instruction
stringclasses 1
value | input
stringlengths 15
6.12k
| output
stringlengths 3
2.67k
|
|---|---|---|
Generate impression based on medical findings. | Ms. Williams is a 19 year old female presenting with a palpable mass in the right breast. Per patient, she has felt it for the past one week. No history of trauma or pain. Upon physical exam at the patient's area of concern, a vague mobile nodular mass is appreciated. A targeted right breast ultrasound was performed for the palpable area of concern. In the right breast, 5:00 position, no suspicious cystic or solid was identified. Normal dense parenchymal breast tissue was identified. | No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted. All results and recommendations were relayed to the patient.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | Right upper quadrant pain LIVER: No significant abnormalities noted. Liver length 18.3 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.2 cm in lengthOTHER: Left kidney 10.2 cm in length. Spleen 8.2 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. |
Generate impression based on medical findings. | 68-year-old male with hepatitis C presenting for hepatocellular carcinoma screening. LIVER: The hepatic parenchyma is mildly coarse and the liver capsule is nodular consistent with cirrhosis. No focal lesion is identified. The liver measures 15 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common bile duct measures 6 mm in caliber, within normal limits. Status post cholecystectomy.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 11.7 cm.RIGHT KIDNEY: The right kidney measures 13.9 cm in length without hydronephrosis or shadowing calculus. There is a 1.4-cm hypoechoic lower pole lesion, characterized as a simple cyst on the prior MRI. Color Doppler demonstrates hilar blood flow.OTHER: Status post left nephrectomy. | Cirrhotic liver morphology without a discrete hepatic lesion. |
Generate impression based on medical findings. | 53-year-old female post islet cell transplant. Evaluate patency of the portal vein. LIVER: Liver is highly and heterogeneously echogenic as seen on the prior exam. There is again noted a wedge shaped area of increased echogenicity in the right lobe measuring approximately 1.1 x 3.2 x 2.3 cm, unchanged from the prior study. This may represent an area of scarring. Foci of shadowing and ring down artifact may be due to pneumobilia. Some of this was present on the prior exam. Please correlate with history. Limited color and spectral Doppler demonstrates patency and appropriate flow direction the main portal vein.BILIARY TRACT: Gallbladder contains small amount of sludge. No shadowing stones, wall thickening or pericholecystic fluid. Possible pneumobilia.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Patent main portal vein.Question pneumobilia within the liver which was present on prior exam.Stable wedged shaped focus of increased echogenicity in the right lobe of the liver. |
Generate impression based on medical findings. | 46-year-old female undergoing renal biopsy. Ultrasound guidance was provided for a renal biopsy by the nephrology service. 5 passes were made. A heterogeneous collection suspicious for postbiopsy hematoma is seen measuring approximately 5.1 x 5.6 x 1.6 cm. | 1. Ultrasound guidance was provided for a renal biopsy by the nephrology service. Correlate with procedural report regarding possible hematoma. |
Generate impression based on medical findings. | 62-year-old female presents with evaluation of thyroid nodule. RIGHT LOBE MEASUREMENTS: 2.1 x 1.8 x 4.9 cm.LEFT LOBE MEASUREMENTS: 2.2 x 2.0 x 5.2 cm.ISTHMUS MEASUREMENTS: 0.2 cm.RIGHT LOBE: Multiple benign-appearing nodules in the right thyroid the largest of which measures approximately 0.6 x 0.4 x 0.6 cm, appear unchanged since the prior exam.LEFT LOBE: A nodule measuring approximate 1.2 x 1.3 x 2.0 cm is "taller than it is wide". It has a mixed echogenicity. There are well-defined borders. It appears unchanged since the prior examination, though given this morphology would recommend biopsy.ISTHMUS: Benign-appearing nodule measuring approximately 1.3 x 0.8 x 1.1 cm, appears unchanged since the prior examination.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Suspicious nodule in the left thyroid. Recommend biopsy. |
Generate impression based on medical findings. | 65 year-old female with hepatitis C, assess for HCC. LIVER: Mildly echogenic measuring 15.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder is normal in echogenicity. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra-or extrahepatic ability ductal location.PANCREAS: Pancreas is not well seen due to overlying bowel gas.RIGHT KIDNEY: Measures 10.6 cm in length. There is mild pelvocaliectasis. No shadowing calculi are noted.OTHER: Left kidney measures 10.7 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 10.4 cm in length. | 1. Mildly echogenic liver parenchyma suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesion.2. Nonspecific right mild pelvocaliectasis. |
Generate impression based on medical findings. | 87-year-old female with thyroid nodule identified on outside imaging. RIGHT LOBE MEASUREMENTS: 5.3 x 1.8 x 2.2 cmLEFT LOBE MEASUREMENTS: 3.8 x 1.4 x 1.3 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: In the midportion of the right lobe of the thyroid there is a solid slightly hypoechoic nodule with small cystic components measuring 1.4 x 1.7 x 2.3 cm. In the inferior right lobe there is a well-defined slightly hypoechoic nodule with a full hypoechoic rim and no cystic component measuring 0.4 x 0.9 x 1.2 cm. LEFT LOBE: At the posterior aspect of lower pole of the left lobe there is a predominantly solid and isoechoic nodule with a focal hypoechoic rim measuring 0.8 x 1 x 1.3 cm. I believe this is more likely intrathyroidal been extrathyroidal in origin. There is also a small thyroid cysts with comet tail artifact consistent with colloid.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules as noted above. |
Generate impression based on medical findings. | Male 49 years old; Reason: assess for cirrhosis, h/o ETOH use and congestive heart failure History: weight loss, elevated LFTS LIVER: The liver measures 15.3 cm in length. There is coarse echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 3.1 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 4.3 mm in diameter. There are prominent vessels around the gallbladder which could be collaterals. This most likely does not represent cavernous transformation given the portal vein is patent.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 5.6 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.5 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted. | 1. Increased and coarse echotexture of liver consistent with chronic liver disease/parenchymal dysfunction. No masses. |
Generate impression based on medical findings. | 58-year-old female with acute kidney injury. RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No hydronephrosis. Increased parenchymal echogenicity. No shadowing calculi or suspicious masses.LEFT KIDNEY: The left kidney measures 9.6 cm in length. No hydronephrosis. Echogenic renal parenchyma. No shadowing calculi or suspicious masses.URINARY BLADDER: The urinary bladder is partially distended and shows no acute abnormality.OTHER: No significant abnormalities noted. | Echogenic renal parenchyma suggestive of chronic medical renal disease. No hydronephrosis. |
Generate impression based on medical findings. | 74-year-old female with thyroid mass and neck adenopathy and priorCT. RIGHT LOBE MEASUREMENTS: 4.1 x 1.8 x 1.6 cmLEFT LOBE MEASUREMENTS: 1.8 x 1.8 x 5.1 cmISTHMUS MEASUREMENTS: 0.2-cmRIGHT LOBE: Heterogeneous in echotexture. Cystic nodule with comet tail artifactconsistent with colloid measuring 0.5 x 0.5 x 0.5 cm. Very small, hypoechoic nodulespresent as well.LEFT LOBE: Heterogeneous in echo architecture. Spongiform appearing lower pole nodulemeasuring 0.8 x 0.7 x 1 cm likely with comet tail artifact consistent with colloid nodule.Posterior solid nodule with internal dense rim calcification measuring 1.4 x 1.3 x 2.3cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Abnormal lymph nodes identified in the left neck including a round cystic --appearing level 3 node measuring 0.5 x 0.5 x 0.7 cm a round solid 0. 5 x 0.5 x 0.8 cmlevel 3 node and a predominantly cystic level floor/supraclavicular cystic node measuring0.9 x 0.9 x 0.9 cm. OTHER: No significant abnormality noted. | Solid left thyroid nodule with smaller nodules most suggestive of colloidnodules.Necrotic -- appearing left neck lymph nodes.US GUIDED FNA; 3/6/2015 12:46 PMCLINICAL INFORMATION AND PRE-OPERATIVE DIAGNOSIS: Thyroid mass, neck adenopathyPOST-OPERATIVE DIAGNOSIS : SameCOMPARISON: Same-day ultrasound, CT neck from 2/19/15OPERATORS: Doctors paushter; The attending physician, Dr. paushter, performed theprocedure. TECHNIQUE: Following a discussion of the procedure with the patient, including its risks,benefits, alternatives and steps to prevent infection, an informed written consent wasobtained and documented in the patient's chart. The time-out form was completed toconfirm patient identity and side/type of procedure.Localizing US demonstrated large solid left thyroid mass and necrotic -- appearing leftsupraclavicular lymph node. The skin over the target area was cleansed with chlorhexidine. Transducer was sterilelysheathed. Local anesthesia was obtained using 1% lidocaine, superficially and at depth. Using aseptic technique, and continuous ultrasound guidance, the thyroid lesion wassampled using 25 gauge needles. Two fine needle aspirations were performed. The leftsupraclavicular lymph node was sampled using 25-gauge needles. Four fine needleaspirations were performed.Cytology was present to confirm specimen adequacy. Specimen was handed to cytology. The patient tolerated the procedure well without immediate complications. Routine postprocedure instructions were communicated to the patient.COMPLICATIONS: NoneESTIMATED BLOOD LOSS: Less than 5 cc. An adhesive bandage was placed on the patient?sskin. |
Generate impression based on medical findings. | Bilateral hydronephrosis with ureteral stent placement. Septic shock. RIGHT KIDNEY: 11.5 cm in length. Increased renal parenchymal echogenicity. 10 mm simple appearing cyst noted in the inferior pole. Subcentimeter echogenic focus in the inferior pole may represent a nonobstructing stone or a portion of the ureteral stent. No suspicious lesions are evident. No hydronephrosis.LEFT KIDNEY: 11.0 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Collapsed with Foley catheter identified.OTHER: Subcentimeter cholelithiasis without sonographic evidence of cholecystitis. Echogenic liver, partially imaged. | 1. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease.2. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on medical findings. | Female, 87 years old. AKI RIGHT KIDNEY: The right kidney measures 8.2 cm in length, with increased cortical echogenicity. Multiple nonobstructing stones are identified, the largest in the upper pole measures 0.7 x 0.3 x 1.0 cm. No obstructing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 7.7 cm in length, with increased cortical echogenicity. Multiple nonobstructing stones are identified, a stone in the upper pole measuring 0.6 x 0.4 x 1.2 cm, and a stone in the midpole measuring 0.7 x 0.6 x 0.5 cm. No obstructing stones or hydronephrosis.OTHER: The bladder is decompressed, with Foley catheter in place. | 1.Multiple bilateral nonobstructing renal stones. No hydronephrosis.2.Increased renal cortical echogenicity, compatible with medical renal disease. |
Generate impression based on medical findings. | Male; 77 years old. Reason: Primary HPT. Please evaluate for parathyroid adenoma. History: Primary HPT. Please evaluate for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 4.6 x 1.7 x 1.5 cmLEFT LOBE MEASUREMENTS: 3.0 x 1.4 x 1.4 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: The thyroid is mildly heterogeneous but there is no discrete nodule.LEFT LOBE: The thyroid is mildly heterogeneous but there is no discrete nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Small amount of calcification is noted in the left carotid artery. | Mildly prominent thyroid with no discrete nodule. |
Generate impression based on medical findings. | 50-year-old male patient with right upper quadrant abdominal pain. Evaluate for biliary etiology. LIVER: The liver measures 16.0 cm in length. No focal hepatic lesion is identified. Hepatic parenchymal echogenicity is increased. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.3 cm in length. No evidence of hydronephrosis.The spleen measures 11.7 cm in length. | 1. Increased hepatic parenchymal echogenicity which can be seen with hepatic parenchymal dysfunction.2. No cholelithiasis or sonographic evidence of acute cholecystitis. |
Generate impression based on medical findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no suspicious solid or cystic mass identified. A few bilateral several millimeter sized cysts are seen. A normal intramammary lymph node is noted in the left breast near one o'clock. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on medical findings. | Female 34 years old; Reason: Assess for evidence of HCC History: Chronic hepatitis B infection LIVER: The liver measures 14.4 cm in length. There is coarse increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 19.1 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.5 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 1.3 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.6 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. A renal cyst is seen in the superior pole measuring 1.8 cm x 1.3 cm x 1.4 cm.LEFT KIDNEY: The left kidney measures 11.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | The liver has a coarse increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No focal hepatic masses are seen. |
Generate impression based on medical findings. | 47-year-old female patient with bacteremia. Evaluate for abdominal abscess or cholecystitis. LIVER: The liver measures 16.8 cm in length. No focal hepatic lesion is identified. Hepatic parenchymal echogenicity is increased. Main portal vein flow is hepatopetal and measures 0.1 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common bile duct measures 2 mm in diameter.PANCREAS: The imaged portion of the pancreatic head is hypoechoic in echogenicity. The remaining pancreas is not visualized secondary to overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.2 cm in length. No evidence of hydronephrosis.The spleen measures 8 cm in length. | 1. No sonographic evidence of acute cholecystitis.2. Increased hepatic parenchymal echogenicity suggestive of hepatic steatosis.3. Hypoechoic pancreatic parenchyma which can be seen with inflammation; correlate with lipase levels. |
Generate impression based on medical findings. | Painless 2 cm nodule in the groin area. Targeted evaluation of the patient's left groin palpable abnormality shows a subdermal hypoechoic 8 x 4 x 10 mm lesion without vascularity. No drainable fluid collection is evident. | Nonspecific subdermal 1 cm hypoechoic oval lesion may represent a sebaceous cyst/epidermal inclusion cyst. No drainable fluid collection or significant adjacent inflammatory changes. If there is persistent clinical concern follow-up to resolution is recommended. |
Generate impression based on medical findings. | Altered mental status Findings are limited by poor acoustic penetrance and inability to reposition the patient.LIVER: Cirrhotic liver morphology. No focal hepatic lesions. Normal portal venous blood flow direction with pulsatile flow compatible with heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Status post cholecystectomy.PANCREAS: Obscured by bowel gas.KIDNEYS: The kidneys are not well visualized due to poor acoustic penetration.SPLEEN: Not well visualized due to overlying bandages and left ventricular assist device.OTHER: Large amount of ascites. | Limited examination. Cirrhosis with large volume ascites. |
Generate impression based on medical findings. | 55-year-old female with although unusual in thyroiditis and myalgia. RIGHT LOBE MEASUREMENTS: 2.6 x 1.4 x 0.6 cm LEFT LOBE MEASUREMENTS: Difficult to marginate. 1.9 x 1.2 x 0.5 cmISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: Atrophic, heterogeneous in echotexture and lobulated. No mass identified.LEFT LOBE: Atrophic, heterogeneous in echo texture and lobulated. No mass identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Prominent right cervical node with a normal morphology.OTHER: The esophagus appears to be to the right of midline of uncertain significance. | Atrophic thyroid without mass. Patient has had an outside study, would be happy to review for comparison. |
Generate impression based on medical findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Revisualization of a lobulated hypoechoic mass in the right upper outer breast measuring approximately 0.9 cm, stable in size and appearance when compared to prior ultrasound exams. There is no solid or cystic mass identified. | Stable fibroadenoma of the right breast. No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on medical findings. | Female; 43 years old. Reason: large gallstone on bedside US, eval for acute cholecystitis History: RUQ abdominal pain LIVER: The liver measures 18.2 cm in length. Liver contour is smooth. The parenchyma demonstrates a coarsened echotexture. No worrisome hepatic mass is identified. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.27 m/sec.BILIARY TRACT: Gallbladder is not distended. There is a 2 x 3 cm shadowing stone within the body of the gallbladder. The gallbladder wall is thickened measuring 6 mm. There is no pericholecystic fluid. Sonographic Murphy's sign was not elicited. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well visualized due to overlying bowel gas.SPLEEN: The spleen measures 7.9 cm in length.RIGHT KIDNEY: Right kidney measures 10.5 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. OTHER: The left kidney measures 10.1 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. | Cholelithiasis without acute inflammation or ductal dilatation. Coarsened echogenic liver parenchyma suggestive for fatty infiltration/parenchymal dysfunction without mass. No ascites.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | 72-year-old female with history of thyroid cancer status post thyroidectomy. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Hypoechoic focus in the left thyroid bed measuring 0.7 x 0.5 cm is not significantly changed since 2012. Adjacent 0.4 cm hyperechoic focus is also noted, most likely postoperative scarring.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. Redemonstration of hypoechoic focus in the left thyroid bed without significant interval change since 2012 most likely represents postoperative scarring. |
Generate impression based on medical findings. | 62-year-old male with fever, abdominal pain. Evaluate for up quadrant from gallbladder pathology. Limited exam as patient unable to lie in the decubitus position or check for Murphy's sign. Midline bandage partially obscures the left liver and pancreas.LIVER: Increased echogenicity of the liver measuring 21.4 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Multiple shadowing stones within the gallbladder. Trace pericholecystic fluid. Gallbladder wall measures up to 3 mm in thickness. Unable to check for sonographic Murphy sign. Common bile duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Normal echogenicity of the visualized pancreas.RIGHT KIDNEY: Increased echogenicity of the right kidney measuring 11.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 14.4 cm in length.Left kidney measures 12.0 cm in length and is increased in echogenicity. No hydronephrosis or shadowing calculi are noted. | 1. Cholelithiasis with trace pericholecystic fluid. Findings may represent early cholecystitis.2. Hepatomegaly with increased echogenicity of the liver compatible with fatty infiltration.3. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No hydronephrosis. |
Generate impression based on medical findings. | 30-year-old female with a palpable lump/mass along the right lateral sternum/chest presents for ultrasound. Patient does not palpate the lump anymore. She felt it was a soft nodule that went away in 2 weeks. Family history of breast cancer in maternal aunt. A targeted right superior/infraclavicular ultrasound was performed for the patient’s area of concern. There is no solid or cystic mass identified. Normal glandular tissue noted. Ultrasound was performed in both supine and sitting position as patient thought the lesion was previously well appreciated in the sitting position. | No sonographic evidence for malignancy corresponding to patient's area of concern in the right infraclavicular/superior breastBIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | 71 year old female with history of primary hyperparathyroidism and thyroid nodules. RIGHT LOBE MEASUREMENTS: 3.4 x 1.4 x 1.4 cm.LEFT LOBE MEASUREMENTS: 3.7 x 1.1 x 0.9 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: There is a 1.0 x 0.7 x 1.0 cm mildly hypoechoic, solid, interpolar nodule without increased vascularity or associated calcifications. The margins are well-defined. This nodule previously measured 1.0 x 0.7 x 1.0 cm. LEFT LOBE: The left thyroid lobe is mildly heterogeneous without a discrete nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically unremarkable and normal sized bilateral cervical lymph nodes are present.OTHER: No significant abnormality noted. | Stable right 1 cm solid nodule. No additional significant interval change. |
Generate impression based on medical findings. | History of hepatitis C. Presents for HCC screening. LIVER: Diffusely coarse and mildly echogenic liver parenchymal echotexture compatible with chronic liver disease. The capsule is relatively smooth. The liver measures 13 cm in craniocaudal dimension.Noted again is a 7 mm mildly hyperechoic lesion adjacent to a hepatic vein, unchanged from prior ultrasound. Stable echogenic shadowing 4 mm probable calcified granuloma in the right lobe of the liver.Normal hepatopedal portal venous blood flow at 18 cm/second. BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid or focal tenderness. The common bile duct measures 5 mm.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable. The remainder is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 9 cm without a focal lesion.RIGHT KIDNEY: The right kidney measures 9.3 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 8.7 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. | 1. Stable examination from prior ultrasound including the stable 7 mm mildly hyperechoic lesion adjacent to the hepatic vein which was not visualized on intervening MRI. 2. Findings compatible with chronic liver disease. |
Generate impression based on medical findings. | 79-year-old male with history of acute kidney injury. Evaluate for hydronephrosis. RIGHT KIDNEY: Slightly hyperechoic renal parenchyma, which may represent medical renal disease. Small, approximately 1 cm right superior pole renal cyst. No hydronephrosis or hydroureter.LEFT KIDNEY: Slightly hyperechoic renal parenchyma, which may represent medical renal disease. No hydronephrosis or hydroureter.OTHER: Bladder is within normal limits, and there is a Foley catheter in place. | Slightly hyperechoic renal parenchyma, which may represent medical renal disease. |
Generate impression based on medical findings. | History of papillary thyroid cancer status post thyroidectomy. RIGHT LOBE THYROIDECTOMY BED: No specific sonographic findings to suggest tumor recurrence.LEFT LOBE THYROIDECTOMY BED: No specific sonographic findings to suggest tumor recurrence.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A morphologically benign-appearing left level 3 lymph node is noted.OTHER: No significant abnormality noted. | Stable examination with no evidence of recurrent disease or lymphadenopathy. |
Generate impression based on medical findings. | 52 year old female with history of thyroid gland malignancy and metastases. Evaluate amount of abdominal ascites, possible paracentesis. LIVER: Limited evaluation of the liver reveals a nodular contour and heterogeneous appearance, similar to prior.OTHER: Minimal abdominal free fluid, likely not amenable to future paracentesis given the small amount. | Heterogeneous/nodular liver, similar to prior, and minimal ascites. |
Generate impression based on medical findings. | HBV LIVER: Mildly heterogeneous liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 21 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 12.7 cm in lengthOTHER: Left kidney 12.6 cm in length. No ascites. | Heterogeneous liver echotexture with mild hepatomegaly again noted without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Reason: hx of goiter s/p thyroidectomy now with regrowth of thyroid tissue lateral on his neck RIGHT LOBE MEASUREMENTS: Status post thyroidectomy. See below.LEFT LOBE MEASUREMENTS: Status post thyroidectomy. See below.ISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: Heterogeneous multilobular mass/residual tissue with internal vascularity but without discrete nodules identified. No suspicious microcalcifications.LEFT LOBE: Heterogeneous multilobular mass/residual tissue measuring up to 4.6 x 4.2 x 6.4 cm with internal vascularity but without discrete nodules identified. No suspicious microcalcifications.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No lymphadenopathy identified.OTHER: No significant abnormality noted. | Multilobular mass/residual tissue within the bilateral thyroidectomy beds without discrete nodules or suspicious microcalcifications. These would be amenable to FNA biopsy if clinically indicated. |
Generate impression based on medical findings. | 57-year-old female with recent pancreatitis and elevated LFTs. LIVER: The liver measures 17.2 cm. Parenchyma is mildly echogenic, compatible with fatty infiltration. The main portal vein is patent and exhibits hepatopedal flow with velocity of 0.2 m/s. No suspicious hepatic lesions or biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: No shadowing gallstones or sonographic evidence of cholecystitis.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Right kidney measures 11.2 cm. Increased cortical echogenicity is suggestive of medical renal disease. Right renal midpole cyst measures 1.4 x 1.6 x 1.2 cm. No hydronephrosis.OTHER: The spleen measures 12.2 cm and is within normal limits. The left kidney measures 10.0 cm. Increased cortical echogenicity is suggestive of medical renal disease. Midpole cyst measures 1.8 x 1.4 x 1.4 cm. No hydronephrosis. No ascites. | 1.Findings compatible with fatty liver infiltration. 2.Echogenic renal cortices, consistent with medical renal disease. No hydronephrosis. |
Generate impression based on medical findings. | 73-year-old female patient with history of multiple nodules. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: 2.0 x 2.4 x 5.6 cmLEFT LOBE MEASUREMENTS: 1.8 x 2.4 x 4.7 cmISTHMUS MEASUREMENTS: 5 mm in thickness.RIGHT LOBE: Multiple heterogeneous nodules are again noted in the right thyroid lobe. The largest measures 1.2 x 0.9 x 0.9 cm in the superior pole, previously 1.0 x 0.9 x 0.8 cm. LEFT LOBE: Multiple heterogeneous nodules, some with cystic components are noted in the left thyroid lobe. The largest measures 1.8 x 1.1 x 1.3 cm in the superior pole, previously 1.9 x 1.1 x 1.2 cm.ISTHMUS: A hypoechoic nodule within the isthmus measures 0.4 x 0.3 x 0.5 cm, previously 0.6 x 0.5 x 0.3 cm. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-morphology lymph nodes are noted in neck.OTHER: No significant abnormality noted. | Bilateral thyroid nodules without significant interval change. |
Generate impression based on medical findings. | Elevated LFTs LIMITED ABDOMENLIVER: Coarse echogenic parenchyma again noted without mass. Liver length 18.6 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10 cm in length RIGHT KIDNEY: No significant abnormalities noted. 11.1 cm in lengthOTHER: Left kidney 10.5 cm in length. No ascites | Coarse echogenic liver echotexture again noted consistent with chronic liver disease without mass or ductal dilatation. No ascites. Patent hepatic vessels with normal directional flow. |
Generate impression based on medical findings. | Ms. Dolehide is a 29-year-old female patient with mass felt by primary care physician in the 10:00 position of the right breast. Patient cannot feel lump. Physical exam was performed and no palpable abnormality was felt. A targeted right ultrasound was performed in the area of concern. There is no solid or cystic mass identified. | Normal glandular tissue seen in the right upper outer breast. No sonographic evidence for malignancy. If there is continued clinical concern for a mass, the palpable area of concern can be marked on the skin and a repeat ultrasound can be performed. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. All results recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | Female 56 years old Reason: r/o growth of nodules, adenopathy, or suspicious features. please compare with prior ultrasound History: multiple thyroid nodules. Family history of thyroid cancer. RIGHT LOBE MEASUREMENTS: 2.1 x 1.5 x 5.7 cmLEFT LOBE MEASUREMENTS: 1.9 x 1.5 x 5 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: Again noted multiple nodules are predominantly cystic many with evidence for colon, tail artifact which are unchanged from previous exam. Index cystic nodule in the upper pole measures 2.2 x 1.1 x 1.7 cm, slightly enlarged compared to previous study. No evidence of solid component.LEFT LOBE: Again noted multiple nodules again predominantly cystic with possible correlate. Index spongiform nodule in the mid inferior left lobe measures 7 x 4 x 6 mm, not significantly changed compared to previous study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes are unchanged.OTHER: No significant abnormality noted. | Stable appearance of the thyroid with multiple nodules, most characteristics of colloid nodules. |
Generate impression based on medical findings. | 51-year-old female status post laparoscopic gastric sleeve surgery with abdominal pain. LIVER: Enlarged measuring 21.7 cm in length. Increased hepatic echogenicity without discrete focal lesion.BILIARY TRACT: No cholelithiasis, gallbladder wall thickening, or biliary ductal dilation.PANCREAS: Portions of the pancreas are not visualized due to bowel gas. The imaged portions of the pancreas appear unremarkable.SPLEEN: No significant abnormalities noted.KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. |
Generate impression based on medical findings. | 37-year-old female with a thyroid nodule. RIGHT LOBE MEASUREMENTS: 4.5 x 1.2 x 1.0 cm.LEFT LOBE MEASUREMENTS: 4.8 x 0.9 x 1.3 cmISTHMUS MEASUREMENTS: 1 mm RIGHT LOBE: 7 x 6 x 6 mm lower pole hypoechoic well-defined solid nodule with punctate echogenic foci which may represent microcalcifications.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Indeterminate 7-mm right thyroid lobe hypoechoic nodule with indeterminate echogenic foci. This nodule is amenable to fine needle aspiration. |
Generate impression based on medical findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 4.6 x 1.7 x 1.6 cmLEFT LOBE MEASUREMENTS: 3.4 x 1.2 x 1.4 cmISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: Diffusely heterogeneous gland again noted. Stable solid right lower pole thyroid nodule measuring 1 x 1 x 1 cmLEFT LOBE: Diffusely heterogeneous gland again noted. Stable left lower pole hyperechoic subcentimeter nodule measuring 0.5 x 0.5 x 0.5 cm.ISTHMUS: Diffusely heterogeneous gland again noted. 1 x 0.4 x 0.9 cm predominantly solid right isthmic nodule; in retrospect, this nodule was present on the prior study and unchanged in appearance.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable diffusely heterogeneous thyroid gland. Stable thyroid nodules. No regional adenopathy. |
Generate impression based on medical findings. | 65-year-old male with AKI and transaminitis. LIVER:The liver measures 15.5 cm.GALLBLADDER, BILIARY TRACT: There is debris in the gallbladder. No stones. Gallbladder wall is within normal limits. No pericholecystic fluid. The common bile duct measures 2.8 mm.PANCREAS: Difficult to asses as pancreas is obscured by bowel gas.SPLEEN: The spleen measures 10.4 cm. No significant abnormalities noted.KIDNEYS: The right kidney measures 10.4 cm. The left kidney measures 10.7 cm. The kidneys have normal echogenicity. No shadowing calculi, hydronephrosis, or masses. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: The IVC is patent without evidence of thrombus.OTHER: No significant abnormality noted. | 1. Gallbladder debris without sonographic evidence of acute cholecystitis.2. Normal ultrasound of the kidneys without stones, hydronephrosis, or masses.3. Normal ultrasound of the liver without evidence of sonographic evidence of parenchymal dysfunction. |
Generate impression based on medical findings. | 74-year-old female with diabetes, elevated BUN/creatinine. RIGHT KIDNEY: Measures 10.7 cm in length. Unremarkable morphology with preserved cortical medullary differentiation without hydronephrosis. Nephrolithiasis with a 0.2 cm stone in the mid polar region.LEFT KIDNEY: Measures 12.4 cm in length. Unremarkable morphology with preserved cortical medullary differentiation without hydronephrosis. Nephrolithiasis with a 0.4 cm stone noted in the interpolar region.URINARY BLADDER: Incompletely distended.OTHER: No significant abnormalities noted. | Bilateral nephrolithiasis without hydronephrosis. |
Generate impression based on medical findings. | Decompensated cirrhosis LIVER: Diffuse coarse echotexture of the liver which measures 18.6 cm with nodular surface suggestive of cirrhotic morphology. Portal vein demonstrates reversal of flow (hepatofugal) within it. If clinically indicated, liver Doppler examination can be performed to evaluate the hepatic artery and portosystemic shunts.Minimal ascites noted.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Gallbladder is distended with mild gallbladder wall thickening measuring up to 4 mm which could be due to adjacent ascites. Gallbladder sludge noted. No definite evidence of gallstones. Sonographic Murphy sign is negative.PANCREAS: Not visualized due to overlying bowel gas.SPLEEN: Spleen measures 21 cm, increased in size without any focal lesions.RIGHT KIDNEY: Right kidney measures 13.2 cm and left kidney measures 12 cm with normal echotexture. No evidence of hydronephrosis. No renal stones. OTHER: Ascites noted. Right pleural effusion noted. | 1. Diffuse cirrhotic morphology of the liver without any focal lesions. Hepatofugal/reversal of flow in the portal vein noted. Distended gallbladder with sludge and gallbladder wall thickening most likely due to adjacent ascites rather than cholecystitis.2. Moderate splenomegaly with ascites.3. Right pleural effusion. |
Generate impression based on medical findings. | 17-year-old female presents to evaluate right breast lump that is increasing in size for one year. History of left breast excision in 2014 which is consistent with a fibroadenoma. A targeted right ultrasound was performed for the palpable area of concern. On physical examination, a 2 cm mobile lump is palpated in the right breast 3:00 position that has increased in size as per the patient. Ultrasound demonstrates a parallel oriented hypoechoic mass well encapsulated that measures 3.9 x 1.9 x 3.9 cm with minimal peripheral blood flow. | Palpable abnormality right breast 3:00 position corresponds to a benign fibroadenoma basin imaging. Surgical consultation and possible FNA is recommended.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical findings. | Ms. Salem is a 15 year old female status post left breast lumpectomy in February 2014 for a borderline Phyllodes tumor. She presents today for a short-term ultrasound follow-up to exclude recurrent disease. Upon physical exam of the left breast, a surgical scar is identified. No palpable masses are appreciated.Targeted left breast ultrasound was performed. Scar tissue and fibrosis is identified without discrete mass. No suspicious sonographic findings seen to suggest residual/recurrent tumor. | No sonographic evidence for residual or recurrent tumor. The patient is scheduled for a follow-up appointment with Dr. Chhablani on 6/11/2015. All results were discussed with the patient and her mother. BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma again noted without worrisome mass, stone, or hydronephrosis. Stable right renal cyst. Right kidney 14 cm in lengthLEFT KIDNEY: Echogenic renal parenchyma again noted without mass, stone, or hydronephrosis. Left kidney 14.5 cm in length.OTHER: Bladder nondistended. Mild ascites. Left pleural effusion. | Echogenic renal parenchyma again noted consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. Mild ascites. Left pleural effusion. |
Generate impression based on medical findings. | History of Hurthle Cell cancer, please evaluate for change in thyroid bed s/p total thyroidectomy and radiation therapy. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. Subcentimeter hypoechoic focus in the right thyroid bed is unchanged allowing for slight differences in technique.LEFT LOBE: Status post thyroidectomy. No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A few small normal morphology lymph nodes are identified in the neck.OTHER: No significant abnormality noted. | Stable examination with no interval change in subcentimeter hypoechoic focus in the right thyroid bed. |
Generate impression based on medical findings. | 69-year-old with personal history of breast cancer presenting with enlarged right supraclavicular lymph nodes. Ultrasound is requested. Targeted ultrasound is performed for the right supraclavicular region and right neck. There are numerous abnormal enlarged lymph nodes in this region. The largest and most superficial node measures 1.8 x 1.5 cm. Adjacent to the right jugular vein, at least two abnormal morphology are also seen, measuring about 9 mm each. | Multiple abnormal right supraclavicular and jugular lymph nodes. Surgical consultation is recommended, and the patient will be seeing Dr. Jaskowiak today.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical findings. | Female 64 years old with epigastric/RUQ pain. History of open cholecystectomy in 1970s. LIVER:The liver has a smooth contour and measures 16.3 cm in length. The parenchyma is somewhat coarse and echogenic. No focal liver lesion is identified. The main portal vein is patent with a velocity of 22.4 cm/s. There is no ascites.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreatic head and body are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.9 cm in length.KIDNEYS: The right kidney measures 11.0 cm in length and the left measures 11.2 cm. The renal cortices are normal in echogenicity. There is no shadowing renal stone, hydronephrosis or evidence of renal mass. OTHER: No significant abnormality noted. | Mild hepatomegaly and increased echogenicity of the liver parenchyma suggestive of hepatic steatosis/parenchymal dysfunction. |
Generate impression based on medical findings. | 49-year-old female patient with history of lung cancer (diagnosed at the age of 48) and painful region in her right breast. Per patient, the painful area in the medial right breast has been present for several years, but has worsened in intensity since her surgery for lung cancer in Oct 2014. The patient's clinical team did not want a mammogram for today's examination. Limited examination without concomitant mammogram. Upon physical exam at the patient's area of concern, no discrete mass is appreciated. A targeted right breast ultrasound was performed for the patient’s area of concern at the 3:00 position within the right breast. There is no suspicious solid or cystic mass identified. Normal glandular tissue is seen. | No sonographic evidence for malignancy in the patient's area of concern with ultrasound showing normal glandular tissue. The patient should follow up with her primary care team as clinically warranted, presuming these results are concordant with the physical exam findings. Of note, this examination is incomplete without an accompanying bilateral mammogram and should be obtained when patient's health allows for it.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | 24-year-old female with a right breast palpable mass who presents for sonographic evaluation. On physical examination, there is a palpable, nontender, mobile mass in the right breast at approximately 11:00 position, 4 cm from the nipple.A targeted right ultrasound was performed for the palpable area of concern. There is a hypoechoic circumscribed mass measuring 3.5 x 1.9 x 3.7 cm with mildly increased vascularity and parallel orientation in the right breast at 11:00 position, 4 cm from the nipple. | Large hypoechoic mass at 11:00 position in the right breast as detailed above. Finding may represent a fibroadenoma; however, based on the large size, surgical consultation is recommended.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical findings. | Known right breast cancer with additional focal asymmetry in the right breast 6:00 position on mammogram. Few asymmetric right axillary lymph nodes. Patient presents for right breast and axillary ultrasound. A targeted right breast and axillary ultrasound was performed for the mammographic area of concern. Irregular hypoechoic taller than wide suspicious mass measuring 1.1 x 0.8 x 1.2 cm identified in the right breast 6:00 position, 3 cm from the nipple with apical blood flow.4 normal morphology right axillary lymph nodes are identified. | 1. Suspicious mass right breast 6:00 position needs ultrasound-guided core biopsy.2. Normal morphology right axillary lymph nodes identified.BIRADS: 6 - Known cancer.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | 31 years old, Female, Reason: Evaluate for gallstones History: RUQ pain occ associated with meals LIVER: The liver measures 15.1 cm in length. Increased parenchymal echogenicity is suggestive of fatty infiltration. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s. There is likely a small calcified granuloma within the hepatic parenchyma.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present, the common bile duct measures 2 mm in diameter.PANCREAS: The pancreas is not well seen due to overlying bowel gas.SPLEEN: No significant abnormalities noted. The spleen measures 9 cm in length. RIGHT KIDNEY: Kidney measures 9.2 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.3 cm in length. Normal echotexture. No hydronephrosis. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or acute cholecystitis.2.Increased hepatic parenchymal echogenicity is consistent with fatty infiltration. |
Generate impression based on medical findings. | Male; 47 years old. Reason: r/o abdominal bleed History: anemia No free fluid is seen within the abdomen. | No free fluid. |
Generate impression based on medical findings. | 58-year-old female with worsening CKD. Evaluate Body habitus limits examination.RIGHT KIDNEY: The right kidney measures 7 cm in length and is increased in echogenicity.LEFT KIDNEY: Evaluation of the left kidney is limited. Again noted is mildly increased echogenicity at the upper pole of the left kidney.Bladder: No significant abnormalities noted. | Limited examination with bilaterally hyperechoic renal parenchyma consistent with renal disease. The left kidney is incompletely imaged. |
Generate impression based on medical findings. | 85 years old, Female, Reason: thyroid nodules seen on 9/2013 ultrasound - please check for progression History: none RIGHT LOBE MEASUREMENTS: 4.7 x 2.2 x 2.4 cmLEFT LOBE MEASUREMENTS: 4.3 x 2.2 x 1.5 centimeters ISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Complex cystic nodule in the right inferior thyroid lobe is not significantly changed size measuring 1.8 x 1.3 x 1.3 cm.LEFT LOBE: Previously noted cystic nodule on the left is not significantly changed in size. There is a newly identified subcentimeter simple cystic nodule in the left lower lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Complex cystic nodule in the right inferior thyroid lobe is not significantly changed.2.Two subcentimeter simple appearing cysts in the left lower lobe. |
Generate impression based on medical findings. | Reason: Evaluate for residual thyroid tissue History: Status post thyroidectomy for questionable pre-malignant lesions RIGHT LOBE: Status post thyroidectomy without new suspicious lesions in the thyroidectomy bed.LEFT LOBE: Status post thyroidectomy without new suspicious lesions in the thyroidectomy bed.ISTHMUS: Status post thyroidectomy without new suspicious lesions in the thyroidectomy bed.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted. Benign-appearing right level 2 cervical lymph node measures 2.1 x 0.6 x 0.9 cm. No cervical lymphadenopathy.OTHER: No significant abnormality noted. | Status post thyroidectomy without evidence of recurrence. |
Generate impression based on medical findings. | Evaluate for hydronephrosis. Acute kidney injury. RIGHT KIDNEY: The right renal cortex is echogenic. The right kidney measures 11.6 cm. No hydronephrosis, renal calculi or suspicious lesion identified.LEFT KIDNEY: The left renal cortex is echogenic. The left kidney measures 11.4 cm. A left upper pole simple cyst measures 2.2 x 1.9 x 2.3 cm, unchanged. No hydronephrosis, renal calculi or suspicious lesion identified.URINARY BLADDER: Incompletely distended urinary bladder, containing debris.OTHER: Large right pleural effusion. | 1.Echogenic kidneys, compatible with medical renal disease. Unchanged left upper pole simple cyst. No hydronephrosis, renal calculi or suspicious lesion.2.Large right pleural effusion.3.Debris noted within the bladder. |
Generate impression based on medical findings. | 39-year-old with right upper quadrant pain and nausea. LIVER: The liver measures 17.6 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.5 m/s.BILIARY TRACT: Numerous small mobile stones are present within the gallbladder. The gallbladder wall is mildly thickened measuring up to 4 mm. There is tenderness over the gallbladder. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.5 mm in diameterPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.The spleen measures 9.7 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.4 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Findings suspicious for early acute cholecystitis.2.Echogenic kidneys suggesting medical renal disease. Findings communicated with WYNNE, JOSEPH at 4:05 p.m. on 6/12/2015. |
Generate impression based on medical findings. | Female 35 years old; Reason: thyroid nodule. RIGHT LOBE MEASUREMENTS: 5.2 x 2.0 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.0 x 2.4 x 1.2 cmISTHMUS MEASUREMENT: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted. The previously noted predominantly cystic nodule in the left lobe is no longer visualized.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant abnormalities noted. The previously noted predominantly cystic nodule in the left lobe is no longer visualized. |
Generate impression based on medical findings. | 52 year-old female with colicky abdominal pain for 2 months. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Note is made of a subcentimeter echogenic focus along the nondependent portion of the neck of the gallbladder without internal vascularity, measuring 5 mm in its largest diameter, most consistent with a gallbladder polyp. It should be noted that gallbladder polyps less than 6 mm in size require no follow-up examination. No gallstones are identified. No evidence of acute cholecystitis. Sonographic Murphy's is negative.PANCREAS: No significant abnormalities noted although the pancreas is partially obscured by overlying bowel gas.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1. No sonographic findings to account for the patient's pain.2. 5 mm gallbladder polyp for which no follow-up examination is required. |
Generate impression based on medical findings. | Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 20 cm in length. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Several subcentimeter gallstones noted. The gallbladder is collapsed, which limits evaluation for wall thickening. Trace pericholecystic fluid is nonspecific in the setting of liver dysfunction. Negative sonographic Murphy's sign reported.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.8 cm in length. The left kidney is 10.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 10.6 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. | 1. Cholelithiasis without specific evidence of cholecystitis. Trace pericholecystic fluid present, nonspecific in the setting of liver dysfunction. The gallbladder is collapsed, which limits evaluation. Negative sonographic Murphy's sign reported. If further clinical suspicion for cholecystitis persists, nuclear medicine HIDA scan may be helpful.2. Increased hepatic echogenicity, compatible with parenchymal dysfunction. |
Generate impression based on medical findings. | Pregnant patient with right upper quadrant pain. The study is slightly limited due to poor soft tissue penetration.LIVER: The liver is normal in size measuring 15.2 cm in length. It is mildly coarse and increased in echogenicity. Normal hepatopedal portal venous blood flow at 0.3 m/s.Shadowing gallstones in a contracted gallbladder. No wall thickening, pericholecystic fluid or focal tenderness.BILIARY TRACT: No biliary ductal dilatation with the common duct measuring 3 mm. Shadowing gallstones in a contracted gallbladder. No wall thickening, pericholecystic fluid or focal tenderness.PANCREAS: The very poorly seen pancreas shows no significant abnormality.SPLEEN: The spleen is normal in size and appearance measuring 10.7 cm.RIGHT KIDNEY: The right kidney is normal in size measuring 12 cm in length. There is mild pelviectasis which persists after the patient voided. OTHER: The left kidney is normal in size measuring 11 cm in length without hydronephrosis or shadowing of lithiasis. | 1. Mild right-sided renal pelviectasis which persisted after the patient voided. This may be physiologic in the gravid state. 2. Cholelithiasis without evidence of acute gallbladder inflammation.3. Mildly coarse and echogenic liver parenchyma may reflect fatty infiltration. |
Generate impression based on medical findings. | Right upper quadrant pain LIVER: No significant abnormalities noted. Liver length 19.1 cmGALLBLADDER, BILIARY TRACT: Mildly prominent extra hepatic duct without obvious distal obstructing lesion. Unremarkable gallbladder.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Increased parenchymal echogenicity. Mild interval enlargement of benign-appearing renal cysts. Right kidney 10.6 cm in lengthOTHER: Left kidney 11.8 cm in length. Increased left renal parenchymal echogenicity. Mild interval increase in benign-appearing left renal cysts. Spleen 10.4 cm in length. No ascites. | Mildly prominent extra hepatic duct without obvious distal obstructing lesion. Unremarkable gallbladder without evidence for acute inflammation. Mild hepatomegaly. No ascites.Echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without obstruction. |
Generate impression based on medical findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of right breast ultrasound-guided core biopsy (7/7/2015) with pathology revealing foci of stromal and ductal hyperplasia, fibroadenomatoid change, and microcysts. Family history of breast cancer in paternal cousin. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on medical findings. | Ventriculomegaly, seizure. There is moderate prominence of the lateral ventricles bilaterally. Cortical sulci are also prominent and there is relative lucency in the periventricular white matter. There is no gross hemorrhage or mass. Subtle scalp swelling is incidentally noted in the frontal region. | Immature appearance with prominent ventricles and sulci especially in the frontal region and decreased attenuation white matter with no hemorrhage. |
Generate impression based on medical findings. | 51-year-old female post thyroidectomy with small nodule right thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: In the right thyroidectomy bed, there is again noted a somewhat high for occult area with surrounding hypoechoic rim, measuring 0.4 x 0.5 x 0.7 cm without significant change. A slightly more caudal, hypoechoic region measuring 0.3 x 0.3 by 0.4 cm is unchanged.LEFT LOBE: Slightly asymmetric hypoechoic region in the left bed measuring 0.4 x 0.4 x 0.5 cm is unchanged and could represent scarring.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically normal lymph nodes bilaterally OTHER: No significant abnormality noted. | Stable examination. Given stability and small size of the abnormality in the inferior right bed comment continued follow up warranted. |
Generate impression based on medical findings. | 21 year-old male with epigastric pain, elevated lipase LIVER: Measures 19.2 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/sec.BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized pancreas is unremarkable.SPLEEN: Normal echogenicity of the spleen measuring 11.4 cm in lengthRIGHT KIDNEY: Atrophic with increased echogenicity measuring 8.0 cm in length. OTHER: Left kidney is atrophic with increased echogenicity measuring 6.3 cm in length. | 1. The visualized pancreas is unremarkable. If there is clinical concern for pancreatitis, this can be better evaluated with a contrast enhanced CT study. 2. Hepatomegaly with no focal hepatic lesions.3. Atrophic and echogenic kidneys suggestive of parenchymal dysfunction. |
Generate impression based on medical findings. | 49-year-old male with elevated liver function tests, right upper quadrant pain, pancreatitis. LIVER: The liver is enlarged measuring 20.4 cm in length. There is mildly increased hepatic echogenicity without discrete focal lesion.GALLBLADDER, BILIARY TRACT: No cholelithiasis, gallbladder wall thickening, sonographic Murphy's sign, or pericholecystic fluid. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: 2.2 x 1.6 x 1.2 cm left renal cyst without septation or suspicious nodular component. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Enlarged liver with increased echogenicity suggestive of hepatic steatosis or diffuse parenchymal disease.2.No evidence of cholelithiasis or cholecystitis. |
Generate impression based on medical findings. | 73 year old female who was recalled from outside screening mammogram for left breast asymmetry. MAMMOGRAM: An ML view and two spot compression views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Within the left breast, 12 o'clock position, the previously visualized asymmetry partially disperses on spot compression imaging, suggesting superimposition of fibroglandular tissues.Within the right breast, upper outer quadrant, there is a new 0.8-cm mass which persists on spot compression imaging.ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. A dense band of fibroglandular tissue is noted. There is no solid or cystic mass identified.A targeted right ultrasound was subsequently performed for the mammographic area of concern. At the 10 o'clock position of the right breast, 5 cm from the nipple, there is a well-circumscribed anechoic cyst mild posterior acoustic enhancement measuring 0.5 x 0.4 x 0.5 cm, likely corresponding to the finding on mammogram. | Dense fibroglandular tissue in the upper central left breast corresponding to the asymmetry on mammogram. Right simple breast cyst. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on medical findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 4.3 x 1.9 x 2 cmLEFT LOBE MEASUREMENTS: 4.9 x 1.9 x 2.3 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Multiple subcentimeter benign-appearing hypoechoic probably cystic nodules. A benign-appearing spongiform nodule within the lower pole measures 0.7 x 0.5 x 0.6 cm.LEFT LOBE: Multiple subcentimeter benign-appearing cystic and spongiform nodules. A representative upper pole spongiform nodule measures 1.3 x 0.9 x 1.1 cm.ISTHMUS: 1.1 x 1.3 x 0.9 hypoechoic nodule with internal echogenic focus.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral subcentimeter benign-appearing thyroid nodules. Benign-appearing left upper pole spongiform nodule.Hypoechoic nodule with internal echogenic focus within the isthmus. While this may represent an intrathyroid lymph node, it is best considered indeterminate in nature. This nodule is amenable to ultrasound-guided biopsy. |
Generate impression based on medical findings. | 86-year-old male with urinary retention presents for suprapubic bladder catheter placement. Ultrasound was provided during and for confirmation of suprapubic catheter placement. Preprocedural images demonstrate predominantly anechoic urine with small, echogenic foci representing debris in a normally distended bladder. After placement of the catheter the retention balloon is visualized within the lumen of the bladder. | Imaging was provided for successful suprapubic urinary bladder catheter placement. |
Generate impression based on medical findings. | Female 58 years old Reason: rule out obstruction History: acute kidney injury RIGHT KIDNEY: 10.5 cm in length. Mildly echogenic suggestive medical renal disease. No hydronephrosis or hydroureter.LEFT KIDNEY: 10.7 cm in length. No hydronephrosis or hydroureter.OTHER: Bladder collapsed with Foley catheter in place. | No evidence of hydronephrosis. Mildly echogenic kidneys. Collapsed urinary bladder. |
Generate impression based on medical findings. | Difficulty swallowing. RIGHT LOBE MEASUREMENTS: 4.3 x 1.4 x 1.7 cm. Normal in size with normal background echotexture and vascularity.LEFT LOBE MEASUREMENTS: 4.4 x 1.2 x 1.9 cm. Normal in size with normal background echotexture and vascularity.ISTHMUS MEASUREMENTS: 5 mm in AP dimension.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Normal sonographic appearance of the thyroid gland. |
Generate impression based on medical findings. | Provided history of toxic nodular goiter. RIGHT LOBE MEASUREMENTS: 5.9 x 2.7 x 2.5 cmLEFT LOBE MEASUREMENTS: 6.7 x 2.3 x 2.5 cmISTHMUS MEASUREMENTS: 6 mmRIGHT LOBE: The right lobe is enlarged and heterogeneous in echogenicity containing several small cystic nodules. No discrete solid right thyroid lobe nodule.LEFT LOBE: The left lobe is enlarged and heterogeneous in echogenicity containing several small cystic nodules. In the mid portion of the lobe there is a 1.0 x 0.6 x 1.2 cm spongiform-appearing nodule consistent with a colloid nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Enlarged heterogeneous thyroid with a 1.2 cm left mid lobe colloid nodule. |
Generate impression based on medical findings. | 64-year-old female with history of thyroid cancer with nodules in right thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: In the inferior right bed there are again noted to hypoechoic nodular densities, measuring 0.4 x 0.4 x 0.6 cm and 0.4 x 0.6 x 0.4 cm. These measurements are unchanged from the prior study.LEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No morphologically normal lymph nodes.OTHER: No significant abnormality noted. | Stable soft tissue nodules right thyroid bed. |
Generate impression based on medical findings. | Male 65 years old Reason: eval for lesions, assess hepatic vessel patency History: s/p OLT for HBV in October 2004, recurrent HBV LIVER: Liver measures 11.7 cm. Small liver cyst is present measuring 1.0 x 0.7 x 1.0 cm. No suspicious hepatic mass identified.BILIARY TRACT: Patient is status post cholecystectomy. No intra or extra hepatic biliary ductal dilatation. Common bile duct measures 0.7 cm.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 12.5 cm.KIDNEYS: Cortical echogenicity is increased bilaterally which can be seen in the setting of medical renal disease. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 9.0 cm. Within the right kidney there is a small anechoic cyst measuring 1.3 x 1.3 x 1.1 cm. Left kidney measures 10.9 cm. Within the left kidney there is a small anechoic cyst measuring 2.7 x 2.6 x 3.6 cm.OTHER: No significant abnormalities noted. | 1.Echotexture of the liver within normal limits. Unchanged small hepatic cyst. Patent hepatic vessels with normal directional flow.2.Echogenic renal parenchyma is again noted, which can be seen in the setting of medical renal disease. |
Generate impression based on medical findings. | 75 years old, Male, Reason: ESRD s/p cadaveric transplant in 2003, now with AKI/ATN likely due to contrast nephropathy. assess graft function, obstruction History: AKI Transplanted kidney: No perinephric fluid collections are identified. The transplant kidney measures 11.8 cm in length. No shadowing calculus or suspicious lesions are evident. No evidence of hydronephrosis or hydroureter.Vascular Doppler data: The peak systolic velocity of the iliac artery is 1.0 m/sec. The peak systolic velocity at the anastomosis is 3.5 m/sec with a resistive index of 0.87 appearing similar to prior exam.Peak systolic velocity of the renal artery is 3.5 m/sec at the origin, 1.9 m/sec in the midportion, 1.3 m/sec distally with system indices of 0.88, 0.84, 0 .81 respectively. These peak systolic velocities and resistive indices are similar to prior exam.Resistive indices within parenchymal branches very between 0.7 and 0.8 which are minimally increased compared to the prior exam.Other: Mild to moderate amount of ascites is present. | 1.Increase velocity at the renal artery anastomosis is stable since the prior exam, but significant stenosis at this site cannot be excluded.2.Increased resistive indices in the main renal artery and in the parenchymal arterial branches.3.Mild to moderate ascites is present. |
Generate impression based on medical findings. | 40-year-old female patient with small thyroid nodule. Family history of thyroid cancer. One year follow-up study. Evaluate for growth of nodule, adenopathy. RIGHT LOBE MEASUREMENTS: 4.7 x 1.6 x 1.4 cm.LEFT LOBE MEASUREMENTS: 4.4 x 1.4 x 1.4 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity and contains a single subcentimeter cystic nodule with colloid in the upper pole, unchanged in size.LEFT LOBE: The left thyroid lobe is homogeneous in echogenicity and contains a single heterogeneous, solid nodule measuring 0.5 x 0.4 x 0.6 cm, unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology lymph nodes are noted bilaterally.OTHER: No significant abnormality noted. | Stable appearance of subcentimeter bilateral thyroid nodules. |
Generate impression based on medical findings. | Ms. Allen submitted outside examinations:-Bilateral screening mammogram: 12/23/2009-Bilateral breast ultrasound: 12/23/2009-Ultrasound-guided biopsy of right breast: 2/12/2010All examinations were performed at Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 4/7/2016. The breast parenchyma is heterogeneously dense (BiRADS Density Category C), unchanged in pattern and distribution. Multiple circumscribed masses identified in both breasts (right upper outer and left upper outer quadrants) are stable when compared to prior examinations and compatible with cysts (as seen on prior ultrasound examinations). In addition, a cluster of calcifications in the left upper outer breast are faintly seen on prior ML view from 2009. There is no significant change between these studies. | Multiple benign cysts of both breasts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in April 2017. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on medical findings. | Female 51 years old Reason: 51 yo female, need US guidance for bx History: AKI Gray scale ultrasonographic images were provided for the nephrology service for an ultrasound-guided biopsy of the left kidney. | Gray scale ultrasonographic images were provided for the nephrology service for an ultrasound-guided biopsy of the left kidney. |
Generate impression based on medical findings. | 25-year-old female with hepatitis C virus. Evaluate for cirrhosis or mass. LIVER: Liver is normal in size and mildly and coarsely echogenic consistent with parenchymal disease. No focal mass is identified and there is no gross evidence for cirrhosis.GALLBLADDER, BILIARY TRACT: The patient has had a cholecystectomy. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Small left renal cyst.Splenic size upper normal. | Mildly echogenic liver without mass.Splenic size upper normal. |
Generate impression based on medical findings. | 61-year-old male with abnormal LFTs, evaluate for cirrhosis, hepatocellular carcinoma. LIVER: Measures 16.8 cm in length. Unremarkable morphology with increased hepatic echogenicity. No discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Cholelithiasis without gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | 1. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. 2. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on medical findings. | 65-year-old man status post liver transplant evaluate for recurrence cirrhosis. LIMITED ABDOMENLIVER: The liver measures 18.7 cm. This is enlarged however stable from prior ultrasound. There is coarse increased echogenicity within the liver. Additionally there is a nodular appearance of liver which was not notable on prior ultrasound from 2015. This is concerning for cirrhotic morphology. There is no intrahepatic ductal dilation. No worrisome mass are noted within the liver.BILIARY TRACT: The common duct measures 0.5 cm.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 14 cm in length, this is slightly enlarged. No significant abnormalities are noted. RIGHT KIDNEY: The right kidney measures 10.3 cm. This cyst is present in the right kidney measures 2.1 cm x 2.0 cm not present on prior exam. No worrisome mass, hydronephrosis, or stones are present.LEFT KIDNEY: The left kidney measures 11.3 cm in length. The cortex is of normal echogenicity. There is no mass, hydronephrosis or stones present. | 1. There is new cirrhotic morphology present on this exam, not seen on prior ultrasound in 2015. No worrisome masses or intrahepatic ductal dilation are seen within the liver.2. Hepatomegaly is stable from prior ultrasound.3. Portal venous system, hepatic arteries, hepatic veins, and IVC are all patent with appropriate flow.4. New 2 x 2 cyst is located in the right kidney. |
Generate impression based on medical findings. | Elevated liver enzymes LIVER: Stable cirrhotic morphology without mass. Liver length 16.2 cm. Limited evaluation of the main portal vein demonstrates a patent portal vein with normal directional flow. Main portal vein velocity 34 cm/s.GALLBLADDER, BILIARY TRACT: Mild gallbladder wall thickening unchanged. Gallbladder sludge without acute inflammation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.5 cm in length. OTHER: Left kidney 10.2 cm in length. Mild ascites. | Stable cirrhotic morphology without mass or ductal dilatation. Main portal vein patent with normal directional flow. Mild ascites. |
Generate impression based on medical findings. | 56-year-old male with upper abdominal pain. Elevated lipase consistent with pancreatitis. Evaluate for cholelithiasis. LIVER: The liver parenchyma is mildly coarsened. No intrahepatic biliary ductal dilatation is evident. The liver measures 15 cm in craniocaudal dimension. Note is made of a 2.7-cm right hepatic lobe simple-appearing cyst. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common bile duct is mildly prominent, measuring 7 mm at the hilum, unchanged. A normally distended gallbladder is noted without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 9.9 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney is malrotated as seen on the prior CT. It measures 11.1 cm in length without hydronephrosis, shadowing calculus or a discrete lesion evident. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 10.9 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. | 1. The pancreas is obscured by overlying bowel gas shadowing. 2. No evidence of cholelithiasis or acute cholecystitis as clinically questioned. 3. Stable prominence of the common bile duct. 4. Mildly coarsened hepatic parenchyma suggesting diffuse fatty infiltration and/or parenchymal dysfunction. |
Generate impression based on medical findings. | 41 years old, Female, Reason: RUQ US for rule out stones History: RUQ pain LIVER: The liver measures 18.1 cm in length. Echogenicity of the liver is within normal limits. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: The gallbladder is not visualized, suspect prior cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.5 cm in length. RIGHT KIDNEY: Kidney measures 12.1 cm in length. Normal echotexture. Nohydronephrosis.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal echotexture. Nohydronephrosis.OTHER: No significant abnormalities noted. | 1.The gallbladder is not visualized. Suspect prior surgery.2.The common bile duct is within normal limits. No evidence of choledocholithiasis. |
Generate impression based on medical findings. | Ms. Ada Louise Palmer is a 34 years old female with fibroadenoma in the left breast. Presents for questionable enlargement of the previously biopsied lump in the left breast. On physical examination, a mobile lobulated mass is palpated in the left subareolar region.A targeted left ultrasound was performed for the patient’s area of concern. The previously biopsied circumscribed, lobulated, hypoechoic mass in the left subareolar area measures 3.2 x 1.8 x 3.8 cm (previously 3.4 x 2 x 4 cm), stable in size and morphology. Biopsy clip with the results of fibroadenoma is noted in the center of this mass. | No sonographic evidence for malignancy. Stable biopsy-proven fibroadenoma in the left subareolar region. Results and recommendations were discussed with the patient. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | 51-year-old female patient with transaminitis, abdominal pain. Evaluate liver and common bile duct. LIVER: The liver measures 20.8 cm in length and demonstrates increased parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. No intrahepatic biliary ductal dilatation is identified. The common duct measures up to 11 mm in diameter, appearing similar to a recent CT. The distal common bile duct is not visualized.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 9.6 cm in length. No evidence of hydronephrosis. OTHER: The left kidney is not visualized on this examination.The spleen is not visualized on this examination. | 1. Hepatic steatosis. 2. Non-specific dilatation of the common bile duct, appearing similar to a recent CT; MRCP may be considered if there is clinical concern for choledocholithiasis. |
Generate impression based on medical findings. | Thyroid carcinoma status post resection RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy without mass or regional adenopathy. |
Generate impression based on medical findings. | Low back pain RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 10.3 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 10.8 cm in lengthOTHER: Bladder nondistended. Incidental note made of 1 x 1.1 x 1 cm well-circumscribed hyperechoic focus within the right lobe of the liver. | Normal renal parenchyma without mass, stone, or hydronephrosis. Incidental note made of well-circumscribed hyperechoic focus within the right lobe of the liver; statistically most probably represents a benign hemangioma. |
Generate impression based on medical findings. | 71-year-old male with a history of scrotal pain. RIGHT TESTIS: The right testis is normal in morphology, echogenicity, and size, measuring 3.2 x 2.4 x 4.6 cm. Spectral Doppler evaluation demonstrates arterial blood flow. There is a small 2 mm cyst.LEFT TESTIS: The left testis is normal in morphology, echogenicity and size measuring 3.2 x 2.0 x 4.8 cm. Spectral Doppler demonstrates arterial blood flow.RIGHT EPIDIDYMIS: Normal in size and appearance and contains a 2.2-cm head cyst. 4-mm epididymal body cyst. 1.5-cm epididymal tail cyst. Coarse calcification adjacent to the epididymal tail.LEFT EPIDIDYMIS: Normal in morphology, echogenicity, and size without hypervascularity.OTHER: Bilateral varicoceles and small hydroceles. | Bilateral varicoceles and small hydroceles. No acute epididymal or testicular abnormality. |
Generate impression based on medical findings. | 20 year-old female with diffuse abdominal pain, mostly epigastric. CT showed ductal dilatation. Evaluate for cholelithiasis or cholecystitis. LIVER: Echogenicity of the hepatic parenchyma is normal. GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance. There is no pericholecystic fluid, gallbladder wall thickening or cholelithiasis. The common bile duct measures 0.5 cm in diameter with an intrahepatic position and at the porta hepatis. The extrahepatic common bile duct measures 0.6 cm. | Minimal prominence of the intrahepatic biliary ducts without dilatation. No cholelithiasis. |
Generate impression based on medical findings. | 30-year-old male with 1 cm mass in the left upper arm, suspected cyst versus lipoma. Grayscale and color ultrasound was performed in the left triceps area at the site of the patient's palpable complaint. Seen is a circumscribed 1.1 x 1.2 x 0.5 cm hyperechoic lesion in the subcutaneous soft tissues without significant vascularity, findings most consistent with a lipoma. | Findings consistent with a subcutaneous lipoma as detailed above. |
Generate impression based on medical findings. | 39-year-old male with sickle cell anemia, epigastric pain and aortic dilatation on prior exam. LIVER:Mild hepatomegaly without focal abnormality. Hepatic echotexture appears within normal limits. No focal mass.GALLBLADDER, BILIARY TRACT: Gallbladder appears unremarkable without cholelithiasis, wall thickening or pericholecystic fluid. Biliary tract is normal in caliber.PANCREAS: Limited due to bowel gas.SPLEEN: Not visualized.KIDNEYS: The right kidney measures 10.9 cm in length, and there is a 2.2 cm simple cyst in the mid upper pole. No hydronephrosis, shadowing calculus or solid mass. Echotexture normal. Left kidney measures 10.7 cm in length and there is a minimally complex 1.4 cm cyst in the lower pole with septation. No hydronephrosis, shadowing calculus or solid mass. Echotexture normal.ABDOMINAL AORTA: On today's study, the aorta is better visualized with proximal measurements of 2.9 x 3.1 cm, midportion measurement of 2.4 x 2.5 cm and distal measurement of 2.1 x 2.4 cm. Both common iliac arteries are within normal limits with the right measuring 1 cm in AP diameter and the left 1.1 cmINFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. | No interval change. No acute abnormality seen.Simple and minimally complex renal cysts.Aortic measurements as above. |
Generate impression based on medical findings. | Ms. Dale is a 64 year old asymptomatic female presenting for whole breast ultrasound for dense breast screening. She has a personal history of multiple bilateral cyst aspirations in 2006, 2007, and 2009. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Multiple anechoic lesions of varying sizes are seen bilaterally, compatible with simple cysts. However, in the left upper outer breast, 1:00 location, there is an oval hypoechoic lesion identified measuring 1.1 x 0.8 cm. This exam was interpreted by two radiologists. | (1) 1.1 cm lesion in the left upper outer breast. Dedicated left unilateral ultrasound is recommended for further evaluation. (2) No sonographic evidence for malignancy in the right breast .BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on medical findings. | 54 year-old female with history of right thyroid lesion, evaluate for progression. RIGHT LOBE MEASUREMENTS: 5.0 x 2.4 x 2.4 cm, previously 4.5 x 2.4 x 2.8 cmLEFT LOBE MEASUREMENTS: 5.2 x 2.4 x 2.2 cm, previously 4.7 x 2.9 x 2.7 cmISTHMUS MEASUREMENTS: 0.6 cm in thickness. RIGHT LOBE: Diffusely heterogeneous thyroid. Small hyperechoic nodule in the right superior gland measures 0.3 x 0.3 x 0.3 cm, unchanged.LEFT LOBE: Diffusely heterogeneous thyroid.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No parathyroid glands visualized. LYMPH NODES: Several benign appearing right level 2 and level 3 lymph nodes are present. | Diffusely heterogeneous thyroid with small hyperechoic lesion in the right superior gland, not significantly changed and likely benign. |
Generate impression based on medical findings. | 64 years old, Female, Reason: stones History: stones RIGHT KIDNEY: Kidney measures 9.3 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus. Simple appearing right renal cyst measures 0.9 x 0.8 x 1 cm.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.Bladder: No evidence of calculus within the bladder. | 1.No definite evidence of renal calculus.2.Simple appearing right renal cyst. |
Generate impression based on medical findings. | 57-year-old male with elevated liver function tests, evaluate for liver pathology. LIVER: Unremarkable echogenicity without discrete focal lesion.BILIARY TRACT: No cholelithiasis or evidence of cholecystitis. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.KIDNEY: Nephrolithiasis without hydronephrosis. The identified renal stones measure 3-4 mm.OTHER: No significant abnormalities noted. | 1. No specific findings to account for the patient's elevated liver enzymes. 2. Nephrolithiasis without hydronephrosis. |