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Generate impression based on medical findings. | 35-year-old female with right upper quadrant pain. Evaluate for cholecystitis. LIVER: The liver is normal in morphology with slightly coarsened echotexture. It measures 21 cm in craniocaudal dimension. No focal hepatic lesion or intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.GALLBLADDER, BILIARY TRACT: Sludge and gallstone at the neck of a normally distended gallbladder. No wall thickening, pericholecystic fluid or focal tenderness. The common bile duct is mildly prominent up to 10 mm without obstructing stone or lesion identified.PANCREAS: Partially visualized pancreas is unremarkable.RIGHT KIDNEY: Dense calcification in the superior pole of the right kidney, unchanged. No hydronephrosis.OTHER: The left kidney measures 9.7 cm in length with mild upper pole pelviectasis. No shadowing nephrolithiasis is apparent. The spleen is normal in size, measuring 10.9 cm. | Gallbladder sludge, gallstones and mild extrahepatic biliary ductal dilatation. No common bile duct stone is evident. No evidence of acute gallbladder inflammation. |
Generate impression based on medical findings. | Hepatitis C and elevated lipase LIVER: Coarse echogenic liver echotexture without mass. Liver length 17 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.5 cm in lengthOTHER: Left kidney 10.6 cm in length. Spleen 11.3 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. Coarse echogenic liver echotexture consistent with fatty infiltration/parenchymal dysfunction without mass. No ascites. |
Generate impression based on medical findings. | 77-year-old male patient with suspected acute cholecystitis. History of hepatitis B. LIVER: The liver measures 12.5 in length and has increased echogenicity. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is distended and contains what appears to be a combination of sludge and shadowing gallstones. The gallbladder wall measures approximately 3-4 mm in thickness. The patient reported mild pain with sonographic palpation. There is no significant pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The pancreas is poorly visualized on this examination.RIGHT KIDNEY: The right kidney measures 8.6 in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.2 cm in length. No evidence of hydronephrosis.The spleen measures 8.7 in length. | 1. Hydropic gallbladder containing gallstones though no definite pericholecystic inflammatory changes; these findings may represent early acute cholecystitis. Correlate with lab values and consider HIDA scan if clinically warranted.2. Hepatic steatosis. |
Generate impression based on medical findings. | Female 2 months old; New gross hematuria. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 2 Left: 3 Length*** Right: 3.9 cm Left: 4.2 cm Mean for age: 4.2 cm Range for age: 3.9 - 5.9 cmADDITIONAL OBSERVATIONS: In the left kidney there are kidney stones at the inferior calix and pelvis. In the right kidney there is a kidney stone at the inferior calix. | Bilateral kidney stones and hydronephrosis.*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. | Right upper quadrant pain LIVER: No significant abnormalities noted. Liver length is 16.1 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge with mild gallbladder wall thickening. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.2 cm in lengthOTHER: Left kidney 10.2 cm in length. Spleen 12.5 cm in length. No ascites. Right pleural effusion. | Gallbladder sludge with mild gallbladder wall thickening; some component of chronic inflammation cannot be excluded. No ductal dilatation. |
Generate impression based on medical findings. | Renal transplant. Acute kidney injury. Transplant kidney identified in the right hemipelvis. Two percutaneous biopsies performed | Ultrasound guidance for percutaneous renal biopsy. |
Generate impression based on medical findings. | History of acute kidney injury on chronic kidney disease. Ultrasound guidance was provided for percutaneous biopsy of right kidney. Three passes were performed. | Ultrasound guidance for percutaneous biopsy of right kidney. |
Generate impression based on medical findings. | 42 year-old female with elevated alkaline phosphatase, evaluate for hepatobiliary etiology LIVER: Measures 14.3 cm. No focal hepatic lesions. No biliary ductal dilation. The portal vein is patent.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance without wall thickening or pericholecystic fluid. The common bile duct is normal in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 9.4 centers. No hydronephrosis or mass.OTHER: The left kidney measures 10.8 cm. The spleen measures 8.5 cm. | Normal ultrasound of the right upper quadrant. |
Generate impression based on medical findings. | Female; 44 years old. Reason: r/o hepatobiliary pathology History: hepatitis LIVER: Liver measures 18.4-cm. Normal echotexture. No focal hepatic lesions. No intra-biliary ductal dilation. Main portal vein is patent with peak systolic velocity of 0.2 m/sec and normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder wall appears prominent, though it measures up to 2 mm. No cholelithiasis, pericholecystic fluid, or sonographic Murphy sign to suggest acute cholecystitis. Common bile duct measures are 4 mm.PANCREAS: No gross abnormalities of the pancreatic head. The pancreatic tail is obscured by overlying bowel gas.RIGHT KIDNEY: Right kidney is 12.1-cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Left kidney is 12.1-cm in length. Normal cortical echotexture. No hydronephrosis. | 1. Mild hepatomegaly.2. Prominent gallbladder wall, which is nonspecific in the setting of hepatitis. No specific evidence of acute cholecystitis. |
Generate impression based on medical findings. | 19-year-old male with hematuria. Ultrasound guidance was provided for biopsy of the right kidney | Ultrasound guidance |
Generate impression based on medical findings. | 50-year-old female with generalized abdominal pain and increased abdominal girth. LIVER: Liver is normal in size and echotexture. 1.3 cm right lobe cyst. No other focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: Gallbladder appears unremarkable without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No ascites. | Normal examination. |
Generate impression based on medical findings. | 57-year-old male with HCV cirrhosis. Evaluate for HCC. LIVER: The liver parenchyma is moderately coarsened and nodular in contour. It is normal in size, measuring 19.4 cm in the craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 5 mm at the level of the pancreatic head. The gallbladder is full of gallstones, but does not appear significantly distended. There is no wall thickening, pericholecystic fluid, or focal tenderness.PANCREAS: The visualized pancreatic head is unremarkable.SPLEEN: The spleen is mildly enlarged, measuring 13.5 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 11.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 12.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.No significant ascites. | 1. Cirrhotic liver morphology, and mild splenomegaly. No biliary ductal dilatation or focal hepatic lesion.2. Partially contracted gallbladder filled with gallstones. |
Generate impression based on medical findings. | NASH with altered mental status LIVER: Cirrhotic morphology again noted. Estimated liver length 11.2 cm. No obvious discrete lesion seen; however technical limitations limit comprehensive evaluation. Limited Doppler interrogation of the hepatic vessels again demonstrate a patent but attenuated main portal vein with reversal of portal venous flow.GALLBLADDER, BILIARY TRACT: Gallbladder absent. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.4 cm in lengthOTHER: Spleen 14.8 cm in length. Mild ascites. | Cirrhotic morphology again noted. No obvious discrete lesion seen; however technical limitations limit comprehensive evaluation. Limited Doppler interrogation of the hepatic vessels again demonstrate a patent but attenuated main portal vein with reversal of portal venous flow; this reversal of main portal flow presumably secondary to extensive portosystemic collaterals seen on the recent MR. Mild ascites |
Generate impression based on medical findings. | Female 55 years old; Reason: r/o mass History: transaminitis LIVER: The liver measures 20 cm in length. There is coarse and heterogeneous echogenicity of the liver parenchyma. No focal hepatic lesions, however there is a hypoechoic mass seen juxtaposed adjacent to the liver which represents inferior aspect of the heart in cross section. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.1 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 3.1 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 9.6 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 9.7 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.2 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted. | 1. Coarse and heterogenous echotexture of liver consistent with diffuse hepatic parenchymal dysfunction. No masses are seen. |
Generate impression based on medical findings. | 61-year-old female with palpable abnormality at mandibular angle Right submandibular gland is generally homogeneous in echotexture without diffuse slialectasis. There is a 1.3 cm lymph node within the substance of the gland. Cranial to this there is a complex cystic mass which is superficial within the gland and corresponds to the palpable abnormality. This measures 0.6 x 0.8 x 0.9 cm and contains multiple shadowing calcifications. On several images, it appears at this may communicate with a segment of duct. No definite thrombosed vasculature is identified.. | Complex cystic mass in the right submandibular gland with calcification. Differential considerations would include Sialic cyst/sialocele, there does not appear to be significant vascularity or soft tissue mass to suggest mucoepidermoid carcinoma or papillary carcinoma, and therefore this may be postinflammatory. |
Generate impression based on medical findings. | 35-year-old male with history of cellulitis at G-tube site, abdominal pain. Grayscale and color limited ultrasound of the site of the patient's G-tube insertion demonstrates a circumscribed round anechoic structure in the subcutaneous soft tissues consistent with the patient's G-tube balloon which has migrated into the subcutaneous soft tissues. There is surrounding induration of the subcutaneous soft tissues with punctate areas of increased echogenicity measuring approximately 1.4 cm, however no drainable collection is identified at this time. | Findings consistent with gastrostomy balloon migration into the subcutaneous tissues. Surrounding inflammatory or phlegmonous changes without evidence of drainable fluid collection or abscess. |
Generate impression based on medical findings. | Female 69 years old; Reason: history of left thyroid lobectomy. Follow up ultrasound of remaining lobe History: history of left thyroid lobectomy. Follow up ultrasound of remaining lobe RIGHT LOBE MEASUREMENTS: 4.5 x 2.1 x 2.4 cmLEFT LOBE MEASUREMENTS: Status post left thyroid lobectomy.ISTHMUS MEASUREMENT: 0.5 cmRIGHT LOBE: Solid cystic nodule measuring 0.9 x 0.7 x 0.7 cm in the mid right thyroid lobe with shadowing and increased shine through suggestive of colloid nodule. An additional homogenous solid nodule with faint hypoechogenicity in the lower thyroid pole measuring 1.8 x 1.3 x 1.3 cm, which is nonspecific.LEFT LOBE: No evidence of residual left thyroid tissue.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious lymphadenopathy.OTHER: No significant abnormality noted. | 1.Homogenous solid nodule with faint hypoechogenicity in the lower right thyroid lobe, which is nonspecific.2.Solid cystic nodule in the mid right thyroid lobe suggestive of colloid nodule. |
Generate impression based on medical findings. | History of thyroid cancer status post thyroidectomy. THYROID : Status post thyroidectomy.RIGHT THYROIDECTOMY BED: No significant abnormality noted.LEFT THYROIDECTOMY BED: Stable 5 x 3 x 2 mm mildly hypoechoic ovoid nodule in the left thyroidectomy bed, may represent a lymph node.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No enlarged or pathologic-appearing cervical lymphadenopathy.OTHER: No significant abnormality noted. | Stable ovoid soft tissue focus in the left thyroidectomy bed may represent a small lymph node. |
Generate impression based on medical findings. | Thyroid carcinoma status post thyroidectomy 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. | Right upper quadrant pain LIVER: No significant abnormalities noted. Liver length 14.6 cm GALLBLADDER, BILIARY TRACT: Cholelithiasis. Mild gallbladder wall thickening without positive Murphy's sign. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.6 cm in lengthOTHER: Left kidney 11.1 cm in length. Spleen 7.4 cm in length. No ascites | Cholelithiasis associated with mild gallbladder wall thickening without positive Murphy's sign or ductal dilatation. Mild chronic inflammation cannot be excluded. No ascites. |
Generate impression based on medical findings. | Thyroid cancer status post surgery RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT 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 regional lymphadenopathy. | Post surgical changes without regional lymphadenopathy. |
Generate impression based on medical findings. | Evaluate for AAA ABDOMINAL AORTA: Proximal aorta measures 2.7 x 2.5 cm with ulcerated calcified plaque within it. Mid aorta measures 2.2 x 2 cm and distal aorta measures 2 x 1.9 cm. Normal flow directionality and patency noted. The flow velocity measures 81.9 cm/s. No evidence of aneurysmal dilatation noted.The right and left iliac artery measure 1.4 x 1.4 cm and 1.1 x 1.3 cm respectively. No evidence of aneurysmal dilatation with normal flow directionality and patency noted.INFERIOR VENA CAVA: PatentOTHER: No significant abnormality noted. | Mild calcified plaques noted in the proximal aorta. No evidence of aneurysmal dilatation of the abdominal aorta and iliac arteries. |
Generate impression based on medical findings. | Right upper quadrant pain with elevated LFTs LIVER: Mildly echogenic parenchyma without mass. Liver length 19.2 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation. Moderately dilated common bile duct with maximal diameter 1.1 cm. No intrahepatic ductal dilatation. Distal common bile duct obscured due to overlying bowel gas.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.5 cm in lengthOTHER: Left kidney 12.1 cm in length. Spleen 11.7 cm in length. No ascites. | Mildly echogenic liver parenchyma with mild hepatomegaly suggestive for fatty infiltration/parenchymal dysfunction without worrisome mass. Cholelithiasis without acute inflammation. Moderately dilated common bile duct; distal common bile duct obscured due to overlying gas. No intrahepatic ductal dilatation. Suggest correlation with CT or MRCP if a distal obstructing lesion is clinically suspected. |
Generate impression based on medical findings. | Right-sided testicular pain RIGHT TESTIS: 4.0 x 2.1 x 3.0 cm. No significant abnormalities noted. Normal testicular vascularity.LEFT TESTIS: 4.2 x 2.3 x 2.7 cm. No significant abnormalities noted. Normal testicular vascularity.RIGHT EPIDIDYMIS: 9 x 11 x 9 mm. No significant abnormalities noted. Normal epididymal vascularity.LEFT EPIDIDYMIS: 10 x 10 x 10 mm. No significant abnormalities noted. Normal epididymal vascularity.OTHER: Small bilateral hydroceles. | No specific evidence of testicular torsion, orchitis, or epididymitis. Small non-specific bilateral hydroceles. |
Generate impression based on medical findings. | 47-year-old female with hematuria. RIGHT KIDNEY: The right kidney measures 9.5 cm in length without hydronephrosis or shadowing calculus. No discrete lesion is evident.LEFT KIDNEY: The left kidney measures 10.2 cm in length without hydronephrosis or shadowing calculus. No discrete lesion is evident.URINARY BLADDER: The urinary bladder is partially distended with anechoic urine. No ureteral jets are visualized.OTHER: Incidental note is made of a rounded hyperechoic right hepatic lobe lesion measuring 2.8 x 1.9 x 2.6 cm. | 1. No hydronephrosis or shadowing calculus.2. Incidental note is made of a 2.8 cm right hepatic lobe hyperechoic rounded lesion. Although this likely represents a benign hemangioma in the absence of chronic liver disease, confirmation with a dedicated liver CT exam or MRI is suggested. |
Generate impression based on medical findings. | History of hydronephrosis status post drainage of obstructing pelvic cyst RIGHT KIDNEY: Normal parenchymal echogenicity without mass or stone. Interval resolution of hydronephrosis. Right kidney 10.4 cm in length.LEFT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Left kidney 10.1 cm in length.OTHER: Bladder nondistended | Interval resolution of right hydronephrosis. |
Generate impression based on medical findings. | 33-year-old female with history of biopsy-proven left papillary thyroid cancer. Assess lymph nodes. RIGHT LOBE MEASUREMENTS: 1.6 x 1.7 x 4.7 cmLEFT LOBE MEASUREMENTS: 1.6 x 1.6 x 4.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Right lobe is diffusely heterogeneous. There is a discrete heterogeneous rounded nodule with a hypoechoic rim in the midportion of the right lobe, measuring 1 x 1.2 x 1.3 cm. This has significant peripheral vascularity.LEFT LOBE: Left lobe is diffusely heterogeneous in echotexture. I see no measurable, focal mass within the left lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: See below.LYMPH NODES: Inferior to the right lobe is a 0.2 x 0.4 x 0.6 cm ovoid nodule with an appearance most suggestive of lymph node. Inferior to the left lobe and medial to the vasculature there is a prominent, 0.5 x 0.7 x 1.1 cm lymph node with likely normal morphology.Normal lymph nodes identified bilaterally including a very superficial level 4 node on the left which has a normal appearance and measures 5 mm in greatest diameter.OTHER: No significant abnormality noted. | 1. Solid right lobe mass. No left lobe mass identified.2. Diffusely heterogeneous gland with a pattern suggestive of thyroiditis.3. Presumed lymph nodes inferior to both lobes, likely normal, although unusual in position.. |
Generate impression based on medical findings. | Ascites. Question of cirrhosis. LIVER: 17 cm in length. Non-cirrhotic liver morphology. Mildly increased hepatic echogenicity suggestive of a mild degree of parenchymal dysfunction. No focal hepatic lesions identified. Normal direction and flow of the portal vein.GALLBLADDER, BILIARY TRACT: Subcentimeter mural echogenicity with vascularity likely represents a benign polyp. There is minimal wall thickening, which is nonspecific in the setting of ascites. No sonographic Murphy's sign. No specific findings to suggest acute cholecystitis.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 7.3 cm in length, with markedly increased parenchymal echogenicity suggestive of medical renal disease. A 9 mm renal cyst is noted. No hydronephrosis is present.3.4 x 3.5 x 3.6 cm lobulated hypoechoic mass at the superior pole of the left kidney, without vascularity identified. The left kidney is otherwise not well visualized, likely due to diminutive size and increased echogenicity of medical renal disease. SPLEEN: 9.9 cm in length, without focal lesions evident.ABDOMINAL AORTA: Patent, without aneurysmal dilation.INFERIOR VENA CAVA: Patent, without significant abnormality noted.BLADDER: No significant abnormality noted.OTHER: Small bilateral pleural effusions are noted. Moderate amount of abdominal ascites is present. | 1. Non-cirrhotic liver morphology. Mildly increased hepatic echogenicity suggestive of mild parenchymal dysfunction.2. 3.6 cm hypoechoic mass at the left upper renal pole, possibly a complex cyst, though better characterized on the prior CT. 3. Moderate amount of abdominal ascites. Small bilateral pleural effusions.4. Increased renal echogenicity, compatible with medical renal disease. |
Generate impression based on medical findings. | 47 years old, Female, Reason: r/o growth of nodules, adenopathy. compare to US 1 year ago History: multinodular goiter. Some subjective increase in size of thyroid RIGHT LOBE MEASUREMENTS: 2.2 x 1.9 x 6.1 cmLEFT LOBE MEASUREMENTS: 3.0 x 3.0 x 7.7 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Right mid nodule measures 1.3 x 1.0 x 1.5 cm, previously measuring 1.0 x 0.8 x 1.2 cm. Another spongiform nodule adjacent to the isthmus measures 1.2 x 0.5 x 1.0 cm, previously measuring 0.8 x 0.6 1.0 cm.LEFT LOBE: Dominant partially cystic lower pole nodule measures 2.8 x 2.4 x 3.6 cm, previously measuring 2.3 x 2.1 x 2.9 cm. Posterior mid left thyroid nodule measures 0.8 x 0.5 x 1 .1 cm, previously measuring 0.8 x 0.8 x 0.5 cm.ISTHMUS: Isthmus nodule which appears partially cystic measures 1.2 x 1.0 x 1 .3 cm, previously measuring 1.2 x 0.8 x 1.2 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight interval increase in size of multiple bilateral thyroid nodules. |
Generate impression based on medical findings. | 26-year-old female with hyperthyroidism RIGHT LOBE MEASUREMENTS: 6.1 x 2.2 x 2.0 cmLEFT LOBE MEASUREMENTS: 5.4 x 1.8 x 1.7 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Diffusely increased vascularity without discrete nodule.LEFT LOBE: Diffusely increased vascularity without discrete 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 gland with increased vascularity can be seen in thyroiditis. No discrete nodules. |
Generate impression based on medical findings. | 50-year-old female with chronic left flank pain. RIGHT KIDNEY: Kidney measures 12.4 cm in length. The renal cortex is of normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 11.6 cm in length. The renal cortex is of normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: The bladder is visualized with no significant abnormalities noted. Limited views of the liver show possible increase in echogenicity. | 1. Bilaterally negative renal ultrasound. No hydronephrosis, stones, or worrisome masses are seen.2. Limited views of the liver show increased echogenicity which may suggest fatty infiltration/parenchymal dysfunction. |
Generate impression based on medical findings. | 25-year-old female with palpable lump in right breast for one week. Family history of breast cancer in grandmother and maternal aunt. A targeted right breast ultrasound was performed for the palpable area of concern. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. Follow-up with primary care physician and return for screening mammography beginning at age 40. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | 77-year-old male with cholangiocarcinoma and prior removal of cholecystostomy tube. Now with sepsis. Evaluate for biliary dilatation or fluid collection. LIVER: Liver is normal in size but highly echogenic due to parenchymal disease. There are scattered masses present within the liver which have a "target" appearance with an echogenic center and hypoechoic rim. Although not specific, findings should be worrisome for metastatic disease. Infection is considered unlikely. Main portal vein is taking by color and spectral Doppler with appropriate flow direction.BILIARY TRACT: No biliary dilatation. The gallbladder is significantly thick-walled with a small amount of pericholecystic fluid. This could be related to prior cholecystostomy tube but certainly cholecystitis cannot be excluded. No shadowing gallstones are identified, and the wall does not appear hypervascular.PANCREAS: Limited by bowel gas.SPLEEN: Limited but normal in size.RIGHT KIDNEY: 14.5 cm in length including a 4 cm cyst in the upper pole. Kidney is echogenic consistent with parenchymal disease. No hydronephrosis. OTHER: Left kidney measures approximately 12.3 cm in length. Kidney is echogenic consistent with parenchymal disease with at least one cyst in the midportion.Trace of perihepatic fluid. | 1. Trace of perihepatic fluid. Thick gallbladder wall. This could be related to prior drainage tube but cannot exclude acalculus cholecystitis.2. Presumed metastatic disease involving the liver.3. Echogenic kidneys with cysts.4. Echogenic liver |
Generate impression based on medical findings. | Shortness of breath and ascites Trace ascites within the left lower quadrant. | Trace ascites within the left lower quadrant. |
Generate impression based on medical findings. | 17-year-old with left breast discharge, nonspontaneous, nonbloody. She has recently started a new birth control shot. A targeted left ultrasound was performed retroareolar region. There is no solid or cystic mass identified. Comparison images of the right retroareolar region demonstrate similar normal breast tissue. | No sonographic evidence for malignancy. The patient should follow-up with her birth control provider regarding her birth control method and potential side effects and to consider other systemic causes of discharge.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | History renal stones RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 10.6 cm in lengthLEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 11.3 cm in lengthOTHER: Bladder nondistended | Negative renal ultrasound. No evidence for worrisome mass, stone, or hydronephrosis. |
Generate impression based on medical findings. | 49-year-old male with chronic mild elevated ALT. Evaluate for NASH versus inflammation/scarring. LIVER: Measures 16.1 cm in length and is diffusely increased in echogenicity suggestive of fatty infiltration.BILIARY TRACT: Gallbladder is normal in echogenicity. No gallbladder wall thickening. No pericholecystic fluid. No gallbladder wall thickening. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.SPLEEN: Measures 14.5 cm in length, upper limits of normal, and is normal in echogenicity.RIGHT KIDNEY: The right kidney measures 10.7 cm in length and is normal in echogenicity with no evidence of hydronephrosis. OTHER: Left kidney measures 11.3 cm in length and is normal in echogenicity with no evidence of hydronephrosis. | Findings suggestive of hepatic steatosis. |
Generate impression based on medical findings. | Follow-up of a left testicular lesion. RIGHT TESTIS: The right testis is normal in morphology and echogenicity and size, measuring 4.0 x 3.2 x 2.1 without a focal lesion. Color and spectral Doppler ultrasound evaluation demonstrates normal blood flow.LEFT TESTIS: The left testis is normal in morphology, echogenicity and size, measuring 3.8 x 2.9 x 2.2 cm. The complex partially cystic/solid lesion anterior to the inferior mediastinum measures 0.6 x 0.4 x 0.5 cm, unchanged. No significant vascularity.There is a 0.6 x 0.5 x 0.4 cm well circumscribed mixed cystic and solid lesion inseparable from the left inferior mediastinum. This lesion demonstrates no appreciable vascularity. This lesion has not changed in its appearance when compared to 7/14/2014.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Stable well-circumscribed mixed cystic and solid subcentimeter lesion without appreciable vascularity. Given this lesion's temporal stability from the prior study and a report from 2002 mentioning a cystic focus arising from the same the left inferior mediastinum location, a benign etiology is favored (such as a post inflammatory/fibrotic lesion.) Would suggest annual ultrasound surveillance monitoring of this lesion. |
Generate impression based on medical findings. | 59-year-old female for follow-up of thyroid nodules RIGHT LOBE MEASUREMENTS: 5.7 x 1.7 x 2 cmLEFT LOBE MEASUREMENTS: 5.7 x 1.7 x 2 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Right lobe is diffusely heterogeneous. There is again noted a right mid thyroid nodule which is difficult to measure. This is hypoechoic and not well marginated. When attempting to measure as per prior exam this nodule measures 0.5 x 1.1 by 0.8 cm.LEFT LOBE: Left lobe is diffusely heterogeneous. A left mid thyroid nodule abutting the isthmus measures 2 x 1.5 x 0.7 cm without change. This nodule appears somewhat spongiform.Left lower lobe isoechoic nodule with a hypoechoic rim measures 1.1 x 0.7 x 0.8 cm without significant change.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable appearance the thyroid. No change in size of bilateral thyroid nodules. |
Generate impression based on medical findings. | Right upper quadrant pain LIVER: Hepatomegaly. No mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 20.4 cm.BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10.8 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 11.6 cm in lengthOTHER: Left kidney 12.4 cm in length. No ascites | Hepatomegaly without mass. Cholelithiasis without acute inflammation or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Male 55 years old Reason: RUQ pain History: RUQ pain This study is limited due to patient's bandages and scars across the abdomen.LIVER: Liver has slightly increased echogenicity, nonspecific. No focal liver lesions.BILIARY TRACT: There is sludge in the gallbladder. No evidence of gallbladder wall thickening or pericholecystic fluid. No evidence of intra or extrahepatic biliary dilatation. Sonographic Murphy sign could not be elicited.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 9.9 cm.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Slightly increased echogenicity of the liver. Sludge in the gallbladder. No sonographic evidence of acute cholecystitis or biliary dilatation. |
Generate impression based on medical findings. | 51-year-old with known left breast cancer and questionable left axillary lymphadenopathy on physician exam. A targeted left ultrasound was performed for the left axilla. Three lymph nodes as are seen in total. Two of these have completely normal morphology. The third node measuring 10 x 8 mm has a slightly eccentrically thickened cortex measuring only between two and 3 mm and preserved normal hilar blood flow. | Three axillary lymph nodes, two of normal morphology and the other of low suspicion. Findings were discussed with Dr. Jaskowiak. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | 44-year-old female with thyroid enlargement. RIGHT LOBE MEASUREMENTS: 5.9 x 1.6 x 2.1 cmLEFT LOBE MEASUREMENTS: 5.4 x 1.6 x 2 cmISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: In the inferior right lobe of the thyroid there is a complex nodule with small cystic spaces measuring 1.3 x 0.7 x 0.9 cm most suggestive of colloid nodule.LEFT LOBE: In the inferior left lobe of the thyroid there is a complex nodule with small cystic spaces measuring 0.6 x 0.4 x 0.7 cm most suggestive of colloid noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Small, bilateral thyroid nodules likely colloid nodules. |
Generate impression based on medical findings. | 66-year-old male with history of hepatitis C presents for evaluation of possible hepatocellular carcinoma. LIVER:Measures 16.3 cm. Increased echogenicity. No focal mass, intrahepatic biliary dilation, or ascites. Portal vein is patent with hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. The common bile duct measures 7.1 cm. The common hepatic duct measures 6.1 cm.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 10.8 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 10.3 cm. Left kidney measures 11.1 cm. Echogenicity is unremarkable. No shadowing, hydronephrosis, or focal mass. OTHER: Known adrenal mass not well visualized on this study. | Echogenic liver consistent with chronic liver disease/parenchymal dysfunction. No focal mass or ascites. |
Generate impression based on medical findings. | Renal stone RIGHT KIDNEY: AbsentLEFT KIDNEY: Echogenic renal parenchyma without worrisome mass. Benign-appearing cyst. 0.3 x 0.3 cm echogenic focus within the lower pole consistent with nonobstructing subcentimeter stone. Interval decrease in degree of hydronephrosis which is now minimal. Left kidney 11.5 cm in length.OTHER: Bladder nondistended | Absent right kidney. Echogenic left renal parenchyma consistent with medical renal disease/chronic parenchymal dysfunction without worrisome mass. Interval decrease in degree of hydronephrosis which is now minimal. Subcentimeter nonobstructing lower pole left renal stone. |
Generate impression based on medical findings. | Assess for abnormalities including changes in nodules/progressive disease RIGHT LOBE MEASUREMENTS: 5.8 x 3.1 x 2.4 cmLEFT LOBE MEASUREMENTS: 5.3 x 2.1 x 2 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: Multiple mixed cystic and solid nodules identified throughout the thyroid gland, largest nodule in the lower pole measures 2.8 x 2.4 x 2 cm, previously measured 3.4 x 2.8 x 3 cm, mostly unchanged in size and morphology.Inferior to the right thyroid gland that appears to be a hypoechoic solid nodule that measures 3.2 x 2.3 x 2.6 cm, previously measured 2.6 x 2 x 2.9 cm, mostly unchanged from prior study in morphology and size, this could represent a parathyroid nodule.LEFT LOBE: Multiple mixed cystic and solid nodules identified throughout the thyroid gland, representative upper pole nodule measures 1.3 x 1 x 1.3 cm, previously measured 3.8 x 0.5 x 0.6 cm, mostly unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: As aboveLYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple mixed cystic and solid nodules in both thyroid lobes are mostly unchanged. Along the inferior aspect of the right thyroid gland there appears to be a exophytic thyroid nodule versus parathyroid nodule which is unchanged in size and morphology from prior exam. |
Generate impression based on medical findings. | Male 66 years old Reason: evaluate urinary retention/hydronephrosis History: urinary retention Technologist note: Limited exam patient confused.RIGHT KIDNEY: 9.5 cm in length. Echogenic suggestive medical renal disease.LEFT KIDNEY: 11.8 cm in length. Upper pole cyst. No hydronephrosis.Urinary bladder is collapsed. | Echogenic kidneys suggestive medical renal disease. No hydronephrosis. Left upper pole renal cyst. Urinary bladder is collapsed. |
Generate impression based on medical findings. | Ms. Blaszka is a 69-year-old female with biopsy-proven left breast IDC on hormonal therapy for 6 weeks, presenting for sonographic evaluation of treatment response. On physical exam, a fixed mass is palpated within the left upper inner quadrant.Targeted ultrasound of the left breast was performed for the patient's area of concern. In the left breast 11:00 location, approximately 5 cm from the nipple, there is revisualization of the biopsy proven malignancy now measuring approximately 3.1 x 2.0 x 2.2 cm, previously measuring 3.2 x 2.2 cm. Internal echogenic focus is compatible with percutaneously placed biopsy marker clip. | No significant interval change in biopsy proven malignancy of the left breast. Continued surgical consultation is recommended at this time. All results and recommendations were discussed with the patient. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | 53-year-old female patient with new onset liver panel abnormalities. LIVER: The liver measures 13.8 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 9.4 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 8.9 cm in length. No evidence of hydronephrosis.The spleen measures 7.7 cm in length. | Increased hepatic echogenicity which can be seen in the setting of hepatic steatosis/hepatic parenchymal dysfunction. No mass |
Generate impression based on medical findings. | 52-year-old male patient with history of cirrhosis. Evaluate for HCC. LIVER: The liver measures 15.1 cm in length. Hepatic parenchymal echogenicity is heterogeneous/coarsened and the liver is nodular in contour. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is not visualized on this examination. 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 12.5 cm in length. No evidence of hydronephrosis. A nonobstructing subcentimeter right lower pole stone is again noted.OTHER: The left kidney measures 14.3 cm in length. No evidence of hydronephrosis.The spleen measures 17.2 cm in length. | 1. Cirrhotic morphology of the liver without focal hepatic lesion. 2. Non-obstructing right nephrolithiasis. |
Generate impression based on medical findings. | Renal cystic lesion seen on MR RIGHT KIDNEY: Multiple benign-appearing cysts without worrisome mass, stone, or hydronephrosis. Right kidney 10.9 cm in lengthLEFT KIDNEY: Multiple appearing cysts without worrisome mass, stone, or hydronephrosis. Left kidney 11.1 cm in lengthOTHER: Bladder nondistended | Multiple bilateral renal cysts without worrisome mass, stone, or obstruction. |
Generate impression based on medical findings. | 39 years old, Male, Reason: Patient with old AV graft with acute swelling after trying to start line. Pleaes evaluate.for hematoma History: As above Ultrasound evaluation of the left mid arm swelling this was a heterogeneous collection consistent with hematoma measuring 4.8 x 1.2 x 4.9 cm. | Left mid arm hematoma measuring up to 4.9 cm in length. |
Generate impression based on medical findings. | CVA tenderness RIGHT KIDNEY: 10.5 cm in length. Normal renal parenchymal echogenicity. No focal lesions, stones, or hydronephrosis.LEFT KIDNEY: 10.2 cm in length. Normal renal parenchymal echogenicity. No focal lesions, stones, or hydronephrosis.OTHER: No significant abnormalities noted. No perinephric fluid collections are identified. | No specific findings to account for the patient's symptoms. |
Generate impression based on medical findings. | Acute kidney injury. Transplant kidney. History of obstruction. RENAL TRANSPLANT LOCATION: Left iliac fossa.PERITRANSPLANT TISSUES: There is a complex 12 cm collection with internal septation adjacent to the transplant kidney upper pole extending cephalad.KIDNEY: 10.6 cm in length. Increased renal parenchymal echogenicity. COLLECTING SYSTEM/URETER: Mild hydronephrosis.URINARY BLADDER: Not well visualized.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels of the transplant kidney. The velocities and resistive indices of the transplant renal artery are within normal limits. There is focal abnormal flow at the upper pole of the kidney, suggestive of a small AV fistula, of questionable clinical significance. The left iliac artery and vein are patent.OTHER: Prominent loop of colon noted adjacent to the kidney. | 1. Mild hydronephrosis which appears unrelated to the fluid collection.. 2. Patent transplant renal artery with normal flow dynamics.3. 12 cm complex collection adjacent to the transplant kidney. This is incompletely evaluated by ultrasound and CT may be considered as clinically warranted.4. Focal abnormal flow at the upper pole of the kidney, suggestive of a small AV fistula, of questionable clinical significance. |
Generate impression based on medical findings. | 28-year-old female patient with history of medullary thyroid cancer, MEN2a RIGHT LOBE: Status post thyroidectomy with a 0.6 x 0.5 x 0.4 cm hypoechoic focus in the right thyroid which is not significantly changed from prior studies.LEFT LOBE: Status post thyroidectomy without residual or recurrent tissue identified. ISTHMUS: Status post thyroidectomy without residual or recurrent tissue identified. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A benign morphology lymph node is noted in the right neck.OTHER: No significant abnormality noted. | Status post thyroidectomy without specific evidence of recurrence or lymphadenopathy. Stable hypoechoic focus in the right thyroidectomy bed. |
Generate impression based on medical findings. | 57-year-old male with primary hyperparathyroidism. RIGHT LOBE MEASUREMENTS: 5.6 x 2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Homogeneous without evidence for mass.LEFT LOBE: Homogeneous without evidence for mass.ISTHMUS: Homogeneous without evidence for mass.PARATHYROID GLANDS: No extrathyroidal masses are identified.LYMPH NODES: No abnormal lymph nodes are identified.OTHER: No significant abnormality noted. | Normal exam without evidence for parathyroid adenoma. |
Generate impression based on medical findings. | 32-year-old female with a history of thyroid cancer status post thyroidectomy presents with palpable lymph nodes. 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 noted on the study.Right level 1 node: Measures approximately 1.5 x 1.2 x 0.7 cm. Has benign morphology.Right level 3 node: Measures approximately 2.1 x 1.6 x 0.7. Has benign morphology.Left level 3 node: Measures approximately 1.4 x 1.4 x 0.4 centers. Has benign morphology.OTHER: No significant abnormality noted. | 1. Surgical changes of a thyroidectomy without evidence of recurrence.2. Reactive lymph nodes as described above; favor benign etiology. |
Generate impression based on medical findings. | Bilateral nephrolithiasis RIGHT KIDNEY: Parenchymal echogenic focus again noted. No renal stone. No worrisome mass or hydronephrosis. Right kidney 10.3 cm in lengthLEFT KIDNEY: No change in subcentimeter nonobstructing lower pole left renal calculus measuring 0.7 cm in diameter. No hydronephrosis. Stable renal cyst. Left kidney 11.2 cm in lengthOTHER: Bladder nondistended | Stable subcentimeter nonobstructing lower pole left renal calculus. No hydronephrosis. |
Generate impression based on medical findings. | History of elevated alkaline phosphatase. Exam limited by positioning and patient body habitus. LIVER: The liver measures 15.5 cm in length. Numerous isoechoic hepatic lesions with hypoechoic halos are noted throughout the liver suspicious for metastases. An example lesion in the left lobe measures 3.4 x 4.8 x 3.3 cm. BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening. The sonographic Murphy's sign is negative. The common bile duct measures 5 mm in diameter.PANCREAS: The pancreatic duct is mildly prominent measuring 4 mm in diameter. SPLEEN: No significant abnormalities noted. The spleen measures 9.3 cm in length. RIGHT KIDNEY: Kidney measures 10.9 cm in length. Multiple right calyceal calculi the largest of which measures 9mm. Resolved hydronephrosis.LEFT KIDNEY: Kidney measures 11.3 cm in length. Mild hydronephrosis with stent.OTHER: Ascites. | 1.Multiple bilobar hepatic lesions suspicious for metastases. Example lesion in left lobe measures 3.4 x 4.8 x 3.3 cm. 2.Cholelithiasis without evidence of cholecystitis.3.Multiple right calyceal calculi the largest of which measures 9mm. Resolved hydronephrosis on right. 4.Mild left hydronephrosis with stent.5.Ascites. Discussed findings with Dr. Akoegbe at 11:00 a.m. on 2/13/2015. |
Generate impression based on medical findings. | 28-year-old male with hepatitis B. Evaluate for cirrhosis and HCC. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16.5 cm in length. The liver capsule is smooth. No focal lesion or intrahepatic biliary ductal dilatation is evident. Normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm. A normally distended gallbladder is present without wall thickening, gallstones, pericholecystic fluid or focal tenderness.PANCREAS: The poorly visualized pancreatic body and head are unremarkable.SPLEEN: The spleen measures 10.8 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 10.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | No focal hepatic lesion or specific stigmata of cirrhosis. |
Generate impression based on medical findings. | Patient had outside mammograms for which ultrasound of the right upper outer quadrant is requested. A targeted right ultrasound was performed for the upper outer quadrant. There is no solid or cystic mass identified. Dense normal parenchymal elements are noted, and these could be the cause of the mammographic focal asymmetry. | No sonographic evidence for malignancy. As long as the patient's physical exam remains normal, then a routine screening mammogram in a year is recommended.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on medical findings. | Ms.Shavonne Lundy is a 28 year old female who presents for follow-up of a nonpalpable right breast fibroadenoma. ULTRASOUND:A targeted right ultrasound was performed for the patient’s area of concern. In the right breast, 3:00 position, 4 cm from the nipple, there is an 8 x 5 x 9 mm circumscribed hypoechoic mass, which is not significantly changed in size from the prior (measuring 9 x 7 x 6 mm). There is no significant internal vascularity associated with this mass. This sonographic appearance is compatible with a fibroadenoma. | No significant change in right breast fibroadenoma. Follow-up ultrasound can be performed at the discretion of the ordering physician or as clinically indicated. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Reason: Hypotension, renal dysfunction, assess for cholecystitis/cholethiasis or hydronephrosis History: hypotension Exam limited due to bowel gas/patient positioning.LIVER:Increase in hepatic parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions. Hepatic length measures 16.4 cm. The main portal vein is patent with normal hepatopetal flow with a velocity of 35 cm/s. No intrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in echotexture with the wall measuring 2 mm in diameter. The common bile duct measures 3 mm in diameter. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Limited evaluation of pancreas due to overlying bowel gas.SPLEEN: The spleen measures 12.2 cm and has a normal echotexture.KIDNEYS: The right kidney measures 12 cm in length and demonstrates normal echogenicity with no hydronephrosis or shadowing calculi. The left kidney measures 12.2 cm and demonstrates normal echogenicity with no hydronephrosis or shadowing calculi. ABDOMINAL AORTA: Abdominal aorta measures 1.5 cm approximately, 1.4 cm mid aorta, and the distal aorta is not well visualized.INFERIOR VENA CAVA: Inferior vena cava is and not well visualized.OTHER: Trace left pleural effusion is noted. | 1.Mild increase in echogenicity and coarsened echotexture of the hepatic parenchyma, suggestive of fatty infiltration/hepatic parenchymal dysfunction with no focal mass or ductal dilatation.2.No evidence of cholelithiasis or acute cholecystitis. |
Generate impression based on medical findings. | 70 year old female with right upper quadrant pain. Evaluate gallbladder and liver. LIVER: Increased echogenicity of the liver measuring 16.8 cm in length. Cyst in the right hepatic lobe measures 1.2 cm x 1.2 cm x 1.4 cm which corresponds to the hypodense focus on prior CT's and appears unchanged. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec. common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: Multiple shadowing calculi within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Sonographic Murphy's sign is negative. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well seen due to overlying bowel gas.RIGHT KIDNEY: Measures 10.5 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.5 cm in length. No hydronephrosis or shadowing calculi are noted. Spleen measures 8.5 cm in length and is normal in echogenicity. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions.2. Cholelithiasis with no evidence of cholecystitis. |
Generate impression based on medical findings. | 70-year-old female with right lower abdominal/groin enlarging mass, possible hernia versus lipoma. In the region of right groin bulge/mass noted by the patient there is a hernial sac containing loops of bowel which increases with Valsalva maneuver and is reducible. | Right inguinal bowel containing reducible hernia. |
Generate impression based on medical findings. | 54-year-old female presents with localized swelling of her neck. There is a clinical concern for goiter. RIGHT LOBE MEASUREMENTS: 2.3 x 1.8 x 4.0 cm.LEFT LOBE MEASUREMENTS: 1.8 x 1.3 x 4.5 cm.ISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: There is an approximately 1.9 x 1.7 x 2.1 cm spongiform nodule; favor benign etiology. Otherwise, the parenchyma appears normal and homogenous.LEFT LOBE: There is approximately 0.9 x 0.8 x 1.1 cm spongiform nodule that appears similar to the nodule in the right lobe. Favor benign etiology. Otherwise, the parenchyma appears normal homogenous.ISTHMUS: Normal and homogenous appearing parenchyma.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes are noted bilaterally.OTHER: No significant abnormality noted. | 1. Bilateral spongiform nodules as above; favor benign etiology. |
Generate impression based on medical findings. | Thyroid nodules. RIGHT LOBE MEASUREMENTS: 6.0 x 1.7 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.7 x 1.2 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: 1.1 x 1.7 x 0.7 mm superior pole hypoechoic well-defined nodule with vascularity and hyperechoic foci is roughly stable.Adjacent subcentimeter nodules appear stable.LEFT LOBE: Previously described 5 mm nodule was not identified on today's exam. Additional subcentimeter nodules appear stable.The background thyroid parenchyma is normal echogenicity.ISTHMUS: Stable 1.0 x 0.4 x 0.8 cm right inferior isthmus hypoechoic nodule with spongiform appearance.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change in several subcentimeter thyroid nodules. |
Generate impression based on medical findings. | 63-year-old male for preheart transplant workup. Ischemic cardiomyopathy. LIVER:Liver is moderately to markedly echogenic. This is non--- specific and could be due to fatty infiltration or other parenchymal disease. No focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: Gallbladder appears distended and contains dependent sludge. No definite shadowing gallstones and no wall thickening or pericholecystic fluid.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted.KIDNEYS: The right kidney measures 14.4 cm in length. No hydronephrosis, shadowing calculus or mass. The left kidney measures 12.7 cm in length. No hydronephrosis, shadowing calculus or mass. ABDOMINAL AORTA: Aorta cannot be adequately assessed due to bowel gas.INFERIOR VENA CAVA: The hepatic portion of the inferior vena cava is patent. Remainder is in adequately visualized due to bowel gas.OTHER: No ascites. Urinary bladder poorly distended with Foley catheter in place. | #1. Echogenic liver.#2. Distended gallbladder with sludge.3. Inadequate visualization of the aorta. |
Generate impression based on medical findings. | 44-year-old male with decreased urine output status post partial nephrectomy RIGHT KIDNEY: Measures 9.0 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. Postoperative changes of right partial mastectomy.LEFT KIDNEY: Measures 11.4 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | 1. Increased renal echogenicity consistent with medical renal disease. No nephrolithiasis or hydronephrosis. 2. Status post right partial nephrectomy. |
Generate impression based on medical findings. | 73-year-old male patient with abdominal distention, prominent abdominal veins. Question of hepatomegaly. LIVER: The liver measures 18 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: 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 pancreas is not visualized on this examination.RIGHT KIDNEY: The right kidney measures 9.3 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.2 cm in length. No evidence of hydronephrosis. There is a 2.2 x 2.1 x 2.1 cm left lower pole renal cyst with a single septation.The spleen measures 10.6 cm in length.No ascites. | 1. Increased hepatic parenchymal echogenicity likely related to hepatic steatosis/hepatic parenchymal dysfunction. No ascites or hepatomegaly.2. Minimally complex left renal cyst. |
Generate impression based on medical findings. | 71 year old male with bleeding and elevated INR. Evaluate liver for cirrhosis or amyloid involvement. LIVER: The liver measures 17.6 cm in length. Mildly coarsened and echogenic parenchyma is compatible with fatty infiltration. No significant capsular nodularity to suggest cirrhosis. No focal lesions or biliary ductal dilatation. The main portal vein is patent and demonstrates hepatopedal flow with velocity of 0.4 m/s.GALLBLADDER, BILIARY TRACT: No shadowing gallstones or sonographic evidence of cholecystitis. No sonographic Murphy sign.PANCREAS: Not visualized due to overlying bowel gas.NATIVE KIDNEYS: Bilateral atrophic native kidneys are present.OTHER: Transplant kidney in right iliac fossa measures 13.4 cm with normal echotexture. No peritransplant fluid collection or evidence of hydronephrosis. Spleen measures 13.6 cm and exhibits normal echotexture. No ascites. | 1.Unremarkable transplant kidney in right iliac fossa with bilateral atrophic native kidneys.2.Mild fatty liver infiltration. No sonographic evidence of cirrhosis or suspicious focal hepatic lesions. |
Generate impression based on medical findings. | Hyperparathyroidism history of thyroid cancer status post thyroidectomy 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. | Elevated LFTs LIVER: Markedly coarse echogenic liver echotexture without obvious mass. Liver length 20.1 cm. Limited interrogation of the main portal vein by Doppler demonstrates a patent portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in lengthOTHER: Left kidney 11 cm in length. Spleen 12.4 cm in length. No ascites. | Markedly coarse echogenic liver echotexture consistent with fatty infiltration/parenchymal dysfunction associated with moderate hepatomegaly. While no obvious mass is appreciated, this degree of fatty infiltration diminishes the sensitivity of ultrasound to detect a subtle mass lesion.Gallbladder sludge without acute inflammation or ductal dilatation. No ascites. |
Generate impression based on medical findings. | 59-year-old female patient with multiple thyroid nodules. Assess thyroid nodules. RIGHT LOBE MEASUREMENTS: 5.1 x 1.7 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.4 x 1.4 x 1.4 cm.ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: There is a solid hypoechoic nodule measuring 0.9 x 0.5 x 0.7 cm within the inferior pole of the right thyroid lobe.LEFT LOBE: There is a well-circumscribed, hypoechoic solid nodule measuring 1.3 x 0.9 x 1.6 cm inferior to the left thyroid lobe which may be exophytic in nature or external to the gland.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: See above.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Subcentimeter right thyroid nodule.2. Hypoechoic solid nodule inferior to the left thyroid lobe which could represent an exophytic nodule or possibly a parathyroid adenoma; correlate with calciums levels/nuclear medicine scan if clinically warranted. |
Generate impression based on medical findings. | 67-year-old female patient with history of multiple thyroid nodules. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: 1.9 x 1.6 x 4.8 cm, previously 1.2 x 2.0 x 4.7 cm.LEFT LOBE MEASUREMENTS: 1.6 x 1.0 x 4.2 cm, previously 1.0 x 1.6 x 4.7 cm.ISTHMUS MEASUREMENTS: 3 mm in thickness.RIGHT LOBE: A hypoechoic nodule within the upper pole measures 0.9 x 1.0 x 1.3 cm, previously 0.8 x 0.9 x 1.5 cm.LEFT LOBE: No new suspicious nodules are identified.ISTHMUS: A solid hypoechoic midline nodule measures 0.6 x 0.4 x 0.5 cm, previously 0.4 x 0.3 x 0.5 cm, and is similar in morphology compared to the prior study with internal calcification. An additional solid nodule within the left aspect of the isthmus measures 0.6 x 0.3 x 0.7 cm, previously 0.8 x 0.4 x 0.8 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A right level two lymph node measures 1.6 x 0.5 x 2.3 cm, previously 1.2 x 0.5 x 2.2 cm.OTHER: No significant abnormality noted. | 1. Stable right thyroid nodule.2. Two isthmic nodules, one of which contains calcifications, also stable. |
Generate impression based on medical findings. | Right upper quadrant pain with leukocytosis. 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 16.6 cmBILIARY TRACT: Cholelithiasis and gallbladder sludge associated with gallbladder wall thickening and pericholecystic fluid. Positive Murphy's sign. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 11 cm in lengthOTHER: Left kidney 11.9 cm in length. No ascites. | Cholelithiasis and gallbladder sludge associated with gallbladder wall thickening and pericholecystic fluid. Positive Murphy's sign. Findings worrisome for acute cholecystitis. No ductal dilatation. Mildly heterogeneous liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass. No ascites. |
Generate impression based on medical findings. | Rising creatinine, rule out hydronephrosis RIGHT KIDNEY: Right kidney measures 12.4 cm. Echogenic renal parenchyma. No hydronephrosis or solid mass.LEFT KIDNEY: Left kidney measures 11.6 cm. Echogenic renal parenchyma. No hydronephrosis or solid mass. Left renal cyst measures up to 2.5 cm.OTHER: The bladder is unremarkable. | Medical renal disease without hydronephrosis. |
Generate impression based on medical findings. | 28-year-old female with a lump in the right armpit With physical exam, there is a mild elevation of the tissue at right axilla. Focused ultrasound is performed. There is normal subcutaneous fat the tissue, without any suspicious findings. | No sonographic evidence for malignancy. Clinical follow-up is recommended. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on medical findings. | 65-year-old male with hepatocellular carcinoma and mass in the hepatic dome. LIVER: High in the dome there is a hypoechoic mass measuring approximately 2.6 x 3.3 x 2.4 cm. Biopsy of this mass was requested. However the mass is immediately adjacent to the heart and lung. It was felt that this could not be approached safely and therefore biopsy was not performed.OTHER: No significant abnormalities noted. | Unable to biopsy hepatic mass due to safety concerns. |
Generate impression based on medical findings. | Chronic liver disease LIVER: Coarse liver echotexture without mass. Liver length 14.5 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: Status post cholecystectomy. No ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10.4 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. Right kidney 10.7 cm in lengthOTHER: Left kidney 10.6 cm in length. No ascites | Coarse liver echotexture suggestive for chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | 40 year-old female complains of ongoing soft lesion in her left lower back. Evaluated with ultrasound. There is an approximately 4.8 x 0.9 x 3.0 cm is elongated isoechoic mass in the subcutaneous tissue of the left lower back was not present on the contralateral side. No calcifications. No internal vascularity. | 1. Soft tissue mass is described above. |
Generate impression based on medical findings. | 30-year-old female with proteinuria and chronic kidney disease. Ultrasound guidance was provided for biopsy of right kidney | Ultrasound guidance was provided for biopsy of right kidney |
Generate impression based on medical findings. | Reason: evaluate hepatomegaly History: RUQ pressure, increased liver span LIVER: The liver measures 16.7 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 0.33 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 3.5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 13.6 cm in length. RIGHT KIDNEY: Kidney measures 12.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | No evidence of hepatomegaly or other significant abnormality. |
Generate impression based on medical findings. | Multinodular goiter. Fine-needle aspiration proven colloid nodules. RIGHT LOBE MEASUREMENTS: 5.7 x 2.1 x 2.5 cm, similar to prior. Normal background echotexture and vascularity.LEFT LOBE MEASUREMENTS: 5.5 x 1.9 and 1.9 cm, similar to prior. Normal background echotexture and vascularity.ISTHMUS MEASUREMENTS: 2 mm in AP dimension.RIGHT LOBE: There is a 2.3 cm mixed solid and cystic nodule in the inferior pole, unchanged in size. The solid components of this nodule demonstrate prominent vascularity, though this is similar to prior. LEFT LOBE: There is a 1.7 cm predominantly solid nodule in the inferior pole, unchanged in size. There is mild internal vascularity, which is similar to prior. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | Bilateral thyroid nodules, unchanged in size and vascularity. |
Generate impression based on medical findings. | NASH LIVER: Increased parenchymal echogenicity and coarseness consistent with fatty infiltration not significantly changed from prior study. No mass lesion. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 15.8 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.8 cm in length RIGHT KIDNEY: No significant abnormalities noted. 11.4 cm in lengthOTHER: Left kidney 11.2 cm in length. No ascites | No significant change in liver fatty infiltration. No mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | 53 years old, Male, Reason: r/o obstruction History: r/o obstruction RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. Small right renal cyst measuring up to 1.9 cm.LEFT KIDNEY: Kidney measures 12.2 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus.Bladder: No significant abnormalities noted. | No evidence of hydronephrosis. No emergent findings to explain patient's symptoms. |
Generate impression based on medical findings. | 48-year-old female patient with HCV infection. LIVER: The liver measures 17 cm in length. Mildly coarsened liver echotexture but no discrete lesion. Main portal vein flow is hepatopetal and measures 0.2 m/s.BILIARY TRACT: There is no intra or extrahepatic biliary ductal dilatation. The common bile duct measures 3 mm in diameter. The gallbladder has been surgically removed.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen is poorly visualized but measures approximately 7.4 cm in length.RIGHT KIDNEY: The right kidney measures 10.4 cm in length. No evidence of hydronephrosis. OTHER: Left kidney measures 10.1 cm in length. No evidence of hydronephrosis. | Mildly coarsened liver echotexture but no discrete lesion. |
Generate impression based on medical findings. | 71-year-old female patient with right upper quadrant discomfort and liver lesion. LIVER: The liver measures 14.8 cm in length. There is at least two hypoechoic lesions within the right hepatic lobe which do not meet criteria for simple cysts. The largest of these measures 0.9 x 0.8 x 1.0 cm. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is surgically absent. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The pancreas is poorly visualized secondary overlying bowel gas. Gas.RIGHT KIDNEY: The right kidney measures 9.0 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 8.7 cm in length. No evidence of hydronephrosis. There is a 4 mm nonobstructing stone within the mid to lower pole.The spleen measures 8.8 cm in length. | 1. Hypoechoic liver lesions which are not definitely cysts; dedicated contrast enhanced CT/MRI of the liver may be considered for further evaluation.2. Non-obstructing left nephrolithiasis. |
Generate impression based on medical findings. | 49-year-old female with history of thyroid cancer. Evaluate for recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyPOSTOPERATIVE BED: Again noted is a heterogeneous focus in the left thyroid bed which measures 1.0 x 0.5 x 0.5 cm, unchanged. No evidence of recurrence or residual disease.LYMPH NODES: No cervical lymphadenopathy.OTHER: No significant abnormality noted. | 1.Status post thyroidectomy. 2.Stable small nodule in the left thyroid bed. |
Generate impression based on medical findings. | Elevated transaminitis alkaline phosphatase and decreased albumin. LIVER: The liver is normal in morphology, size and echogenicity measuring 18.5 cm in craniocaudal dimension. No focal lesion or intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 27 cm/s. Small amount of perihepatic fluid. BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 2 mm. Partially contracted gallbladder without gallstones, significant wall thickening, pericholecystic fluid or focal tenderness.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable. The remainder is obscured by overlying bowel gas shadowing.SPLEEN: Splenomegaly, measuring 17.8 cm in length without focal abnormality. Small amount of perisplenic fluid.RIGHT KIDNEY: The right kidney measures 12.7 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 13.2 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. A prominent cortical column is noted. Color Doppler demonstrates hilar blood flow.Small right pleural effusion. | No biliary ductal dilatation or gallbladder pathology. The liver is normal in size without a focal lesion.Splenomegaly and trace abdominopelvic ascites is nonspecific. |
Generate impression based on medical findings. | Male, 71 years old. BPH. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 6.6 cm in length, with significantly increased cortical echogenicity. No hydronephrosis or perinephric fluid.LEFT KIDNEY: The left kidney measures 11.3 cm in length with mild increased cortical echogenicity. No hydronephrosis or perinephric fluid.OTHER: The bladder is distended. The prostate measures 6.1 x 5.8 x 4.3 cm. Post void residual volume is approximately 446 mL. | 1.Atrophic right kidney and increased renal cortical echogenicity, compatible with medical renal disease. No hydronephrosis.2.Enlarged prostate and significant post-void residual volume. |
Generate impression based on medical findings. | Ms. Metcalf submitted outside study for review. Submitted for review is:-Right breast ultrasound: 1/11/2016 This examination was performed at Ingalls Memorial Hospital. Static ultrasound images are submitted for interpretation. In the right retroareolar region, approximately 1 cm from the nipple, there is a lobulated hypoechoic mass identified measuring 2.9 x 1.2 cm. There is minimal associated vascularity. | Sonographic findings most suggestive of a fibroadenoma. Given patient's age and palpability, a surgical consultation is recommended at this time for further evaluation and for consideration of palpably-guided FNA. Alternatively, the patient may return for a short term 6 month ultrasound follow-up examination to confirm stability as long as the mass is unchanged. BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Abdominal pain and nausea. Evaluate for cholecystitis. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 16.4 cm in length. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Distended gallbladder, without stones, wall thickening, or pericholecystic fluid. No sonographic Murphy's sign.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 10.9 cm in length. The left kidney is 12.1 cm in length. The renal parenchymal echogenicity is increased bilaterally. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 9.7 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No significant upper abdominal free fluid is identified. | 1. No evidence of cholecystitis.2. Increased hepatic echogenicity, compatible with parenchymal dysfunction.3. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on medical findings. | Reason: LUE wound with induration c/f abscess History: as above Limited ultrasound along the dorsal aspect of the left forearm was performed. There is a tubular structure within the subcutaneous tissues without flow which likely represents a thrombosed vein. The adjacent subcutaneous tissues are mildly echogenic which may reflect inflammatory change. No focal fluid collection is identified. | 1.Superficial thrombophlebitis along the dorsal aspect of the left forearm.2.No underlying focal fluid collections. |
Generate impression based on medical findings. | 20-year-old with history of left breast mass for the last 11 months. A targeted left ultrasound was performed for the palpable area of concern. In the left breast 4:00 position, an oval circumscribed mass measuring 1.9 x 1.8 cm is present. | Left breast mass measuring 1.9 cm at the site of palpable concern is probably a fibroadenoma. Surgical consultation is recommended for consideration of palpably guided FNA and further management. The patient has already scheduled an appointment for surgical consultation.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical findings. | 66 years old, Female, Reason: evaluate for residual thyroid cancer RIGHT LOBE MEASUREMENTS: Status post thyroidectomy. No definite soft tissue echogenicity seen to suggest tumor recurrence.LEFT LOBE MEASUREMENTS: Status post thyroidectomy. No definite soft tissue echogenicity seen to suggest tumor recurrence.ISTHMUS MEASUREMENTS: Status post thyroidectomy. No definite soft tissue echogenicity seen to suggest tumor recurrence.LYMPH NODES: Single subcentimeter benign-appearing level 2 lymph node on the left, with a fatty hilum. | No evidence of recurrent disease or lymphadenopathy. |
Generate impression based on medical findings. | 40-year-old female presents for evaluation of her parathyroid. RIGHT LOBE MEASUREMENTS: 4.7 x 1.4 x 1.3 cm.LEFT LOBE MEASUREMENTS: 5.1 x 1.5 x 1.17 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Homogenous parenchyma without nodule. Normal vascularity.LEFT LOBE : Homogenous parenchyma without nodule. Normal vascularity.ISTHMUS: Homogenous parenchyma without nodule. Normal vascularity.PARATHYROID GLANDS: Unable to identify parathyroid candidate.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Normal ultrasound of the thyroid without nodule. No definite parathyroid candidates. |
Generate impression based on medical findings. | 63-year-old female with chronic kidney disease. Ultrasound guidance was provided for biopsy of the right kidney. | Ultrasound guidance. |
Generate impression based on medical findings. | Reason: Is there an aneurysm? History: Reported history of AAA LIVER: The liver measures 18.9 cm in length. The hepatic parenchymal echotexture and echogenicity is coarse. There is a mildly nodular hepatic contour, concerning for a cirrhotic liver morphology. There are no focal masses. The main portal vein is patent with normal directional hepatopedal flow, maximum systolic velocity 19.4 cm/s.GALLBLADDER, BILIARY TRACT: The common hepatic duct measures 2 mm in diameter. The gallbladder is moderately distended. There is a small echogenic focus in the dependent portion of the gallbladder with posterior acoustic shadowing, consistent with a small stone. There is no pericholecystic fluid. The gallbladder wall measures 2 mm. There is no biliary ductal dilatation. Murphy's sign was negative.PANCREAS: Obscured by bowel gas.SPLEEN: The spleen measures 16.9 cm in length.KIDNEYS: The left kidney measures 11.8 cm in length. The right kidney measures 11.9 cm in length. No hydronephrosis. ABDOMINAL AORTA: The abdominal aorta is obscured by bowel gas distally. The abdominal aorta measures 3.2 cm proximally and 2.9 cm more distally in the AP diameter. The distal abdominal aorta was nonvisualized. The arterial waveform is pulsatile, consistent with reported history of intra-aortic balloon pump.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Left pleural effusion. No free intraperitoneal fluid. | 1. Echogenic coarse hepatic parenchyma with nodular contour, concerning for cirrhosis.2. Cholelithiasis without evidence of cholecystitis.3. Limited evaluation of the abdominal aorta without evidence of abdominal aortic aneurysm. |
Generate impression based on medical findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.1 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.5 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |