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Generate impression based on medical findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 5.8 x 1.6 x 1.9 cmLEFT LOBE MEASUREMENTS: 6.2 x 1.6 x 1.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant change in multiple right thyroid nodules. Upper lobe nodule measures 1.1 x 0.8 x 1.1 cm. Mid pole nodule measures 1 x 10.6 x 0.9 cm. Lower pole nodule measures 0.6 x 0.3 x 0.6 cmLEFT LOBE: Stable left thyroid nodules. The largest again measures 1 x 0.6 x 1 cm.ISTHMUS: Stable solid isthmic nodule measuring 0.7 x 0.4 x 0.6 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral thyroid nodules. No regional adenopathy. |
Generate impression based on medical findings. | 58-year-old female post thyroidectomy for thyroid cancer. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No enlarged or morphologically abnormal lymph nodes. Patient describes a small palpable area at level 2 on the right which corresponds to a normal appearing lymph node.OTHER: No significant abnormality noted. | No evidence for recurrent disease. |
Generate impression based on medical findings. | Ms. Alexandridou submitted outside mammogram dated 06/12/2012 and two prior ultrasounds dated 06/12/2012 and 01/21/2013, from University of Illinois, Urbana. Submitted outside studies were compared to the current mammogram dated 10/14/2016. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. Previously identified mass in the right medial breast, far posterior depth, is new when compared to the prior mammogram from 2012.Previously identified mass in the left central breast, mid depth, appears to have increased in size when compared to the prior mammogram. In addition, prior ultrasound examination from 2012 may show a corresponding partly cystic/partly solid mass, which needs to be further evaluated. | Bilateral partially obscured incompletely characterized masses. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on medical findings. | Pancreatitis. Evaluate for cholelithiasis. Please note that this examination was limited due to poor acoustic penetration.LIVER: Non-cirrhotic liver morphology. Mildly increased hepatic echogenicity, compatible with parenchymal dysfunction. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Biliary sludge noted within the gallbladder. No cholelithiasis identified.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEY: The right kidney is 9.1 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present. The left kidney is not well visualized.SPLEEN: Not well visualized.OTHER: No significant abnormalities noted. No significant ascites identified. | No cholelithiasis identified. |
Generate impression based on medical findings. | Acute renal insufficiency RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. Right kidney 10.6 cm in length.LEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. Left kidney 10.6 cm in length.OTHER: Bladder nondistended | Mildly echogenic renal parenchyma suggestive for medical renal disease/parenchyma dysfunction without mass, stone, or obstruction. |
Generate impression based on medical findings. | 73-year-old female with chronic kidney disease Ultrasound guidance was provided for biopsy of right kidney. | Ultrasound guidance. |
Generate impression based on medical findings. | Male; 69 years old. Reason: neutropenic fever abdominal pain please r/o infection LIVER: Liver is 18.3-cm in length. Normal parenchymal echotexture. Minimally complex, predominantly anechoic cystic lesion in the right hepatic lobe measures 3.4 x 2.2 x 2.8 cm with a similar but smaller cystic lesion in the left hepatic lobe, as seen on preceding CT and for which benign etiology is favored. No intrahepatic biliary ductal dilation. Main portal vein is patent with normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder is filled with numerous shadowing calculi. No definite gallbladder wall thickening, though evaluation is limited due to the cholelithiasis. No pericholecystic fluid, gallbladder fossa hepatic parenchymal hyperemia, or sonographic Murphy's sign to suggest acute cholecystitis. Normal caliber of the common bile duct measuring 4 mm.PANCREAS: Limited images of the pancreatic head are within normal limits. The remainder of the pancreas obscured by overlying bowel gas.RIGHT KIDNEY: Stable appearance of both kidneys since prior renal ultrasound with the right kidney measuring up to 12.4-cm and a septated cyst seen in the upper pole as well as additional smaller cysts.OTHER: Spleen measures 12.8-cm in length. No focal splenic lesions. | 1. Cholelithiasis without evidence of acute cholecystitis.2. No findings to explain the patient's symptoms. |
Generate impression based on medical findings. | 73 year-old female with right lower quadrant pain. Evaluate for fluid. The study was limited by the patient's body habitus. Targeted evaluation of the 4 abdominal quadrants demonstrates no significant fluid. | No significant peritoneal fluid. |
Generate impression based on medical findings. | 81-year-old female for follow-up of small, complex renal cysts. RIGHT KIDNEY: The right kidney measures approximately 10.9 cm in length. There are 2 small, complex cyst identified in the right kidney, one in the upper pole measuring approximately 1.2 cm in greatest diameter and a second in the upper pole as well measuring 0.9 cm in greatest diameter. These contain scattered internal echoes but no solid component or thick septation. No hydronephrosis or shadowing calculus.LEFT KIDNEY: The left kidney measures 10.2 cm in greatest length. Small cysts identified in prior CT are not definitely visualized on this study, due to small size and somewhat limited view. No hydronephrosis or shadowing calculus. OTHER: Bladder poorly distended. | Mildly complex, small right renal cysts. Although one appears slightly larger than on prior CT, the appearance remains consistent with a benign cyst.Very small left renal cysts not identified, indirectly suggesting stability. |
Generate impression based on medical findings. | 28-year-old woman history of left breast excisional biopsy in 2013 for intraductal papilloma/atelectasis. Left breast mass was found in 2014, subsequently biopsied and revealed a fibroadenoma. Patient now presents to assess stability of this left breast mass. A targeted grayscale and color Doppler left ultrasound was performed for the area of concern. There is a circumscribed hypoechoic mass in the left breast 12:00 position 3 cm from the nipple measuring 0.9 x 0.5 x 1.2 cm, consistent with the biopsy-proven fibroadenoma. A marking clip is seen slightly inferior and lateral to the mass. There has been no significant change in size of this mass since 11/14/2014 when it measured up to 1.2 cm. | No change in size of biopsy proven left breast fibroadenoma measuring up to 1.2 cm.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | 53-year-old female presents for follow-up of hepatic lesions. LIVER:Measures 14.3 cm. Increased and coarse echogenicity of liver limits evaluation of the parenchyma. Several hypoechoic lesions are noted again on the current study, but definite evaluation of these cannot be performed due to increased echotexture and decreased penetration of ultrasound beam. GALLBLADDER, BILIARY TRACT: The lumen is anechoic. No stones or sludge. The wall measures 2.1 cm. The common hepatic duct is 6.1 cm. No pericholecystic fluid.PANCREAS: Pancreas has uniformly increased echogenicity, compatible with fatty infiltration.SPLEEN: Measures 9.3 cm. No sonographic abnormalities.KIDNEYS: Right kidney is 11.2 cm. Left kidney is 10.2 cm. Cortex disease have normal echogenicity. No shadowing I, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Coarse and increased echogenicity of liver consistent with chronic liver disease/parenchymal dysfunction.2. Several hypoechoic lesions as described above inadequately evaluated on this study. Could be better evaluated with multiphasic CT exam.3. Increased echogenicity of pancreas consistent with fatty infiltration. |
Generate impression based on medical findings. | 62 year old female who was recalled from screening mammogram for calcifications and focal asymmetry in the right breast. An ML view and three spot views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Focal asymmetry in the right outer breast persists with benign morphology. The right outer breast calcifications are linear in distribution and pleomorphic in morphology. These are discontinuous but span 4-5 cm. ULTRASOUND | 1. Right breast calcifications for which stereotactic biopsy is recommended. The patient should hold her aspirin 5 days before the biopsy is performed, if possible. Recommendation was discussed with the patient.2. Simple cysts in the right breast.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | Cirrhosis. Hepatocellular carcinoma status post ablation. LIVER: Limited evaluation. Coarsened parenchymal echogenicity. Deep hyperechoic right hepatic lobe lesion is again seen, incompletely evaluated. The TIPS and portal vein are patent, with normal direction of blood flow.OTHER: No significant abnormalities noted. No ascites identified in the upper abdomen. | Patent TIPS and main portal vein. |
Generate impression based on medical findings. | Female, 58 years old. Flank pain RIGHT KIDNEY: The right kidney measures 9.7 cm in length, with normal cortical echotexture. No shadowing stones or hydronephrosis. No perinephric collection.LEFT KIDNEY: The left kidney measures 10.9 cm in length, with normal cortical echotexture. No shadowing stones or hydronephrosis. No perinephric collection.OTHER: The visualized portions of the bladder are unremarkable. | No hydronephrosis or urinary stones. |
Generate impression based on medical findings. | 38-year-old female with right breast cancer. Evaluate right axilla. A targeted right ultrasound was performed of the right axilla. Few short axis subcentimeter lymph nodes are present, with normal morphology. No suspicious lymph node or mass identified. | No abnormal lymph node or mass identified within the right axilla. Known right breast cancer not evaluated. BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Female 66 years old; Reason: r/o adenopathy, increased size of nodules, concerning features. Are nodes concerning and should be biopsied? History: h/o thyroid nodules, s/p lobectomy. Has nodes that are felt to be indeterminate. This is 9 month follow up study; please compare to prior ultrasounds. LEFT LOBE MEASUREMENTS: 5.1 x 2.3 x 1.9 cmISTHMUS MEASUREMENT: 0.4 cmRIGHT LOBE: Patient is status post right thyroidectomy.LEFT LOBE: There are multiple hyperechoic nodules, the largest of which measures 0.9 x 0.9 x 0.8 cm and the inferior pole and is stable.ISTHMUS: Nodule measuring 0.7 x 0.5 x 0.3 cm is stable.LYMPH NODES: Normal lymph nodes seen.OTHER: No significant abnormality noted. | No significant change in thyroid nodules and lymph nodes without suspicious features. |
Generate impression based on medical findings. | 60 year-old male with cirrhosis status post TIPS. LIVER: Cirrhotic liver morphology without focal hepatic lesion. The liver measures 12.5 centimeters in length. The TIPS is patent, however the undivided left portal vein still demonstrates hepatopedal flow. GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance. There is no pericholecystic fluid, gallbladder wall thickening or cholelithiasis. PANCREAS: The head and proximal body of the pancreas are normal. The tail is obscured by bowel gas.SPLEEN: The spleen is normal in echogenicity and measures 16.3 cm in length. RIGHT KIDNEY: The right kidney measures 9.9 cm in length and shows diffusely increased echotexture. No stone or hydronephrosis. A 2.8 x 2.7 x 2.3 cm hypoechoic focus at the right upper pole may represent a discrete mass or may be due to artifact secondary to the echogenic cortex and irregular contour of the kidney.LEFT KIDNEY: The left kidney measures 12.8 cm in length and shows diffusely increased echotexture. No mass, stone or hydronephrosis.OTHER: No ascites. | 1.The TIPS is patent, however the undivided left portal vein still demonstrates hepatopedal flow. No ascites.2.Diffusely increased echogenicity of both kidneys can be seen in the setting of medical renal disease/parenchymal dysfunction.3.A hypoechoic focus at the right upper pole may represent a discrete mass or may be due to artifact secondary to the echogenic cortex and irregular contour of the kidney. Would pay special attention to this lesion on future surveillance scans. |
Generate impression based on medical findings. | 57 year-old female with a history of gradual increase in abdominal appearance. Rule out ascites. LIVER: Mild hepatomegaly. Increased echogenicity if the liver is nonspecific but can be seen in hepatic steatosis. The liver measures 17.4 cm in length. The liver contour is smooth. Portal vein flow is hepatopetal.BILIARY TRACT: Note is made of a 1.4 cm dependent gallstone in the body of the gallbladder without evidence of acute cholecystitis.PANCREAS: The pancreas is partially obscured by overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Note is made of a 4.9 x 4.8 x 4.2 cm cyst in the superior pole of the left kidney, with associated septation and peripheral nodularity. There is no internal vascularity.OTHER: No significant abnormalities noted. | 1. No evidence of ascites, as clinically questioned.2. Complex cyst in the left kidney with peripheral nodularity and septation. Further evaluation with a dedicated renal CT protocol is recommended.3. Mild hepatomegaly. Increased echogenicity if the liver is nonspecific but can be seen in hepatic steatosis. 4. Gallstones without evidence of acute cholecystitis. |
Generate impression based on medical findings. | Right groin lymphadenopathy Lobules of normal-appearing fat are noted in the region of the patient's palpable abnormality. No abnormal vascularity is noted in this area. No soft tissue mass or lymph node is identified. | Normal subcutaneous fat. No soft tissue mass or lymphadenopathy identified. |
Generate impression based on medical findings. | Reason: Hx of sudden gross hematuria with AKI History: As above RIGHT KIDNEY: The right kidney measures 10.6 cm in length. Echogenic renal parenchyma. No shadowing renal calculi, hydronephrosis, or focal mass.LEFT KIDNEY: The left kidney measures 10.2 cm in length. Echogenic renal parenchyma. No shadowing renal calculi, hydronephrosis, or focal mass.OTHER: The bladder is decompressed by a Foley catheter, limiting its evaluation, however the bladder wall appears thickened and intraluminal mass cannot be excluded. | 1. Bladder wall thickening, similar to that seen on CT dated 2/22/2016; intraluminal mass cannot be excluded.2. Echogenic renal parenchyma, consistent with medical renal disease. |
Generate impression based on medical findings. | Reason: evaluate for gallstone History: RUQ pain LIVER: The liver measures 15.5 cm in length. Unremarkable hepatic parenchyma. The portal vein is patent with normal directional hepatopedal flow, peak velocity 29.9 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: Stone filled, contracted gallbladder without signs of acute inflammation. The common bile duct measures 0.4 cm. No pericholecystic fluid or gallbladder wall thickening. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 9.6 cm in length. Unremarkable renal parenchyma. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 9.4 cm in length. Unremarkable renal parenchyma. No hydronephrosis or shadowing stones.OTHER: The spleen measures 9.6 cm in length. | Cholelithiasis without evidence of acute inflammation or biliary ductal dilatation. |
Generate impression based on medical findings. | 44 year old female who was recalled from screening mammogram for new asymmetry in the right axillary tail. Mammogram: An ML, MLO view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. 7 mm asymmetry best seen on the MLO and ML view appears circumscribed, oval and does not have a definite correlate on the CC spot compression view. Ultrasound: Targeted right lower axillary/upper, outer quadrant ultrasound was performed. A 7 x 4 mm benign intramammary lymph node is identified with normal morphology. | Asymmetry in the right lower axillary region, most likely corresponds to a benign intramammary lymph node. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended in 6 months to confirm stability. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on medical findings. | 22 year old female with left flank pain and frequency. RIGHT KIDNEY: The right kidney measures 11 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 10.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.URINARY BLADDER: The urinary bladder is normally distended with anechoic urine. No ureteral jets are visualized. | Normal sonogram of the kidneys and bladder. |
Generate impression based on medical findings. | Abdominal pain and elevated lipase LIVER: No significant abnormalities noted. 14.3 cm in lengthGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Minimally complex upper pole right renal cyst measuring 1.7 x 1.8 x 1.3 cm. No stone or hydronephrosis. Right kidney 10.3 cm in length.OTHER: Left kidney cyst. Left kidney 10.4 cm in length. Spleen 8.4 cm in length. No ascites. | Negative for acute, inflammatory, or neoplastic process. No evidence for sonographically obvious complication of patient's known pancreatitis. |
Generate impression based on medical findings. | FDG avid right thyroid nodule RIGHT LOBE MEASUREMENTS: 4.5 x 2.2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Multiple right thyroid nodules. The dominant midpole nodule in is solid and measures 1.9 x 1.4 x 1.9 cm. Spongiform upper pole nodule measures 0.8 x 0.5 x 0.8 cm. A hypoechoic spongiform nodule within the lower pole measures 1.2 x 2.8 x 0.7 cm.LEFT LOBE: Multiple subcentimeter nodules. Representative upper pole nodule measures 0.5 x 0.4 by 0.4 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple thyroid nodules bilaterally. The dominant solid nodule within the right thyroid gland corresponds to the FDG avid lesion on PET/CT. This nodule will be biopsied today. |
Generate impression based on medical findings. | Diabetes with abdominal pain LIVER: Coarse echogenic liver echotexture without mass. Liver length 16.3 cm.GALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.6 cm in lengthOTHER: Left kidney 11.2 cm in length. Spleen 11.9 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Cholelithiasis without acute inflammation. No ascites. |
Generate impression based on medical findings. | Status post cystectomy with ileal conduit RIGHT KIDNEY: Atrophic right kidney without mass or stone. Minimal hydronephrosis. 10.1 cm in lengthLEFT KIDNEY: Minimal to mild left hydronephrosis. No mass or stone. Left kidney 11.4 cm in length.OTHER: Ileal conduit not visualized.Incidental note is made of a large right lobe liver mass measuring 10.7 x 7.6 x 9.4 cm. | Atrophic right kidney with minimal hydronephrosis. Minimal to mild left hydronephrosis. No mass or stone.Incidental note is made of a large right lobe liver mass; a malignant etiology must be considered.Dr. Bales notified of findings 4/20/2016; 9:55am. |
Generate impression based on medical findings. | Male 69 years old Reason: eval for hepatomegaly and ascites History: swelling Small volume generalized ascites.Mild hepatomegaly noted liver 18.7 cm in length. | Small volume generalized ascites. |
Generate impression based on medical findings. | Acute pancreatitis. Rule out cholecystitis. Gallstones. LIVER: Liver is markedly echogenic compatible fatty infiltration. Portal vein is patent with flow toward the liver on color Doppler imaging. No focal liver lesions were identified.BILIARY TRACT: Gallstones. Gallbladder wall is minimally thickened. There is no evidence of a sonographic Murphy sign. No significant pericholecystic fluid.PANCREAS: Partially visualized and difficult to evaluate.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Gallstones with minimal thickening of the gallbladder wall. Fatty infiltration of the liver. |
Generate impression based on medical findings. | 73 year old female who was recalled from screening mammogram for 7 mm focal asymmetry in the right upper outer quadrant. Patient on estradiol for the past 2 years. Mammogram: An ML view and four spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Focal asymmetry in the right upper-outer quadrant persist only on the ML and MLO view. It is not definitely seen on the cc view. A benign morphology partially circumscribed slightly hyperdense mass is identified in the central breast on CC spot magnification view.Ultrasound: Targeted superior right breast ultrasound was performed. Multiple simple, complex and septated cysts with milk of calcium identified in the superior right breast, largest simple cyst measuring 7 x 5 mm. No suspicious solid mass noted. | High probability benign morphology asymmetry in the superior right breast and multiple simple and complex cysts in the superior right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram and ultrasound is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on medical findings. | Reason: Rule out hepatobiliary disease (cholelithiasis vs cholecystitis) History: RUQ pain LIVER: The liver measures 15.1 cm in length. Hepatic parenchymal echogenicity is suggestive of hepatic steatosis or parenchymal dysfunction. Normal hepatopedal portal venous blood flow, 25.4 cm/s.BILIARY TRACT: No significant abnormalities noted. No shadowing gallstones or sludge. Probable adenomyomatosis in the gallbladder fundus. The gallbladder wall measures 3 mm. The common bile duct measures 2 mm. No intrahepatic or extrahepatic biliary ductal dilatation. Negative sonographic Murphy sign.PANCREAS: Obscured due to overlying bowel gas.SPLEEN: The spleen measures 8.6 cm in length. Several scattered microcalcifications are noted.KIDNEYS: The right kidney measures 10 cm in length. The left kidney measures 11 cm in length. 2.4 x 2.2 x 1.9 cm anechoic left lower pole cyst.OTHER: No significant abnormalities noted. | Echogenic liver, which may reflect parenchymal dysfunction or hepatic steatosis. No cholelithiasis, evidence of cholecystitis or biliary ductal dilatation. |
Generate impression based on medical findings. | Female 69 years old Reason: multinodular goiter History: eval and c/w prior thyroid US RIGHT LOBE MEASUREMENTS: Patient is status post right thyroidectomy.LEFT LOBE MEASUREMENTS: 6.0 x 1.6 x 1.5 centimetersISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Echogenic focus in the right thyroidectomy bed likely represents small amount of fat or scar.LEFT LOBE: In the left thyroid lobe there are multiple spongiform-appearing nodules which are unchanged in size. The superior nodule measures 1.5 x 1.1 x 0.6 cm. A mid lobe nodule measures 1.0 x 1.4 x 1.2 cm. Unchanged inferior nodule measures 2.3 x 1.8 x 0.9 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No regional lymphadenopathy. OTHER: No significant abnormality noted. | Unchanged spongiform nodules in the left thyroid lobe. No evidence of recurrent or metastatic disease. |
Generate impression based on medical findings. | 63 year old female who was recalled from screening mammogram for 5 mm oval circumscribed mass in the right lower inner quadrant, mid depth, close to the skin, could represent a tortuous blood vessel or benign 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 almost entirely fatty(BiRads Density Category A), unchanged in pattern and distribution. 5 mm round circumscribed mass located in the right lower inner quadrant persist on spot compression views. No associated calcifications.Ultrasound: Targeted right lower inner quadrant ultrasound was performed. 4 x 3 mm oval hypoechoic mass is identified at 4:00 position of the right breast. No peripheral blood flow is noted. | Indeterminate 5 mm hypoechoic mass in the right lower inner quadrant. Outside hospital mammograms cannot be obtained. 6 month follow-up versus ultrasound-guided possible cyst aspiration/core biopsy were discussed with the patient. Final plan of possible cyst aspiration/core biopsy was deferred by the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | 66-year-old male with chronic kidney disease RIGHT KIDNEY: Measures 10.6 cm in length. Unremarkable echogenicity with preserved corticomedullary differentiation. No hydronephrosis or nephrolithiasis.LEFT KIDNEY: Measures 11.0 cm in length. Unremarkable echogenicity with preserved corticomedullary differentiation. No hydronephrosis or nephrolithiasis.OTHER: Increased hepatic echogenicity partially imaged. | 1. Unremarkable sonographic appearance of the kidneys without hydronephrosis or nephrolithiasis.2. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. |
Generate impression based on medical findings. | Patient has multiple myeloma, hypertension, PE presented with recurrent abdominal pain, vomiting and diarrhea found to have increased lipase on CT scan so far ? Pancreatitis. RIGHT KIDNEY: Right kidney measures 14.2 cm increased echogenicity. No evidence of hydronephrosis or hydroureter. A prominent calyx noted in the right upper pole. No focal lesions.LEFT KIDNEY: Left kidney measures 13.4 cm, increased echogenicity. No evidence of hydronephrosis or hydroureter. No focal lesions.OTHER: Moderately distended bladder, limited evaluation without any focal lesions. | Bilateral echogenic kidneys consistent with underlying medical renal disease. |
Generate impression based on medical findings. | 55-year-old male with acute kidney injury. RIGHT KIDNEY: Measures 11.8 cm. Echogenic renal parenchyma without discrete focal lesion or hydronephrosis.LEFT KIDNEY: Measures 11.5 cm. Echogenic renal parenchyma without discrete focal lesion or hydronephrosis.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Echogenic renal parenchyma consistent with medical renal disease. No hydronephrosis. |
Generate impression based on medical findings. | 56-year-old male with pain and edema. Evaluate for Baker cyst. Grayscale and color ultrasound of the posterior left knee soft tissues demonstrate no evidence of Baker's cyst or other findings to account for the patient's symptoms. | No evidence of Baker's cyst. |
Generate impression based on medical findings. | 51 year old female who was recalled from screening mammogram for new mass in the left lower inner breast.. Mammogram: 2 ML views and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. 14 mm circumscribed oval hyperdense mass in the left lower inner quadrant posterior depth persist on spot compression views. No associated calcifications. Multiple other benign morphology masses elsewhere are stable.Ultrasound: Targeted left lower inner quadrant ultrasound was performed. A small 5 x 4 mm simple cyst was identified in the left breast 8:00 position, 10 cm from the nipple. This probably is an incidental finding and might not correspond to the 14 mm circumscribed oval benign morphology mass in the left breast on the mammogram. | High probability benign morphology 14 mm circumscribed oval mass in the left breast lower inner quadrant without definite sonographic correlate needs further evaluation with left unilateral diagnostic mammogram in 6 months to confirm stability.Incidentally noted 5 mm simple cyst in the left breast on ultrasound.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on medical findings. | 44-year-old male with acute kidney injury. Evaluate for hydronephrosis RIGHT KIDNEY: Right kidney is normal in echogenicity and measures 12.3 cm in length without evidence of hydronephrosis. LEFT KIDNEY: Left kidney is normal in echotexture and measures 13.5 cm in length without evidence of hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of hydronephrosis. |
Generate impression based on medical findings. | Follow-up renal abscess RIGHT KIDNEY: No significant abnormalities noted. 9.3 cm in length LEFT KIDNEY: Continued interval decrease in size of complex cystic focus arising from the mid left kidney now measuring 1.3 x 1.4 x 1.3 cm; this is in comparison to 2.1 x 2.2 x 2.7 cm on 7/19/2016. Left kidney 9.4 cm in length.OTHER: Bladder collapsed. | Continued interval decrease in size of complex cystic focus arising from the mid left kidney consistent with resolving abscess. |
Generate impression based on medical findings. | 85-year-old female with history of intracystic papillary carcinoma on hormonal therapy. Follow-up study. Due to limited mobility of the patient, ultrasound was performed in sitting position.A targeted right ultrasound was performed for the known cancer.At 9:00 position, 5 cm from the nipple, there is redemonstration of a isoechoic mass. The mass now measures 6 x 7 x 10 mm (previously 6 x 8 x 9 mm). There is mild internal vascularity. | No interval changes in size of right breast cancer BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | Reason: Evaluate for cholecystitis/docholithiasis History: Abdominal pain. Pancreatic and cbd dilation on ct. Possible ampullary cancer vs impacted gallstone. 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. No shadowing choledocholithiasis identified.PANCREAS: Pancreas is largely obscured. There appears to be mild prominence of the proximal pancreatic duct as seen on recent CT. | No evidence of acute cholecystitis or significant biliary ductal dilatation. Mildly prominent proximal pancreatic duct as seen on same-day CT. If there is continued clinical concern for an ampullary process or choledocholithiasis, MRCP can be considered as clinically warranted. |
Generate impression based on medical findings. | 58-year-old female with right upper quadrant pain, elevated alkaline phosphatase. LIVER: Measures 20.2 in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Small gallstones layer dependently within the gallbladder, without gallbladder wall thickening or pericholecystic fluid. There is dilation of the common bile duct proximally measuring up to 1.3 cm at the level of the porta hepatis. However, the distal common bile duct is not well visualized due to bowel gas.PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | 1. Cholelithiasis without specific evidence of acute cholecystitis. Dilation of the common bile duct proximally up to 1.3 cm, with incomplete visualization of the distal common bile duct due to bowel gas. If there is high clinical suspicion for choledocholithiasis, an MRCP may be considered as warranted clinically.2. Hepatomegaly with increased echogenicity consistent with hepatic steatosis or parenchymal disease. |
Generate impression based on medical findings. | Female, 51 years old. AKI. RIGHT KIDNEY: The right kidney measures 8.6 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.3 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. | Increased renal cortical echogenicity, compatible with medical renal disease. No hydronephrosis. |
Generate impression based on medical findings. | 73-year-old female with renal failure. RIGHT KIDNEY: The right kidney measures 9.9 cm in length, and is highly echogenic consistent with parenchymal disease. There is no hydronephrosis or shadowing calculus. There is a 1.9 cm cyst in the lower pole. There is diffuse and focal parenchymal loss. There is an echogenic focus in the midportion of the kidney and I cannot exclude a small nonobstructive stone. LEFT KIDNEY: The left kidney measures 12.6 cm in length. Cortex is thinned and highly echogenic consistent with parenchymal disease. There is no hydronephrosis, shadowing calculus or mass.URINARY BLADDER: Poorly distended without gross abnormality.OTHER: No significant abnormalities noted. | Echogenic kidneys bilaterally with parenchymal loss, progressive on the right.Right renal cyst. |
Generate impression based on medical findings. | 21-year-old male with fever of unknown origin. LIVER: Echogenicity of the hepatic parenchyma is diffusely increased. The liver measures 23.6 centimeters in length. No dilatation or cystic changes are noted of the intrahepatic or extrahepatic biliary ducts.The main portal vein is patent with normal hepatopedal flow and velocity of 24.9 cm/s.GALLBLADDER, BILIARY TRACT: A subcentimeter gallbladder stone or polyp is noted. There is no pericholecystic fluid, gallbladder wall thickening or cholelithiasis. The common bile duct measures 0.3 cm in diameter. PANCREAS: The head and proximal body of the pancreas are normal. The tail is obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 17.3 cm in length and shows normal echotexture. No mass, stone or hydronephrosis.OTHER: There is no free or loculated fluid. | Moderate hepatomegaly and fatty infiltration of the liver. A subcentimeter gallbladder stone or polyp is noted. No evidence of cholecystitis. |
Generate impression based on medical findings. | 23-year-old male with acute kidney injury. Evaluate for hydronephrosis. History of sickle cell disease. RIGHT KIDNEY: The right kidney measures 10.1 cm in length. No hydronephrosis, shadowing stones, or suspicious masses. Increased echogenicity of the renal parenchyma.LEFT KIDNEY: The left kidney measures 10.3 cm in length. No hydronephrosis, shadowing calculi, or suspicious lesions. Increased echogenicity of the renal parenchyma.URINARY BLADDER: No significant abnormality notedOTHER: No significant abnormalities noted. | 1. No hydronephrosis.2. Increased echogenicity of the renal parenchyma is nonspecific and suggestive of chronic medical renal disease. |
Generate impression based on medical findings. | Male, 77 years old. Evaluate renal stones. RIGHT KIDNEY: The right kidney measures 11.3 cm in length, with normal echotexture. No hydronephrosis. Multiple echogenic shadowing foci compatible with stones are again seen. An inferior pole stone measures 0.5 x 0.4 cm. A mid pole stone measures 0.5 x 0.2 cm. A midpole exophytic simple cyst measures 1.5 x 1.5 x 1.2 cm.LEFT KIDNEY: Left kidney measures 11.4 cm in length, with normal echotexture. No hydronephrosis. A midpole echogenic shadowing focus compatible with a stone measures 0.4 x 0.3 x 0.4 cm. A midpole exophytic cyst measures 5.1 x 3.5 x 5.1 cm, unchanged. URINARY BLADDER: The bladder is incompletely distended.OTHER: Enlarged prostate again noted. | Bilateral nonobstructing renal stones and exophytic renal cysts are not significantly changed from prior. |
Generate impression based on medical findings. | 45 year old presents for a short term follow up ultrasound for an enlarged lymph node in the left axilla. Focused ultrasound of left axilla revealed that the enlarged lymph node seen on the prior study has become normal sized. There are several normal size lymph nodes in the left axilla. | No sonographic evidence of malignancy. Normal lymph nodes in left axilla. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on medical findings. | Prominent thyroid on examination. History salivary gland carcinoma. RIGHT LOBE MEASUREMENTS: 1.3 x 1.1 x 3.6 cmLEFT LOBE MEASUREMENTS: 1 x 1.1 x 3.5 cmISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 0.3 x 0.3 x 0.3 lower pole hypoechoic noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal sized thyroid gland. Subcentimeter hypoechoic left thyroid nodule. No adenopathy. |
Generate impression based on medical findings. | 47-year-old male status post LVAD with drainage around the drive line. Evaluate for fluid collection. A targeted portable ultrasound was performed of the left lower quadrant along the course of the LVAD drive line. There is no discrete fluid collection. | No discrete fluid collection. |
Generate impression based on medical findings. | 76-year-old female with heterogeneous thyroid gland. RIGHT LOBE MEASUREMENTS: 7.2 x 3.5 x 2.9 cmLEFT LOBE MEASUREMENTS: 9.0 x 4.7 x 3.4 cmISTHMUS MEASUREMENTS: 2.4 cmRIGHT LOBE: Enlarged heterogeneous gland without discrete nodule.LEFT LOBE: Enlarged heterogeneous gland with nodular configuration but no discrete measurable nodule.ISTHMUS: Enlarged heterogeneous gland without discrete nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Enlarged heterogeneous gland without discrete measurable nodule. No significant interval change since the prior study. |
Generate impression based on medical findings. | 8-week-old male presents with anuria and concern for compartment syndrome. BLADDER Wall Thickness: Incompletely evaluated given underdistention. Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Increased echogenicity. Medullary Echogenicity: Increased echogenicity. Pelvicaliceal System -- SFU Grade* Right: 2 Left: 2 Length*** Right: 4 cm Left: 3.7 cm Mean for age: 5 cm Range for age: 4 - 6 cmADDITIONAL OBSERVATIONS: The urinary bladder is decompressed with a Foley catheter. Trace free fluid. | Echogenic kidneys suggestive of medical renal disease with bilateral grade 2 hydronephrosis. Trace free fluid.*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. | Female 55 years old Reason: history of thyroid nodules History: none RIGHT LOBE MEASUREMENTS: Right lobe measures 6.1 x 2.4 x 2.3 cm.LEFT LOBE MEASUREMENTS: 5.2 x 2.5 x 2.5 cm.ISTHMUS MEASUREMENTS: 0.6 cm.RIGHT LOBE: Right heterogeneously echogenic nodule measures 2.8 x 1.7 x 1.7 cm. Heterogeneous background thyroid.LEFT LOBE: Left solid thyroid nodule with some mixed echogenicity measures 1.9 x 1.7 x 2.5 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing left level 3 lymph node.OTHER: No significant abnormality noted. | Right heterogeneously echogenic thyroid nodule and left solid thyroid nodule are amenable to biopsy if clinically warranted. |
Generate impression based on medical findings. | Globus sensation RIGHT LOBE MEASUREMENTS: 1.6 x 5 x 1.5 cm.LEFT LOBE MEASUREMENTS: 1.7 x 4.1 x 1.2 cmISTHMUS MEASUREMENTS: 0.1 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. | Negative thyroid ultrasound. No evidence for acute, inflammatory, or neoplastic process. No regional adenopathy. |
Generate impression based on medical findings. | Female 48 years old Reason: Please assess for cirrhosis and r/o portal venous clot History: acute hepatitis NYD LIVER: Coarse appearance of the liver with increased echogenicity. No focal mass. Main portal vein is patent with normal directional flow and a peak velocity of 23.6 cm/s. No thrombus.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 4 mm.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 measures 8.5 cm and is normal in appearance.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 9.5 cm. Left kidney measures 11.0 cm. OTHER: No significant abnormalities noted. | Coarse appearance of the liver without focal mass. Main portal vein is patent and has normal directional flow. No portal venous thrombus as clinically questioned. |
Generate impression based on medical findings. | 61-year-old male presents with transaminitis. LIVER:The liver measures 20.2 cm. There is increased and coarse echogenicity of the liver. No masses or ascites. No intrahepatic biliary dilation. The portal vein is patent with hepatopedal flow measured with peak velocity at 16.6 cm/s.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended. An echogenic foci within the gallbladder is thought to represent a gallstone. Gallbladder wall measures 0.2 cm. Common bile duct measures 0.7 cm. No pericholecystic fluid. Negative sonographic Murphy's sign.PANCREAS: Evaluation of pancreas is limited due to overlying bowel gas.SPLEEN: The spleen measures 8.5 cm. No abnormalities are noted.KIDNEYS: The right kidney measures 11.5 cm. The cortex has normal echogenicity. No shadowing calculi or hydronephrosis. Left kidney measures approximately 11.1 cm. The cortex has normal echogenicity. No no shadowing calculi or hydronephrosis. OTHER: No significant abnormality noted. | 1. Coarse and echogenic liver consistent with chronic liver disease/parenchymal dysfunction.2. Hepatomegaly without masses or ascites.3. Cholelithiasis without signs of acute inflammation. |
Generate impression based on medical findings. | Thyroid carcinoma status post resection RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy without worrisome mass or regional adenopathy. |
Generate impression based on medical findings. | Female 69 years old Reason: rule out gallbladder, liver pathology History: right upper shoulder pain with inspiration LIVER: Liver measures 17 cm. No focal lesions. Normal echogenicity.BILIARY TRACT: There are multiple subcentimeter cholesterol polyps within the gallbladder. No evidence of gallstones. No evidence of intra or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Spleen measures 8.7 cm, normal in size.RIGHT KIDNEY: No evidence of hydronephrosis in both kidneys. There is a 1.5 cm in diameter simple cyst within the right kidney. Normal echogenicity of the right kidney.Within the left kidney there is a large complex cyst measuring 10 x 9 cm. This cyst contains thick septations and mural irregularity and internal echoes. CT or MRI of the kidneys with contrast is recommended to exclude a renal neoplasm. OTHER: No significant abnormalities noted. | Complex left renal mass. Cystic Renal cell carcinoma cannot be excluded. Contrast-enhanced CT or MRI is recommended for further evaluation.Multiple small cholesterol polyps within the gallbladder.Dr. Blackman was notified and acknowledged about the above findings at the time of the dictation |
Generate impression based on medical findings. | 49 years old, Male, Reason: screening into clinical trial History: none LIVER: The liver measures 12.7 cm in length. A nodular morphology of the liver is consistent with cirrhosis. Simple appearing cyst in the right hepatic lobe measures 1.6 x 1.6 x 1.5 cm. No hepatic lesion suspicious for HCC. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: Patient status post cholecystectomy. Cystic structure in the gallbladder fossa appears similar to prior exam measuring 1.0 x 1.1 x 1.1 cm. 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 is enlarged measuring 15.3 cm in length. RIGHT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. No evidence of hydronephrosis or shadowing calculus. Superior pole simple-appearing cyst measures 0.8 x 1.2 x 0.9 cm.LEFT KIDNEY: Kidney measures 13.4 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: Mild amount of ascites is present. | 1.Cirrhotic morphology of the liver without any focal lesions to suggest HCC.2.Mild amount of ascites.3.Splenomegaly. |
Generate impression based on medical findings. | Male 77 years old; Reason: history of thyroid nodule, please evaluate for interval change History: left thyroid nodule Multiple nodules identified within the right and left lobes of the thyroid as noted previously without substantial change.RIGHT LOBE MEASUREMENTS: 5.3 x 2.5 x 2.3 cm, not substantially changedLEFT LOBE MEASUREMENTS: 4.6 x 2.2 x 2.1 cm, not substantially changedISTHMUS MEASUREMENT: 0.4 cm, not substantially changedRIGHT LOBE:The largest nodule on the right measures 0.6 x 0.6 x 0 .3 cm, stable in size, with the cystic component, as noted previously. This nodule is located within the superior pole and contains central calcifications. Small nodule also noted posterior to the right lobe of the thyroid which could represent a parathyroid gland.LEFT LOBE: The largest nodule on the left is predominantly solid. It is centrally iso/hyperechoic and peripherally hypoechoic and measures 1.2 x 1.2 x 1.0 cm, slightly smaller (this nodule was previously sampled). This is located within the inferior pole.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Atherosclerosis of the carotid arteries noted. | Multiple nodules are redemonstrated throughout the thyroid gland, not substantially changed compared to prior. |
Generate impression based on medical findings. | Acute kidney injury RIGHT KIDNEY: 11.2 cm in length. Mildly increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 10.1 cm in length. Mildly increased renal parenchymal echogenicity. An 11 mm benign-appearing cyst is noted at the inferior pole No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: No significant abnormality noted.OTHER: No significant abnormality noted. | Mildly echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on medical findings. | 57-year-old female status post fall on 1/18/16 with trauma to the left anterior chest. Now feels a "knot" in the left breast, superior to the nipple. Rule out hematoma. According to the patient today, the palpable area is improving significantly in the past week and was also not present before the fall. On physical exam, a small lump was palpable in the 1:00 position 3 cm from the nipple. A targeted left breast ultrasound was then performed in the palpable area of concern. In the 1:00 position approximately 1 cm from the nipple is a heterogenous, predominantly hyperechoic area measuring 9 x 10 mm without appreciable vascular flow. | Physical exam and ultrasound findings likely represent a evolving hematoma/fat necrosis in the left breast. However, a three month follow-up is recommended to ensure resolution. These findings and recommendations were discussed with the patient who agreed with the plan.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on medical findings. | Acute renal insufficiency RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Stable complex benign cyst. Right kidney 11.3 cm in length.LEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.4 cm in lengthOTHER: Bladder not visualized due to overlying bandages | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. |
Generate impression based on medical findings. | Elevated LFTs LIVER: Diffusely heterogeneous parenchyma with new contour nodularity. While no discrete measurable lesion is clearly identified, the possibility of widespread mass lesions should be considered. Liver length 20 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or duct dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12 cm in lengthOTHER: Left kidney 9.9 cm in length. | Diffusely heterogeneous liver echotexture with new contour nodularity. While no discrete measurable lesion is clearly identifiable, the possibility of widespread mass lesions should be considered. Would recommend correlation with contrast cross sectional imaging. |
Generate impression based on medical findings. | 61-year-old female presents for evaluation of thyroid. She status post lobectomy. RIGHT LOBE MEASUREMENTS: The right side of the thyroid is absent.LEFT LOBE MEASUREMENTS: 1.0 x 1.0 x 3.4 cm.ISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: The right lobe is absent.LEFT LOBE: The parenchyma is homogenous without a nodule.ISTHMUS: The parenchyma is homogenous without a nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: There is a partly-calcified approximately 8 mm echogenic focus in level 2 of the left neck that could represent partial calcification of a lymph node. Given the absence of abnormality on the left, this may represent a postinflammatory lymph node. | 1. Surgical changes of a right-sided thyroid lobectomy. Otherwise, normal ultrasound of the isthmus and left thyroid without nodule.2. Partly calcified lymph node in level 2 of the left neck may represent postinflammatory lymph node. |
Generate impression based on medical findings. | 35 year old female with right upper quadrant pain. The examination is limited and suboptimal due to the patient's body habitus.LIVER: The liver parenchyma is moderately coarse. The liver measures 20 cm in the craniocaudal length. No focal hepatic lesion or intrahepatic biliary ductal dilatation is evident. Normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: A normally distended gallbladder is identified without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common bile duct measuring 4 mm.PANCREAS: Limited evaluation of the pancreatic head and body is grossly unremarkable.SPLEEN: The spleen measures 11 cm in length without a discrete focal abnormality.RIGHT KIDNEY: The right kidney measures 12.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 13 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | Slightly limited study with no specific findings to account for the patient's right upper quadrant pain. Coarsened hepatic parenchyma may represent diffuse fatty infiltration/parenchymal dysfunction. |
Generate impression based on medical findings. | 68 year old female with abnormal alkaline phosphatase and lipase. History of cholecystectomy and lupus on steroids. The study was limited due to the patient's body habitus and bowel gas shadowing.LIVER: The liver parenchyma is coarse and mildly hyperechoic. The liver measures 13.9 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is also hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 3 mm. The patient is status post cholecystectomy.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen is mostly obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.4 cm in length without hydronephrosis or shadowing calculus. OTHER: There is mild generalized body wall edema. Small amount of ascites and pleural effusions. | 1. Limited study as described above without biliary ductal dilatation.2. Heterogeneous and coarse liver parenchyma likely related to steatosis/diffuse parenchymal dysfunction.3. Trace ascites and bilateral pleural effusions. |
Generate impression based on medical findings. | Right upper quadrant pain LIVER: Mildly heterogeneous liver without mass. Liver length 15.7 cm.BILIARY TRACT: Cholelithiasis with mild diffuse wall thickening. No pericholecystic fluid. No positive Murphy's sign. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.1 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Left kidney 10.6 cm in length. No ascites. | Mildly heterogeneous liver raises the possibility of fatty infiltration/parenchymal dysfunction without mass. Cholelithiasis with mild diffuse wall thickening without pericholecystic fluid or Murphy's sign. While there is no evidence for acute cholecystitis, chronic inflammation cannot be excluded. No ductal dilatation. No ascites. |
Generate impression based on medical findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Family history of breast cancer in mother and sister. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on medical findings. | Male 34 years old; Reason: 34 year old M with left thyroid cyst noted on CT imaging History: Patient reports additional history of recent sinus infection on antibiotics. RIGHT LOBE MEASUREMENTS: 8.0 x 2.7 x 2.4 cmLEFT LOBE MEASUREMENTS: 8.4 x 2.8 x 2.1 cmISTHMUS MEASUREMENT: 0.8 cmRIGHT LOBE: Diffusely heterogeneous gland with multiple small hypoechoic mainly cystic or complex cystic nodules. There is no dominant nodule.LEFT LOBE: Diffusely heterogeneous gland with multiple small hypoechoic mainly cystic or complex cystic nodules. A dominant nodule in the midpole measures 1.1 x 0.7 to 0.8 cm. It is cystic with a peripheral solid component. Vascularity is not increased on color Doppler. There is no calcification.ISTHMUS: Diffusely heterogeneous without dominant nodule.LYMPH NODES: Prominent bilateral cervical lymph nodes. A left level 2 node measures 0.6 x 0.5 x 0.9 centimeters with a fatty hilum. A right level 3 node measures 1.3 x 0.5 x 1.6 cm with a fatty hilum.OTHER: No significant abnormality noted. | 1.Bilateral small cystic and complex cystic nodules with appearance most consistent with colloid nodules.2.Prominent bilateral cervical chain lymph nodes are likely reactive given their otherwise normal ultrasound appearance and the patient's reported current sinus infection. |
Generate impression based on medical findings. | Acute kidney injury, not improving Examination is limited by inability to reposition the patient.RIGHT KIDNEY: Poorly visualized due to inability to reposition the patient. No gross hydronephrosis.LEFT KIDNEY: 9.9 cm in length. Increased renal parenchymal echogenicity. An 8 mm nonobstructing stone is noted in the inferior pole. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Poorly visualized due to inability to position the patient.OTHER: No significant abnormality noted. | Left nephrolithiasis, without hydronephrosis. |
Generate impression based on medical findings. | 60 year-old male with alcohol withdrawal and abnormal liver function. LIVER: Liver is highly echogenic which may be due to fatty infiltration or other parenchymal disease. Mildly nodular contour but appearance is not grossly cirrhotic. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal veinBILIARY TRACT: Gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Relatively small and echogenicSPLEEN: Mild splenomegaly without focal abnormalityRIGHT KIDNEY: No significant abnormalities noted. OTHER: No ascites | Echogenic and mildly nodular liver.Splenomegaly. |
Generate impression based on medical findings. | 47 years old, Male, Reason: r/o cause for renal failure History: renal failure RIGHT KIDNEY: Kidney measures 11.5 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis or shadowing calculus. Hypoechoic right lower pole renal cyst measures 1.7 x 1.7 x 1.5 cm. LEFT KIDNEY: The left kidney is very difficult to visualize due to patient's body habitus. Kidney measures 9.0 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis, shadowing calculus or mass. Left lower pole renal cyst measures 3.8 x 3.1 x 4 cm.Bladder: The bladder is nondistended. | 1.Bilateral diffusely increased echogenicity of the kidneys consistent with medical renal disease.2.No evidence of hydronephrosis or shadowing calculus.3.Bilateral renal cysts. |
Generate impression based on medical findings. | 51 years old, Female, Reason: evaluate for neck mass History: neck mass for past 4 months, freely mobile and nontender RIGHT LOBE MEASUREMENTS: 5.4 x 1.4 x 1.8 centimetersLEFT LOBE MEASUREMENTS: 5.2 x 1.4 x 1.8 cmISTHMUS MEASUREMENTS: 0.7 cmRIGHT LOBE: Hypoechoic spongiform nodule in the inferior right thyroid lobe without peripheral capsule measures 0.6 x 2.5 x 0.4 cm, which is favored to represent colloid nodule. There is no calcification within this nodule.LEFT LOBE: Solid appearing left inferior thyroid lobe nodule has a discontinuous hypoechoic rim measuring 1.0 x 0.7 x 0.4 cm. This nodule is amenable to biopsy. There is no calcification within this nodule.ISTHMUS: There is an anechoic well defined, semi-complex 1.8 x 1.4 x 0.6 centimeter nodule which partially deforms the trachea. There is not significant nodularity within the cystic structure itself. There is thyroid tissue around this entire structure. The structure may represent a minimally complex colloid cyst or less likely a thyroglossal duct cyst.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Midline anechoic cystic structure which minimally deforms the trachea is favored to represent a mildly complex colloid cyst versus less likely a thyroglossal duct cyst.2. Solid appearing left inferior lobe nodule is indeterminate on this exam and is amenable to biopsy.3. Subcentimeter spongiform right thyroid nodule is favored to represent a colloid cyst. |
Generate impression based on medical findings. | History of left breast benign biopsy 2007, patient presents with palpable lump in her left breast.Recent mammogram from May 2016 was within normal limits. A targeted left ultrasound was performed for the patient’s area of concern at 11:00 position 6 cm from the nipple. On physical examination, no discrete palpable mass noted. Patient complains of tenderness over that area. There is no solid or cystic mass identified. Normal glandular tissue noted. | No sonographic evidence for malignancy corresponding to patient's palpable area of concern in the left breast 11:00 position.Routine diagnostic mammogram is recommended due in May 20, 2017BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on medical findings. | Ms. Slavik is a 60-year-old female presenting for a short-term 6 month follow-up for complicated cysts of the right breast. She has no current breast related complaints. On physical exam at the mammographic areas of concern, no discrete masses are palpated.A targeted right breast ultrasound was performed for the mammographic areas of concern. -In the right breast 6:00 location, approximately 1 cm from the nipple, there is revisualization of a round anechoic mass measuring 0.3 x 0.2 x 0.3 cm, previously measuring 0.4 x 0.3 x 0.3 cm. Sonographic findings are compatible with a simple cyst.-In the right breast 10:00 location, approximately 2 cm from the nipple, there is revisualization of a round anechoic mass measuring 0.4 x 0.3 x 0.4 cm, previously measuring 0.4 x 0.2 x 0.4 cm. Sonographic findings are compatible with a simple cyst. | Simple cysts of the right breast. No sonographic evidence for malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually, due next in May 2016. All results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on medical findings. | Thyroid nodule seen on CT scan. RIGHT LOBE MEASUREMENTS: 5.1 x 2.0 x 1.8 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.4 x 1.4 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: The parenchyma is normal in echogenicity. In the inferior pole there is a 2.1 x 1.6 x 1.9 cm well-defined isoechoic solid nodule.LEFT LOBE: The parenchyma is normal in echogenicity. In the mid region there is a 9 x 8 x 8 predominately cystic nodule. More superiorly there is a 8 x 5 x 7 mm predominantly solid isoechoic nodule with small cystic components with possible comet tail artifact suggesting a colloid nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules with the largest being a solid 2.1 cm on the right. No specific suspicious sonographic features, however it is amenable to FNA sampling as clinically indicated. |
Generate impression based on medical findings. | Papillary thyroid carcinoma status post resection RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy without mass or regional adenopathy |
Generate impression based on medical findings. | 66 year old female with a personal history of palpable left breast lump. Three standard views of both breasts with repeat left CC and MLO views and additional spot compression right CC, superior left CC, superior right MLO, and superior left ML 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). There is a marker overlying the left breast immediately inferior to the nipple, corresponding to the palpable area of concern. In this region is a lobulated, obscured mass which measures approximately 2.0 x 1.8 cm. There is a focal asymmetry in the left upper outer breast, relatively low suspicion on full field views. An additional focal asymmetry is present in the right upper outer quadrant at posterior depth, most likely a lymph node. Additional focal asymmetry in the right upper outer breast at mid depth is only evaluated with on the CC compression and partially disperses. An additional asymmetry in the right ML view is low suspicion. Patient declined the completion of spot compression views, which is a limitation, though all areas of asymmetry were evaluated on ultrasound. ULTRASOUND | 1.Lobulated mass in the left breast corresponding to the palpable area of concern, suspicious for malignancy. Ultrasound-guided biopsy is recommended. Mammogram and ultrasound findings as well as recommendation for ultrasound-guided biopsy were discussed with the patient and the patient's son, who both verbalized understanding. Written and verbal instructions were provided to the patient to hold her daily aspirin for 5 days prior to biopsy.2.Other typically benign findings as described above. A 6 month follow up bilateral mammogram is suggested to ensure stability of these typically benign findings.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | 25-year-old female with bilateral breast masses. A targeted bilateral breast ultrasound was performed at the site of the patient's known breast masses thought to represent fibroadenomas. In the left breast at 10:00, 5 cm from the nipple there is a 1.2 x 0.7 x 1.7 cm hypoechoic smoothly marginated mass which previously measured 1.5 x 0.8 x 1.6 cm.In the right breast at 2:00, 5 cm from the nipple there is a small hypoechoic mass measuring 5 x 5 x 2 mm which previously measured 7 x 4 x 5 mm. | Bilateral masses likely representing fibroadenomas are stable for least 2 years. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually beginning at age 40. 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: Evaluate for cirrhosis History: autoimmune hepatitis Examination somewhat limited.LIVER: The liver measures 16.1 cm in length and is nodular in contour. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.18 m/s.BILIARY TRACT: The gallbladder is contracted. No gallbladder wall thickening. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4.8 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.0 cm in length. RIGHT KIDNEY: Kidney measures 9.7 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: Ascites. | Cirrhotic liver morphology without focal hepatic lesions identified. Ascites. |
Generate impression based on medical findings. | Hepatitis C. Evaluate for hepatocellular carcinoma. LIVER: Non-cirrhotic liver morphology. 18.3 cm in length. Unremarkable parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Status post cholecystectomy.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 10.0 cm in length. The left kidney is 10.9 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 12.1 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. | No suspicious hepatic lesion identified. |
Generate impression based on medical findings. | 72-year-old woman presents for call back for left axillary lymph node larger in comparison to prior exams. Targeted grayscale sonography of the left axilla demonstrates a well circumscribed enlarged lymph node with loss of normal fatty hilum, measuring approximately 3.0 x 1.1 x 2.1 cm. Color Doppler shows internal vascularity. Further evaluation is recommended with an ultrasound guided core biopsy. A few normal size lymph nodes with fatty hilum and smooth cortex are also seen in the axilla. | 3.0 x 1.1 x 2.1 cm abnormal left axillary lymph node, indeterminate. Ultrasound-guided core biopsy is recommended for further evaluation. Findings and recommendations were discussed with the patient at the time of examination. She takes aspirin and should be off of that medication for 5 days before the biopsy is done. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | History of liver transplant with recurrent hepatitis C, clinical research surveillance examination. LIVER: The liver measures 14.5 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesion or mass identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.27 m/s.BILIARY TRACT: Status post cholecystectomy. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11.1 cm in length. RIGHT KIDNEY: Kidney measures 10.1 cm in length. Normal echotexture. LEFT KIDNEY: Kidney measures 9.8 cm in length. Normal echotexture. OTHER: No significant abnormalities noted. | Increased hepatic parenchymal echogenicity suggestive of hepatic steatosis/parenchymal dysfunction without focal hepatic lesion identified. |
Generate impression based on medical findings. | Patient presents for evaluation of previously noted ill-defined mass in the inferior medial right breast at posterior depth seen on study from 1/23/2015. RIGHT BREAST DIGITAL MAMMOGRAPHY: Three standard views and 2 spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Again identified is a subcentimeter ill-defined mass in the inferior medial right breast at the posterior depth.TARGETED RIGHT BREAST ULTRASOUND: Targeted right breast ultrasound demonstrates a hypoechoic mass with peripheral echogenicity at 4:00 position, 3 cm from the nipple measuring 5 x 5 x 5 mm with associated vascularity. | Right breast 4:00 position subcentimeter mass as above. Further evaluation with percutaneous biopsy is recommended. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | 65-year-old female. Callback from 5/6/2015 screening mammogram for adjacent masses in the lateral aspect of the right breast. RIGHT BREAST DIAGNOSTIC MAMMOGRAM: A standard ML view and three spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Again seen are two adjacent masses in the right breast upper outer quadrant that persist on spot compression views. The larger of the two masses is on the 9:00 radian, measures 1.5 cm in diameter and has microlobulated margins. The second mass is anterior and inferior to the first. The second mass has partially smooth margins. An asymmetry at the superficial margin of the fibroglandular tissue that was superior to both masses on the MLO view dispersed into normal fibroglandular tissue on the spot compression views. RIGHT BREAST ULTRASOUND: Targeted ultrasound of the right breast upper outer quadrant demonstrated an irregular 1.5 x 1.2 x 1.7 cm hypoechoic mass at 9 o'clock 4 cm from the nipple, corresponding to the larger of the two masses seen on the mammogram. The mass has microlobulated margins, an echogenic halo, and mild internal flow on color Doppler imaging.A second mass is seen at the 8 o'clock periareolar position, approximately 1.5 cm anteroinferior to the first mass. The second mass is a parallel hypoechoic circumscribed mass measuring 0.8 x 0.4 x 1 cm, corresponding to the second mass visualized on mammography. There is no definite internal flow on color Doppler imaging. | 1. Right breast 9 o'clock mass with suspicious features. Ultrasound guided percutaneous biopsy is recommended. 2. Right breast 8 o'clock mass, approximately 1.5 cm away from the first mass, which has benign features, but which is non-specific. Ultrasound guided percutaneous biopsy is recommended. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | 72-year-old female patient with abdominal pain, worsening right upper quadrant. Evaluate for biliary pathology. LIVER: The liver measures 16.2 cm in length. Hepatic parenchymal echogenicity is increased. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are numerous shadowing gallstones without pericholecystic fluid or gallbladder wall thickening. Sonographic Murphy's sign is negative. No intrahepatic biliary ductal dilatation is identified. The common duct is slightly dilated and measures 9 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 8.9 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 8.6 cm in length. No evidence of hydronephrosis.The spleen measures 8.7 cm in length.The right and middle hepatic veins are patent. | 1. Cholelithiasis without sonographic evidence of acute cholecystitis. 2. Hepatic steatosis. |
Generate impression based on medical findings. | 71 year old female presents for preoperative exam prior to heart transplant. LIVER: The liver parenchyma is within normal limits. No intrahepatic biliary dilatation.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common bile duct measures up to 0.9 cm, which may be related to the patient's age and postoperative status. No intrahepatic biliary dilatation or significant abnormality otherwise.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. Spleen measures 9.1 cm in length.KIDNEYS: The right kidney measures 9 cm. There is a mildly complex cyst in the right kidney upper pole which measures 2.8 x 2.1 x 2.7 cm, and has an internal septation and subtle nodularity of the wall. This may be followed on subsequent exams. The left kidney is within normal limits, and measures 9.2 cm.ABDOMINAL AORTA: The proximal aorta measures 2.5 cm, mid aorta measures 1.9 cm, and the distal aorta measures 1.8 cm in diameter.INFERIOR VENA CAVA: The inferior vena cava is within normal limits.OTHER: No significant abnormality noted. | Mildly complex cyst in the right kidney upper pole, which may be followed on subsequent exams.No additional significant abnormality. |
Generate impression based on medical findings. | 83 year-old female with chronic kidney disease. RIGHT KIDNEY: No significant abnormalities noted.LEFT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. The bladder is normal in appearance. Note is made of bilateral ureteral jets. | Unremarkable ultrasound examination of the kidneys and urinary bladder. |
Generate impression based on medical findings. | 39 year old female with proteinuria. Ultrasound guidance was provided for biopsy of right kidney | Ultrasound guidance. |
Generate impression based on medical findings. | Evaluate previously seen renal lesions. LIVER: The liver is normal in morphology and mildly coarse in echotexture. No focal lesion. It measures 15 cm in craniocaudal length. Normal hepatopedal portal venous blood flow at 29 cm/s.BILIARY TRACT: Cholelithiasis within a normally distended gallbladder without wall thickening, pericholecystic fluid or focal tenderness.No biliary ductal dilatation with the common duct measuring 3 mm.PANCREAS: Suboptimal evaluation of the pancreatic head and body is unremarkable. The remainder is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 12.4 cm in length without a focal lesion.RIGHT KIDNEY: Mild cortical thinning and echogenicity. The right kidney measures 11.6 cm. In the interpolar region there is an isoechoic round mass measuring 4.1 x 3.5 x 4.4 cm demonstrating internal vascularity. An adjacent 3.3 x 2.6 x 4.8 cm hypoechoic lesion with enhanced through transmission, a probable cyst.OTHER: The left kidney measures 12.3 cm in length with mild cortical thinning and echogenicity. Note is made of a 2.9 x 1.6 x 2.9 cm simple appearing cyst. | 4.4 cm right interpolar round isoechoic mass with internal vascularity is suspicious for a renal neoplasm. Bilateral simple appearing cysts are also noted. |
Generate impression based on medical findings. | Female 54 years old with palpable left breast lumps and thickening. History of left breast calcifications status post biopsy showing radial scar in outside hospital. A targeted left ultrasound was performed for the patient’s area of concern. On physical examination, no discrete palpable mass noted. No discrete solid or cystic mass identified. Normal glandular tissue noted. | No sonographic evidence for malignancy corresponding to palpable area of concern in the left upper-outer quadrant.Annual diagnostic mammogram due, in August 2017 is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on medical findings. | Reason: Rule out cholestasis History: pruritis, pregnancy LIVER: The liver measures 13.7 cm in length. Normal parenchymal echogenicity and echotexture. The portal vein is patent with normal directional hepatopedal flow, peak velocity is 31.6 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The gallbladder wall measures 0.3 cm. The common bile duct measures 0.3 cm. No biliary ductal dilatation.PANCREAS: The body and tail are obscured by bowel gas. No significant abnormalities noted.KIDNEYS: The right kidney measures 10.5 cm in length. The left kidney measures 10.4 cm in length. No hydronephrosis or shadowing stones.OTHER: No significant abnormalities noted. | No acute hepatobiliary abnormality. |
Generate impression based on medical findings. | 59 years old, Female, Reason: nodule size and characteristics History: multinodular goiter RIGHT LOBE MEASUREMENTS: 7.8 x 4.5 x 3.4 cmLEFT LOBE MEASUREMENTS: 5.0 x 1.7 x 1.9 cmISTHMUS MEASUREMENTS: 0.18 cmRIGHT LOBE: The right lobe of the thyroid is enlarged and heterogeneous with focal subcentimeter anechoic areas, solid areas in some areas possibly representing colloid.LEFT LOBE: Multiple left thyroid nodules. The most superior nodule is solid in appearance measuring 1.9 x 1.0 x 1.3 cm. The superior solid nodule is indeterminate on this ultrasound examination and is amenable to biopsy. Another mid left thyroid nodule is solid in appearance measuring 1.0 x 0.9 x 0.8 cm. The most inferior nodule is predominantly cystic in appearance measuring 1.2 x 1.0 x 1.0 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Findings consistent with multinodular goiter.2.Diffusely enlarged heterogeneous right thyroid lobe.3.Multiple left thyroid nodules, the largest of which is amenable to biopsy if clinically indicated. |
Generate impression based on medical findings. | 78 year old female with history of pulmonary fibrosis and suspected cholestasis. Elevated LFTs. LIVER: Heterogeneous liver echogenicity, without additional significant abnormalities noted. The liver measures 15 cm.GALLBLADDER, BILIARY TRACT: Cholecystectomy years ago. No significant biliary dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. The right kidney measures 8.6 cm.OTHER: No significant abnormalities noted. The left kidney is normal in appearance, and measures 10 cm. The spleen measures 12 cm, and has arterial calcifications at the hilum. | Post cholecystectomy changes and mildly heterogeneous liver parenchyma, without additional significant abnormality. |
Generate impression based on medical findings. | Reason: serial evaluation of liver morphology History: abdominal distension/ascites LIVER: The liver measures 17.8 cm in length, mildly enlarged. Mildly heterogeneous, echogenic hepatic parenchyma with a mildly nodular contour. The portal vein is patent with normal directional hepatopetal portal venous blood flow, peak velocity of 49.5 cm/s, however demonstrates a pulsatile waveform. The hepatic veins appear dilated. No focal mass.GALLBLADDER, BILIARY TRACT: Echogenic shadowing gallstones in a collapsed gallbladder. No evidence of acute pericholecystic inflammation. The gallbladder wall measures 0.4 cm. The common bile duct measures 0.2 cm. No biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.2 cm in length. No hydronephrosis or shadowing stonesLEFT KIDNEY: The left kidney measures 10.5 cm in length. No hydronephrosis. Subcentimeter nonobstructive shadowing calculus.OTHER: The spleen measures 11.9 cm in length. Moderate volume ascites. | 1. Dilated hepatic veins with pulsatile portal venous waveform, consistent with congestive heart failure.2. Mild hepatomegaly and mildly heterogeneous hepatic parenchyma and nodular contour, which is suggestive of hepatic parenchymal dysfunction.3. Moderate volume ascites.4. Cholelithiasis without evidence of acute inflammation.5. Subcentimeter non-obstructing left renal calculus. |
Generate impression based on medical findings. | 64-year-old female with goiter, history of Graves' disease and nodules. RIGHT LOBE MEASUREMENTS: 6.4 x 2.9 x 2.4 cmLEFT LOBE MEASUREMENTS: 6.2 x 2.4 x 2.8 cmISTHMUS MEASUREMENTS: 0.8 cmRIGHT LOBE: Mildly and diffusely heterogeneous. In the upper pole there is a hypoechoic and somewhat spongiform nodule measuring 0.6 x 0.9 x 0.9 cm review of the prior study demonstrates this is unchanged. There may be a spongiform nodule in the posterior upper pole measuring 1 x 0.9 x 1.2 cm. It is likely that this was present on the prior study. Other, smaller complex cystic nodules are present as well.LEFT LOBE: Mildly and diffusely heterogeneous. Isoechoic but mildly heterogeneous nodule in the midportion of the left lobe with a somewhat spongiform appearance measures 0.9 x 1.3 x 1.3 cm. Review of the prior study demonstrates that this is likely unchanged in the interim although with certainly less well-visualized on the prior exam. Previously noted left upper pole nodule is not visualized. ISTHMUS: Mildly and diffusely heterogeneous in echotexture.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules. Although at least 3 nodules were not previously measured but appear unchanged. |
Generate impression based on medical findings. | Female, 77 years old. Anuric Examination is limited due to body habitus and patient positioning.RIGHT KIDNEY: The right kidney measures 10.8 cm in length. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.7 cm in length. No shadowing stones or hydronephrosis.OTHER: The bladder is not visualized, likely decompressed. | Limited examination. No hydronephrosis. |
Generate impression based on medical findings. | 62-year-old female with hepatitis B. Elevated liver function. LIVER: Liver is relatively small and echogenic, without interval change. There is no focal hepatic abnormality except for a stable cyst in the left lobe.GALLBLADDER, BILIARY TRACT: No biliary tract dilatation. The gallbladder appears unremarkable.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Stable examination. Echogenic liver without mass or biliary tract dilatation. |