echotexture. In the mid portion of the left lobe there is a rounded, solid nodule measuring approximately 1 x 1 x 1 cm which is uniform and slightly hypoechoic compared to thyroid tissue.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Solitary 1 cm solid left thyroid nodule the appearance is nondescript by ultrasound and in this age range could be followed. |
Generate impression based on findings. | 53-year-old female a history of left lumpectomy for IDC and DCIS in April of 2008, status post chemotherapy and radiation. Mammogram: Three standard views of both breasts and two left breast spot compression views 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. Post surgical scar with surgical clips is re-demonstrated at upper outer quadrant in the left breast without significant change. Focal asymmetry in the left lower inner breast disperses on spot compression views, however, ultrasound was subsequently performed for confirmation.No suspicious mass or suspicious microcalcifications in either breast. Ultrasound: Targeted left lower, inner quadrant ultrasound was performed. Normal glandular tissue is noted. No suspicious cystic or solid mass noted. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 72 year old female with epigastric pain LIVER: Liver is relatively small and prepped and minimally coarsely echogenic. No focal hepatic abnormality identified.GALLBLADDER, BILIARY TRACT: The gallbladder contains shadowing dependent and nondependent calculus as well as sludge. There is no associated wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Not adequately visualized due to bowel gas.RIGHT KIDNEY: Large, exophytic renal cyst.OTHER: Limited views of the spleen and left kidney are unremarkable. | Gallstones and sludge without complication.Large right renal cyst. |
Generate impression based on findings. | Elevated liver enzymes, evaluate for cirrhosis, portal vein thromboses LIVER: Coarsened hepatic echotexture. There is a 1 cm cyst in the left hepatic lobe. The main portal vein is patent.GALLBLADDER, BILIARY TRACT: Gallbladder sludge without wall thickening. There is nonspecific pericholecystic fluid.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 10.0 cm in length. No hydronephrosis or mass.OTHER: Left kidney measures 11.2 cm in length. The spleen measures 9.2 cm in length. | 1.Coarsened hepatic echotexture without evidence of cirrhosis. 2.The main portal vein is patent. 3.Gallbladder sludge without evidence of cholecystitis. |
Generate impression based on findings. | Transaminitis, fever LIVER: Cirrhotic morphology with perihepatic ascites. No biliary dilation. The main portal vein is patent.GALLBLADDER, BILIARY TRACT: Gallbladder is contracted. The common bile duct is normal in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 8.5 cm. No hydronephrosis.OTHER: The left kidney and spleen are not visualized. Ascites. | 1.Cirrhosis. 2.Ascites. |
Generate impression based on findings. | Thyroid cancer, evaluate for adenopathy or recurrence RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No suspicious lesions in the right thyroid bed.LEFT LOBE: No suspicious lesions in the left thyroid bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No specific evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 71 year old female presents for preoperative exam prior to heart transplant. LIVER: The liver parenchyma is within normal limits. No intrahepatic biliary dilatation.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common bile duct measures up to 0.9 cm, which may be related to the patient's age and postoperative status. No intrahepatic biliary dilatation or significant abnormality otherwise.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. Spleen measures 9.1 cm in length.KIDNEYS: The right kidney measures 9 cm. There is a mildly complex cyst in the right kidney upper pole which measures 2.8 x 2.1 x 2.7 cm, and has an internal septation and subtle nodularity of the wall. This may be followed on subsequent exams. The left kidney is within normal limits, and measures 9.2 cm.ABDOMINAL AORTA: The proximal aorta measures 2.5 cm, mid aorta measures 1.9 cm, and the distal aorta measures 1.8 cm in diameter.INFERIOR VENA CAVA: The inferior vena cava is within normal limits.OTHER: No significant abnormality noted. | Mildly complex cyst in the right kidney upper pole, which may be followed on subsequent exams.No additional significant abnormality. |
Generate impression based on findings. | 60-year-old female with history of right breast lumpectomy for breast cancer in 1996 followed by recurrence (ILC), in November 2009, underwent right breast mastectomy in January 2010 and left breast reduction surgery in November, 2014 in New Orleans. Patient presents to evaluate a physician palpated lump in the left breast and denies a mammogram, due to discomfort and pain associated with the compression. A targeted left breast ultrasound was performed for the palpable area of concern at 3 to 4:00 position. On physical Examination, a 2-cm lump is palpated. Ultrasound demonstrates a oval mixed echogenic area measuring 1.3 x 0.8 x 1 cm, corresponding to the palpable abnormality, most consistent with area of fat necrosis. | Palpable abnormality in the left breast corresponds to area of fat necrosis. Surgical consultation is recommended. Patient is scheduled to see her plastic surgeon from New Orleans next week. No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bialteral diagnostic mammogram is recommended, due in October 2014. Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 50 year-old male with history of elevated liver enzymes. LIVER: The liver parenchyma is normal in appearance. The liver measures 17 cm.GALLBLADDER, BILIARY TRACT: The gallbladder wall measures 0.5 cm in thickness. There is no pericholecystic fluid, the gallbladder is not dilated, and no gallstones are seen.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. The right kidney measures 5.7 cm.OTHER: No significant abnormalities noted. The left kidney measures 5.3 cm. The spleen is enlarged, measuring 13 cm. No sonographic Murphy's sign. No significant ascites. | 1.Thickened gallbladder wall, nonspecific but given the patient's relatively benign presentation this would be atypical for cholecystitis. This thickening may be seen with heart failure or hypoproteinemia, among other causes.2.No biliary dilatation, perihepatic fluid collections or other significant liver parenchymal abnormalities. |
Generate impression based on findings. | 67 year-old female with right upper quadrant pain. LIVER: Liver is normal in size and is moderately echogenic. This is not specific but could be due to fatty infiltration. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: The gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Fatty liver. Normal gallbladder and biliary tract. |
Generate impression based on findings. | 52 year old female with lupus nephritis, needs ultrasound guidance for biopsy Ultrasound guidance was provided for right kidney biopsy performed by the renal service. | Ultrasound guidance was provided for right kidney biopsy performed by the renal service. |
Generate impression based on findings. | Evaluate for growth of thyroid nodules or adenopathy RIGHT LOBE MEASUREMENTS: 3.9 x 1.2 x 1.2 cmLEFT LOBE MEASUREMENTS: 3.6 x 1.1 x 1.2 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Heterogeneous thyroid echotexture with mixed hyper and hypoechoic parenchyma typical for thyroiditis, increasing from the prior examination. Inferior nodule measures 0.9 x 0.3 x 0.6 cm. LEFT LOBE: Heterogeneous thyroid echotexture with mixed hyper and hypoechoic parenchyma typical for thyroiditis, increasing from the prior examination.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous thyroid echotexture with mixed hyper and hypoechoic parenchyma typical for thyroiditis. Stable right inferior lobe nodule. |
Generate impression based on findings. | 44-year-old female with mass posterior to the left shoulder. In the region of the mass in the left posterior subcutaneous tissues, there is an ovoid and septated -- appearing mass measuring 9.7 cm in greatest diameter with a thickness of approximately 2.3 cm. The appearance is consistent with lipoma. | Large lipoma involving subcutaneous fat of the left posterior shoulder. |
Generate impression based on findings. | 77 year-old female with thyroid masses. Also findings of lung cancer with metastatic disease on CT. RIGHT LOBE MEASUREMENTS: 5.9 x 2.9 x 2.5 cmLEFT LOBE MEASUREMENTS: 5.5 x 2 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Highly heterogeneous in echotexture with multiple ill-defined nodules including small complex cystic nodules consistent with colloid nodules. Most measurable nodule is in the lower pole measuring 1.6 x 2.1 x 2.1 cm. This is solid and demonstrates rim calcification.LEFT LOBE: Highly heterogeneous in echotexture with multiple ill-defined nodules. Most measurable nodule in the midportion of the left lobe is predominantly solid with cystic components measuring 0.9 x 1.1 x 1.2 cm. There are some internal bright reflectors which could represent comet tail artifact, which is seen with colloid, although small calcifications cannot be completely excluded. Several other smaller nodular areas within the left lobe have the appearance of colloid nodulesISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically abnormal level 3 node on the right measuring 0.8 x 1.2 x 1.5 cm and may contain small calcifications.OTHER: No significant abnormality noted. | Multiple thyroid nodules including a nodule with rim calcification on the right.Abnormal level 3 right lymph node. |
Generate impression based on findings. | 42 year-old female with elevated alkaline phosphatase, evaluate for hepatobiliary etiology LIVER: Measures 14.3 cm. No focal hepatic lesions. No biliary ductal dilation. The portal vein is patent.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance without wall thickening or pericholecystic fluid. The common bile duct is normal in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 9.4 centers. No hydronephrosis or mass.OTHER: The left kidney measures 10.8 cm. The spleen measures 8.5 cm. | Normal ultrasound of the right upper quadrant. |
Generate impression based on findings. | 60 year-old female for follow-up of thyroid nodule. RIGHT LOBE MEASUREMENTS: 4.5 x 1.6 x 1.9 cmLEFT LOBE MEASUREMENTS: 3.9 x 1.5 x 1.5 cmISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: In the mid portion of the right lobe there is a mildly heterogeneous and hyperechoic solid nodule with a partial hypo-echoic rim measuring 0.8 x 0.8 x 1.3 cm without change. Right lobe is diffusely heterogeneous.LEFT LOBE: Diffusely heterogeneous without mass.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable right lobe thyroid nodule. |
Generate impression based on findings. | AKI, history of CHF, rule out obstruction RIGHT KIDNEY: Echogenic kidney measures 12.5 cm in length. No hydronephrosis or mass. LEFT KIDNEY: Echogenic kidney measures 12.0 cm in length. No hydronephrosis or mass.OTHER: The bladder is nondistended. | Medical renal disease. No hydronephrosis. |
Generate impression based on findings. | 20 year-old female with a history of thyroid cancer post thyroidectomy and radioactive iodine. Enlarged submandibular lymph nodes identified on prior study. There is a heterogeneous right submandibular lymph node measuring 1.1 x 2.7 by 2.5 cm with punctate internal echogenic foci. Several of these areas demonstrate comet tail artifact. This is decreased in size when compared to the prior exam.There is a heterogeneous left submandibular lymph node measuring 0.9 x 1.7 x 2.2 cm without significant change. There are several punctate internal echogenic foci, at least a few of which may also demonstrate comet tail artifact.OTHER: No significant abnormality noted. | No change or slight decrease in submandibular lymph nodes. |
Generate impression based on findings. | 62-year-old male with history of thyroid cancer. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massLEFT LOBE: No massISTHMUS: No massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically normal lymph nodes at levels two and three on the right and level five on the left. Left submandibular region was scanned due to patient stating palpable abnormality. In this location there is a morphologically normal 1.7 x 1.5 x 1.6 cm lymph nodeOTHER: No significant abnormality noted. | No evidence for recurrent disease. Results discussed with the patient at his request. |
Generate impression based on findings. | Left upper quadrant LVAD drive line site wound There are no focal fluid collections in or surrounding the drive line bed. | No evidence of fluid collections. |
Generate impression based on findings. | Acute pancreatitis LIVER: Echogenic and coarse liver parenchyma without mass. Liver length 23 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10 cm in lengthOTHER: Left kidney 12.5 cm in length. Spleen 10 cm in length. No ascites | Hepatomegaly with echogenic and coarse liver parenchyma suggestive for chronic parenchymal liver dysfunction/fatty infiltration without mass or ductal dilatation. Unremarkable gallbladder. No ascites. |
Generate impression based on findings. | Epigastric pain with distended gallbladder and prominent biliary system on CT LIVER: No significant abnormalities noted. Liver length 15.1 cmGALLBLADDER, BILIARY TRACT: Diffusely thickened gallbladder wall with positive Murphy's sign. Mild prominence of extrahepatic bile duct with maximal diameter of 8 mm. No cholelithiasis.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.3 cm in lengthOTHER: Left kidney 12.1 cm in length. Spleen 9 cm in length. No ascites. | Abnormally diffuse thickening of gallbladder wall with positive Murphy's sign worrisome for acute acalculus cholecystitis. Mild prominence of extrahepatic bile duct; distal aspect of bile duct obscured by gas. No ascites. |
Generate impression based on findings. | Positive urine culture renal transplant RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Multiple cysts again noted. Transplant kidney 11.1 cm in length.COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedOTHER: No significant abnormality noted | Stable right iliac fossa renal transplant without evidence for perinephric fluid collection, hydronephrosis, or obvious acute inflammatory process. |
Generate impression based on findings. | 41 year old female who was recalled from screening mammogram for left breast asymmetry. No family history of breast cancer. ML and laterally exaggerated CC views, as well as five 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 persistent mass in the upper outer left breast. This is felt more likely to represent a lymph node. ULTRASOUND: On physical examination, no palpable abnormality is identified.Targeted ultrasound of the left breast was performed for the mammographic area of concern. At the 2:00 position of the left breast, 12 cm from the nipple, there is a circumscribed, hypoechoic mass measuring 0.4 x 0.6 cm with suggestion of a fatty hilum with vascularity, suggesting a benign intramammary lymph node. | Hypoechoic mass a the 2:00 position of the left breast, likely representing a benign appearing intramammary lymph node. Follow up left breast mammogram, and possible ultrasound, in 6 months to assess stability.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 34 year old female with history of hepatitis B. Evaluate for HCC. LIVER: The liver parenchyma is coarse, similar to prior. The liver is 14.3 cm in length. Punctate, 3-mm hyperechoic focus which is likely a benign granuloma, however this area may be given special attention on subsequent screening utrasound as occasional HCC may contain large amounts of fat and be similarly hyperechoic.BILIARY TRACT: The gallbladder appears normal, and there is no gallbladder wall thickening, pericholecystic fluid, or cholelithiasis. No intrahepatic or extrahepatic biliary duct dilation. The common bile duct measures 0.2 cm.PANCREAS: Pancreas is partially visualized, and is normal in appearance.KIDNEYS: The right kidney measures 10.5 cm in length, and has normal parenchymal echogenicity. No shadowing calculi are present.The left kidney measures 10 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present.SPLEEN: The spleen measures 9 cm. | Coarse hepatic parenchyma echotexture, similar to prior. Punctate, 3-mm hyperechoic focus which is likely a benign granuloma, however this area may be given special attention on subsequent screening utrasound -- see above discussion. |
Generate impression based on findings. | 36 year old female at 22 weeks gestation presents for right breast ultrasound. Patient states she had warm, erythematous, and extremely tender right breast two weeks ago, which has somewhat resolved with warm compresses. Physician palpated right breast nodule. On physical examination, there is diffuse nodular pattern of glandular tissue appreciated, compatible with the patients gravid state. No discrete palpable mass is identified.A targeted right ultrasound was performed for the patient’s area of concern. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. If the patients physical examination remains normal, she should return for annual screening mammograms, beginning at age 40. Result and recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 35-year-old pregnant female presents for right axillary ultrasound following physical examination where her physician noted a palpable area. A targeted right axillary ultrasound was performed for the patient’s area of concern. There is no suspicious solid or cystic mass identified. A normal appearing right axillary lymph node is present measuring 1.8 x 0.8 cmm, with normal hilar vascularity. | No sonographic evidence for malignancy. Normal morphology right axillary lymph node. Clinical follow up is recommended to ensure that this result is concordant with physical exam. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female 66 years old Reason: 66 F with left gluteal cellulitis s/p bedside I\T\D; please ultrasound left buttock and hip for possible fluid collection History: please ultrasound left buttock and hip for possible residual fluid collection Soft tissues adequately visualized no evidence of any loculated fluid collections. | No fluid collections to suggest abscess. |
Generate impression based on findings. | 60 year old female who was recalled from screening mammogram for left breast calcifications. No family history of breast cancer. MAMMOGRAM: An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. There is redemonstration of a developing cluster of calcifications in the upper outer left breast, which appear pleomorphic on spot magnifications views. There is questionable asymmetry associated with these calcifications. ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. Within the upper outer quadrant of the left breast, there is no solid or cystic mass. | Cluster of pleomorphic calcifications within the upper outer left breast. Stereotactic guided left breast biopsy is recommended. Result and recommendations were discussed with the patient, and all of her questions were answered.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Female 60 years old Reason: Palpable approximately 1 x 1 cm vertically oriented firm lesion in the left anterior cervical chain. ? Lymph node. Please evaluate. History: As above Probable nodule is identified is an elliptical hypoechoic solid area consistent with a lymph node measuring 1.7 x 0.3 cm by 0.6-cm. Homogeneous texture. Fatty hilum not clearly identified. Mild vascularity and color Doppler imaging. | Based on shape likely benign superficial lymph node corresponds to the palpable abnormality. |
Generate impression based on findings. | Male 44 years old Reason: left upper thigh lesion, c/w lipoma, large, over 6 cm, enlarging causing discomfort. History: as above Ultrasound shows echogenic material only suggestive of possible lipoma. There are no fluid density areas. The tissue is relatively hypovascular color Doppler imaging. If clinically indicated, lipoma could be confirmed with CT or MR. | Palpable abnormality is solid echogenic material. |
Generate impression based on findings. | 46 year old female who was recalled from screening mammogram for bilateral breast masses. No family history of breast cancer. MAMMOGRAM: An ML view and 3 spot compression views of the right breast, and An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. There is redemonstration of a subcentimeter mass within the upper central right breast, which persists on spot compression imaging. Additionally, there is redemonstration of a subcentimeter mass in the upper outer left breast, which partially disperses on spot compression imaging. ULTRASOUND: Targeted right ultrasound was performed for the mammographic area of concern. At the 12 o'clock position of the right breast, 14 cm from the nipple there is a circumscribed hypoechoic mass with parallel orientation measuring 0.6 x 0.1 x 0.1 cm. A second 0.1 x 0.2 x 0.4 cm is noted adjacent to this. These likely represent simple cysts and account for findings on mammogram.Targeted left ultrasound was performed of the mammographic area of concern. Within the upper outer quadrant of the left breast, no solid or cystic mass is identified. Findings on mammogram likely represent superimposed glandular tissue. | 1. High-probability benign right breast lesions most likely cysts, accounting for findings on mammogram. Six month follow-up right unilateral mammogram and possible ultrasound are recommended to assess stability.2. Partial dispersement of the left breast findings, with no sonographic correlate. The mammographic finding likely represents superimposition of normal glandular tissue. BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 55-year-old female with known right breast malignancy and bilateral axillary lymphadenopathy currently undergoing neoadjuvant chemotherapy. Evaluate treatment response. Family history of ovarian carcinoma in her sister at age 45 and cervical cancer in her daughter and maternal niece. A targeted right ultrasound was performed for the areas of concern. At the 11 o'clock position of the right breast, 3 cm from the nipple there is an irregular hypoechoic mass measuring 2.1 x 1.2 x 3.2 cm (previously 4.0 x 3.6 x 3.4 cm). Mild peripheral vascularity is appreciated.At the 7 o'clock position of the right breast, 2 cm from the nipple, there is a 2.1 x 1.0 x 2.9 cm irregular hypoechoic mass with mild peripheral vascularity (previously 3.7 x 2.5 x 3.6 cm).Targeted ultrasound of the right axilla was performed, without evidence for adenopathy. The previously identified abnormal lymph nodes are not visualized on today's examination.A targeted left axillary ultrasound was performed for the area of concern. Two prominent lymph nodes are present in the left axilla, both demonstrating a hyperechoic appearance, and decreased in size from prior examination suggesting treatment response. The largest lymph node measures 1.9 x 1.0 x 1.7 cm. The second lymph node measures 1.9 x 0.9 x 0.8 cm. No submitted vascularity is associated with either lymph node. | 1. Decrease in size of two right breast masses, as above. 2. Nonvisualization of previously identified right axillary lymph nodes, suggesting response to therapy.3. Decrease in size of left axillary lymph nodes with treatment response. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 82-year-old male with history of right upper back soft tissue swelling/mass which he first noticed approximately 3 weeks ago. No pain, no limited range of motion, no fevers, no redness or any other complaints. Physical exam reveals a fluctuant, nontender soft and relatively mobile approximately 6 to 8-cm wide area of masslike swelling in the right upper back just deep to the skin surface. No overlying redness or crepitus.Ultrasound shows a large, approximately 5-10 cm structure within the subcutaneous soft tissues between the skin and the chest wall. It appears separate from the underlying ribs and chest wall, and has a clearly defined interface with the adjacent soft tissues. The structure contains relatively homogeneously isoechoic material that causes dirty shadowing and partially obscures its posterior extent. Although the relatively high acoustic impedance of this structures internal contents limits evaluation, we favor a benign etiology such as epidermoid inclusion cyst. | Findings suggestive of benign etiology, such as a large epidermoid inclusion cyst. |
Generate impression based on findings. | Abdominal pain with leukocytosis LIVER: No significant abnormalities noted. 14.2 cm in lengthGALLBLADDER, BILIARY TRACT: Cholelithiasis with mild gallbladder wall thickening. No pericholecystic fluid. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. 8.6 cm in lengthOTHER: No ascites | Cholelithiasis with mild gallbladder wall thickening. No ductal dilatation. No strong evidence to suggest acute cholecystitis; however chronic inflammation of the gallbladder cannot be excluded.Echogenic right renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without worrisome mass or stone. Minimal hydronephrosis. Right kidney 10.3 cm in length.LEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. Left kidney 10 centimeters in length.OTHER: Bladder nondistended. Moderate ascites. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass or stone. Minimal right hydronephrosis. Moderate ascites |
Generate impression based on findings. | 68-year-old female with bilateral palpable areas of concern. Areas of concern are marked by Dr. Jaskowiak. A targeted right ultrasound was performed for the palpable area of concern, as marked. At the approximate 10 o'clock position of the right areolar border, there is a lobulated, heterogeneous mass measuring 1.3 x 0.9 x 1.0 cm. There is mild posterior acoustic shadowing with minimal peripheral vascularity appreciated.A targeted left ultrasound was performed for the palpable area of concern, as marked. At the approximate 3 o'clock position of the left areolar border, there is an ill-defined, heterogeneous lesion measuring 1.2 x 0.4 x 0.8 cm with mild posterior acoustic shadowing. Mild peripheral vascularity is present. | 1. Lobulated, heterogeneous mass at the area of palpable concern at the 10 o'clock position of the right retroareolar breast. Differential considerations include fat necrosis and malignancy. Fine needle aspiration is recommended.2. Heterogeneous mass at the 3 o'clock position of the left retroareolar breast, which demonstrates similar sonographic characteristics to the right breast lesion.Results and recommendations were discussed with the patient and Dr. Jaskowiak. The patient will be scheduled for ultrasound guided FNA.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 26 year old female with history of recurrent anorexia, nausea vomiting, evaluate for cholecystitis or cholelithiasis. LIVER: No biliary dilatation, abnormal hepatic parenchyma echogenicity or other significant abnormality. The liver is 12 cm in length.BILIARY TRACT: The gallbladder is relatively collapsed, and the gallbladder wall measures 2 mm. No pericholecystic fluid or other findings of cholecystitis. Small amount of gallbladder sludge is noted. No biliary dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 8 cm in length, without significant abnormality.RIGHT KIDNEY: The right kidney measures 10.2 cm, and is within normal limits. OTHER: The left kidney is within normal limits, and measures 10.1 cm. | No evidence of cholecystitis or choledocholithiasis. Small amount of sludge within a contracted gallbladder. |
Generate impression based on findings. | 41-year-old male with history a right upper quadrant abdominal pain. Nausea after eating. LIVER: The liver parenchyma is within normal limits, and the liver measures 15.6 cm in length. No intrahepatic biliary dilatation.BILIARY TRACT: No biliary dilatation, gallbladder wall thickening or pericholecystic fluid. Small gallstones are seen in the gallbladder neck, however they do not appear impacted since the gallbladder is not excessively distended.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted, and the spleen measures 11.5 cm.RIGHT KIDNEY: No significant abnormalities noted, and the right kidney measures 11 cm. OTHER: No significant abnormalities noted, and the left kidney measures 11 cm. | Cholelithiasis, without findings of cholecystitis or other significant abnormality. |
Generate impression based on findings. | Recurrent papillary thyroid carcinoma status post resection RIGHT LOBE: Status post thyroidectomy. Interval resection of recurrent focus. No worrisome lesion appreciated.LEFT LOBE: Status-post thyroidectomy. Interval resection of recurrent focus. No worrisome lesion appreciated.ISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post resection of bilateral recurrent tumor foci. No worrisome lesion appreciated. No regional adenopathy. |
Generate impression based on findings. | 67 year old female with history of acute renal failure. Evaluate right upper quadrant due to elevated bilirubin, and for renal obstruction. LIVER: The liver has a subtly nodular contour, and measures 15.5 cm in length. Heterogeneous echogenicity, suggestive of cirrhosis. Moderate amount of abdominal and pleural fluid.GALLBLADDER, BILIARY TRACT: No biliary dilatation, or other significant abnormality. History of cholecystectomy.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. The spleen measures 13.5 cm.KIDNEYS: No hydronephrosis or hydroureter, and no additional significant abnormality noted. The right kidney measures 13 cm, the left kidney measures 12.5 cm.ABDOMINAL AORTA: The abdominal aorta measures 2.4 cm in widest dimension.INFERIOR VENA CAVA: The IVC is not well visualized.OTHER: No significant abnormality noted. | Abdominal ascites and pleural effusions as above, without findings of biliary dilatation, or renal obstruction. Imaging findings suggestive of cirrhosis. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Unremarkable echogenicity for age. No worrisome mass, stone, or hydronephrosis. Minimally complex cysts. Right kidney 12.6 cm in lengthLEFT KIDNEY: Unremarkable echogenicity for age. No worrisome mass, stone, or hydronephrosis. Minimally complex cysts. Left kidney 11.3 cm in lengthOTHER: Enlarged prostate. Bladder nondistended. | No evidence for worrisome renal mass, stone, or obstruction. |
Generate impression based on findings. | Right upper quadrant pain 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. 10.3 cm in lengthOTHER: Left kidney 10.4 cm in length. Spleen 9.3 cm in length. No ascites | Negative right upper quadrant ultrasound. No hepatobiliary abnormality. |
Generate impression based on findings. | History left AML and renal cysts RIGHT KIDNEY: Unremarkable echogenicity. No worrisome mass, stone, or hydronephrosis. Multiple right renal cysts. The largest cyst located within the upper pole measures 3.9 x 5 cm. Right kidney 11.2 cm in length.LEFT KIDNEY: Unremarkable echogenicity. No worrisome mass, stone, or hydronephrosis. Inferior pole cyst measures 1.8 x 1.7 cm. Left kidney 10.3 cm in length.OTHER: Bladder nondistended | Bilateral benign-appearing renal cysts. No worrisome mass, stone, or obstruction. AML not identified. |
Generate impression based on findings. | Bilateral renal masses RIGHT KIDNEY: Right midpole hypoechoic lesion unchanged measuring 2.1 x 1.7 x 1.8 cm. Other subcentimeter lesions also stable. No stone or hydronephrosis. Right kidney 12.6 in meters in length.LEFT KIDNEY: Left renal lesions seen on the recent CT are not visible on today's ultrasound. No hydronephrosis. Left kidney 12.2 cm in length.OTHER: Bladder nondistended | Stable right midpole hypercholic renal lesion. Other right subcentimeter lesions also stable. Left renal lesions seen on the recent CT cannot be visualized on today's ultrasound. |
Generate impression based on findings. | 43 year old female who was recalled from screening mammogram for 17 mm focal asymmetry in the right breast 12 o'clock position . 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. The focal asymmetry in question most likely represents glandular tissue on spot compression views Ultrasound: Targeted right breast upper outer quadrant ultrasound was performed. Normal glandular tissue noted on ultrasound. No suspicious cystic or solid mass seen. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 44-year-old female bilateral axillary adenopathy and history of systemic lupus erythematosus. Please evaluate for stability. A targeted right axillary ultrasound was performed. Multiple enlarged lymph nodes with symmetric cortical thickening are visualized. The largest lymph node measures 2.1 x 1.2 x 3.7 cm and demonstrates normal hilar vascularity.Retarded left axillar ultrasound was performed. Again, multiple enlarged lymph nodes with symmetric cortical thickening are visualized. The largest lymph node measures 2.5 x 1.0 x 3 .8 cm, and demonstrates normal hilar vascularity. | Bilateral symmetric axillary adenopathy, compatible with the patient's history of lupus.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 25-year-old female with a painful palpable mass in the right breast near the areola presents for right breast ultrasound A targeted right breast ultrasound was performed for the palpable area of concern. On physical examination, a 1 cm palpable, tender mass is noted at the 9 o'clock position of the right areola. Patient indicates interval increase in size of the mass in last 10 days. Ultrasound demonstrates a complex cystic mass with internal echoes and increased blood flow measuring 2.3 x 1.2 by 1.6 cm most likely representing an abscess. | Palpable mass right breast 9 o'clock position most likely corresponds to an abscess. Findings conveyed to Donna Christian, Dr. Chhablani's nurse at the time of the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 60 year-old female complaining of right-sided pain and mass which has increased in size. History of prior fine needle aspiration of the right breast mass with findings of fat necrosis. A targeted right ultrasound was performed for the patient’s area of concern, as marked by Dr. Chhablani. Vague hypoechoic areas with internal hyperechogenicity are present throughout the upper central and outer right breast, compatible with fat necrosis. There is no solid or cystic mass is identified. | Vague areas of mixed echogenicity in the area of concern within the right breast, compatible with fat necrosis. No sonographic evidence for malignancy. Findings are discussed with Dr. Chhablani at the time of the examination. Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 45-year-old female with known right breast mass, and clinical palpable findings within the right retroareolar region and right axilla presents for ultrasound examination. A targeted right ultrasound was performed for the palpable areas of concern. At the area of palpable concern at the 12 o'clock position of the right areolar border, there is a circumscribed anechoic cyst measuring 1.1 x 0.6 x 1.3 cm.Within the right axilla, for normal morphology lymph nodes are present in with normal fatty hila. The largest lymph node identified measures 1.2 cm and demonstrates thin cortex with normal fatty hilum and vascularity. | 1. Simple cyst at the 12 o'clock position of the right breast, corresponding to area of palpable concern. 2. Normal right axillary lymph nodes.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 63-year-old female patient with right breast asymmetry on screening mammogram. History of two benign left breast biopsies in 2002 and 2003. Family history of breast cancer in paternal aunt diagnosed at unknown age. RIGHT DIAGNOSTIC MAMMOGRAM: An ML view and 3 spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. A 6-mm oval mass in the right lower inner breast persists on spot compression views.RIGHT BREAST ULTRASOUND: Targeted right breast ultrasound was performed. In the 5 o'clock position of the right breast 1 cm with from the nipple there is a septated cyst that measures 5 x 2 x 5 mm. | 5 mm benign morphology mass in the right breast possibly corresponding to a benign septated cyst on ultrasound. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 35 year old female with a history of mild transaminitis and concern for NASH. LIVER: The liver parenchyma is coarsened and increased in echogenicity. Normal hepatic contour and morphology. Increased echogenicity limits evaluation for a small focal lesion. Given this limitation, no focal hepatic lesion is evident. The liver is normal in size, measuring 20 cm in craniocaudal dimension. There is no intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm. There are small layering gallstones without wall thickening, pericholecystic fluid, or focal tenderness.PANCREAS: The visualized portions of the pancreatic body and head are normal.RIGHT KIDNEY: The right kidney measures 13.3 cm in length without hydronephrosis, shadowing nephrolithiasis, or focal lesion evident.OTHER: The left kidney is normal in size, measuring 13.2 cm without hydronephrosis or focal lesion evident. There is an approximately 8mm collecting system shadowing calculus. The spleen is normal in size, measuring 11.4 cm. | 1. Coarsened and increased hepatic echogenicity compatible with diffuse fatty infiltration/NASH. No focal hepatic lesion is identified.2. Cholelithiasis without evidence of acute cholecystitis. 3. Nonobstructive left renal collecting system 8-mm calculus. |
Generate impression based on findings. | 59-year-old male with a history of hepatitis C presenting for HCC screening. LIVER: The liver capsule is relatively smooth. The parenchyma is coarse in echotexture. No focal hepatic lesion or intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 30 cm/sec.GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 2 mm at the pancreatic head. Normally distended gallbladder without wall thickening, pericholecystic fluid, or focal tenderness. Cholelithiasis. 6-mm gallbladder polyp.PANCREAS: The visualized pancreatic body and head are normal in appearance.RIGHT KIDNEY: The right kidney is normal in size, measuring 11.5 cm without hydronephrosis or shadowing nephrolithiasis. There is a 10 mm inferior pole probable cyst.OTHER: The spleen is normal in size, measuring 10.5 cm. The left kidney is normal in size, measuring 12.3 cm, without hydronephrosis, shadowing nephrolithiasis, or discrete lesion evident. | 1. Coarse hepatic echotexture compatible with parenchymal disease without a focal lesion identified.2. Cholelithiasis without evidence of acute cholecystitis.3. 6-mm gallbladder polyp. |
Generate impression based on findings. | 36-year-old female with right flank/upper quadrant pain. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Post cholecystectomy. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY:Known right staghorn calculus incompletely visualized. 2.2-cm cystic lesion in the upper pole of the right kidney. Complexity is difficult to evaluate.OTHER: No significant abnormalities noted. | No biliary tract abnormality.Shadowing staghorn calculus right kidney. Cystic lesion upper pole right kidney incompletely characterized. |
Generate impression based on findings. | 53-year-old male with a history of altered mental status and elevated bilirubin. LIVER: The liver echotexture is mildly coarsened. No focal hepatic lesion or biliary ductal dilatation. Normal hepatic size, measuring 18.8 cm in craniocaudal dimension. Perihepatic ascites. Pulsatile normally oriented portal venous blood flow up to 40 cm/sec. BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 4 mm. The gallbladder appears contracted and full of shadowing gallstones and sludge. No pericholecystic fluid. Evaluation for focal tenderness is limited by the patient's mental status.PANCREAS: Limited evaluation of the pancreatic head is unremarkable.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.9 cm in length without hydronephrosis, shadowing nephrolithiasis or focal lesion identified. OTHER: The spleen is normal in size measure 11.4 cm. It is partially obscured. The left kidney is partially obscured, measuring 10.2 cm without gross hydronephrosis.The urinary bladder is collapsed with a Foley. Pelvic ascites. Bilateral pleural effusions. | 1. The gallbladder appears partially contracted with gallstones/sludge. No significant gallbladder wall thickening or pericholecystic fluid to suggest acute inflammation. Evaluation for focal tenderness is limited by the patient's mental state. 2. Pulsatile portal venous blood flow is unchanged.3. Ascites and pleural effusions. |
Generate impression based on findings. | 58-year-old male with a history of cirrhosis presents for HCC screening. LIVER: The liver is nodular in contour and coarse in echogenicity. The liver measures 14 cm in craniocaudal dimension. There is a new 2 cm hypoechoic well-defined mass in the left hepatic lobe. GALLBLADDER, BILIARY TRACT: Partially contracted gallbladder without wall thickening, pericholecystic fluid, gallstones or focal tenderness. No intrahepatic biliary ductal dilatation. No extra-hepatic biliary ductal dilatation with the common duct measuring 2 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.5 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident.OTHER: Splenomegaly, measuring 15.8 cm. The left kidney measures 11.3 cm without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. 1.3-cm simple appearing cyst. | New 2 cm hypoechoic mass is suspicious for HCC. Further characterization with a dedicated liver MRI is recommended. These findings were discussed with the ordering physician Dr. Shah at 1530 on 05/01/2015. |
Generate impression based on findings. | 14-year-old female patient with history of fibroadenoma removal of the left breast presents with bilateral irregular breast tissue and pain. A targeted bilateral breast ultrasound was performed for the patient’s area of concern. Normal appearing dense breast tissue was seen in the right breast at the 10 and 9 o'clock positions as well as in the left breast at the 2 o'clock position. There is no solid or cystic mass identified. | Normal appearing dense breast tissue in the area of patient's pain in right breast 9 and position and left breast two o'clock position. Recommend continued clinical management.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 61-year-old female with alcoholic cirrhosis. The noted for hepatocellular carcinoma. Known liver lesion. LIVER: Liver is coarsely echogenic and normal in size. In the left lobe there is a hypoechoic 1.5 x 1.7 x 1.9 cm rounded mass. Although the mass measures larger than on the prior exam, is better seen on today's study and is unchanged from prior ultrasounds. No new hepatic abnormality.Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Shadowing in the dependent gallstones within the gallbladder without complication. The biliary tract is normal in caliber. PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Trace ascites. | Stable liver mass. Trace ascites. |
Generate impression based on findings. | 59 year-old female with hepatitis C virus. Evaluate for cirrhosis. LIVER: Liver is moderately and coarsely echogenic. The liver capsule is mildly undulating and there is enlargement of the left lobe suggestive of cirrhosis. There is no focal hepatic mass seen. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: Upper normal in size.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Echogenic liver with suggestion of cirrhotic morphology. No discrete mass. |
Generate impression based on findings. | 72-year-old male with hyperparathyroidism. Evaluate for stones. RIGHT KIDNEY: The right kidney measures 12.9 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident.LEFT KIDNEY: The left kidney measures 12.5 cm without hydronephrosis, shadowing nephrolithiasis, or discrete lesion evident.OTHER: No significant abnormalities noted. | No hydronephrosis. |
Generate impression based on findings. | 65-year-old male with acute on chronic pancreatitis and abdominal pain. Evaluate for gallstones. LIVER: Mildly echogenic without focal abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder contains deep tendon sludge, but no shadowing gallstones or wall thickening. There is no pericholecystic fluid.PANCREAS: Pancreatic substance is poorly visualized. Multiple large complex cystic masses are identified in the abdomen consistent with pseudocystsRIGHT KIDNEY: No significant abnormalities noted.OTHER: Trace ascites | Gallbladder sludge without stones.Pseudocysts.Trace ascites. |
Generate impression based on findings. | 50 year-old female with right upper quadrant pain. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: The gallbladder contains likely two small non-dependent and non-shadowing echogenic foci measuring 4 -- 5 mm in diameter arising from the wall. The gallbladder is otherwise normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Small gallbladder polyps. No other abnormality identified. |
Generate impression based on findings. | 54-year-old male with history of kidney stones. RIGHT KIDNEY: The right kidney measures 12.2 cm in length. Normal parenchymal echogenicity. No evidence of renal stone, hydronephrosis, or renal mass.LEFT KIDNEY: The left kidney measures 12.9 cm in length. Normal parenchymal echogenicity. A 1.3 x 1.0 cm stone is identified in the lower pole, similar to that seen on previous CT. No evidence of hydronephrosis or renal mass.OTHER: Hyperechoic, coarse liver echotexture suggestive of hepatic steatosis. | 1.Nonobstructing 1.3 cm left inferior pole renal stone.2.Hepatic steatosis. |
Generate impression based on findings. | 56-year-old male with AKI. RIGHT KIDNEY: The right kidney measures 11.4 cm in length. Mild parenchymal hyperechogenicity. No evidence of renal stone, mass, or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.6 cm in length. Mild parenchymal hyperechogenicity. No evidence of renal stone, mass, or hydronephrosis.OTHER: Foley catheter in the bladder. Bladder is decompressed, limiting evaluation. Splenule. | Mild bilateral parenchymal hyperechogenicity suggestive of medical renal disease. No hydronephrosis. |
Generate impression based on findings. | 66-year-old male with elevated creatinine. RIGHT KIDNEY: The right kidney measures 10.4 cm in length. Mild parenchymal hyperechogenicity. No evidence of renal stone, mass, or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.0 cm in length. Mild parenchymal hyperechogenicity. No evidence of renal stone, mass, or hydronephrosis.OTHER: Bladder decompressed, limiting evaluation. | Normal exam. |
Generate impression based on findings. | 2-year-old male with history of bilateral hydronephrosis and bladder wall thickening. Status post valve resection. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Within normal limitsKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 1 Left: 1 Length*** Right: 7.6 cm Left: 7 cm Mean for age: 7 cm Range for age: 6 - 8 cmADDITIONAL OBSERVATIONS: None | Grade 1 pelvic caliectasis bilaterally, without additional abnormality.*SFU grading system: Grade 0: No hydronephrosis.: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | 36-year-old 20 week pregnant female presents for follow-up of left breast finding from outside institution. History of left lumpectomy in February 20, 2014. Per the patient this was done for premalignant findings. A targeted left ultrasound was performed for the patient’s area of concern. In the upper outer quadrant of the left breast, there is no solid or cystic mass identified. | Comparison with prior examinations is necessary for complete evaluation. Results and recommendations were discussed with the patient.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison. |
Generate impression based on findings. | 28-year-old female with palpable mass right breast underwent ultrasound-guided core biopsy with benign results. As per outside hospital report, these results were discordant. Patient presents for a right breast repeat ultrasound. A targeted right ultrasound was performed for the palpable area of concern. Hypoechoic area with a clip surrounding it identified in the right breast 9:00 position corresponding to the palpable abnormality measuring 1 x 0.7 mm. No peripheral blood flow identified. This area was biopsied, targeting appears adequate and clip is in appropriate location. Outside Hospital pathology reveals benign etiology which is concordant with imaging. | Palpable abnormality right breast 9:00 position postbiopsy, pathology revealed benign results. This is concordant. Follow-up right breast ultrasound can be performed in 6 months to confirm stability.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 53 year old female who was recalled from screening mammogram for 2 focal asymmetries in the left upper-outer quadrant. Mammogram: An ML view and four 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. Total of 3 subcentimeter asymmetries are noted in the anterior, mid and posterior depth in the lateral left breast. All 3 symmetries have benign morphology and a definite correlate is identified to the most anterior asymmetry. Ultrasound: Clustered cyst in the left breast 12:00 position measures 6 x 3 mm most likely corresponding to the anterior-most focal asymmetry. The other 2 mid and posterior depth asymmetries do not have an ultrasound correlate. | Clustered cyst identified in the left breast 12:00 position corresponding to the anterior most focal asymmetry. Benign morphology asymmetries in the lateral left breast without sonographic correlate for which six-month follow-up left unilateral diagnostic mammogram is recommended. No mammographic evidence of malignancy. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | History of palpable left breast mass. A targeted left ultrasound was performed for the patient’s area of concern. There is no solid or cystic mass identified. Normal breast tissue is seen superficial to her implant. | No sonographic evidence for malignancy. Clinical follow up with a breast surgeon is suggested to ensure that physical exam findings are concordant with negative imaging.BIRADS: 1 - Negative.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 26 -year-old female. History of benign breast biopsy 2006 for a fibroadenoma and resection of multiple fibroadenomas in her right breast. Has pain in the lateral aspect of her right breast, currently breastfeeding. Targeted ultrasound of the patient's area of pain in the right lateral breast was performed. No suspicious underlying mass was identified. Two adjacent small cysts, the larger of which measured 9 x 3 mm, was seen at the 6 o'clock position. | Targeted ultrasound of the right breast at patient's site of pain showed no suspicious mass or other significant abnormality. Incidental note of benign simple cysts at the 6 o'clock position. Patient may follow-up with her clinician for management of her pain.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Cirrhosis of liver LIVER: Heterogeneous and coarse echotexture unchanged. No worrisome mass. Stable benign-appearing subcentimeter cyst. Liver length 17.9 cmGALLBLADDER, BILIARY TRACT: Stable adenomyomatosis.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.6 cm in lengthOTHER: Minimal prominence of left renal collecting system. Spleen 7.6 cm in length. No ascites. | Stable heterogeneous and coarse liver echotexture without worrisome mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Testicular pain RIGHT TESTIS: 5.2 x 3.3 x 2.3 cm. No intratesticular mass.LEFT TESTIS: 4.4 x 3.6 x 2.5 cm. No intratesticular massRIGHT EPIDIDYMIS: Benign-appearing epididymal head cystLEFT EPIDIDYMIS: Enlarged left epididymis with slight increase in vascularity.OTHER: Moderate size left varicocele. Doppler interrogation demonstrates bilaterally symmetric testicular flow. | Enlarged left epididymis with slight increase in vascularity raises the possibility of epididymitis. No evidence of abscess or testicular involvement. Moderate-sized left varicocele. |
Generate impression based on findings. | Renal stone RIGHT KIDNEY: Normal parenchymal echogenicity. No worrisome mass or hydronephrosis. Stable subcentimeter stone measuring 0.8 x 0.9 x 0.5 cm. Right kidney 15.2 cm. in lengthLEFT KIDNEY: AbsentOTHER: Bladder nondistended | Stable nonobstructing subcentimeter right renal stone. |
Generate impression based on findings. | Epigastric pain LIVER: No significant abnormalities noted. Liver length 14.4 cmBILIARY TRACT: Cholelithiasis without acute inflammation or duct dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.5 cm in lengthRIGHT KIDNEY: Nonobstructing subcentimeter renal stone. Right kidney 8.2 cm in length OTHER: Nonobstructing subcentimeter left renal stone. Left renal cyst. Left kidney 8.9 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. Bilateral nonobstructing subcentimeter renal stones. No ascites. |
Generate impression based on findings. | Elevated liver enzymes LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 13.7 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.3 cm in lengthRIGHT KIDNEY: Absent OTHER: Echogenic left renal parenchyma with multiple cysts. Left kidney 12.1 cm in length. No hydronephrosis. No ascites. | Mildly heterogeneous liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. No ascites. Echogenic left renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without evidence for obstruction. |
Generate impression based on findings. | Leukocytosis with positive urinalysis RIGHT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. Right kidney 12.7 cm in length.LEFT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. 13.6 cm in length.OTHER: Foley within a collapsed bladder. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | Primary biliary cirrhosis LIVER: Coarse heterogeneous liver echotexture unchanged without mass. Liver length 16.4 cmBILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation. Stable subcentimeter gallbladder polyp measuring 0.5 x 0.4 x 0.4 cm.PANCREAS: No significant abnormalities noted.SPLEEN: Mild splenomegaly; spleen length 15.1 cmRIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 10.3 cm in length. No ascites. | Stable coarse heterogeneous liver echotexture without mass or ductal dilatation. Gallbladder sludge without acute inflammation. Stable subcentimeter gallbladder polyp. No ascites. |
Generate impression based on findings. | 7-year-old female with history of solitary right kidney and hydronephrosis BLADDER Wall Thickness: The bladder is incompletely distended, but appears upper limits of normal in thickness. Contents: Incompletely distended. Distal Ureter -- SFU Grade** Right: 0 Ureteral Jets Right: Not observed KIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Corticomedullary differentiation is normal in all but the posterolateral right lower pole Pelvicaliceal System -- SFU Grade* Right: 1 Length*** Right: 7.6 cm Mean for age: 8 cm Range for age: 7 - 9 cmADDITIONAL OBSERVATIONS: None | Solitary right kidney with grade 1 dilation. Persistent focal cystic dysplasia or segmental multicystic dysplasia in the lower pole.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | Right lower quadrant abdominal pain LIVER: Coarse echogenic liver echotexture without mass. Liver length 13.5 cmBILIARY TRACT: 0.3 x 0.3 x 0.2 cm subcentimeter gallbladder polyp. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11 cm in lengthRIGHT KIDNEY: Right renal cyst. Right kidney 10.5 cm in lengthOTHER: Left kidney 9.5 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Subcentimeter gallbladder polyp. No ascites. |
Generate impression based on findings. | RIGHT KIDNEY: Normal parenchymal echogenicity. No worrisome mass or hydronephrosis. Stable subcentimeter stone measuring subcentimeter stone measuring 0.8 x 0.9 x 0.5 cm. Right kidney 15.2 cm. in lengthLEFT KIDNEY: AbsentOTHER: Bladder nondistended | Stable nonobstructing subcentimeter right renal stone. |
Generate impression based on findings. | Renal stone RIGHT KIDNEY: Normal parenchymal echogenicity. No worrisome mass or hydronephrosis. Stable subcentimeter stone measuring subcentimeter stone measuring 0.8 x 0.9 x 0.5 cm. Right kidney 15.2 cm. in lengthLEFT KIDNEY: AbsentOTHER: Bladder nondistended | Stable nonobstructing subcentimeter right renal stone. |
Generate impression based on findings. | 61-year-old male with right upper quadrant pain. LIVER: Liver 17 cm in length. No focal hepatic lesions. No intrahepatic biliary ductal dilation. Main portal vein is patent with normal directional flow and peak systolic velocity of 0.3 m/s.GALLBLADDER, BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening or pericholecystic fluid. Negative sonographic Murphy's sign. Normal caliber of the common duct measuring up to 4 mm.PANCREAS: No focal pancreatic lesions in the pancreatic head. The remainder of the pancreas is poorly visualized due to overlying bowel gas.RIGHT KIDNEY: Right kidney is 12.7 cm in length. Left kidney is 12.4 cm in length. Increased nonspecific cortical echogenicity of both kidneys. Moderate left hydronephrosis and bilateral perinephric free fluid, similar to CT from yesterday.OTHER: No significant abnormalities noted. | 1. No cholelithiasis or acute cholecystitis.2. Left hydronephrosis, similar to CT from yesterday.3. Increased nonspecific cortical echogenicity of both kidneys, which may be related to medical renal disease. |
Generate impression based on findings. | Abdominal pain LIVER: No significant abnormalities noted. Liver length is 18.1 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 13.5 cm in lengthOTHER: Left kidney 13.6 cm in length. Spleen 11.9 cm in length. No ascites. | Gallbladder sludge without acute inflammation or ductal dilatation. No ascites. |
Generate impression based on findings. | 69-year-old female. Call back from screening for a focal asymmetry in the left outer breast. MAMMOGRAM: A standard ML view and three 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. The previously noted focal asymmetry in the left upper outer breast became less conspicuous on the spot compression views. LEFT BREAST ULTRASOUND: Targeted ultrasound of the left upper outer quadrant showed a 5 x 3 x 3 mm cyst at 2:00 o'clock, 6 to 10 cm from the nipple. An additional smaller cyst is seen at 1 o'clock. | Small benign cysts in the left breast. No mammographic or sonographic evidence of malignancy. The 2:00 cyst explains the asymmetry for which the patient was recalled. As long as the patient's physical examination remains normal, patient may return to annual bilateral screening mammogram. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Elevated bilirubin LIVER: Mildly coarse and echogenic liver echotexture without mass. Liver length 17.8 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 13.1 cm in lengthOTHER: Left kidney 11.8 cm in length. Spleen 11.2 cm in length. No ascites. | Mildly coarse and echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Chronic hepatitis C LIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 19.7 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation again noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.6 cm in length.OTHER: Left kidney 11.8 cm in length. Spleen 12.2 cm in length. No ascites. | No change in fatty infiltration of liver/parenchymal dysfunction without mass or ductal dilatation. Stable cholelithiasis without acute inflammation. No ascites. |
Generate impression based on findings. | 50-year-old female. Recall from screening for a small mass in the right lower inner quadrant. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. The circumscribed small round mass in the lower inner quadrant of the right breast persisted on spot compression views.RIGHT BREAST ULTRASOUND: Targeted ultrasound of the right lower inner quadrant showed an anechoic 3 x 3 mm focus without internal vascularity in the retroareolar region at 5:00 o'clock, most likely a cyst and corresponding to the mass seen on mammography. | Small mass in the right lower inner quadrant on mammography most likely corresponds to a cyst. Ultrasound guided aspiration is recommended to confirm that it is a cyst. The results and recommendations were discussed with the patient at the completion of the exam, and the patient elected to schedule the ultrasound-guided aspiration.BIRADS: 3 - Probably benign finding.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: nodule on CT History: none RIGHT LOBE MEASUREMENTS: 5.9 x 1.7 x 1.7 cm.LEFT LOBE MEASUREMENTS: 4.9 x 1.9 x 1.5 cm.ISTHMUS MEASUREMENTS: 0.6 cm.RIGHT LOBE: In the inferior pole, there is a predominantly solid well-defined ovoid nodule measuring 0.9 x 0.5 x 0.9 cm, likely benign.LEFT LOBE: In the left lobe, there is a spongiform ovoid nodule measuring 1.2 x 0.8 x 1.0 cm.ISTHMUS: In the isthmus, there is a spongiform ovoid nodule measuring 1.2 x 0.8 x 1.0 cm, likely benign.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.OTHER: No significant abnormality noted. | Three likely benign thyroid nodules. |
Generate impression based on findings. | Abnormal LFTs LIVER: Mildly echogenic and heterogeneous liver echotexture without mass. Liver length 17.4 cm.GALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 8.2 cm in lengthOTHER: Left kidney 9.9 cm in length. Spleen 11.9 cm in length. No ascites | Mildly echogenic and heterogeneous liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Cholelithiasis without acute inflammation. No ascites. |
Generate impression based on findings. | Cirrhosis LIVER: Cirrhotic morphology without mass. Liver length is 13.8 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Nonobstructing subcentimeter renal stone. Right kidney 11.9 cm in length.OTHER: Left kidney 14.5 cm in length. Spleen 15.7 cm in length. No ascites. | Cirrhotic liver without mass or ductal dilatation. Mild splenomegaly. No ascites. Nonobstructing subcentimeter right renal stone. |
Generate impression based on findings. | Obstruction of bile duct, malignant neoplasm of the pancreas. Evaluate for jaundice On call after hours exam performed.LIVER: The liver measures 16.1 cm in length. No focal liver lesions. Presumed pneumobilia is noted making evaluation of the intrahepatic bile ducts somewhat limited. These appear to be mildly dilated. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: Gallbladder sludge and wall thickening. Patient did not have a sonographic Murphy sign. The common duct measured 5 mm in diameter; metal stent noted.PANCREAS: There is a mass in head of the pancreas measuring approximately 3.8 cm in diameter. Pancreatic duct appears dilated Correlation with cross-sectional imaging is advised.RIGHT KIDNEY: No hydronephrosis of either kidney.OTHER: Right pleural effusion. | Pancreatic mass with mild intrahepatic and pancreatic ductal dilatation. Correlation with CT or MRI is advised. Right pleural effusion. Gallbladder sludge. |
Subsets and Splits