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Generate impression based on medical findings. | Reason: HCV, elevated APRI @ 2.99 eval for lesions. History: HCV, probable cirrhosis LIVER: The liver measures 11.6 cm in length. Coarse, echogenic hepatic parenchyma. The portal vein is patent with normal directional hepatopedal portal venous flow, peak velocity 23 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common hepatic duct measures 0.3 cm. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 9.7 cm in length. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.2 cm in length. No shadowing stones or hydronephrosis.OTHER: No ascites. | 1. Coarse, echogenic liver, consistent with hepatic parenchymal dysfunction or chronic liver disease. No focal mass is identified. |
Generate impression based on medical findings. | Reason: 69 yo with cirrhosis please screen for HCC LIVER: The liver measures 15.5 cm in length and is nodular in contour. The liver parenchymal echotexture demonstrates increased echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.1 m/s. Recanalized umbilical vein.BILIARY TRACT: Gallbladder wall thickening is nonspecific but likely represents the sequela of chronic liver disease. Single 1 mm adherent stone versus tiny polyp. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common hepatic duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: Spleen is enlarged measuring 20.8 cm in length. Small splenule.RIGHT KIDNEY: Kidney measures 9.7 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 9.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Large volume ascites, particularly in the pelvis. | 1.Cirrhotic liver morphology and increased hepatic echogenicity consistent with chronic liver disease, without discrete lesion.2.Sequelae of portal hypertension including splenomegaly and ascites.3.Gallbladder wall thickening nonspecific but likely related to chronic liver disease. |
Generate impression based on medical findings. | Male, 49 years old. Urinary retention, CKD. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 10.3 cm in length with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.9 cm in length with increased cortical echogenicity. No shadowing stones or hydronephrosis.OTHER: The bladder is decompressed with Foley catheter in place. | Increased renal cortical echogenicity compatible with medical renal disease. No hydronephrosis. |
Generate impression based on medical findings. | 44-year-old female with a history of follicular thyroid carcinoma status post thyroidectomy presents for follow-up of nodules noted on prior ultrasound. RIGHT LOBE, LEFT LOBE, ISTHMUS MEASUREMENTS: The thyroid is absent.RIGHT LOBE: The thyroid is absent.LEFT LOBE: The thyroid is absent.ISTHMUS: The thyroid is absent.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Several lymph nodes are seen on the study.The previously seen node in level 2 on the right neck is not visualized on this study.Right neck level 3: An approximately 0.8 x 0.4 by is 1.6 cm node is seen with benign morphology.Right neck level 5: An approximately 1.0 x 0.4 x 1.3 cm node is seen with benign morphologyLeft node level 2: Previously seen lymph node is not visualized on this study.Left neck level 4: A previously seen 0.9 x 0.5 x 0.8 cm lymph node appears stable but is without definite benign characteristics.Left neck level 1: An approximately 1.0 x 0.3 x 1.5 cm lymph node is seen with benign morphologyOTHER: No significant abnormality noted. | 1. Surgical changes of a thyroidectomy.2. Lymph nodes appears stable as described above. Specifically, left neck level IV lymph node is stable but without definite benign characteristics. Recommend continued follow up with ultrasound. |
Generate impression based on medical findings. | Liver transplant LIMITED ABDOMENLIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 20.7 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: Mild splenomegaly. Spleen length 16.3 cm RIGHT KIDNEY: No significant abnormalities noted. 11.8 cm in lengthOTHER: Left kidney 12.5 cm in length | Coarse echogenic liver parenchyma again noted consistent with chronic liver disease without mass or ductal dilatation. Hepatosplenomegaly. No significant ascites.Patent hepatic vessels with normal directional flow. |
Generate impression based on medical findings. | 57 year old female who was recalled from screening mammogram for new right upper outer quadrant mass. 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. A 5 mm spiculated mass persists on spot compression views in the right upper outer quadrant.Ultrasound: Targeted right upper quadrant ultrasound was performed. Right breast 10 o'clock position 4 cm from the nipple, there is a suspicious taller than wide hypoechoic mass measuring 5 x 4 mm, which most likely responsible mammographic abnormality. | Suspicious spiculated 5-mm mass in the right breast 10 o'clock position on mammogram and ultrasound, needs further evaluation with ultrasound guided biopsy.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | 77-year-old male patient with history of melena. Evaluate for liver parenchyma for changes suggestive of cirrhosis. Evaluation limited secondary to patient body habitus.LIVER: The liver measures 17.9 cm in length and demonstrates coarsened hepatic echotexture. Main portal vein flow is hepatopetal and measures 0.6 m/sec. The hepatic veins are dilated.GALLBLADDER, BILIARY TRACT: The gallbladder contains biliary sludge. No gallbladder wall thickening or pericholecystic fluid is identified. There is no intra- or extrahepatic biliary ductal dilatation. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 9.8 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.6 cm in length. No evidence of hydronephrosis.The spleen is poorly visualized. | 1. Limited evaluation with coarsened hepatic echotexture suggestive of hepatic parenchymal dysfunction.2. Biliary sludge. |
Generate impression based on medical findings. | Evaluate for hydronephrosis. Acute kidney injury. History of renal infarct. Evaluate for pancreatitis, gallstones and cirrhosis. LIVER: The liver measures 16.3 cm in length. Its mildly echogenic and nodular in contour compatible with cirrhosis. No focal liver lesions are evident. Mild intrahepatic biliary ductal prominence; correlate with bilirubin. The portal vein is patent with flow toward the liver on color Doppler imaging. Small probable portal lymph node noted measuring 2 cm in length.GALLBLADDER, BILIARY TRACT: Small non-shadowing gallstone or gallbladder polyp. No pericholecystic fluid. Common duct measures 4 mm which is within normal limits.PANCREAS: No significant abnormality noted. Body and tail obscured by overlying bowel gas.SPLEEN: No significant abnormality noted.KIDNEYS: No hydronephrosis of either kidney although both kidneys are mildly echogenic. The right kidney measures 11.5 cm in length and the left kidney measures 10.4cm in length. Left kidney was difficult to visualize, probably secondary to the known infarct. This complex area measured approximately 2.7 x 2.2 x 2.3 cm.ABDOMINAL AORTA: No significant abnormality. The proximal aorta measured 2.3 x 2.9 x 3.4 cm. The mid aorta measured 2.1 cm. The distal aorta was obscured by overlying bowel gas.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. Spleen measures 10.5 cm in length. | 1. Cirrhotic appearing liver with questionable intrahepatic biliary ductal dilatation but no evidence of extrahepatic biliary ductal dilatation; correlate with bilirubin.2. Presumed evolving left renal infarct. No hydronephrosis.3. Nonshadowing gallstone versus polyp. No evidence of cholecystitis. |
Generate impression based on medical findings. | 51-year-old female with left flank pain. RIGHT KIDNEY: Measures 11.7 cm in length. No renal stones, suspicious masses, or hydronephrosis.LEFT KIDNEY: Measures 11.5 cm in length. Left renal cyst measures 1.7 x 1.2 x 1.2 cm without septation or suspicious nodular component. No renal stones or hydronephrosis.OTHER: No significant abnormalities noted. | No nephrolithiasis, hydronephrosis, or suspicious mass lesions. |
Generate impression based on medical findings. | 45 years old, Female, Reason: assess for causes of RUQ pain radiating to back History: NAFLD LIVER: The liver is enlarged measuring 22.5 cm in length. Increased liver parenchymal echotexture suggestive of fatty infiltration. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: Patient has history of cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.2 cm in length. RIGHT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 11.5 cm in length. Normal echotexture. Nohydronephrosis or shadowing calculus.OTHER: No significant abnormalities noted. | 1.Hepatomegaly and increased hepatic parenchymal echogenicity consistent with fatty infiltration of the liver. |
Generate impression based on medical findings. | 49-year-old female with right upper quadrant abdominal pain concerning for capsulitis versus issues with gallbladder. LIVER: The liver measures 17.3 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal measures approximately 0.2 m/s.GALLBLADDER, BILIARY TRACT: There are no gallstones, pericholecystic fluid, or gallbladder wall thickening. No intra or extrahepatic biliary ductal dilatation is identified. The common bile duct measures approximately 2 mm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 11.3 cm in length. No evidence of hydronephrosis.OTHER: The left kidney measures 11.9 cm in length. No evidence of hydronephrosis. The spleen measures 9.3 cm in length. An accessory splenule is noted. | No specific findings to account for the patient's symptoms. |
Generate impression based on medical findings. | Thyrotoxicosis RIGHT LOBE MEASUREMENTS: 3.9 x 2 x 1.5 cmLEFT LOBE MEASUREMENTS: 1.9 x 1.7 x 3.6 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.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. | Slightly small gland without nodules or regional adenopathy. No evidence for increased vascularity to suggest acute inflammation.. |
Generate impression based on medical findings. | Hypercalcemia RIGHT LOBE MEASUREMENTS: 3.6 x 1.5 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.1 x 1 x 1.5 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Diffusely heterogeneous gland without discrete nodule.LEFT LOBE: Diffusely heterogeneous gland without discrete noduleISTHMUS: Diffusely heterogeneous gland without discrete nodulePARATHYROID GLANDS: 3.7 x 1.7 x 1.4 cm hypoechoic extrathyroidal focus projecting posterior and inferior to the left thyroid gland. The inferior margin of this lesion extends down to the supraclavicular thoracic inlet region.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Hypoechoic extrathyroidal focus projecting posterior and inferior to the left thyroid gland consistent with suspected parathyroid adenoma. The inferior margin of this lesion extends down to the supraclavicular thoracic inlet region.Diffusely heterogeneous gland without discrete nodule; raises the possibility of chronic thyroiditis. |
Generate impression based on medical findings. | Male 65 years old; Reason: r/o liver lesion History: HCV LIVER: The liver measures 13.2 cm in length. There is a coarse echotexture 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 22.5 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.6 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 3.9 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.5 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.3 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 12.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | Nonspecific coarse echotexture of the liver, which is compatible with chronic liver dysfunction. No worrisome masses are seen. |
Generate impression based on medical findings. | 48-year-old female with asymmetry on screening mammogram. Three standard views of the left breast with exaggerated CC and 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(BiRads Density Category B), unchanged in pattern and distribution. The previously seen asymmetry in the posterior outer breast on the cc view disperses somewhat with spot compression, and ultrasound was performed for further evaluation.ULTRASOUND | No mammographic or sonographic 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 medical findings. | 25-year-old male with sickle cell anemia, jaundice, hyperbilirubinemia. LIVER: Measures 19.0 in length, mildly enlarged. Unremarkable hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Cholelithiasis and gallbladder sludge without gallbladder wall thickening or sonographic Murphy sign. No 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: 1.6 cm complex right mid-polar cyst with internal echogenic material is unchanged since the prior study. 2.4 x 1.4 x 1.0 cm left renal cyst also unchanged. No hydronephrosis. OTHER: No significant abnormalities noted. | 1.Cholelithiasis and gallbladder sludge without evidence of acute cholecystitis or biliary ductal dilation.2.Bilateral renal cysts as described above without significant interval change since the prior study. |
Generate impression based on medical findings. | Bacteremia and diffuse pain LIVER: Coarse echogenic liver parenchyma without mass. Liver length 19.2 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.6 cm in lengthOTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. 9.8 cm in length. Spleen 12.7 cm in length. No ascites. Right pleural effusion. | Coarse echogenic liver parenchyma suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Cholelithiasis without acute inflammation. No ascites.Echogenic renal parenchyma raises the possibility of medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on medical findings. | 38-year-old female status post left lumpectomy 2007 for invasive ductal carcinoma DCIS status post radiation, chemotherapy and hormonal therapy presents to evaluate left breast thickening for one week. A targeted left ultrasound was performed for the patient’s area of concern. Area of thickening and pain noted in the left upper inner quadrant 10 to 11 o'clock position which is marked by Donna Christian. No lump was palpated on physical examination. Ultrasound demonstrates normal glandular tissue. There is no solid or cystic mass identified. | No sonographic evidence for malignancy, corresponding to area of left breast thickening and pain.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on medical findings. | Female 62 years old Reason: eval for PCKD History: family history of PCKD RIGHT KIDNEY: Right kidney measures 11.6 cm. No hydronephrosis. No shadowing calculi. No cysts as clinically questioned. Cortical echogenicity is normal.LEFT KIDNEY: Left kidney measures 11.8 cm. No hydronephrosis. No shadowing calculi. No cysts as clinically questioned. Cortical echogenicity is normal.BLADDER: No significant abnormalities noted. | No renal cysts as clinically questioned. No other abnormality noted. |
Generate impression based on medical findings. | Female 65 years old; Reason: goiter, evaluate. History: goiter. Previously with nodules. Euthyroid. RIGHT LOBE MEASUREMENTS: 4.8 x 1.9 x 1.9 cm, previously 5.0 x 1.6 x 1.9 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.6 x 1.6 cm, previously 5.1 x 1.6 x 1.5 cm.ISTHMUS MEASUREMENT: 0.3 cm, previously 0.3 cmRIGHT LOBE: Hypoechoic nodule in the midportion of the right lobe measures 0.9 x 0.9 x 0.8 cm as compared to 1.1 x 1.0 x 0.6 cm on prior exam, essentially unchanged.LEFT LOBE: Multiple hypoechoic nodules with ill-defined border, with the largest measuring 1.1 x 0.8 x 0.6 as compared to 1.3 x 0.6 x 0.5 cm on prior exam, unchanged.ISTHMUS: Hypoechoic and well-defined nodule in the isthmus measuring 0.4 x 0.4 x 0.3 as compared to 0.5 x 0.4 x 0.2 cm on prior exam, unchanged. Additional nodule is also unchanged.LYMPH NODES: No significant lymphadenopathy.OTHER: No significant abnormality noted. | Stable multinodular thyroid. |
Generate impression based on medical findings. | 48-year-old female patient with history of goiter. Now with thyroid tenderness, possible subacute thyroiditis which did not respond to steroids. Question of masses or other lesions. RIGHT LOBE MEASUREMENTS: 2.3 x 2.7 x 6.7 cm, previously 2.2 x 1.9 x 6.17 cm.LEFT LOBE MEASUREMENTS: 2.2 x 3.1 x 8.3 cm, previously 3.0 x 3.0 x 7.7 cmISTHMUS MEASUREMENTS: 7 mm in thickness.RIGHT LOBE: A solid nodule with cystic spaces within the right midpole measures 1.6 x 1.2 x 1.0 cm, previously 1.3 x 1.0 x 1.5 cm. A spongiform-appearing nodule near the isthmus measures 1.0 x 0.4 x 1.1 cm, previously 1.2 x 0.5 x 1.0 cm.LEFT LOBE: A dominant left lower pole complex solid nodule is similar in appearance to the prior study measuring 3.7 x 2.4 x 2.8 cm, previously 3.6 x 2.4 x 2.8 cm. An additional hypoechoic nodule within the posterior medial aspect of the lower pole is similar in size measuring 0.9 x 0.8 x 0.4 cm, previously 0.8 x 1.1 x 0.5 cm. However, the appearance has changed now with a more defined cystic component and nodular solid component which could be related to hemorrhage.ISTHMUS: A predominately solid nodule with cystic spaces within the isthmus measures 1.0 x 0.6 x 1.1 cm, previously 1.2 x 1.0 x 1.3 cm. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral neck lymph nodes are noted.OTHER: No significant abnormality noted. | Similar size and appearance of multiple bilateral thyroid nodules except for a hypoechoic left lower pole nodule which has more defined cystic and solid components. |
Generate impression based on medical findings. | Hepatitis C LIVER: Coarse echogenic liver echotexture again noted with mild contour irregularity. No mass. Liver length 16 cm.GALLBLADDER, BILIARY TRACT: Stable 0.3 x 0.3 x 0.4 cm gallbladder polyp.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Stable right subcentimeter cyst. Right kidney 10 cm in lengthOTHER: Left kidney 10.8 cm in length. Spleen 8.4 cm in length. No ascites. | Coarse echogenic liver echotexture with cirrhotic morphology without mass or ductal dilatation. No ascites. Stable subcentimeter gallbladder polyp. |
Generate impression based on medical findings. | Female 55 years old Reason: eval liver morphology, r/o thrombosis History: decompensated cirrhosis vs acute liver failure LIMITED ABDOMENLIVER: Nodular and cirrhotic contour of the liver. No focal masses identified. Liver measures 16.8 cm in length.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. No evidence of acute gallbladder inflammation. Bile duct is normal measuring 5 mm. Gallstone is present within the gallbladder measuring 2.8 x 2.8 x 2.9 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 not well-visualized. KIDNEYS: Kidneys are not well-visualized secondary to body habitus and ascites. Left kidney measures 10.7 cm. Right kidney has normal echogenicity measuring 9.8 cm.OTHER: Mild to moderate ascites | 1.Cirrhotic liver morphology without mass. Portal vein is patent with hepatopetal flow, however the flow is sluggish and the caliber is small, which can be seen when a significant portosystemic shunt is present . Mild/moderate ascites2.Cholelithiasis. |
Generate impression based on medical findings. | 27-year-old female status post thyroidectomy RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.POSTOPERATIVE BED: No suspicious thyroid bed lesions.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left neck lymph node measures 2.5 x 1.1 x 0.5 cm, previously measuring 2.3 x 1.1 x 0.5 cm. Right level 2/3 lymph node measures 1.1 x 0.8 x 0.6 cm with a fatty hilum. Right level 5 lymph node measures 2.5 x 1.7 x 0.6 cm, previously measuring 2.1 x 1.3 x 0.5 cm,OTHER: No significant abnormality noted. | 1.Benign-appearing bilateral lymph nodes.2.No suspicious lesions in the thyroid bed. |
Generate impression based on medical findings. | 60-year-old female with flank pain, hematuria Limited examination due to body habitus. RIGHT KIDNEY: Measures 10.5 cm in length. No hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 12.0 cm in length. No hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | No nephrolithiasis, hydronephrosis, or suspicious lesion. |
Generate impression based on medical findings. | History of a mobile sternal subcutaneous palpable lesion. Targeted grayscale and color Doppler ultrasound of the patient's reported palpable parasternal subcutaneous soft tissues demonstrates no discrete solid lesion or fluid collection. | No discrete solid lesion or fluid collection. |
Generate impression based on medical findings. | Short term follow-up ultrasound for a probable area of fat necrosis. Per the patient, this area was easily palpable in the past and has now completely resolved to her. A targeted left ultrasound was performed at the site of the previously palpable abnormality. At the site of previous palpable concern, in the left breast 10:00 position, there is a mixed echogenicity circumscribed lesion with hyperechoic components measuring 5 x 4 mm compatible with resolving fat necrosis/oil cyst formation. Note that though the current measurements are slightly larger than the prior measurements reported, the prior measurements included only the central cystic component and not the surrounding hyperechoic fat necrosis. When the surrounding hyperechoic areas included on the old exam, the finding previously measured up to 9 mm. | Resolving fat necrosis/oil cyst formation. As long as the patient's physical examination remains normal and no palpable abnormality can be re-appreciated at this site, routine clinical follow-up is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | Reason: RUQ, rule out obstruction History: new elevated bilirubin LIVER: Coarse, echogenic hepatic parenchyma. The liver measures 17.5 cm in length. The portal vein is patent with normal directional hepatopedal portal venous blood flow, peak velocity 25.6 cm/s.GALLBLADDER, BILIARY TRACT: Shadowing mobile echogenic stone is seen in the gallbladder neck along with layering sludge. No evidence of pericholecystic inflammation or fluid. The gallbladder wall measures up to 3 mm. The common bile duct measures 0.2 cm. No biliary ductal dilatation.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 9.9 cm in length. No hydronephrosis, masses, or stones.LEFT KIDNEY: The left kidney measures 10.47 m in length. No hydronephrosis, masses, or stones.OTHER: No ascites. The spleen measures 9.5 cm in length. | 1. Single stone in the gallbladder neck and layering sludge without evidence of cholecystitis.2. Coarse, echogenic hepatic parenchyma, consistent with hepatic steatosis or parenchymal dysfunction. |
Generate impression based on medical findings. | History of fatty liver LIVER: Echogenic heterogeneous echotexture without mass. Liver length 19.4 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.6 cm in lengthOTHER: Left kidney 12 cm in length. Spleen 11.7 cm in length. No ascites | Echogenic heterogeneous liver echotexture consistent with fatty infiltration without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | 83-year-old female with urinary sepsis. Acute kidney injury. Evaluate for hydronephrosis/pyelonephritis. The exam is limited by patient motion and breathing.RIGHT KIDNEY: The right kidney measures approximately 11.4 cm in length. The kidney is moderately echogenic consistent with parenchymal disease. There is no hydronephrosis. Arising from the lower pole is a renal sinus and cortical cysts measuring 4.1 cm in greatest diameter. Trace of perirenal fluid.LEFT KIDNEY: Not adequately visualized due to shadowing bowel gas and patient motion.URINARY BLADDER: Collapsed with Foley catheter.OTHER: No significant abnormalities noted. | Echogenic right kidney with cyst and no hydronephrosis.Inadequate visualization of the left kidney. |
Generate impression based on medical findings. | EtOH with increased LFTs LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 22.9 cm. Perihepatic ascites. Liver is mildly nodular suggesting cirrhosis.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. Common duct measures 6 mm which is at the upper limits of normal.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.5 cm in lengthOTHER: Left kidney 12.8 cm in length. Spleen 10 cm in length. Small amount of ascites surrounds the liver. | New perihepatic ascites. Cirrhotic appearing liver. |
Generate impression based on medical findings. | Incidental liver lesion LIVER: Coarse echogenic liver echotexture. 3.9 x 3.2 x 4.3 cm peripheral hypoechogenic focus within segment 4A of the liver corresponding to the lesion seen on the noncontrast chest CT. Liver length 14.6 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.8 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.9 cm in lengthOTHER: Left kidney 11.2 cm in length. No ascites. | Peripheral hypoechoic echogenic lesion within segment 4A of the left lobe of the liver corresponding to lesion seen on the noncontrast CT. This lesion is incompletely characterized on ultrasound. After talking to the patient, he confirms that prior CTs are available from an outside institution. Comparison with these images would be very helpful to document temporal stability of this lesion. If these images are not available or if this lesion is new relative to these prior studies, would recommend correlation with dedicated cross sectional imaging.Coarse echogenic liver suggestive for fatty infiltration/parenchymal dysfunction. No ductal dilatation. No ascites. |
Generate impression based on medical findings. | 57 years old, Male, Reason: assess for liver cirrhosis History: hepatitis C positive LIVER: The liver measures 17 cm in length. Majority of the hepatic parenchyma normal limits. A focal hypoechoic area may be posttraumatic or represent focal fatty sparing. No nodularity to suggest cirrhosis. No focal hepatic masses. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 7.5 cm in length. RIGHT KIDNEY: Kidney measures 8.8 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.1 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.No nodularity of the hepatic parenchyma to suggest cirrhosis.2.Anterior hypoechoic region of the liver may be posttraumatic or represent focal fatty sparing. No suspicious focal hepatic masses. |
Generate impression based on medical findings. | 72-year-old male with history of cirrhosis, evaluate for hepatocellular carcinoma. LIVER: Measures 9.2 in length. Cirrhotic morphology and increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No 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. | Cirrhosis and increased hepatic echogenicity consistent with chronic liver disease. No focal lesion identified. |
Generate impression based on medical 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 medical findings. | Reason: gallbladder, cholelithiasis on CT, now pain in RUQ LIVER: The liver measures 15.2 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.29 m/s.BILIARY TRACT: Cholelithiasis including large gallstone without associated significant gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 6.9 cm in length. RIGHT KIDNEY: Right pelvic kidney measures 9.9 cm in length. Increased cortical echogenicity. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis or biliary ductal dilatation. 2.Increased hepatic echogenicity raising the possibility of parenchymal dysfunction/fatty infiltration.3.Increased echogenicity of right pelvic kidney raising the possibility of medical renal disease. |
Generate impression based on medical findings. | Reason: concern for cholecystitis on CT scan History: epigastric abdominal pain BILIARY TRACT: The gallbladder is mildly distended and contains layering sludge. No shadowing gallstones are identified. No gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter. | Sludge in a mildly distended gallbladder without specific sonographic evidence of acute cholecystitis. If there is persistent clinical concern for acute cholecystitis, nuclear medicine HIDA scan may be considered as clinically warranted. |
Generate impression based on medical findings. | 50-year-old male presents for evaluation of a possible left hydrocele. RIGHT TESTIS: Measures 3.7 x 3.2 x 3.3 cm. Parenchyma has normal homogenous echogenicity without focal mass. Normal vascular flow without evidence of torsion.LEFT TESTIS: Measures 3.5 x 2.7 x 3.7 cm. Parenchymal has normal homogenous echogenicity without focal mass. Normal vascular flow without evidence of torsion.RIGHT EPIDIDYMIS: Measures 0.6 x 1.0 x 0.9 cm. No radiographic abnormalities.LEFT EPIDIDYMIS: Measures 0.6 x 0.6 x 1.4 cm. No radiographic abnormalitiesOTHER: Large amount of simple appearing fluid area the left testicle and enlarging the scrotum compatible with a hydrocele. Small anechoic area surrounding the right testicle suggestive of a hydrocele. | 1. Large left-sided hydrocele and small right-sided hydrocele. No sonographic evidence of torsion, focal mass, or infection. |
Generate impression based on medical findings. | 46-year-old female patient with irregular goiter. History of subacute thyroiditis. Question of nodules. RIGHT LOBE MEASUREMENTS: 6.7 x 2.4 x 2.1 cm.LEFT LOBE MEASUREMENTS: 6.8 x 2.2 x 2.8 cm.ISTHMUS MEASUREMENTS: 7 mm in thickness.RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity without dominant thyroid lesion.LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity and contains a 0.7 x 0.4 x 0.6 cm cystic nodule within the upper pole.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous, enlarged thyroid gland without dominant thyroid lesion. |
Generate impression based on medical findings. | 49-year-old male patient status post DDRT now with increased JP output and dropping hemoglobin. RENAL TRANSPLANT: LOCATION: Left iliac fossa.PERITRANSPLANT TISSUES: There is a 10.1 x 15.0 cm heterogeneous collection superior and lateral to the transplant kidney suggestive of a hematoma.KIDNEY: The transplant kidney measures 10.6 cm in length.COLLECTING SYSTEM/URETER: No evidence of hydronephrosis.URINARY BLADDER: The bladder is decompressed with a Foley catheter.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vesselsTransplant renal artery anastomosis: 54 cm/s with RI of 0.77Transplant renal artery proximal: 51 cm/s with RI of 0.79Transplant renal artery mid: 56 cm/s with RI of 0.80Transplant renal artery distal: 46 cm/s with RI of 0.74Transplant renal artery hilum: 37 cm/s with RI of 0.72Segmental arteries RI range: 0.61 to 0.70Arcuate arteries RI range: 0.55 to 0.67OTHER: No significant abnormality noted | Heterogeneous collection superolateral to the transplant kidney which is suggestive of a perinephric hematoma; correlation with non-contrast CT is recommended. |
Generate impression based on medical findings. | 38 years old, Female, Reason: evaluate GB History: RUQ pain Exam is limited due to patient's body habitus.LIVER: The liver measures 18.5 cm in length. Increased echogenicity of the liver 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.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 11.3 cm in length. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.6 cm in length, kidney not well visualized. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or acute cholecystitis.2.Increased echogenicity of the liver is consistent with fatty infiltration. |
Generate impression based on medical 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 medical findings. | 42-year-old female with sepsis in abdominal gallbladder wall and CT. LIVER: Attenuation of liver is somewhat limited by patient's ability to cooperate. No gross, focal abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder wall is thickened and somewhat hypoechoic. However no gallstones are identified. No focal pericholecystic fluid. Gallbladder wall thickening may be nonspecific in the face of ascites is identified in prior CT, and hypoalbuminemia may contribute to this appearance. The biliary tract is normal in caliber.PANCREAS: Not adequately visualized.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Borderline splenomegaly | Gallbladder wall thickening without obvious gallstones. |
Generate impression based on medical findings. | Elevated creatinine RIGHT KIDNEY: Echogenic parenchyma with multiple cysts. No worrisome mass, stone, or hydronephrosis. Right kidney 10.7 cm in length.LEFT KIDNEY: Echogenic parenchyma with multiple cysts. No worrisome mass, stone, or hydronephrosis. Left kidney 12.4 cm in length.OTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction with multiple cysts. No worrisome mass, stone, or obstruction. |
Generate impression based on medical findings. | 39-year-old female patient with bilateral saline implants with history of prior implant revision. Patient presented with a palpable abnormality in the left breast. Patient submitted outside study for review. Submitted for review are diagnostic mammogram and ultrasound (4/14/15), biopsy ultrasound (5/4/15), and postbiopsy mammogram (5/4/15) performed at Presence St. Mary's Hospital Indiana. For comparison,standard mammogram (11/30/2011) is available. DIAGNOSTIC MAMMOGRAM AND ULTRASOUND | Palpable abnormality in the left breast 6:00 position with ultrasound demonstrating 2 cm hypoechoic area. Concordant pathology reports from biopsy of this area at outside hospital demonstrated fibrocystic disease without atypia or malignancy, with areas of fibrosis and pseudoangiomatosis hyperplasia. Correlation with physical examination is recommended to ensure concordance between the biopsy result and physical exam. As long as the patient's physical examination remains benign, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Evaluate left renal cyst RIGHT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Right kidney 11.3 cm in lengthLEFT KIDNEY: Stable minimally complex left renal cyst measuring 6.9 x 6 x 5.4 cm. Normal parenchymal echogenicity without worrisome mass, stone, or hydronephrosis. Left kidney 13.1 cm in length.OTHER: No significant abnormalities noted. | Stable minimally complex left renal cyst. |
Generate impression based on medical findings. | Abdominal swelling, evaluate for ascites Limited 4-quadrant ultrasound of the abdomen shows no ascites. Coarsened hepatic echotexture suggests fatty infiltration. | Limited exam without ascites. |
Generate impression based on medical findings. | Febrile, hypotensive, rule out gallbladder pathology LIVER: Liver measures 17.6 cm with increased echogenicity compatible with fatty liver. No focal lesions noted. No intrahepatic biliary ductal dilatation noted. BILIARY TRACT: Gallbladder is markedly distended with sludge layering within it. Few hyperechoic small stones could be noted within the gallbladder. No evidence of gallbladder wall thickening. Patient cannot lie injected disposition therefore limited evaluation as per the technologist.On bile duct at the porta hepatis measures 1.5 cm.PANCREAS: Limited evaluation due to overlying bowel gas.SPLEEN: Spleen measures 10 cm without any focal lesions.KIDNEY: Right kidney measures 13 cm and left kidney measures 13.4 cm. Both kidneys demonstrate increased echogenicity compatible with chronic medical renal disease. No hydronephrosis or focal lesions.OTHER: Ascites noted | Hepatic steatosisDistended gallbladder with sludge and small stones without acute cholecystitisIncreased echogenicity of the kidneys consistent with chronic medical renal disease.Ascites |
Generate impression based on medical findings. | 57-year-old female with history of left breast mass status post trauma. Annual follow-up. Family history of breast cancer in maternal cousin. Mammogram: Three standard views of both breasts 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. An 10:00 position of the left breast, the previously mentioned dense mass has significantly decreased in size now measuring 20 x 8 mm. There are stable subcentimeter benign type masses, likely benign intramammary lymph nodes, in the left upper outer quadrant.The right breast is unremarkable.Ultrasound: A targeted left breast ultrasound was performed in the area of mammographic abnormality at the 10:00 position. Approximately 8- 10 cm from the nipple at the 10:00 position, there is a mixed echogenicity oval lesion with a hyperechoic rim which has significantly decreased in size now measuring 16 x 7 x 5 mm (compared to 13 x 12 x 12 mm on prior). There was no internal vascularity. | Findings compatible with a resolving hematoma in the left breast. 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. | 20-year-old female with bilateral fibroadenomas, biopsy proven in the left breast 12:00 position and right breast 7:00 position. Follow-up examination. Mild intermittent pain, otherwise no new breast complaints. Ultrasound of both breasts was performed, redemonstrating five fibroadenomas, three in the right breast and two in the left breast, with measurements as follows.Right breast:7:00 position, 4 cm from the nipple: 2.7 x 1.4 x 2.0 cm, previously 3.1 x 2.5 x 1.8 cm.9:00 position, 3 cm from the nipple: 2.0 x 1.1 x 1.9 cm, previously 2.0 x 2.0 x 1.3 cm.Retroareolar region: 1.8 x 1.1 x 2.0 cm, previously 2.0 x 1.2 x 2.2 cm.Left breast:4:00 position, 2 cm from the nipple: 2.4 x 1.1 x 2.6 cm, previously 2.1 x 1.8 x 1.1 cm.12:00 position 1 cm from the nipple: 2.2 x 1.6 x 2.6 cm, previously 3.3 x 3.5 x 2.1 cm. | Bilateral solid masses consistent with fibroadenomas, which are overall stable or decreased in size compared with the prior studies dating back to 2013. No further ultrasound follow-up is necessary at this time. Additional imaging may be performed in the setting of new symptoms or as warranted clinically. BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | 3-year-old female with left cutaneous ureterostomy takedown and reimplantation 10/04/16. History of cloacal reconstruction, left solitary kidney with obstructing megaureter with left pyeloplasty. Assess for possible improvement in dilation of bladder and left upper tracts. BLADDER Wall Thickness: Moderate wall thickening. Contents: There is slight decrease in the debris within the bladder, with the bladder appearing slightly more decompressed as compared to prior exam. Distal Ureter -- SFU Grade** Left: 0 , no significant ureter dilatation is observed on this exam. Ureteral Jets Left: Not observed LEFT KIDNEY Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Left: 3, small amount of debris is identified within the left renal pelvis. Dilatation of the renal pelvis measures 2.5 cm anteroposteriorly, as compared to 2.8 cm on the prior exam. Length*** Left: 8.4 cm Mean for age: 7.3 cm Range for age: 6.1 - 8.1 cmADDITIONAL OBSERVATIONS: No significant abnormalities noted | Persistent left hydronephrosis with debris in the renal pelvis and bladder. Ureteral dilatation is no longer visualized.*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 medical findings. | Hepatitis C LIVER: Coarse echogenic liver echotexture again noted without mass. Liver length 14.8 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.3 cm in length.OTHER: Left kidney 12.2 cm in length. Spleen 11.7 cm in length. No ascites. | Stable coarse echogenic liver echotexture consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Abdominal pain LIVER:Mildly coarse and echogenic liver echotexture without mass. Liver length 15.4 cm.GALLBLADDER, BILIARY TRACT: No significant abnormality noted.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. Spleen 8.3 cm in lengthKIDNEYS: Benign bilateral renal cysts. Right kidney 12.1 cm in length; left kidney 13.1 cm in length. ABDOMINAL AORTA: Proximal abdominal aorta not visualized due to overlying gas. Mid and distal aorta are unremarkable.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. No ascites | Mildly coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | History of multinodular goiter. Previous bilateral fine-needle aspiration demonstrated benign thyroid nodules. RIGHT LOBE MEASUREMENTS: 5.3 x 2.2 x 1.5 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.4 x 1.2 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: 2 dominant right thyroid lobe nodules with the superior nodule measuring 2.7 x 1.5 x 1.7 cm, compared to approximately 2.3 x 1.5 x 1.2 cm previously. It is isoechoic well-defined and without significant vascularity.The mid nodule measures 1.6 x 0.6 x 1.4 cm, compared to 1.6 x 0.6 x 0.9 cm when remeasured using similar technique. This nodule has a more cystic colloid appearance.LEFT LOBE: 3 discrete nodules are noted in the left lobe with a stable mid nodule measuring 0.9 x 0.6 x 0.7 cm with coarse calcifications. The superior and inferior nodules measure 1.4 x 0.5 x 1.0 cm and 1.3 x 0.8 x 1.1 cm respectively and are predominantly isoechoic with cystic changes favoring colloid nodules, not significantly changed in size accounting for differences in measurement technique.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral thyroid nodules are stable to minimally increased in size accounting for differences in measurement technique. Subcentimeter coarsely calcified mid left thyroid lobe nodule is unchanged. |
Generate impression based on medical findings. | Status post cardiac arrest LIVER: Coarse echogenic liver echotexture without mass. Liver length 16 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. Right kidney 11.5 cm in lengthOTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. Left kidney 12.3 cm in length. Spleen 7.9 cm in length. Mild ascites. Bilateral pleural effusions. | Coarse echogenic liver echotexture suggestive for parenchymal dysfunction without mass or ductal dilatation. Mild ascites. Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on medical findings. | Hepatitis B LIVER: Coarse echogenic liver parenchyma without mass. Liver length 13.7 cm.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11 cm in lengthOTHER: Left kidney 11.7 cm in length. Spleen 8.2 cm in length. No ascites. | For parenchyma consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Male 77 years old with elevated bili, fever/septic shock, assess for cholangitis LIMITED ABDOMENLIVER: The liver has a smooth contour, it measures 22.0 cm in length. The parenchyma is mildly coarse and echogenic . No focal liver lesion is identified. The main portal vein is patent and demonstrates hepatopetal flow with a velocity of 3.0 m/s. There is a small amount of perihepatic ascites.BILIARY TRACT: There is no cholelithiasis. The gallbladder wall is thickened at 1.2 cm, there is no pericholecystic fluid. Common duct measures 4 mm in diameter, there is mild thickening of the common bile duct wall. There is no intrahepatic biliary ductal dilatation or focal liver lesion.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 13.2 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 12.7 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 11.9 cm. in length. There are scattered splenic calcifications.OTHER: Trace right pleural effusion. | 1.Gallbladder wall edema and mild thickening of the common duct wall are non-specific findings that can be seen in cholangitis. 2.Hepatomegaly with mildly echogenic liver parenchyma compatible with hepatic steatosis/parenchymal dysfunction. |
Generate impression based on medical findings. | Ms. Padilla is a 19 year old female with questionable lesion identified on outside ultrasound exam. She presents today for a repeat ultrasound study. Per patient, she has had a palpable lesion for the past 4 months, which has been decreasing in size. She denies any history of trauma, fever, chills. On physical exam at the palpable area of concern, dense nodular tissue is appreciated. No discrete mass is appreciatedA targeted right breast ultrasound was performed for the palpable area of concern. In the right breast 10:00 position, approximately 6 cm from the nipple, dense fibroglandular tissue is apparent. There is no suspicious cystic or solid mass identified. | No sonographic evidence for malignancy. Patient should follow-up with her primary physician as warranted. All results and recommendations were relayed to the patient and her mother.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Right upper quadrant pain LIVER: No significant abnormalities noted. 15.7 cm in lengthGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation. No focal Murphy's sign couldn't be elicited.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 10.4 cm in length. Spleen 9.4 cm in length. No ascites. | Cholelithiasis without morphologic evidence for acute inflammation or ductal dilatation. Although the patient experienced diffuse pain while scanning, no focal Murphy's sign couldn't be elicited. |
Generate impression based on medical findings. | 47-year-old male patient with history of lymphoma, papillary thyroid cancer for thyroidectomy, lymph node mapping. RIGHT LOBE MEASUREMENTS: 5.4 x 2.1 x 2.2 cm, previously 6.0 x 2.5 x 2.0 cm.LEFT LOBE MEASUREMENTS: 4.8 x 1.9 x 1.7 cm, previously 5.3 x 1.8 x 1.7 cm.ISTHMUS MEASUREMENTS: 3 mm in thickness.RIGHT LOBE: The right thyroid lobe is diffusely heterogeneous in echotexture. Again seen is a complex cystic mass in the mid to inferior right lobe measuring approximately 1.2 x 1.3 x 1.3 cm. This has internal round calcifications as well debris.LEFT LOBE: The left thyroid lobe is diffusely heterogeneous in echotexture without a dominant thyroid mass.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Numerous enlarged lymph nodes are noted in the neck bilaterally including the submandibular regions.A right submandibular region lymph node measures 3.0 x 0.8 x 2.6 cm. A right level two lymph node measures 2.0 x 0.7 cm. Multiple additional right level three and level four lymph nodes are seen. These lymph nodes appear to have normal morphology.An enlarged lymph node within the left submandibular region measures 1.7 x 1.3 x 1.4 cm and is abnormal in morphology. A left level two lymph node measures 1.5 x 0.6 cm. Additional lymph nodes are noted within the left three and four stations.OTHER: No significant abnormality noted. | 1. Dominant right thyroid nodule, previously biopsied demonstrating papillary thyroid cancer.2. Enlarged bilateral submandibular and neck lymph nodes, many of which demonstrate normal morphology except for a left submandibular region node. |
Generate impression based on medical findings. | 38-year-old male with pancreatitis and persistent abdominal pain, now trending conjugated bilirubin and LFTs Limited visualization of the solid organs and pancreas due to overlying bowel gasLIVER: Liver measures 20.7 cm, diffuse fatty liver noted. No intrahepatic ductal dilatation.. No definite focal lesions noted.GALLBLADDER, BILIARY TRACT: Gallbladder is well-distended without any focal lesions. Gallbladder wall thickness in the upper limit of normal measuring up to 5 mm probably secondarily inflamed due to pancreatitis. Minimal fluid noted in the Morison's pouch.Common hepatic duct measures up to 3 mm.PANCREAS: Head of the pancreas is visualized appears edematous. Rest of the pancreas not visualized due to overlying bowel gas. Haziness noted within the mid abdomen.KIDNEY: Right kidney measures 11.2 cm the left kidney measures 11 cm. No hydronephrosis. Normal echotexture noted. OTHER: Spleen measures 11.5 cm with normal echo texture. | Limited visualization of the pancreas and mid abdomen due to overlying bowel gas.Gated matter is head of the pancreas consistent with known pericarditis.Gallbladder wall thickness is secondary to the pancreatitisDiffuse fatty liver noted.Mild ascites |
Generate impression based on medical findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 4.4 x 1.5 x 1.4 cmLEFT LOBE MEASUREMENTS: 4 x 1.5 x 1.4 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Multiple subcentimeter nodules identified in the right lobe, mostly partly cystic partly solid in nature especially in the midpole that measures 0.8 x 0.6 x 0.7 cm.LEFT LOBE: A large partly cystic partly solid nodule identified in the midpole that measures 2 x 1.2 x 1.3 cm with minimal peripheral blood flow.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology level 3 right neck lymph nodes and level 2 left neck lymph nodes noted.OTHER: No significant abnormality noted. | Dominant left thyroid partly cystic partly solid nodule amenable to FNA. |
Generate impression based on medical findings. | Reason: RUQ; h/o HCV; abdominal pain. Per electronic medical record, also history of end-stage renal disease. LIVER: The liver measures 19.2 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 0.25 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.4 cm in length. RIGHT KIDNEY: Kidney measures 12.5 cm in length. Most of the renal parenchyma is replaced by innumerable cysts, some with internal complexity.LEFT KIDNEY: Kidney measures 14.0 cm in length. Most of the renal parenchyma is replaced by innumerable cysts, some with internal complexity.OTHER: No significant abnormalities noted. | 1.Innumerable cysts in both kidneys compatible with acquired cystic renal disease in the setting of dialysis.2.No focal hepatic lesions identified. |
Generate impression based on medical findings. | 34 year old female with a small palpable lump in the right breast With physical exam, a small, mobile mass is palpated at 9:00 position near the nipple in the right breast. With focused ultrasound, there is an oval shaped simple cyst, measuring 5 x 4 mm at the site of palpable lump in the right breast. | Simple cyst in the right breast BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | 44-year-old female with transaminitis. Evaluate liver. LIVER:Measures 14.8 cm. Increased echogenicity. No focal mass, ascites, or intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. The wall measures 2.7 mm. No pericholecystic fluid, stones, or sludge. The common bile duct measures 2.8 mm.PANCREAS: Evaluation is limited due to overlying bowel gas.SPLEEN: Measures 8.4 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 9.4 cm. Left kidney measures 11.0 cm. Normal echogenicity. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Increased hepatic echogenicity consistent with fatty infiltration and chronic liver disease/parenchymal dysfunction. No mass or ascites. |
Generate impression based on medical findings. | 46-year-old female with lump of 1.5 cm diameter on the right posterior calf. Grayscale and color limited ultrasound of the right posterior lower extremity at the patient's described palpable abnormality demonstrates no mass, fluid collection, or other specific findings to account for the patient's symptoms. | No sonographic abnormalities to account for the patient's palpable complaint. |
Generate impression based on medical findings. | 32-year-old male with history of nausea and vomiting. LIVER: No hepatic lesions identified. Mild increased echogenicity of the hepatic parenchyma. The liver measures 17.9 cm in length. The main portal vein demonstrates normal hepatopedal flow.BILIARY TRACT: No evidence for gallstones or wall thickening. The common bile duct measures 3 mm in diameter.PANCREAS: Normal echogenicity of the pancreatic head and body. The tail is obscured due to overlying bowel gas.SPLEEN: The spleen measures 8.6 cm in length.RIGHT KIDNEY: The right kidney measures 10.9 cm in length. No hydronephrosis. OTHER: The left kidney measures 10.1 cm in length. No hydronephrosis. There is a 1.8 x 1.9 x 2.2 cm parapelvic cyst of the left upper renal pole. | 1. No acute abnormality of the right upper quadrant.2. Mild increased echogenicity of the hepatic parenchyma. Consider fatty infiltration. |
Generate impression based on medical findings. | 78-year-old female patient with chronic right flank pain. Assess for liver metastases. LIVER: The liver measures 15.7 cm in length and demonstrates increased parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.13 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. Sonographic Murphy's sign is negative. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 2 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 9.0 cm in length. No evidence of hydronephrosis. There is a 3.3 x 3.7 x 2.4 cm minimally complex right upper pole renal cyst.OTHER: The left kidney measures 9.4 cm in length. No evidence of hydronephrosis.The spleen measures 8.1 cm in length. | 1. Increased hepatic parenchymal echogenicity without focal hepatic lesion. 2. Minimally complex right upper pole renal cyst. |
Generate impression based on medical findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Personal history of bilateral cyst aspiration approximately 10-15 years ago. Family history of breast cancer in sister, diagnosed at the age of 52. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. This examination was interpreted by both Dr. Sheth and Dr. Schacht. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on medical findings. | Reason: Evaluate biliary tree History: abdominal pain, nausea, h/o cholecystectomy BILIARY TRACT: Status post cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter. | Limited examination. No biliary ductal dilatation. |
Generate impression based on medical findings. | Female 41 years old; Reason: RUQ pain, eval stones History: above LIVER: The liver measures 16.9 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 20.0 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 4.0 mm. No stones or sludge are seen. No pericholecystic fluid. Negative sonographic Murphy sign. The common bile duct measures 1.7 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.2 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.9 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 13.7 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | 1. No evidence of cholelithiasis or acute cholecystitis are seen. No intra or extrahepatic ductal dilation.2. Coarse increased echogenicity of the liver parenchyma compatible with fatty infiltration/hepatocellular dysfunction. |
Generate impression based on medical findings. | Hepatitis B. Evaluate for HCC. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity, suggestive of steatosis. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: 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 10.6 cm in length. The left kidney is 10.9 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 10.9 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No significant free fluid is identified. | Increased hepatic echogenicity, compatible with steatosis. No suspicious hepatic lesions identified. |
Generate impression based on medical findings. | 79-year-old male with oliguria. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 10.9 cm in length. There is a 2.7 cm renal sinus cyst identified. No hydronephrosis, shadowing calculus or solid mass. Echotexture likely within normal limits.LEFT KIDNEY: The left kidney measures 10.6 cm in length. Echotexture is likely within normal limits. There is an exophytic 3 cm cyst arising from the left kidney which may be mildly complex. No hydronephrosis or shadowing calculus.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | No hydronephrosis. Echogenic kidneys with cysts. Left renal cyst may be mildly complex. |
Generate impression based on medical findings. | 60 year old female with history of hepatitis C. Screening for HCC. LIVER: Slightly increased liver echogenicity, without focal masses. BILIARY TRACT: No biliary dilatation. Gallbladder is within normal limits.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney measures 9.3 cm in length.OTHER: No significant abnormalities noted. Left kidney measures 9.2 cm in length. Small, approximately 1.3 cm anechoic left kidney inferior pole cyst. | Slightly increased liver echogenicity, likely due to hepatic steatosis, without focal masses or other findings of malignancy. |
Generate impression based on medical findings. | 63 year-old male with questionable history of sarcoidosis. Evaluate liver, hepatic vein and artery. LIMITED ABDOMENLIVER: Coarse and echogenic in appearance measuring 18.3-cm in length. No focal hepatic lesions.BILIARY TRACT: Sludge and stones within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.SPLEEN: Normal in echogenicity measuring 14.9 cm in length. RIGHT KIDNEY: Measures 11.4 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 12.1 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.Moderate ascites. | 1. Hepatomegaly with coarse and increased echotexture suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. Patent hepatic inflow and outflow vasculature.2. Sludge and cholelithiasis with no evidence of cholecystitis.3. Moderate ascites. |
Generate impression based on medical findings. | 30-year-old female patient with mild hepatomegaly and mottled appearance of right hepatic lobe of uncertain etiology on outside hospital CT with concern for Budd-Chiari versus hepatic venoocclusive disease. LIMITED ABDOMENLIVER: The liver measures 17.9 cm in length. Hepatic parenchyma echogenicity is mildly increased. No focal hepatic lesion is identified.BILIARY TRACT: No gallstones, pericholecystic fluid, or gallbladder wall thickening is identified. There is no intra or extrahepatic biliary ductal dilatation. The common duct measures 3 mm in diameter.PANCREAS: The head of the pancreas has normal echogenicity. The body and tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 8.5 cm in length. RIGHT KIDNEY: The right kidney measures 9.3 cm and the left kidney measures 10.4 cm in length. No evidence of hydronephrosis.OTHER: No significant abnormalities noted. | Patent hepatic vasculature. |
Generate impression based on medical findings. | 60-year-old female with hypothyroidism and history of abnormal thyroid imaging. RIGHT LOBE MEASUREMENTS: 6.3 x 2.8 x 2.2 cmLEFT LOBE MEASUREMENTS: 5.3 x 2.2 x 1.5 cmISTHMUS MEASUREMENTS: 0.7 cm minimally heterogeneous in echotexture. At the junction of the right lobe and isthmus there is a rounded almost isoechoic mass which is slightly heterogeneous in echotexture measuring 1.6 x 1.8 x 1.7 cm.RIGHT LOBE: Mildly heterogeneous in echotexture. Mass as noted above.LEFT LOBE: Mildly heterogeneous in echotexture. No focal mass. There is a solitary, dense 4 mm calcification in the upper pole of the left lobe medially without a defined, associated mass.ISTHMUS: Mildly heterogeneous in echotexture. Mass as noted above.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Enlarged gland with likely focal nodule at the junction of right lobe and isthmus.Solitary, coarse left lobe calcification without associated mass. |
Generate impression based on medical findings. | Male; 61 years old. Reason: 61 y/o M with elevated ALT, RUQ u/s requested to rule out fatty liver disease LIVER: The liver measures 15.2 cm in length. The liver contour is smooth. The parenchyma is markedly increased in echogenicity with a coarsened echotexture. There is a geographic area of sparing adjacent to gallbladder fossa. These findings limit sensitivity for identification of focal hepatic masses.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.2 m/sec.BILIARY TRACT: A small amount of debris is seen layering within the dependent portions of the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. The common duct measures 0.3 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9 .0 cm in length.KIDNEYS: The right kidney measures 11.1 cm in length, the left kidney measures 11.4 cm in length. There is no hydronephrosis or shadowing renal stone bilaterally. | Echogenic and coarse liver parenchyma compatible with hepatic steatosis. |
Generate impression based on medical findings. | 40-year-old female with a history of thyroid cancer with possible nodule on ultrasound. RIGHT LOBE: Status post thyroidectomy. Redemonstration of unchanged hyperechoic focus within the right thyroid bed representing benign postoperative change.LEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Scattered, subcentimeter lymph nodes.OTHER: No significant abnormality noted. | Status post thyroidectomy without evidence of worrisome mass or regional adenopathy.. |
Generate impression based on medical findings. | Male, 79 years old. Elevated creatinine RIGHT KIDNEY: The right kidney measures 11.7 cm in length, with increased cortical echogenicity. An upper pole exophytic simple cyst measures 2.1 x 1.9 x 1.9 cm. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 12.8 cm in length, with increased cortical echogenicity. An exophytic lower pole simple cyst measures 3.4 x 2.6 x 3.4 cm. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. | 1.Increased renal cortical echogenicity compatible with medical renal disease.2.Bilateral renal cysts. |
Generate impression based on medical findings. | 68-year-old male with nausea, evaluate for gallstones. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The imaged portions of the common bile duct appear unremarkable. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Status post cholecystectomy. No abnormalities to account for the patient's symptoms. |
Generate impression based on medical findings. | 67 years old, Male, Reason: renal mass History: renal mass RIGHT KIDNEY: Kidney measures 10.6 cm in length. Normal echotexture. Complex renal lesion measures slightly smaller than on the prior study now measuring 1.5 x 1.4 x 1.5 cm, previously measuring 1.8 x 1.6 x 1.7 cm.LEFT KIDNEY: Kidney measures 11 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.Other: The prostate is markedly enlarged and lobulated measuring 8.1 x 5.0 x 6.5 cm. | 1.Stable complex lesion in the right kidney which can be further characterized with dedicated kidney CT or MRI. Continued follow-up imaging is recommended.2.Markedly enlarged prostate. |
Generate impression based on medical findings. | Ultrasound follow-up for a small palpable area in the left breast inferior breast. A targeted left ultrasound was performed for the patient’s area of concern. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. The patient will be following up in surgical clinic later today.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Right renal cyst. Right kidney 10.9 cm in lengthLEFT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. 11.3 cm in length.OTHER: Bladder nondistended. Trace ascites. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. Trace ascites. |
Generate impression based on medical findings. | 2-year-old female patient with history of MEN2A presents for presurgery evaluation. Evaluate for suspicious nodules or lymph nodes. RIGHT LOBE MEASUREMENTS: 0.9 x 0.9 x 2.0 cm.LEFT LOBE MEASUREMENTS: 0.9 x 0.6 x 2.2 cm.ISTHMUS MEASUREMENTS: 0.1 cm.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No definitive parathyroid glands are observed.LYMPH NODES: Multiple enlarged lymph nodes are noted bilaterally. A right level III lymph node measures 0.8 x 0.3 x 1.1 cm. A left level II lymph node measures 0.9 x 0.9 x 1.8 cm.OTHER: No significant abnormality noted. | Normal-appearing thyroid gland with multiple enlarged bilateral lymph nodes in the neck. |
Generate impression based on medical findings. | Ms. Miller is a 24 year old female with a recent history of PE and left axillary adenopathy seen on recent CT study. She has no other medical problems. Targeted left axillary ultrasound is performed.In the left axilla, there is an enlarged abnormal morphology lymph node identified measuring 3.2 x 1.2 x 2.1 cm. There is no significant vascularity. | Abnormal morphology left axillary lymph node. An ultrasound-guided biopsy with clip placement is recommended for further evaluation. Of note, the patient does take Xarelto for her recently diagnosed PE.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | Oliguria. Rising creatinine. Status post sigmoid colectomy. Please note that the examination is limited by poor acoustic penetrationRIGHT KIDNEY: 7.6 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 8.5 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Not well visualized due to abdominal wounds and bandages.OTHER: No significant abnormality noted. | Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on medical findings. | Male 60 years old; Reason: pt s/p robotic whipple with biliary leak s/p IR Right biliary system PTC - concern for obstruction of left biliary system - please eval for ductal dilation History: rising Alk phos LIVER: The liver measures 16.1 cm in length. The left lobe of the liver is not well-visualized. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 14.8 cm/s. GALLBLADDER/BILIARY TRACT: The patient is status post Whipple procedure. The common bile duct measures 3.1 mm.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen is poorly visualized in this study.RIGHT KIDNEY: The right kidney is poorly visualized in this study.LEFT KIDNEY: The left kidney measures 13.9 cm in length. The cortex appears to have normal echogenicity but is not well-visualized. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No obvious loculated fluid collection is seen. | This study is technically limited due to patient's discomfort however no obvious intrahepatic ductal dilation or loculated fluid collections are seen. |
Generate impression based on medical findings. | Ms. Zhang is a 22-year-old female presenting with left breast pain for the past 3 to 4 days. However, on examination today, patient states that the pain is no longer present. Upon physical exam at the patient's area of concern, no discrete mass is appreciated.A targeted left breast ultrasound was performed for the patient’s area of concern. In the left breast 3 o'clock location, approximately 2 cm from the nipple, no suspicious cystic or solid mass is identified. | No sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Reason: portal vein thromboses? History: rapidly accumulating abdominal ascites, presumably malignant. LIVER: The liver measures 11.2 cm in length. Focal solid hepatic lesion with hypoechoic rim within the right lobe measuring 6.1 x 3.7 x 2.8 cm compatible with metastatic lesion as seen on recent CT. The lesion appears slightly increased in size compared to the comparison CT. The portal vein is patent demonstrating hepatopetal flow with a velocity of 0.16 m/s.BILIARY TRACT: Cholelithiasis including stones within the gallbladder neck. Mild gallbladder wall thickening which is nonspecific but likely related to ascites. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2.6 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.3 cm in length. RIGHT KIDNEY: Kidney measures 8.6 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.0 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Large volume ascites, increased from comparison CT. | 1.Large volume ascites, increased. Main portal vein grossly patent.2.Hepatic metastasis, increased in size.3.Cholelithiasis. Nonspecific gallbladder wall thickening which may related to ascites. If there is clinical concern for acute cholecystitis, nuclear medicine HIDA scan could be considered. |
Generate impression based on medical findings. | 42-year-old female status post gastric sleeve now with portal vein, SMV thrombosis. LIVER: Measures 13.3 cm in length. Patent hepatic artery with normal waveforms. The right portal vein is apparently patent and diminutive in caliber, with flow measuring 0.2 m/s. The left portal vein is patent, with flow measuring 0.3 m/s. The hepatic veins are patent.GALLBLADDER, BILIARY TRACT: No significant abnormality noted.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted.KIDNEYS: No significant abnormality noted. OTHER: The superior mesenteric vein is not visualized. | 1. Patent left and right portal vein branches as detailed above. 2. Nonvisualization of the superior mesenteric vein. |
Generate impression based on medical findings. | Female 23 years old Reason: r/o cholecystitis or ab source, fever unknown origin History: as above LIVER: Liver is enlarged measuring 18.7 cm. Hepatic veins and IVC are dilated. No focal liver lesions.BILIARY TRACT: No evidence of intra or extrahepatic biliary dilatation. No evidence of gallstones. Gallbladder is unremarkable.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 8.8 cm.RIGHT KIDNEY: Bilateral slightly echogenic kidneys. Right kidney measures 11.8 cm. Left kidney measures 11.8 cm. No evidence of hydronephrosis. OTHER: No significant abnormalities noted. | Mild hepatomegaly likely secondary to heart failure. Otherwise unremarkable study. |
Generate impression based on medical findings. | 23 year-old female with a history of hypothyroidism. RIGHT LOBE MEASUREMENTS: 1.7 x 1.3 x 5 cmLEFT LOBE MEASUREMENTS: 1.7 x 1.3 x 4.9 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: The thyroid lobe parenchyma is heterogeneous compatible with history of hypothyroidism. No discrete suspicious nodule is evident.LEFT LOBE: The left thyroid lobe parenchyma is heterogeneous in echotexture compatible with history of hypothyroidism. No discrete suspicious nodule is evident.ISTHMUS: Heterogeneous echotexture, without discrete suspicious nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: There is a 5 x 5 x 6 mm hypoechoic nodule inferior to the left thyroid lobe, which may reflect a small lymph node or parathyroid adenoma. | Heterogeneous thyroid parenchyma compatible with history of hypothyroidism without a discrete suspicious nodule evident. 6-mm hypoechoic nodule inferior to the left thyroid lobe may reflect a small lymph node or parathyroid adenoma; correlate with PTH/calcium. |
Generate impression based on medical findings. | 42-year-old female with lateral parotid swelling and left cervical adenopathy. Evaluate for parotitis. There is massive adenopathy involving both sides of the face and neck. The majority of the nodes have normal morphology although largest node on the right has a somewhat rounded appearance. The right parotid gland is enlarged and cystic-appearing. Left parotid gland is less well-visualized although enlarged and cystic-appearing. Both submandibular glands are enlarged and cystic-appearing.No focal fluid collection suggest abscess. Neck vasculature not evaluated. | Extensive adenopathy within the face and neck.Enlarged parotid and submandibular glands.No evidence for focal abscess. |
Generate impression based on medical findings. | Collected carcinoma with biliary stent with elevated bilirubin LIVER: Bilobar hepatic cysts unchanged.BILIARY TRACT: Interval improvement in degree of intrahepatic ductal dilatation. Biliary stents again noted.OTHER: Mild ascites again noted | Interval improvement in degree of intrahepatic ductal dilatation. Biliary stents again noted. Mild ascites again noted. |
Generate impression based on medical findings. | Male, 42 years old. Hematuria. RIGHT KIDNEY: The right kidney measures 10.3 cm in length, with normal cortical echotexture. A few scattered punctate nonshadowing echogenic foci are noted. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 12.3 cm in length with normal cortical echotexture. A few scattered punctate nonshadowing echogenic foci are noted. No shadowing stones are identified. No hydronephrosis.OTHER: The bladder is incompletely distended. | A few scattered punctate nonshadowing echogenic foci bilaterally correspond with punctate areas of calcification as seen on prior CT imaging. No hydronephrosis. |
Generate impression based on medical findings. | Two month old male with hydrocephalus seen on serial head ultrasounds from baseline CT. There is no evidence of intracranial hemorrhage, mass or edema. The lateral ventricles are markedly enlarged, most noted in the occipital horn of the left lateral ventricle, which contains an external drainage catheter. The third ventricle is mildly enlarged, and the fourth ventricle demonstrates normal volume. Ventricular volumes are grossly stable from recent ultrasound exams, given differences in imaging technique. The ventricles remain midline. The basal cisterns are normal in size and configuration. The myelination pattern is within normal limits. There is mild encephalomalacia left parietal lobe near the enlarged occipital horn of the left lateral ventricle.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized. | Stable hydrocephalus and associated left parietal encephalomalacia as described. |
Generate impression based on medical findings. | 63-year-old male with history of chronic kidney disease and 1 cm lesion seen on prior ultrasound. RIGHT KIDNEY: Measures 12.1 cm in length. No nephrolithiasis, hydronephrosis, or suspicious lesions.LEFT KIDNEY: Measures 11.4 cm in length. No nephrolithiasis or hydronephrosis. Redemonstration of a 1 cm echogenic focus in the superior pole, which may represent interposed adjacent mesenteric fat or possibly a small angiomyolipoma, unchanged since the prior study and without definite correlate lesion on prior CT scan.OTHER: No significant abnormalities noted. | No interval change in 1 cm echogenic focus in the left kidney, which may represent interposed adjacent mesenteric fat or possibly a small angiomyolipoma. |
Generate impression based on medical findings. | 72 year old female with history of thyroid nodule. RIGHT LOBE MEASUREMENTS: 4.7 x 1.7 x 1.3 cmLEFT LOBE MEASUREMENTS: 5 x 1.9 x 1.7 cm ISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: There are several well-defined cystic and spongiform subcentimeter nodules. The largest measures 9 mm and is predominantly cystic. No specific suspicious sonographic features.LEFT LOBE: There are several well-defined cystic and spongiform nodules. The largest is a spongiform nodule with comet tail artifact reflecting colloid, measuring 1.3 cm.ISTHMUS: There is a 2.3 x 2.0 x 1.8 cm solid nodule extending from the inferior aspect of the isthmus without hypervascularity or microcalcifications. It is well defined and heterogeneous.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. 2.3 cm indeterminate solid inferior isthmus nodule. Given its size and hypermetabolism on PET an FNA should be considered.2. Multiple additional bilateral cystic and spongiform nodules. |
Generate impression based on medical findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 10.6 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 10.6 cm in lengthOTHER: Bladder nondistended. Cholelithiasis incidentally noted | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. Cholelithiasis incidentally noted. |