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Generate impression based on 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 findings. | Male 58 years old Reason: 58M s/p OLT 10/2 now with elevated LFTs s/p liver biopsy. History: Elevated LFTs LIVER: Background liver echogenicity is within normal limits. Stent or drain is partially visualized.BILIARY TRACT: Mildly prominent intrahepatic ducts without significant dilatation of the common bile duct which measures up to 6 mm.OTHER: No significant abnormalities noted. | Mildly prominent intrahepatic ducts without significant common bile duct dilatation, possibly related to cholestasis. |
Generate impression based on findings. | Female 49 years old Reason: gall stones History: epigastric pain LIVER: Heterogeneous background echogenicity of the liver. No definite focal mass is identified. Main portal vein is patent with normal directional flow and a peak velocity of 13.4 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No gallbladder wall thickening or signs of acute inflammation. No gallstones are identified.PANCREAS: Pancreas is obscured by overlying bowel gasSPLEEN: Spleen is normal in appearance measuring 10.5 cm.RIGHT KIDNEY: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10 cm. Left kidney measures 10.3 cm.OTHER: No significant abnormalities noted. | Normal appearance of the gallbladder without evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | Female 63 years old Reason: thyroid nodules History: thyroid nodules RIGHT LOBE MEASUREMENTS: 6.0 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 7.5 x 3.1 x 3.3 cm.ISTHMUS MEASUREMENTS: 0.6 cm.RIGHT LOBE: Normal appearance of the right thyroid lobe.LEFT LOBE: Mildly heterogeneous background left thyroid lobe echogenicity. Heterogeneous solid-appearing nodule which is slightly increased in size compared to the prior exam measuring 4.0 x 3.1 x 4.2 cm, previously 3.1 x 3.5 x 2.5 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No regional lymphadenopathy.OTHER: No significant abnormality noted. | Heterogeneous solid-appearing left thyroid nodule slightly increased in size compared to the prior exam. |
Generate impression based on findings. | Male 64 years old Reason: eval thyroid nodule seen on CT of chest RIGHT LOBE MEASUREMENTS: 5.2 x 2.2 x 1.3 cm.LEFT LOBE MEASUREMENTS: 5.4 x 2.1 x 1.1 cm.ISTHMUS MEASUREMENTS: 0.6 cm.RIGHT LOBE: Within the right thyroid lobe there is a linear, shadowing calcification. Background echogenicity of the right thyroid lobe is mildly heterogeneous.LEFT LOBE: Mildly heterogeneous background echogenicity. No nodules or significant abnormality.ISTHMUS: Solid, hypoechoic nodule in the right isthmus with mildly increased vascularity and a hypoechoic rim measures 1.5 x 1.0 x 1.8 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing left level 3 lymph node measures 0.7 x 0.5 x 0.8 cm.OTHER: No significant abnormality noted. | Hypoechoic, predominantly solid nodule in the right isthmus is amenable to biopsy. |
Generate impression based on findings. | Male 38 years old Reason: Evaluate for graft patency History: urinary retention LOCATION: Left iliac fossaPERITRANSPLANT TISSUES: No perinephric fluid collection.KIDNEY: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass.URINARY BLADDER: Bladder has a Foley within it and is mildly distended. Adjacent to the bladder is a portion of the penile prosthesis.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels No significant abnormality of the floor of the vessels. Vessels are patent with normal waveforms. Resistive indices are within normal limits.OTHER: No significant abnormality noted | Normal evaluation of the transplant kidney without hydronephrosis. Patent inflow and outflow vessels. |
Generate impression based on findings. | Male 55 years old Reason: pre liver transplant work up; assess vasculature liver, inflow/outflow studies of vessels, ascites, portal vein thrombosis, lesions, masses History: cirrhosis, partial PVT, ascites LIVER: Extremely limited evaluation of the liver. Visualized portions are coarse.BILIARY TRACT: Cannot be evaluated on this examPANCREAS: No significant abnormalities noted.SPLEEN: The visualized portions of the spleen are normal in appearance measuring 13.8 cm. KIDNEYS: Kidneys are also not well visualized. Unchanged cystic lesion in the left kidney measures 3.3 x 5.9 x 7.2 cm.OTHER: No significant abnormalities noted.ABDOMINAL DOPPLER: Color and spectral Doppler were performed on inflow and outflow vessels.PORTAL VENOUS: Portal vasculature is not well visualized, however the there is suggestion of normal directional flow in the region of the portal vein. Splenic vein and artery are patent with normal directional flow.HEPATIC ARTERIES: Not well visualized. HEPATIC VEINS: Not well visualizedINFERIOR VENA CAVA: No significant abnormalities noted. | Extremely limited evaluation of the hepatic inflow and outflow vessels, which appear grossly patent. Very limited evaluation of the hepatic parenchyma. If further evaluation is clinically warranted, cross-sectional imaging with CT or MRI is recommended. |
Generate impression based on findings. | 47-year-old male presents for follow-up of palpable left breast mass. A targeted left ultrasound was performed for the palpable area of concern. In the left breast 6:00 periareolar region, immediately adjacent to the nipple, there is a 2.0 x 0.4 x 1.1 cm circumscribed oval hypoechoic mass within the skin, previously 1.9 x 0.6 x 1.3 cm. No internal vascularity is seen within this mass. There is peripheral vascularity. | Slight interval decrease in size of a palpable left breast lesion centered within the skin, suggestive of an epidermal inclusion cyst. Clinical correlation is recommended for further management. No sonographic evidence for malignancy in the left breast. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Male 58 years old Reason: OHT evaluation History: OHT evaluation LIVER:Liver parenchyma is within normal limits. No focal hepatic mass. Main portal vein is patent with normal directional flow.GALLBLADDER, BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallbladder is normal. No gallstones.PANCREAS: The visualized portions of the pancreas are normal in appearance.SPLEEN: No significant abnormality noted. Spleen measures 11.6 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 11.6 cm. Left kidney measures 11.5 cm. ABDOMINAL AORTA: No significant abnormality within the aorta. No aneurysms identified. Normal vascular flow in the aorta.INFERIOR VENA CAVA: No significant abnormality noted.BLADDER: No significant abnormality noted. | Normal sonographic evaluation of the abdominal viscera. |
Generate impression based on findings. | Male 59 years old Reason: patient with hepatomegaly on exam increased LFT's History: above LIVER: Liver parenchyma is within normal limits. Liver measures 14.0 cm in length. No focal hepatic lesion. Main portal vein is patent with normal directional flow.BILIARY TRACT: No intra-axial hepatic biliary ductal dilatation. The gallbladder is collapsed. Common bile duct measures up to 5 mm.PANCREAS: The visualized portions of the pancreas are normal in appearance.SPLEEN: Spleen is normal in appearance measuring 9.5 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. OTHER: Mild ascites is present. Bilateral small pleural effusions. | 1.Mild ascites and bilateral small pleural effusions.2.Normal echogenicity of the liver with a patent portal vein. Liver is not enlarged by ultrasound. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 6.2 x 2.4 x 2.3 cmLEFT LOBE MEASUREMENTS: 6 x 2.3 x 2.6 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Stable right thyroid nodules. Reference inferior pole nodule measures 2.5 x 2.2 x 1.2 cm.LEFT LOBE: Stable spongiform nodules. Reference inferior pole nodule measures 1.7 x 1.2 x 0.8 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral thyroid nodules. |
Generate impression based on findings. | Right thyroid enlargement RIGHT LOBE MEASUREMENTS: 4.9 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.6 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Multiple predominantly cystic and spongiform nodules. The largest within the upper pole measures 0.6 x 0.4 x 0.4 cm.LEFT LOBE: Multiple spongiform nodules. The largest within the lower pole measures 1.1 x 0.5 x 0.8 cm.ISTHMUS: Spongiform nodule within the right isthmus measuring 1.9 x 1 x 1.7 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral and right isthmic cystic and spongiform nodules; a benign etiology is favored. No regional adenopathy. |
Generate impression based on findings. | 65-year-old female with history of hepatitis C virus cirrhosis. Evaluate for mass or ascites. LIVER: Liver is coarsely echogenic with a cirrhotic morphology. Focal, coarse calcifications again noted within the liver. Addition, complex cyst in the left lobe of the liver measures 1.6 x 2 x 2 cm. Right lobe hepatic cyst measures 2.6 x 3.9 x 4.1 cm. There is a less well-defined rounded, hypoechoic subcapsular nodule in the right lobe measuring 1 x 1 x 1.2 cm. This does have some evidence of cystic characteristics. This was not visualized with certainty on the prior exam. Previously noted vague nodular density not seen on today's study.BILIARY TRACT: Poorly tract is normal in caliber. The gallbladder may contain a small, nonshadowing polyp. In addition, there is some focal increased echogenicity in the region of the fundus. Given lack of stones or other fundal abnormality and prior studies, this may represent an adjacent hepatic calcification. There is not gross wall thickening or pericholecystic fluid.PANCREAS: The head and and body are normal. The tail was not well seen.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No ascites. | Cirrhotic liver with heterogeneous echotexture. No change in cysts within the liver or calcifications. Vague, subcapsular nodule may represent a complex cyst although difficult to assess in a liver that is this heterogeneous. Patient has had multiple cysts on prior MR exam as well as other noncystic nodules.Gallbladder polyp. See above. |
Generate impression based on findings. | 52-year-old male with history of Kennedy's disease with right flank superficial discomfort and swelling. In the subcutaneous tissues in the region of the patient's discomfort and visible swelling there is an ovoid region which is isoechoic to surrounding fat measuring 0.8 x 3.8 x 3.5 cm. There is no defect in the adjacent abdominal wall nor is or significant change with Valsalva. Findings are most suggestive of lipoma. | Findings most consistent with lipoma involving the subcutaneous fat of the right flank. |
Generate impression based on findings. | 39-year-old female with hepatitis B without delta agent. Evaluate for cirrhosis or mass. LIVER: Liver is normal in size and is mildly echogenic. Morphology is normal. There is no focal hepatic mass identified.BILIARY TRACT: Biliary tract is normal in caliber. The gallbladder appears unremarkable without cholelithiasis, wall thickening or pericholecystic fluid.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Mildly echogenic liver. Otherwise, normal exam. |
Generate impression based on findings. | 68-year-old male with multiple myeloma and renal insufficiency. Ultrasound guidance. | Ultrasound guidance for left renal biopsy. |
Generate impression based on findings. | 61-year-old female with urinary retention for suprapubic tube placement. Ultrasound guidance | Ultrasound guidance as noted above. |
Generate impression based on findings. | 63 year old female who was recalled from screening mammogram for incompletely characterized mass in the left superior breast. Mammogram: An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty(BiRads Density Category A), unchanged in pattern and distribution. 5 mm round circumscribed mass with lucency in the center most likely represents a benign intramammary lymph node.Ultrasound: Targeted left upper-outer quadrant ultrasound was performed. Benign morphology 5 x 4 mm hypoechoic mass is identified in the left breast 1:00 position without definite peripheral blood flow which could represent a complex cyst or a benign intramammary lymph node with central fatty hilum. No suspicious cystic or solid mass noted. | Benign morphology subcentimeter mass in the left breast most likely represents a complex cyst or a benign intramammary lymph node. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on 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 findings. | 48-year-old female with abdominal pain and question calcification on an outside plain film. RIGHT KIDNEY: The right kidney measures 10.6 cm in length. Echotexture is normal. There is no hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 10.9 cm in length. There is a very small, septated cyst in the midportion of the left kidney. In the upper pole of the kidney extending to the periphery of the cortex there are shadowing calcifications. There is focal parenchymal loss adjacent to this. Findings are suggestive of chronic calyceal stones. No associated mass is identified.OTHER: Bladder is decompressed. | Calcifications left kidney associated with parenchymal cortical loss. Presumably, chronic stone disease. |
Generate impression based on findings. | 78-year-old female with goiter. RIGHT LOBE MEASUREMENTS: Incompletely measured due to substernal component. 7.7 x 3.2 x 5.4 cmLEFT LOBE MEASUREMENTS: Incompletely measured due to substernal component. 7.1 x 2.6 x 3.6 cmISTHMUS MEASUREMENTS: 1.6 cmRIGHT LOBE: Diffusely heterogeneous. Small cystic colloid nodule measuring 0.5 x 1.1 x 0.5 cm. Solid, isoechoic nodule arising from the lower pole likely incompletely visualized, measuring 2.3 x 2.5 x 1.9 cm. Other less well-defined solid nodules are present. LEFT LOBE: Diffusely heterogeneous. Complex cystic nodule in the upper pole measuring 0.7 x 1 x 1.3 cm. Rounded, probably cystic nodule with small wall nodule in the midportion measuring 1.1 x 1.2 x 1.1 cm. Incompletely marginated, isoechoic but heterogeneous solid lower pole nodule measuring 3.5 x 4 by at least 3.5 cm. There are discrete, coarse calcifications in the left thyroid.ISTHMUS: Confluent heterogeneous and solid nodules with coarse calcification the most measurable approximating 1.6 x 1.6 x 1.6 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Large goiter with substernal thyroid. Multiple solid and cystic nodules. Coarse calcification in the left lobe and isthmus. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of benign left breast in 2004 for "densely hyalinized breast tissue." 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Stable macrolobulated mass of the left upper outer breast, compatible with previously benign biopsy. Additional round anechoic lesions are identified bilaterally, compatible with simple cysts. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | Stable benign mass of the left breast. No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on 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 findings. | 44-year-old female with right upper quadrant pain. LIVER: Moderately echogenic presumably due to fatty infiltration as seen on the prior exam. No focal hepatic abnormality. Liver is not enlarged.BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Limited in visualization.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Presumed fatty liver without change. Normal gallbladder and biliary tract. |
Generate impression based on findings. | 69-year-old male with right upper quadrant pain. LIVER: Normal in size, contour and echogenicity. No focal hepatic abnormality.BILIARY TRACT: Biliary tract is normal in caliber. Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Lobulation involving the midportion left kidney without underlying mass. | Normal gallbladder and biliary tract. |
Generate impression based on findings. | 79-year-old female with metastatic breast cancer and abnormal liver function. LIVER: Hepatic size is normal upper normal. There is diffuse replacement of hepatic parenchyma by metastatic disease. BILIARY TRACT: The patient has had a cholecystectomy. There is no obvious, focal biliary tract dilatation and the common bile duct is normal in caliber.PANCREAS: Poorly visualized due to bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Spleen not visualized. Patient has had a left nephrectomy. | Diffuse metastatic replacement of hepatic parenchyma without biliary abnormality. |
Generate impression based on findings. | 90-year-old female with elevated creatinine. Rule out obstruction/hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.6 cm in length. Echogenic renal parenchyma unchanged from prior exam. No hydronephrosis or shadowing calculus.LEFT KIDNEY: The left kidney measures 8.9 cm in length. Echogenic renal parenchyma unchanged from prior exam. No hydronephrosis or shadowing calculus.URINARY BLADDER: Partially distended urinary bladder is not well evaluated.OTHER: Gallbladder contains dependent stones and sludge. No gross wall thickening or pericholecystic fluid. | 1. No hydronephrosis.2. Echogenic renal parenchyma compatible with medical renal disease.3. Dependent gallstones and sludge within the gallbladder. |
Generate impression based on findings. | Fifth finger injury The central slip is visualized inserting upon the tuberosity at the base of the middle phalanx dorsally and there is no evidence of central slip disruption. The tendon appears slightly enlarged and edematous which may represent a mild strain, but this is equivocal. The overlying subcutaneous soft tissues also appear edematous. The ulnar collateral ligament appears edematous, perhaps representing a mild sprain. | Possible mild edema of the central slip extensor tendon but without evidence of tear. |
Generate impression based on findings. | Recent screening mammogram performed on 8/16/2016 was within normal limits. Patient presents with right breast itching and pain. Personal history of bilateral breast reduction in 2012. Family history of breast cancer in a maternal aunt and a maternal cousin. A targeted right ultrasound was performed for the patient’s area of concern. On physical examination, no discrete palpable mass noted in the right breast 3:00 position. No evidence of skin redness noted. Ultrasound demonstrates normal glandular tissue. There is no solid or cystic mass identified. | No sonographic evidence for malignancy corresponding to patient's area of pain in the right breast 3:00 position. Annual screening mammogram is recommended.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 46-year-old male with hepatitis C, Stevens-Johnson syndrome and sepsis. Evaluate for cholecystitis. LIVER: Liver is diffusely and mildly echogenic which is non--- specific. Liver is enlarged measures 22 cm in length. Main portal vein is patent with appropriate flow direction.BILIARY TRACT: Gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Poorly visualized due to bowel gas.SPLEEN: Enlarged, measuring 16.7 cm in length without focal abnormality.RIGHT KIDNEY: Echogenic without hydronephrosis. OTHER: Left kidney is echogenic without hydronephrosis. | Normal gallbladder and biliary tract. Hepatosplenomegaly without change.Echogenic liver without change.Echogenic kidneys without change. |
Generate impression based on findings. | 66-year-old female with a small thyroid nodule in the left lobe. Please evaluate for interval changes. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4 x 1.2 x 1.4 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 3.2 x 0.9 x 1.3 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.2 cm in thickness.RIGHT LOBE: In the right upper thyroid pole, there is a 0.9 x 0.6 x 0.7 cm heterogenous hyperechoic nodule. The measurements are unchanged when including the hypoechoic rim on the prior exam. Heterogeneous echotexture of the right thyroid lobe.LEFT LOBE: Heterogeneous echotexture the left thyroid lobe. No discrete nodules on the left.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious cervical lymphadenopathy.OTHER: No significant abnormality noted. | 1. Stable subcentimeter heterogenous hyperechoic nodule of the right upper thyroid pole.2. Heterogenous thyroid gland. No discrete nodules on the left. |
Generate impression based on findings. | Ms. Siwak is a 26 year old female presenting with a palpable tender lump in the right axilla for one month. A targeted right breast ultrasound is performed for the patient's area of concern.In the right breast 10:00 location, approximately 6 cm from the nipple, no suspicious cystic or solid mass is identified.Seen just slightly superolateral to this is a normal right axillary lymph node measuring approximately 1.8 x 1.1 cm with normal hilar flow. | Patient's palpable tender lump may correspond to a low-lying normal right axillary lymph node. No sonographic evidence of malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. All results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Ms. Johnson is a 51 year old female with a recent diagnosis of metastatic adenocarcinoma of the left axillary lymph node, concerning for breast primary. She presents today for further evaluation to locate the breast primary. Given patient's body habitus and limited mobility, a breast mammogram was not able to be performed today. Therefore, a whole left breast ultrasound was performed.In the left breast 2:00 location, approximately 10 cm from the nipple, there is an irregular hypoechoic mass identified measuring 1.5 x 0.7 x 0.9 cm. There is moderate associated vascularity.This mass is located approximately 3.3 cm inferolateral to the recently biopsied left axillary lymph node. | 1.5 cm suspicious mass in the left upper outer breast, likely representing patient's breast primary. An ultrasound-guided biopsy with clip placement can be attempted if clinically warranted. All results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 77-year-old female with primary hyperparathyroidism. Please evaluate. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.6 x 2.3 x 2.1 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.1 x 2.2 x 1.6 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.5 cm in thickness.RIGHT LOBE: There are multiple subcentimeter hypoechoic nodules with a spongiform appearance. The largest of these nodules measures 0.9 x 0.8 x 0.5 cm and is located in the anterior right upper pole.LEFT LOBE: Multiple subcentimeter hypoechoic nodules with a spongiform appearance. The largest of these nodules measures 0.9 x 0.7 x 1 cm and is located in the left lower pole. An additional complex cystic nodule posterior to the left mid thyroid lobe measures 1.5 x 1.2 x 1.4 cm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: See below.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Complex cystic nodule posterior to the left mid thyroid pole could represent an exophytic cystic thyroid nodule, however a cystic parathyroid adenoma cannot be excluded. Correlation with nuclear medicine imaging is recommended.Multiple thyroid nodules bilaterally; favor benign etiology. |
Generate impression based on findings. | 67-year-old male with hypercalcemia. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.9 x 2.1 x 2.2 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.4 x 2.3 x 2.3 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.3 cm in thickness.RIGHT LOBE: Subcentimeter hypoechoic foci with the largest measuring 0.5 x 0.4 x 0.5 cm.LEFT LOBE: Subcentimeter hypoechoic foci. The largest measures 0.4 x 0.3 x 0.5 cm and has a spongiform appearance.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No parathyroid candidates appreciated. |
Generate impression based on findings. | Ms. Battie is a 40 year old presenting with an enlarging palpable lesion in the right breast, previously found to be a cyst on prior diagnostic mammogram on 08/19/2016. A targeted right ultrasound was performed for the patient’s palpable area of concern. Multiple enlarging simple cysts are identified, the largest of which measures 3.9 x 2.5 x 3.3 cm. No suspicious solid masses identified. | Multiple benign simple cysts of the right breast. No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. The patient can certainly get an ultrasound-guided cyst aspiration as a possible option for her enlarging cysts. Bilateral screening mammogram is recommended annually, due next in August 2017. All results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female 69 years old Reason: HCC surveillance History: HCV cirrhosis LIVER: The liver is coarse and nodular consistent with history of cirrhosis. No new suspicious focal hepatic mass is identified. Main portal vein is patent with normal directional flow and a peak velocity of 13.7 cm/s. Unchanged septated cyst right hepatic lobe measuring 0.8 x 0.7 x 0.7 cm.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallbladder is normal in appearance without gallstones. Common bile duct measures 3 mm.PANCREAS: The visualized portions of the pancreas are unremarkable.SPLEEN: Spleen is enlarged measuring 15.5 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10.0 cm. Left kidney measures 10.0 cm. OTHER: No significant abnormalities noted. | Cirrhotic morphology of the liver without suspicious focal hepatic mass. Sequela of portal hypertension including splenomegaly. |
Generate impression based on findings. | Female 48 years old Reason: epigastric pain/ RUQ pain, loss of appetite History: as above LIVER: Echogenic liver parenchyma, which is nonspecific but may be seen in the setting of fatty infiltration or diffuse hepatic dysfunction. No focal hepatic mass. Main portal vein is patent with normal directional flow.BILIARY TRACT: Common bile duct is dilated measuring approximately 10 mm near the porta hepatis and distally tapering to 8 mm. No common bile duct stone is visualized. Gallbladder is normal in appearance. No gallstones. No intrahepatic biliary ductal dilatation.PANCREAS: Partially visualized portions of the pancreas are unremarkable.SPLEEN: Spleen is normal in appearance measuring 8.3 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass.. Right kidney measures 10.8 cm. Left kidney measures 10.9 cmOTHER: There is a multilobulated, predominantly anechoic collection, which appears peripherally calcified with septations. This does not definitely connect to the spleen or to the kidney. | 1.Dilated common bile duct without ductal stone identified. Recommend MRCP for further evaluation of possible intraductal pathology and/or stone.2.Nonspecific multilobulated fluid collection in the left upper quadrant, which may originate from the adrenal gland or retroperitoneum. MRI of the abdomen will also help further evaluate this lesion.Discussed with ordering physician Dr. Veskovic. |
Generate impression based on findings. | 57 year old female with history of complex cystic and solid left breast mass with pathology revealing LCIS and ALH here for follow-up. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The previously noted complex cystic and solid left mass in the medial left breast is not well visualized. There is a hydromark clip in the left central breast. There are scattered benign calcifications bilaterally. ULTRASOUND | A biopsy clip is present in the 10:00 position without associated discrete mass identified. Consider further evaluation with MRI given history of LCIS and ALH.Annual diagnostic mammogram is recommended in 6 months. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 68-year-old male with hematuria. RIGHT KIDNEY: The right kidney measures 8.9 cm in length. Small to moderate hydronephrosis, unchanged. A simple cyst of the right upper renal pole is unchanged measuring 1.7 x 1.7 x 1.6 cm. Mildly echogenic renal parenchyma.LEFT KIDNEY: The left kidney measures 8.8 cm in length. No hydronephrosis. Multiple renal cysts are again seen. In the left lower renal pole, there is a complex cystic lesion with the cystic component measuring 4 x 3.8 x 4.4 cm and a mural nodule measuring 0.6 x 0.5 0.6 cm. The cystic component on the prior ultrasound measured 4 x 3.9 x 3.8 cm, however the mural nodule was not clearly identified. Mildly echogenic renal parenchyma.URINARY BLADDER: A Foley catheter and suprapubic catheter are in place. Intraluminal debris is noted within the bladder. OTHER: No significant abnormalities noted. | 1. Suprapubic catheter and Foley catheter are in place. The urinary bladder contains intraluminal debris.2. Complex cystic nodule of the left lower renal pole containing a subcentimeter mural nodule. The cystic component is unchanged in size compared to 12/5/2014 ultrasound exam, however the mural nodule was not clearly identified. Attention on follow-up imaging is recommended.3. Stable mild to moderate right-sided hydronephrosis. |
Generate impression based on findings. | Male 89 years old Reason: bilateral groin History: groin swelling Complex heterogeneous collections in the subcutaneous tissues of the left and right lower quadrant, near the incisions, which do not appear to connect in the midline. The right lower quadrant collection measures 9.9 x 2.8 x 4.0 cm. Left lower quadrant collection measures 5.3 x 3.6 x 5.1 cm. | Two subcutaneous nonspecific complex fluid collections near incision sites in right and left lower quadrants. |
Generate impression based on 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 findings. | Male 65 years old Reason: Eval testicular fluid History: significant swelling extending into scrotum RIGHT TESTIS: Right testicle measures 4.8 x 3.5 x 2.7 cm. Echogenicity of the right testicle is normal.LEFT TESTIS: Left testicle measures 4.4 x 2.7 x 2.9 cm. Echogenicity of the left testicle is normal.RIGHT EPIDIDYMIS: Right epididymis measures 2.1 x 1.0 x 0.7 cm. There is a small right epididymal cyst measuring 0.4 x 0.2 x 0.4 cm. No evidence of epididymitis.LEFT EPIDIDYMIS: Left epididymis measures 2.4 x 1.2 x 1.6 cm. No evidence of epididymitis.OTHER: Small left hydrocele is present. Scrotal skin thickening consistent with soft tissue edema. | Small left hydrocele with simple appearing fluid. Scrotal soft tissue edema. |
Generate impression based on findings. | 56-year-old female with sickle cell pain crisis. Abdominal tenderness and guarding. Pain on the left side. Rule out free fluid. LIVER: Partial visualization of the hepatic parenchyma demonstrates stable appearance of echogenic coarse hepatic echotexture.OTHER: No ascites identified in the 4 abdominal quadrants. Fluid distended bowel in the left lower quadrant and fluid distention of the stomach. | 1. No ascites.2. Fluid distended small bowel in the left lower quadrant (area of pain). |
Generate impression based on findings. | Female 81 years old Reason: evaluate calcification History: calcification on CT scan RIGHT LOBE MEASUREMENTS: 5.3 x 3.0 x 2.8 cm.LEFT LOBE MEASUREMENTS: Patient reports no history of surgery, however there appears to have been a left thyroidectomy.ISTHMUS MEASUREMENTS: 0.6 cm.RIGHT LOBE: Background echogenicity of the right thyroid lobe is heterogeneous with some cystic components. No discrete nodules are identified. No shadowing calcifications are definitely identified.LEFT LOBE: Patient is likely status post left thyroidectomy.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small benign-appearing lymph nodes are present in the left and right neck, the largest of which on the right level 2 measuring 1.6 x 0.4 x 0.9 cm.OTHER: No significant abnormality noted. | Enlarged and heterogeneous right thyroid lobe with some cystic components without discrete nodule. Punctate calcification not visualized. |
Generate impression based on findings. | Female 30 years old Reason: h/o goiter, 2 nodules detected on scan in NY 12/2015 RIGHT LOBE MEASUREMENTS: 5.9 x 2.4 x 1.7 centimetersLEFT LOBE MEASUREMENTS: 5.7 x 2.1 x 1.3 cmISTHMUS MEASUREMENTS: 0.2 centimetersRIGHT LOBE: Heterogeneous background echogenicity of the right thyroid lobe. No discrete nodules are identified.LEFT LOBE: Heterogeneous background echogenicity of the left thyroid lobe. Small, well-circumscribed, mildly hypoechoic, spongiform appearance and nodule in the inferior left thyroid with mild increased vascularity, without microcalcifications, measuring 0.7 x 0.8 x 0.6 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous echogenicity of the thyroid which could be due to tiny nodules or thyroiditis. Small spongiform nodule in the inferior left thyroid lobe without definite microcalcifications. |
Generate impression based on findings. | Female 63 years old Reason: assess for liver lesions History: HCV LIVER: Increased echogenicity of the liver, which is nonspecific but can be seen in the setting of fatty infiltration or diffuse hepatic dysfunction. Unchanged, approximately 1 cm calcification with shadowing most likely representing a granuloma versus scar. No focal hepatic mass. Portal vein is patent with normal directional flow.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures up to 6 mm. No evidence of acute inflammation of the gallbladder. No gallstones are identified. Ringdown artifact of the gallbladder wall suggests adenomyomatosis.PANCREAS: Pancreas is not well-visualized secondary to overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 8.5 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Left kidney measures 9.0 cm. Right kidney measures 10.5 cm.OTHER: No significant abnormalities noted. | No focal hepatic mass. Increased echogenicity of the liver is nonspecific but can be seen in the setting of fatty infiltration of diffuse hepatic dysfunction. |
Generate impression based on findings. | Male 36 years old Reason: eval for liver disease History: persistently elevated LFTs w/o clear etiology despite work-up LIVER: Diffusely increased hepatic attenuation most compatible with fatty infiltration. No focal hepatic mass. No nodularity to the contour of the liver to suggest cirrhosis. Main portal vein is patent with normal directional flow and a peak velocity of 17 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 2 mm. No evidence of acute inflammation of the gallbladder. No gallstones.PANCREAS: The visualized portions of the pancreas are normal in appearance.SPLEEN: Spleen is normal in appearance measuring 11.5 cm.KIDNEYS: Normal cortical medullary differentiation bilaterally. No hydronephrosis, shadowing calculi, or mass. Anechoic cyst in the superior pole the right kidney measures 2.0 x 1.9 x 1.5 cm, similar to what was seen on prior CT. Right kidney measures 12.9 cm. Left kidney measures 12.0 cm.OTHER: No ascites | Diffusely increased hepatic attenuation most compatible with fatty infiltration. No focal hepatic mass or sonographic evidence of cirrhosis. |
Generate impression based on findings. | Female 83 years old Reason: rule out obstruction, hydronephrosis, stone History: elevated AKI Exam is somewhat limited by patient inability to change positions or hold breath.RIGHT KIDNEY: Marked echogenicity of the right kidney, suggesting atrophy or scarring. No hydronephrosis. Small cyst in the right kidney measures 1.2 x 0.9 x 1.4 cm. Right kidney measures 8.6 cm.LEFT KIDNEY: Difficult visualization of the left kidney. However, the cortex appears normal in echogenicity. Multiple large stones are identified in the left kidney. No hydronephrosis. Left kidney measures 8.47 m.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1.Marked cortical echogenicity of the right kidney suggesting atrophy or scarring. No right hydronephrosis.2.Multiple large stones are identified in the left kidney. No left hydronephrosis. |
Generate impression based on findings. | Male 56 years old Reason: baseline exam for transplant LIVER:Mildly coarse liver, which is nonspecific but can be seen in the setting of fatty infiltration. No specific sonographic evidence of cirrhosis. No focal hepatic mass. Main portal vein is patent with normal directional flow and a peak velocity of 17 cm/s.GALLBLADDER, BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 3 mm. Patient is status post cholecystectomy.PANCREAS: Pancreas is obscured by overlying bowel gas.SPLEEN: Spleen is within normal limits measuring 13.2 cm.KIDNEYS: Right kidney measures 10.7 cm. Left kidney measures 12.6 cm. Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. ABDOMINAL AORTA: Abdominal aorta is not well visualized secondary to overlying bowel gas.INFERIOR VENA CAVA: Not well-visualized secondary to overlying bowel gas.OTHER: Bladder is mildly distended without significant abnormality. | Mildly coarse liver which is nonspecific but can be seen in the setting of fatty infiltration. No hydronephrosis. |
Generate impression based on findings. | 79-year-old male with febrile condition. Status post robotic mitral valve repair and developed post operative fever. Positive UA. RIGHT KIDNEY: The right kidney measures 13.2 cm in length. No hydronephrosis, shadowing calculi, or suspicious lesions. Increased echogenicity of the renal parenchyma.LEFT KIDNEY: The left kidney measures 10.1 cm in length. No hydronephrosis, shadowing calculi, or suspicious masses. Increased echogenicity of the renal parenchyma.URINARY BLADDER: The distended urinary bladder shows no acute abnormality.OTHER: No significant abnormalities noted. | 1. Mild increased echogenicity of the renal parenchyma is nonspecific and suggestive of chronic medical renal disease.2. No acute abnormality. |
Generate impression based on findings. | Female 30 years old Reason: RUE fluctuating mass, abscess vs lipoma vs hematoma? Site of heparin shot Lobulated hypoechoic fluid collection measuring 2.3 x 1.2 x 1.1 cm in the right upper extremity. This may represent hematoma or an abscess. No solid soft tissue mass. | Lobulated fluid collection the right upper extremity may represent a hematoma or an abscess. No soft tissue mass. |
Generate impression based on findings. | 25-year-old female for follow-up exam. Evaluate for stability of thyroid gland and resolution of cervical lymphadenopathy. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 1.6 x 1.1 x 4.4 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 1.6 x 1 x 4.8 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.3 cm in thickness.RIGHT LOBE: Mildly heterogenous echotexture. No discrete nodules.LEFT LOBE: Mildly heterogenous echotexture. No discrete nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious cervical lymphadenopathy.OTHER: No significant abnormality noted. | 1. Mildly heterogenous thyroid gland without evidence of discrete nodules.2. No cervical lymphadenopathy. |
Generate impression based on findings. | Female 23 years old Reason: is there evidence of cholecystitis History: ruq pain, history gallstones LIVER: Liver parenchyma is within normal limits. No focal hepatic mass. Liver measures 15.8 cm.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No gallstones are present. The gallbladder wall is within normal limits measuring 2 mm. No evidence of acute cholecystitis. Common bile duct measures 3 mm.PANCREAS: The visualized portions of the pancreas are normal.SPLEEN: Spleen is normal measuring 8.5 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Left kidney measures 10.6 cm. Right kidney measures 9.9 cm.OTHER: No significant abnormalities noted. | No evidence of acute cholecystitis as clinically questioned. No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Male 83 years old Reason: left testicular or epididymal lesion RIGHT TESTIS: Right testis has normal homogeneous echogenicity and normal vascular flow.LEFT TESTIS: Left testis has normal homogeneous echogenicity and normal vascular flow. No intratesticular mass. Inferior to the left testicle but separate there is a round, heterogeneous soft tissue mass with internal calcifications and vascular flow.RIGHT EPIDIDYMIS: Right epididymis measures 1.1 x 1.1 x 0.9 cm. Small right renal cyst. Small right hydrocele. Varicocele with calcification seen on the right.LEFT EPIDIDYMIS: Left epididymis measures 1.8 x 1.1 x 0.8 cm. Left epididymis cyst measures 0.4 x 0.4 x 0.4 cm. Small left hydrocele.OTHER: No significant abnormalities noted. | Extratesticular heterogeneous soft tissue nodule inferior to the left testicle with calcifications and vascular flow has a nonspecific sonographic appearance. Although the majority of extra-testicular masses are benign, metastasis cannot be excluded.Findings discussed with ordering service at time of dictation. |
Generate impression based on findings. | Female 34 years old Reason: known stable goiter - evaluate for nodules etc History: goiter present for 12 years- family history of thyroid disease RIGHT LOBE MEASUREMENTS: 7.8 x 3.2 x 2.7 cm.LEFT LOBE MEASUREMENTS: 6.6 x 3.3 x 2.7 cm.ISTHMUS MEASUREMENTS: 0.7 cm.RIGHT LOBE: Heterogeneous and multinodular right thyroid lobe. Largest heterogeneous nodule on the right in the inferior right thyroid lobe measures 3.9 x 3.0 x 2.8 cm.LEFT LOBE: Heterogeneous and multinodular left thyroid lobe. Largest heterogeneous left thyroid nodule measures 2.9 x 2.9 x 2.9 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Findings most compatible with multinodular goiter. |
Generate impression based on findings. | Female 70 years old Reason: re-eval thyroid nodules RIGHT LOBE MEASUREMENTS: 5.8 x 2.3 x 2.3 cm.LEFT LOBE MEASUREMENTS: 4.2 x 1.7 x 2.0 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Multinodular and mildly heterogeneous thyroid. Heterogeneous nodule in the right inferior thyroid measures 1.9 x 1.1 x 1.4 cm, not significantly changed.LEFT LOBE: Multinodular mildly heterogeneous thyroid. Ovoid, spongiform nodule in the inferior left thyroid measures 1.1 x 0.9 x 0.8 cm, not significantly changed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable thyroid nodules as detailed above. |
Generate impression based on findings. | Male 55 years old Reason: incidental lesions in right kidney. Had ultrasound here in 2010, pleas compare RIGHT KIDNEY: Right kidney measures 9.7 cm. Renal cortical echogenicity is within normal limits. There are multiple cysts again seen in the right renal cortex. Within the lower pole of the right kidney there is a ill-defined, predominantly anechoic structure with an adjacent or peripheral calcification. Although this does not meet criteria for a simple renal cyst, it has not increased in size since the prior exam 6 years ago measuring 1.4 x 1.0 x 0.9 cm. A separate well-circumscribed anechoic right renal cyst near the superior pole measures 1.1 x 1.1 x 1.3 cm. No hydronephrosis.LEFT KIDNEY: Left kidney measures 10.5 cm. Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass.OTHER: No significant abnormalities noted. | 1.Cyst in the lower pole the right kidney has ill-defined borders with an adjacent or peripheral calcification. Although this does not meet criteria for a simple renal cyst, it has not increased in size since the prior exam 6 years ago2.No hydronephrosis. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of benign left breast biopsy in 1980. She has a family history of breast cancer in her sister, diagnosed at age 57, and her daughter, diagnosed at age 31. 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 findings. | Female 31 years old Reason: Vague upper and LUQ pain. Exclude splenomegaly, pancreatic abnormalities LIVER: Normal, relatively homogeneous appearance of the liver parenchyma. No focal hepatic mass is visualized. Main portal vein is patent with normal directional flow and a peak velocity 26 cm/s.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Common bile duct measures up to 5 mm. No evidence of acute inflammation of the gallbladder. No gallstones. Gallbladder wall is within normal limits measuring 2 mm.PANCREAS: The visualized portions of the pancreas are normal.SPLEEN: Spleen is normal in appearance measuring 8.8 cm.RIGHT KIDNEY: Normal cortical echogenicity. No hydronephrosis or shadowing calculus. Right kidney measures 11.8 cm.LEFT KIDNEY: Per technologist the left kidney is somewhat inferiorly displaced and has a configuration that is somewhat altered, which may be seen in ptotic kidney. Visualized portions of the cortex of normal echogenicity. No hydronephrosis or shadowing calculus. Left kidney measures 9.3 cm. OTHER: No significant abnormalities noted. | The left kidney is somewhat inferiorly displaced and has a somewhat altered orientation, appearance may be seen in setting of ptotic kidney. If there is further clinical concern for anatomic abnormality causing patient's symptoms, contrast enhanced CT may be helpful for further evaluation (would provide improved evaluation of pancreas as well). No evidence of splenomegaly as clinically questioned. |
Generate impression based on findings. | Female 20 years old Reason: evaluate for gallstones or cholecystitis History: ruq pain LIVER: Liver has normal echogenicity. No focal hepatic mass. Main portal vein is patent with normal directional flow and a peak velocity of 21 cm/s. There are measures 17 cm in length.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No gallstones. No evidence of acute inflammation of the gallbladder. The gallbladder wall is within normal limits measuring 1 mm. Common bile duct measures 3 mm. Negative sonographic Murphy's sign.PANCREAS: The visualized portions of pancreas are normal.SPLEEN: Spleen is normal in appearance measuring 11.9 cm.KIDNEYS: Normal cortical echogenicity. No hydronephrosis or shadowing stone. Right kidney measures 11.4 cm. Left kidney measures 12.0 cm.OTHER: No significant abnormalities noted. | No gallstones or evidence of acute inflammation of the gallbladder. No specific sonographic findings to account for the patient's symptoms. |
Generate impression based on findings. | 47 year old female who has a complaint of palpable left breast cyst. Personal history of right mastectomy for malignant phylloides tumor, left implant exchange, and left breast cysts. A targeted left ultrasound was performed for the palpable area of concern. Multiple simple cysts were identified in the left breast, the largest of which measures 3.9 x 3.8 x 1.7 cm and is located in the retroareolar region. No discrete solid mass identified. | Multiple benign simple cysts in the left breast along the palpable area of concern along the areola. Consider cyst aspiration if patient experiences worsening pain. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 24 years old Reason: Intermittent LUQ pain, assess for splenomegaly/hepatomegaly History: Intermittent LUQ pain, assess for splenomegaly/hepatomegaly LIVER: Liver parenchyma is normal. No focal mass. Liver measures 16 cm, within normal limits. Main portal vein is patent with normal directional flow and a peak velocity of 29 cm/s.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Common bile duct measures 3 mm. Gallbladder is normal in appearance. No gallstones.PANCREAS: Visualized portion of the pancreas are normal.SPLEEN: Spleen is normal in appearance measuring 11.5 cm.RIGHT KIDNEY: Normal cortical echogenicity. No hydronephrosis or shadowing stone. Right kidney measures 11.5 cm. LEFT KIDNEY: Normal cortical echogenicity. No hydronephrosis or shadowing stone. Left kidney measures 11.8 cm.OTHER: No significant abnormalities noted. | Normal appearance of the liver and spleen. No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Male 54 years old with history of lymphoma and new palpable bilateral axillary adenopathy. A bilateral breast ultrasound was performed for the palpable areas of concern. Multiple enlarged lymph nodes at varying depths are noted bilaterally.In the right lower axilla the largest lymph node measures 3.6 x 1.8 x 2.6 cm without increased vascularity.In the right upper axilla the largest lymph node in measures 5.1 x 2.6 x 2.4 cm without increased vascularity.In the left lower axilla the largest lymph node measures up to 3.7 cm without increased vascularity.In the left upper axilla the largest done measures 4.7 x 3.0 x 3.3 cm without increased vascularity. | Multiple enlarged axillary lymph nodes bilaterally (in the lower axillary tail and higher axillary tail). Palpable masses in the bilateral lower axillary regions are necrotic axillary lymph nodes. The patient is scheduled to follow-up with surgery for excisional biopsy. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male 54 years old Reason: r/o recurrence History: h/o medullary thyroid cancer. Some subjective abnormality in left upper neck. MEASUREMENTS: Patient is status post thyroidectomy.RIGHT THYROIDECTOMY BED: No significant abnormality noted. No abnormal tissue or evidence of recurrence.LEFT THYROIDECTOMY BED: No significant abnormality noted. No abnormal tissue or evidence of recurrence.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination without evidence of disease recurrence. |
Generate impression based on findings. | Female 37 years old Reason: Localization of parathyroid glands for patient with secondary hyperparathyroidism, assess for thyroid nodules History: Secondary hyperparathyroidism RIGHT LOBE MEASUREMENTS: 5.2 x 2.0 x 1.5 cm.LEFT LOBE MEASUREMENTS: 4.4 x 1.9 x 1.5 cm.ISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: Normal echogenicity of the right thyroid lobe without nodules.LEFT LOBE: Normal echogenicity of the left thyroid lobe without nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Inferior and separate to the left thyroid lobe is a hypoechoic focus measuring 0.7 x 0.3 x 0.5 cm, which may represent a parathyroid gland or small adenoma.LYMPH NODES: No significant abnormality noted. No regional lymphadenopathy.OTHER: No significant abnormality noted. | Inferior to the left thyroid lobe is a hypoechoic nodule likely representing a hyperplastic parathyroid gland or small parathyroid adenoma. Please see same day nuclear medicine study for additional findings. |
Generate impression based on findings. | 33-year-old female with history of left breast DCIS status post lumpectomy, followed by radiation and tamoxifen presents for six-month follow-up of probably benign right breast mass. A targeted right ultrasound was performed for the previously described area of concern.In the right breast, 5:00, 8 cm from the nipple, there is a 1.1 x 0.5 x 1.1 cm oval circumscribed hypoechoic mass, previously 1 x 0.5 x 1 cm. This mass demonstrates no internal vascularity. | No significant interval change in a right breast mass at the 5:00 position, which is probably benign given morphology and stability over time. Six-month follow-up right breast ultrasound is recommended to evaluate for stability. Patient will be due for bilateral mammogram at that time.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Male 39 years old Reason: right testicular pain, evaluate for abnormality History: acute right testicular pain with active hand, foot and mouth illness RIGHT TESTIS: Right testicle measures 5.1 x 2.4 x 3.3 cm. Diffusely increased vascular flow within the right testicle. Background echogenicity of the testicle is mildly heterogeneous. Small hydrocele. No focal testicular mass. LEFT TESTIS: Left testicle measures 5.4 x 2.7 x 3.2 cm. Background echogenicity of the testicle is relatively homogeneous. No focal testicular mass. Small hydrocele.RIGHT EPIDIDYMIS: Right epididymis measures 0.2 x 1.0 x 1.0 cm. Increased vascular flow of the right epididymis suggests epididymitis.LEFT EPIDIDYMIS: Left epididymis measures 3.2 x 0.8 1.5 cm, and is normal in appearance.OTHER: No significant abnormalities noted. | Findings consistent with acute epididymo-orchitis |
Generate impression based on findings. | Male 58 years old Reason: Pt has had 5 years of progressively enlarging R-sided solitary nodule. LAD vs lipoma. Now causing him pain on arm movement History: Pain on R arm motion In the right shoulder area there is a superficial, well circumscribed, mildly hyperechoic to muscle, oval mass measuring 4.2 x 2.7 cm. No abnormal vascular flow within this lesion. | Findings are most compatible with a lipoma. |
Generate impression based on findings. | Female 35 years old Reason: ABD ultrasound History: pain left abdominal LIVER: Normal background echogenicity of the liver. The liver measures 15.9 cm. There is no focal hepatic mass. Main portal vein is patent with normal directional flow in the velocity of 16.2 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Gallbladder is normal in appearance. No gallstones. Gallbladder wall is normal measuring 1 mm.PANCREAS: The visualized portions of the pancreas are normal.SPLEEN: Spleen is normal in appearance measuring 8.2 centimeters.KIDNEYS: Normal cortical echogenicity bilaterally. No hydronephrosis or shadowing stone. Right kidney measures 10.6 cm. Left kidney measures 10.0 cm. OTHER: No significant abnormalities noted. | No specific findings to account for the patient's symptoms. Unremarkable appearance of the visualized abdominal organs. |
Generate impression based on 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 findings. | Male 63 years old Reason: 63 yo with cirrhosis, RUQ pain R/o cholelithiasis and possible ascites History: RUQ pain LIVER: Increased echogenicity of liver without change. Liver measures 15.1 cm. No focal mass. Main portal vein is patent with normal directional flow velocity of 13 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 4 mm. The gallbladder is visualized and echogenic focus along the nondependent portion of the gallbladder wall, which may represent adenomyomatosis versus a small adherent stone. No evidence of acute inflammation of the gallbladder. No other gallstones are identified.PANCREAS: Visualized portions of the pancreas are normal.SPLEEN: Spleen is within normal limits measuring 10.5 cm.KIDNEYS: Normal cortical echogenicity bilaterally. No hydronephrosis. Subcentimeter nonobstructing stone in the inferior portion of the right kidney measures 0.6 x 0.3 x 0.4 cm, similar to the prior exam. Nonobstructing stone in the inferior left kidney measures 1.0 x 0.4 x 0.8 cm.OTHER: No ascites. | 1.No evidence of acute cholecystitis. Focal echogenic area in the gallbladder may represent adenomyomatosis versus a small adherent stone. No other shadowing gallstones are identified. 2.Nonobstructing bilateral renal stones measuring up to 1.0 cm.3.Unchanged morphology and echogenicity of the liver . No suspicious masses are identified. |
Generate impression based on findings. | Female 52 years old Reason: Evaluate for HCC History: HCV LIVER: Liver echogenicity is within normal limits and homogeneous. No significant nodularity to the capsule. No focal hepatic mass. Main portal vein is patent with normal directional flow with peak velocity of 19 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 2 mm. No gallstones. No evidence of acute inflammation of the gallbladder.PANCREAS: The visualized portions of the pancreas are normal.SPLEEN: Spleen is normal measuring 8.8 cm.KIDNEYS: Cortical echogenicity is within normal limits bilaterally. No hydronephrosis or shadowing calculus. Left kidney measures 10.6 cm. Right kidney measures 8.2 cm.OTHER: No ascites. | No focal hepatic mass or sonographic evidence of cirrhosis. |
Generate impression based on findings. | 73-year-old male with history of hepatitis C virus. Evaluate for liver mass. LIVER: Liver is mildly and coarsely echogenic. Overall hepatic length is within normal limits. Main portal vein is patent with appropriate flow directionality. Very mild nodularity of the liver surface with enlargement of the left lobe.BILIARY TRACT: Dependent gallstones within the gallbladder without gross wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Echogenic with cysts as previously noted. OTHER: Kidney echogenic with cysts as previously noted. Splenic size within normal limits. | . 1. Echogenic liver with borderline nodularity of the contour with left lobe enlargement.2. No evidence for hepatic mass.3. Gallstones.4. Echogenic kidneys with cysts. |
Generate impression based on findings. | 59-year-old female with history of hepatitis C virus. Evaluate for mass. LIVER: Liver is normal in size, contour with very slightly heterogeneous echogenicity. No focal hepatic mass is identified. Main portal vein is patent with appropriate flow direction.BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The visualized biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.SPLEEN: Normal in size.RIGHT KIDNEY: Small and highly echogenic with cysts. OTHER: Left kidney poorly visualized with cysts and probable cyst wall calcification which was present on prior CT. Kidney is small and echogenic. | Minimally heterogeneous echotexture of the liver without mass.Echogenic, small kidneys with cysts, at least one complex on the left. |
Generate impression based on findings. | 58-year-old male with chronic kidney disease and worsening renal function. RIGHT KIDNEY: Right kidney measures 11.5 cm in length. Echotexture is difficult to judge due to overlying ascites, cortex is at least moderately echogenic. There is a small cyst in the upper pole of the kidney. No hydronephrosis, shadowing calculus or solid mass.LEFT KIDNEY: The left kidney measures 12.7 cm in length. Cortex is moderately echogenic. No hydronephrosis, shadowing calculus or mass.URINARY BLADDER: No significant abnormalities noted.OTHER: Moderate ascites. | Echogenic kidneys with small right cyst. Overall, the appearance of the kidneys is little changed from prior exams.Moderate ascites. |
Generate impression based on findings. | Female 51 years old Reason: 12 month f/u on known colloid thyroid nodules History: Thyroid Nodule Colloid RIGHT LOBE MEASUREMENTS: 5.3 x 1.3 x 1.4 cmLEFT LOBE MEASUREMENTS: 6.1 x 1.9 x 1.9 cm.ISTHMUS MEASUREMENTS: 0.5 cm.RIGHT LOBE: Unchanged multiple subcentimeter nonspecific hypoechoic nodules in the right thyroid lobe. Background echogenicity of the thyroid is relatively homogeneous and normal in appearance.LEFT LOBE: Within the left thyroid lobe there is an unchanged cystic nodule measuring 2.9 x 1.3 x 1.9 cm. This nodule appears to have 2 small peripheral punctate calcifications.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality notedOTHER: No significant abnormality noted. | Unchanged cystic left thyroid nodule representing a benign cyst. |
Generate impression based on findings. | 72-year-old female post thyroidectomy for thyroid cancer. Follow-up nodules. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: In the right thyroid bed there is again noted a predominantly hypoechoic nodule with a more echogenic periphery again suggestive of lymph node. This essentially unchanged in the prior study. Remeasuring this nodule due to bilobed appearance and measures 0.3 x 0.5 x 1 cm, not significantly changed from a retrospective measurement of 0.3 x 0.5 x 1 cm.LEFT LOBE: In the left thyroid bed there is again noted a hypoechoic nodule with an echogenic center consistent with lymph node measuring 0.3 x 0.4 x 0.5 cm without significant change. There is a second similar-appearing area measuring 0.5 x 0.6 x 0.5 cm which again appear stable.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination is noted above with presumed lymph nodes in the bilateral thyroid beds. |
Generate impression based on findings. | Female 49 years old Reason: eval for gallbladder/liver etiology History: severe RUQ tenderness, elevated LFTs, fevers LIVER: Partially visualized liver is normal in appearance.BILIARY TRACT: No evidence of acute inflammation of the gallbladder. No gallstones. Gallbladder wall is within normal limits measuring 2 mm. No pericholecystic fluid. Common bile duct is normal measuring 4 mm. Negative sonographic Murphy's sign. OTHER: No significant abnormalities noted. | No evidence of acute cholecystitis, cholelithiasis, or specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Ms. Campbell is a 25 year old female presenting with a nontender palpable mass in the right breast for the past 2-3 months. Targeted right breast ultrasound was performed for the patient's area of concern.In the right breast 3:00 location, approximately 3 cm from the nipple, there is an oval lobulated mass identified measuring approximately 1.6 x 0.5 x 1.2 cm. | High probability benign mass of the right breast, likely representing a fibroadenoma. As long as the patient's physical examination remains normal, right unilateral ultrasound is recommended in 6 months in order to ensure stability of these findings. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 54-year-old female with abnormal liver function history of right upper quadrant pain. LIVER: Liver is normal in size and is moderately to markedly echogenic. This is nonspecific. No focal hepatic abnormality is identified.BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Echogenic liver. Normal gallbladder and biliary tract. |
Generate impression based on findings. | Female 51 years old Reason: Eval for gallstones History: Stones seen on bedside US, RUQ pain LIVER: Liver measures 18.4 cm. Mildly hyperechoic echogenicity of the liver parenchyma, which is nonspecific but may be seen in fatty infiltration or diffuse hepatic dysfunction.BILIARY TRACT: Shadowing gallstones at the neck of the gallbladder. Pericholecystic fluid, thickened gallbladder wall, and positive Murphy's sign. PANCREAS: The visualized portion of the pancreas are normal in appearance.SPLEEN: Spleen is normal in appearance measuring 8.5 cm.KIDNEYS: Normal cortical echogenicity bilaterally. No hydronephrosis or shadowing calculi. Right kidney measures 11.1 cm. Left kidney measures 12.8 cm.OTHER: No significant abnormalities noted. | Findings most consistent with acute cholecystitis. Discussed with ordering physician Dr. Bradley and ER physician Dr. Ward at approximately 1425 on 10/21/2016. |
Generate impression based on findings. | 71-year-old male with biopsy demonstrating "suspicious for follicular neoplasm" in the right lobe of the thyroid. Evaluate thyroid preoperatively. RIGHT LOBE MEASUREMENTS: 2.3 x 2.5 x 4.7 cmLEFT LOBE MEASUREMENTS: 1.5 x 1.8 x 5.5 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Within the right lobe of the thyroid posteriorly there is an unusually shaped and well-demarcated heterogeneous but hypoechoic mass with several small bright reflectors which could represent calcification. It is difficult to determine whether this is predominantly intra or extra thyroidal, and the mass corresponds to the outside biopsy.LEFT LOBE: No significant abnormality noted.ISTHMUS: In the left isthmus there is dense, shadowing calcification. No obvious mass although a mass posterior to the shadowing can't be excluded.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mass involving the right lobe of the thyroid although this could be arising from an extrathyroidal location.Dense calcification without obvious mass involving the left isthmus.No mass identified within the left lobe and no adenopathy. |
Generate impression based on findings. | 85-year-old female with acute kidney failure. RIGHT KIDNEY: The right kidney measures 9 cm in length. No hydronephrosis, shadowing calculi, or suspicious masses. Normal parenchymal echogenicity.LEFT KIDNEY: The left kidney measures 9.6 cm in length. No hydronephrosis, shadowing calculi, or suspicious masses. Normal parenchymal echogenicity.URINARY BLADDER: The urinary bladder is distended and shows no acute abnormality.OTHER: The partially visualized hepatic parenchyma has an echogenic echotexture. | 1. Normal sonographic appearance of the kidneys and urinary bladder.2. Echogenic appearance of the hepatic parenchyma is nonspecific and could represent parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | Female 35 years old Reason: eval for Cholelithiasis History: R flank pain, Right-abd pain No evidence of cholelithiasis or acute cholecystitis. Minimal prominence of the right renal collecting system is unchanged from previous study. Normal echogenicity of the liver. Normal size of the liver. Spleen is also normal size. | Mild right-sided caliectasis, unchanged from previous study. |
Generate impression based on findings. | Elevated serum bilirubin LIVER: Again noted is a large mass replacing most of the right lobe of the liver. The mass is very heterogeneous. Main portal vein is compressed by the mass but patent. There is small amount of perihepatic fluid. Common bile duct is not dilated. There is no intrahepatic biliary dilatation. Gallbladder was not definitely identified due to heterogeneous liver and large masses. Small amount of right-sided pleural effusion.BILIARY TRACT: No biliary dilatation. Gallbladder cannot be well differentiated from the surrounding large mass.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Large heterogeneous liver mass. No definite biliary dilatation. |
Generate impression based on findings. | Female 72 years old Reason: 72 y/o with hemolytic anemia, eval for splenomegaly History: abdominal pain LIVER: Increased echotexture of the liver suggestive of chronic liver disease. Liver is enlarged measuring 18.7 cm. No focal liver lesions.BILIARY TRACT: Gallbladder is distended with sludge. No evidence of gallbladder wall thickening or pericholecystic fluid. No evidence of intra or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Spleen measures 10 cm.RIGHT KIDNEY: No evidence of hydronephrosis bilaterally. OTHER: No significant abnormalities noted. | Enlarged liver with increased echotexture suggestive of fatty liver.Distended gallbladder with moderate amount of sludge. |
Generate impression based on findings. | Male 49 years old Reason: 49 year old male with history of ulcerative colitis and abnormal LFTs, evaluate for biliary ductal dilation/PSC or changes in liver architecture. History: abnormal LFTs LIVER: Liver measures 17.5 cm, enlarged. Echogenicity of the liver is slightly increased. IVC and hepatic veins are dilated likely secondary to heart failure.BILIARY TRACT: Cholelithiasis. Contracted gallbladder. No evidence of fracture or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 9.4 cm.RIGHT KIDNEY: Shadowing hyperechoic focus in the lower pole of the left kidney likely represents a small stone. No evidence of hydronephrosis. Right kidney measures 11.5 cm. Left kidney measures 11.7 cm.OTHER: No significant abnormalities noted. | Cholelithiasis without evidence of biliary dilatation. Right nephrolithiasis. |
Generate impression based on findings. | HCV, cirrhosis, evaluate for HCC LIVER: Liver measures 18 cm, with increased echogenicity. No intrahepatic biliary ductal dilatation. Normal capsule of the liver. No focal lesions within the liver.BILIARY TRACT: Gallbladder is well-distended with multiple gallstones within it measuring approximately 7 mm. No evidence of gallbladder wall thickening. Common duct measures within normal limits up to 3 mm. No pericholecystic fluid noted.PANCREAS: Head of the pancreas appears unremarkable. Body and tail of pancreas is not visualized and appears unremarkable.SPLEEN: Spleen measures 10.6 cm, normal echotexture.KIDNEY: Right kidney measures 14.4 cm left kidney measures 14.8 cm. Normal collection noted. No hydronephrosis or hydroureter. No focal lesions noted. OTHER: No ascites. | Increased hepatic echogenicity suggestive of hepatic steatosis/chronic liver disease without any focal lesions.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Cirrhosis, low platelets, high INR LIVER: Liver measures 18.3 cm with coarse echotexture suggestive of hepatic parenchymal dysfunction/steatosis. No intrahepatic biliary duct dilatation. No focal lesions within the liver.BILIARY TRACT: Gallbladder is well-distended without any gallstones within it. Mild gallbladder wall thickening without pericholecystic fluid. No evidence of gallstones. No intra or extra hepatic delivery ductal dilatation.PANCREAS: Head) visualized appears unremarkable. Body and tail of pancreas is not visualized due to overlying bowel gas.SPLEEN: Spleen measures 7.9 cm without any focal lesions.KIDNEY: Right kidney measures 12.2 cm and left kidney measures 12.9 cm. Bilateral renal sinus cysts, unchanged from prior examination. The cyst in the left kidney measures 2.6 x 2.2 cm, previously measured 2.2 x 2.7 cm and the cyst in the right kidney measures 1.7 x 2.6 cm, previously measured 1.5 x 2.8 cm. No hydronephrosis or focal lesions. OTHER: No ascites | Mild coarse echotexture of the liver suggestive of hepatic parenchymal dysfunction/chronic liver disease. No focal lesions in the liver.Bilateral renal cysts are stable.Mild gallbladder wall thickening probably due to chronic liver disease.No ascites |
Generate impression based on findings. | Possible mass on CT chest in the liver, probably in the dome LIVER: Liver measures 15.8 cm without any focal lesion. Especially in the dome of the liver no suspicious cystic or solid mass noted. Increased echogenicity of the liver suggestive of hepatic steatosis. Gallbladder is distended with a gallstone within it. Common bile duct measures up to 5 mm without any stones or sludge within it.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Gallbladder is distended with a gallstone within it.No pericholecystic fluid is notedPANCREAS: Head of the pancreas as visualized appears unremarkable. Body and tail of pancreas is not visualized.OTHER: No significant abnormalities noted. | No suspicious mass noted in the dome of the liver. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Ms. Stevens is a 66 year old female with known multicentric right breast cancer with metastatic axillary lymphadenopathy. She presents today for imaging evaluation to assess treatment response. Targeted right breast ultrasound was performed for the known areas of malignancy.In the right breast 9:00 location, approximately 7 cm from the nipple, there is revisualization of the biopsy-proven malignancy with associated biopsy marker clip now measuring approximately 2.2 x 1.7 x 1.8 cm, previously measuring 2.8 x 2.1 x 2.9 cm.In the right breast 9:00 location, approximately 5 cm from the nipple, there is revisualization of the second biopsy-proven malignancy with associated biopsy marker clip now measuring approximately 0.9 x 0.3 x 0.9 cm, previously measuring 1.0 x 1.2 x 1.0 cm.Of note, the two sites of malignancy at the 9:00 location are confluent on today's examination.In the right breast 8:00 location, approximately 7 cm from the nipple, there is revisualization of the third biopsy-proven malignancy now measuring approximately 0.9 x 0.7 x 0.7 cm, previously measuring 0.9 x 0.6 x 0.8 cm. | Stable to slight interval improvement in known multifocal right breast malignancy, measurements as above. Patient should continue to follow up with her breast surgeon/medical oncologist for further evaluation. All results recommendations were discussed with the patient and Dr. Nanda.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 73-year-old female with dyspnea on exertion. Rule out nodules. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 6.3 x 2.1 x 1.9 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 6.4 x 1.8 x 1.9 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.6 cm in thickness.RIGHT LOBE: The right thyroid lobe has a heterogenous multinodular echotexture. The largest nodule is in the lower pole measuring 2.5 x 2.2 x 1.8 cm and has a spongiform appearance.LEFT LOBE: The left thyroid lobe has a heterogenous multinodular echotexture. The largest nodule is in the left lower pole measuring 2.9 x 2 x 2.6 cm and has a spongiform appearance.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious cervical lymphadenopathy.OTHER: No significant abnormality noted. | Multinodular goiter. |
Generate impression based on findings. | Area of firmness around pleural catheter site. Concern for hematoma versus collection. There is mild skin thickening. No drainable fluid collection or mass is identified. | Skin thickening, without focal collection or hematoma. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then comparisons will be made for future exams. BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of right breast ultrasound-guided core biopsy (7/7/2015) with pathology revealing foci of stromal and ductal hyperplasia, fibroadenomatoid change, and microcysts. Family history of breast cancer in paternal cousin. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Goiter with growth, evaluate with thyroid ultrasound RIGHT LOBE MEASUREMENTS: 8 x 3.4 x 3.2 cm, heterogenous, mostly unchanged from prior exam when it measured 8.5 x 3.1 x 2.7 cmLEFT LOBE MEASUREMENTS: 10.1 x 4 x 5.6 cm, heterogenous and increased in size from prior examination when it measured 9.2 x 5.8 x 3.7 cm.ISTHMUS MEASUREMENTS: 2 cmRIGHT LOBE: 2 adjacent solid hypoechoic nodules identified in the right lobe, upper pole nodule measures 4.4 x 2.6 x 3 cm previously measured 3.5 x 3.2 x 2.2 cm. The lower/inferior pole nodule has infraclavicular extension and cannot be completely visualized by ultrasound, now measures 4.6 x 4 cm, previously measured 3.4 x 3.2 x 2.2 cmLEFT LOBE: At least 2 enlarged nodules identified in the left lobe, the upper to midpole nodule has multiple increased microcalcifications in the further evaluation with tissue sampling. It has increased from prior examination, currently measures 5.5 x 3.4 x 4.9 cm, previously measured 5.2 x 5.8 x 3.7 cm. The second solid nodule along the inferior pole measures 4.6 x 4 x 4.3 cm, previous measured 5 x 3.9 x 2.3 cm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology bilateral neck lymph nodes level 3 noted. Largest lymph node in the right lateral neck measures 2.3 x 0.3 x 1.2 cm.OTHER: No significant abnormality noted. | 1. Multinodular goiter with interval increase in size and microcalcifications within the left upper pole nodule, consider tissue sampling. |
Generate impression based on findings. | Reason: history of papillary thyroid carcinoma, please evaluate for recurrence RIGHT LOBE: Status post thyroidectomy without evidence of disease recurrence.LEFT LOBE: Status post thyroidectomy without evidence of disease recurrence.ISTHMUS: Status post thyroidectomy without evidence of disease recurrence.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a small subcentimeter left level 4 lymph node, favored benign. There is no regional lymphadenopathy.OTHER: No significant abnormality noted. | Status post thyroidectomy without evidence of disease recurrence. No mass or regional lymphadenopathy. |
Generate impression based on findings. | Reason: History of left lobectomy. Now with fullness neck sensation. Assess Right lobe. RIGHT LOBE MEASUREMENTS: 2.3 x 1.3 x 4.9 cm.LEFT LOBE MEASUREMENTS: Status post left lobectomy.ISTHMUS MEASUREMENTS: 0.1 cm in AP diameter.RIGHT LOBE: The right thyroid lobe appears diffusely heterogeneous. There is a mixed cystic and solid subcentimeter nodule in the mid pole measuring 0.5 x 0.4 x 0.5 cm without calcifications, favored benign.LEFT LOBE: Status post left lobectomy without evidence of disease recurrence.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is no regional lymphadenopathy.OTHER: No significant abnormality noted. | 1. Diffusely heterogeneous right thyroid with a subcentimeter mixed cystic and solid nodule which is favored to be benign.2. Status post left lobectomy without evidence of disease recurrence or regional lymphadenopathy. |
Generate impression based on findings. | Reason: Patient with neutropenic fevers, pericholecystic fluid seen on CT. Assess for cholecystitis LIVER: The liver measures 20.5 cm in length, enlarged. The hepatic parenchymal echotexture and echogenicity is coarse and echogenic. There is no focal mass. No biliary ductal dilatation. The portal vein is patent with normal directional hepatopedal flow and waveform, peak velocity 39.5 cm/s.BILIARY TRACT: The gallbladder appears unremarkable. There is no pericholecystic fluid. There is no evidence of stones or sludge. The gallbladder wall measures 4 mm. The common bile duct measures 5 mm.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 13.7 cm.RIGHT KIDNEY: The right kidney measures 16.1 cm in length. There is no focal mass or hydronephrosis. LEFT KIDNEY: The left kidney measures 16.8 cm in length. There is no focal mass or hydronephrosis.OTHER: No significant abnormalities noted. | 1. Coarse, echogenic liver possibly representing hepatic parenchymal dysfunction or hepatic steatosis.2. Normal gallbladder. |