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Generate impression based on findings. | RIGHT LOBE MEASUREMENTS: 4 x 1.2 x 2.1 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.5 x 2.2 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Multiple nodules identified. In the extreme upper pole there is a 0.6 x 0.7 x 1.0 cm nodule. This was clearly spongiform in the prior study although the cystic spaces are somewhat less well-visualized on today's exam. Overall this is changed little in size. Large complex cystic nodule with thick septation and slight wall irregularity measures 0.7 x 1.1 x 1.6 cm, without change. There are several, small colloid nodules with comet tail artifact. LEFT LOBE: Multiple nodules identified. In the midportion of the left lobe there is a predominantly solid nodule with some spongiform characteristic. This measures 0.7 x 1.6 x 1.6 cm without change. There is a second, inferior spongiform nodule measuring 1.3 x 1.7 x 1.6 cm also unchanged. There is some coarse calcification associated with the rim of this nodule, but there is also clear comet tail artifact. Smaller colloid nodules are identified as well as.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: The patient complained of an enlarging nodular density slightly to the right at the base the neck. Scanning demonstrates this to be an asymmetric clavicular head. There is, however, suggestion of a rounded nodular density more caudally and at midline which cannot be adequately visualized. If further information is needed, recommend CT of the neck.OTHER: No significant abnormality noted. | Bilateral thyroid nodules which are mixed cystic and solid, are similar in size to prior study, most low suspicion. However, a single right superior thyroid nodule previously spongiform, now appears more solid.See above discussion of rounded nodular density in the substernal region.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 93-year-old female with right upper quadrant pain and elevated transaminases. LIVER: There is normal in size and echotexture. No focal hepatic abnormality except for small cyst adjacent to the gallbladder fossa. Limited spectral and color Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Patient was unable to turn for this exam. The gallbladder appears unremarkable without cholelithiasis, wall thickening or pericholecystic fluid. The very tract is normal in caliber.PANCREAS: The head and body are adequately visualized. Small cystic area in the head as previously noted.. The tail was not well seen.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Moderate right pleural effusion. | Normal gallbladder and supine position.Right pleural effusion. |
Generate impression based on findings. | 46-year-old male with cirrhosis and on autoimmune hepatitis. Evaluate for hepatocellular carcinoma. LIVER: Mildly and coarsely echogenic without focal abnormality. Overall size within normal limits. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Biliary tract is normal in caliber. Gallbladder appears unremarkable.PANCREAS: Head and body are normal. The tail was not well seen.SPLEEN: Upper normal in size.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Stable examination without hepatic mass. |
Generate impression based on findings. | 89-year-old male with thyroid mass on CT.] Weight loss. RIGHT LOBE MEASUREMENTS: 4.6 x 2.2 x 2.4 cmLEFT LOBE MEASUREMENTS: 8.0 x 3.4 x 3.4 cm. This underestimates the size of the left lobe which extends far into a substernal location.ISTHMUS MEASUREMENTS: 0.7 cmRIGHT LOBE: Multiple small, cystic and benign nodules. A spongiform nodule in the upper pole measures 0.5 x 0.8 x 0.8 cm.LEFT LOBE: There are small benign cystic nodules identified. There is a large, solid, heterogeneously echogenic mass extending below the level of the clavicle and therefore incompletely measured. This approximates 3.6 x 3.8 x 5.3 cm.ISTHMUS: Left mass extends to the level of the left isthmus where there is some lobularity.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Substernal thyroid as noted above. The large left nodule cannot be adequately evaluated.Otherwise, small, benign nodules bilaterally. |
Generate impression based on findings. | Ms. Byrd is a 43-year-old female presenting for short term ultrasound follow-up for a high probability benign fibroadenoma of the right breast. On physical exam, an oval mobile mass is palpated inferior to the nipple.Targeted right ultrasound of the right breast, 6:00 position 3 cm from the nipple, reveals an oval circumscribed parallel hypoechoic shadowing mass measuring 2.4 x 1.2 x 2.1 cm and demonstrating mild internal vascularity, stable in size and sonographic appearance dating back to ultrasound study of 2009. | Stable right breast mass, with imaging appearance most characteristic of a fibroadenoma. Considering the stable imaging appearance of this mass dating back to 8/17/2009, patient may return for a bilateral diagnostic mammogram in April 2017. No need for repeat ultrasound evaluation.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 26-year-old female with transaminitis. LIVER: Coarsely echogenic as previously noted but normal in size. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Gallbladder is collapsed without significant wall thickening. No cholelithiasis or pericholecystic fluid. Visualized biliary tract is normal in caliber.PANCREAS: Limited due to bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Both kidneys are within the pelvis. OTHER: No significant abnormalities noted. | No significant change. Echogenic liver. No biliary tract dilatation. |
Generate impression based on findings. | 25-year-old female with glomerular disease. Systemic lupus. Ultrasound guidance was performed for biopsy of right kidney. | Ultrasound guidance. |
Generate impression based on findings. | 70-year-old female with right sided abdominal pain. LIVER: Liver is normal in echotexture and upper normal in size. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: The biliary tract is normal in caliber. The gallbladder is well-visualized and appears unremarkable.PANCREAS: There is mild dilatation of the pancreatic duct without obstructing mass or calculus identified.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Echogenic with significant parenchymal thinning and cysts as previously identified. No hydronephrosisOTHER: Left kidney is echogenic with parenchymal thinning and cysts as previously identified.. No hydronephrosis. | 1. Normal gallbladder.2. Mild dilatation pancreatic duct of uncertain significance.3. Echogenic kidneys with parenchymal thinning and cysts. |
Generate impression based on findings. | 54-year-old female with right upper quadrant pain. LIVER: Normal in size, contour and echogenicity. No focal abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: The biliary tract is normal in caliber. The 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: No significant abnormalities noted. | Normal exam. No findings to explain the patient's pain. |
Generate impression based on findings. | 72-year-old male with acute kidney failure. Ultrasound guidance was provided for biopsy of left kidney. | Ultrasound guidance. |
Generate impression based on findings. | Ms Minor is a 15-year-old female presenting with a history of bilateral clear nipple discharge over the last few months. Patient denies any palpable breast lump. However, her physician detected bilateral breast masses with bilateral nipple skin changes. On physical exam, bilateral areolar dryness and cracking are noted, left more than right.Bilateral whole breast ultrasound was performed. There is no cystic or solid mass in either breast. | No sonographic findings to explain patient's bilateral nipple discharge. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. Of note, patient has an appointment to be seen by Dr. Bao for further evaluation. All results and recommendations were discussed with the patient and her mother.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 68-year-old male with acute kidney failure. Ultrasound guidance was provided for biopsy of the left kidney. | Ultrasound guidance. |
Generate impression based on findings. | Acute kidney failure. Evaluate for obstruction. Lack of urine. RIGHT KIDNEY: Right kidney measures 11.0 cm. The cortex is mildly echogenic. No hydronephrosis or renal calculi are identified.LEFT KIDNEY: Left kidney measures 10.3 cm. The cortex is mildly echogenic. No hydronephrosis or renal calculi are identified.URINARY BLADDER: A Foley catheter is identified within a collapsed bladder.OTHER: No significant abnormalities noted. | Echogenic kidneys, compatible with medical renal disease. No hydronephrosis or renal calculi. |
Generate impression based on findings. | 50-year-old female with small left thyroid bed nodule after thyroidectomy. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massLEFT LOBE: There is again noted in the left thyroid bed a medial, hypoechoic nodular density measuring approximately 0.2 x 0.4 x 0.4 cm without significant changeISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable nodular density left thyroid bed. |
Generate impression based on findings. | 50-year-old female with renal cyst for follow-up. RIGHT KIDNEY: The right kidney measures 11.2 cm in length. No hydronephrosis, shadowing calculus or mass. LEFT KIDNEY: The left kidney measures 11.5 cm in length. There is a 1.6 cm simple cyst in the upper pole of left kidney as seen on remote CT. No hydronephrosis, shadowing calculus or solid mass.OTHER: Echogenic liver which may be due to fatty infiltration.Limited views of the bladder demonstrate no abnormality. | Stable left renal cyst requires no follow-up.Likely fatty liver. |
Generate impression based on findings. | Reason: 14 y/o M with mixed phenotype ALL; concerns for cholecystitis; liver toxicity; VOD; please comment on presence of ascites History: RUQ and RLQ abdominal tenderness and guarding LIMITED ABDOMENLIVER: The liver is mildly echogenic with a slightly coarsened echotexture, measuring 16.2 cm in length. No focal liver masses are identified. There is no significant intrahepatic biliary ductal dilatation. BILIARY TRACT: The gallbladder is nondistended and filled with debris, as seen previously. Mild echogenicity in the gallbladder fossa may reflect focal fat deposition. The gallbladder wall is upper limits of normal in thickness, measuring 3 mm. No definite pericholecystic fluid is identified. The common bile duct is 4 mm in diameter, within normal limits.PANCREAS: The pancreatic head is visualized and appears normal. The distal pancreas is obscured.SPLEEN: No significant abnormalities noted. KIDNEYS: The right kidney is normal in size and echogenicity without hydronephrosis or nephrolithiasis. The left kidney is also normal in appearance, without hydronephrosis or nephrolithiasis. OTHER: No free fluid. | 1.Echogenic and coarsened texture of the liver, compatible with an infiltrative process, as can be seen in hepatic steatosis among other etiologies.2.Mild gallbladder distention and gallbladder debris/sludge without definite evidence of acute cholecystitis. No biliary ductal dilatation.3.No free fluid. |
Generate impression based on findings. | Reason: 14 y/o M with mixed phenotype ALL; concerns for cholecystitis; liver toxicity; VOD; please comment on presence of ascites History: RUQ and RLQ abdominal tenderness and guarding LIMITED ABDOMENLIVER: The liver is mildly echogenic with a slightly coarsened echotexture, measuring 16.2 cm in length. No focal liver masses are identified. There is no significant intrahepatic biliary ductal dilatation. BILIARY TRACT: The gallbladder is nondistended and filled with debris, as seen previously. Mild echogenicity in the gallbladder fossa may reflect focal fat deposition. The gallbladder wall is upper limits of normal in thickness, measuring 3 mm. No definite pericholecystic fluid is identified. The common bile duct is 4 mm in diameter, within normal limits.PANCREAS: The pancreatic head is visualized and appears normal. The distal pancreas is obscured.SPLEEN: No significant abnormalities noted. KIDNEYS: The right kidney is normal in size and echogenicity without hydronephrosis or nephrolithiasis. The left kidney is also normal in appearance, without hydronephrosis or nephrolithiasis. OTHER: No free fluid. | 1.Echogenic and coarsened texture of the liver, compatible with an infiltrative process, as can be seen in hepatic steatosis among other etiologies.2.Mild gallbladder distention and gallbladder debris/sludge without definite evidence of acute cholecystitis. No biliary ductal dilatation.3.No free fluid. |
Generate impression based on findings. | Elevated bilirubin and fever LIVER: No significant abnormalities noted. Main portal vein patent with normal directional flow. Liver length 19.3 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.4 cm in lengthOTHER: Right pleural effusion. Trace ascites. | Mild hepatomegaly without worrisome mass or ductal dilatation. Unremarkable gallbladder without acute inflammation. Trace ascites. |
Generate impression based on findings. | History Crohn's disease with elevated LFTs LIVER: Mildly coarse and echogenic liver echotexture without mass. Main portal vein patent with normal directional flow. Liver length 17.5 cm.BILIARY TRACT: Status post cholecystectomy. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 9.8 cm in lengthOTHER: Left kidney 10.7 cm in length. No ascites. | Mildly coarse and echogenic liver echotexture raises the possibility of fatty infiltration without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Reason: Is there an aneurysm? History: Reported history of AAA LIVER: The liver measures 18.9 cm in length. The hepatic parenchymal echotexture and echogenicity is coarse. There is a mildly nodular hepatic contour, concerning for a cirrhotic liver morphology. There are no focal masses. The main portal vein is patent with normal directional hepatopedal flow, maximum systolic velocity 19.4 cm/s.GALLBLADDER, BILIARY TRACT: The common hepatic duct measures 2 mm in diameter. The gallbladder is moderately distended. There is a small echogenic focus in the dependent portion of the gallbladder with posterior acoustic shadowing, consistent with a small stone. There is no pericholecystic fluid. The gallbladder wall measures 2 mm. There is no biliary ductal dilatation. Murphy's sign was negative.PANCREAS: Obscured by bowel gas.SPLEEN: The spleen measures 16.9 cm in length.KIDNEYS: The left kidney measures 11.8 cm in length. The right kidney measures 11.9 cm in length. No hydronephrosis. ABDOMINAL AORTA: The abdominal aorta is obscured by bowel gas distally. The abdominal aorta measures 3.2 cm proximally and 2.9 cm more distally in the AP diameter. The distal abdominal aorta was nonvisualized. The arterial waveform is pulsatile, consistent with reported history of intra-aortic balloon pump.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Left pleural effusion. No free intraperitoneal fluid. | 1. Echogenic coarse hepatic parenchyma with nodular contour, concerning for cirrhosis.2. Cholelithiasis without evidence of cholecystitis.3. Limited evaluation of the abdominal aorta without evidence of abdominal aortic aneurysm. |
Generate impression based on findings. | Post heart transplant 2 weeks ago. Now with acute kidney injury. Evaluation limited by patient body habitus.RIGHT KIDNEY: Right kidney measures 9.5 cm. No hydronephrosis or renal calculus identified.LEFT KIDNEY: Left kidney measures 10.0 cm. No hydronephrosis or renal calculus identified.URINARY BLADDER: No significant abnormalities noted. Right ureteral jet is observed.OTHER: No significant abnormalities noted. | Limited evaluation, with no evidence of acute renal abnormality. No renal calculus or hydronephrosis. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. Personal history of multiple bilateral benign breast biopsies (left breast stereotactic biopsy in 2009 for fibrocystic changes, bilateral cyst aspiration in 2005, right excisional biopsy in 2000 for fibrocystic changes, right stereotactic biopsy in 2000 for fibrotic breast tissue). Strong family history of breast cancer in mother, maternal great aunt, and maternal great 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. Given the patient's strong family history, a consultation with the cancer high risk clinic/genetic counselor is advised.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Acute kidney injury. RIGHT KIDNEY: The right kidney measures 10.3 cm. The cortex is mildly echogenic. There is a right upper pole exophytic lesion measuring 1.0 x 1.0 x 0.8 cm, probable cysts. There is no hydronephrosis, renal calculus, or suspicious mass.LEFT KIDNEY: Left kidney measures 10.7 cm. The cortex is mildly echogenic. There is no renal calculus, hydronephrosis, or suspicious mass.URINARY BLADDER: No significant abnormalities noted.OTHER: Small volume of ascites. | 1.Echogenic kidneys, compatible with medical renal disease. No hydronephrosis, renal calculus or suspicious mass.2.Small volume ascites. |
Generate impression based on findings. | Ms. Toy is a 46-year-old female who presents for short-term follow-up of mass in upper outer quadrant of left breast. A targeted left ultrasound was performed at the site of the previously described mass.In the left breast 1:00 location, approximately 4 cm the nipple, there is a circumscribed, lobulated hypoechoic mass most likely representing a benign fibroadenoma measuring 1.2 x 0.7 x 1.0 cm, previously 1.2 x 0.6 x 1.0 cm. | High probability benign mass of the left breast, likely representing a fibroadenoma. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram and possible left breast ultrasound is recommended in 6 months in order to ensure stability of these findings. All 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. | Ms. Blaszka is a 69-year-old female with biopsy-proven left breast IDC on hormonal therapy for 6 weeks, presenting for sonographic evaluation of treatment response. On physical exam, a fixed mass is palpated within the left upper inner quadrant.Targeted ultrasound of the left breast was performed for the patient's area of concern. In the left breast 11:00 location, approximately 5 cm from the nipple, there is revisualization of the biopsy proven malignancy now measuring approximately 3.1 x 2.0 x 2.2 cm, previously measuring 3.2 x 2.2 cm. Internal echogenic focus is compatible with percutaneously placed biopsy marker clip. | No significant interval change in biopsy proven malignancy of the left breast. Continued surgical consultation is recommended at this time. All results and recommendations were discussed with the patient. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Elevated LFTs. History stem cell transplant LIMITED ABDOMENLIVER: Coarse echogenic parenchyma again noted without mass. Liver length 18.9 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 12.1 cm in length RIGHT KIDNEY: No significant abnormalities noted. Right kidney 10.9 cm in lengthOTHER: Left kidney 11.9 cm in length. No ascites. | Echogenic coarse liver echotexture again noted consistent with fatty infiltration/parenchymal dysfunction. Mild hepatomegaly. No worrisome mass lesion or ductal dilatation. Hepatic vessels patent with normal directional flow. No ascites. |
Generate impression based on 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 findings. | Reason: Evaluate for perinephric abscess History: UTI, fever BLADDER Wall Thickness: Normal Contents: Bladder is distended with small amount of debris within the bladder. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 9 cm Left: 8.2 cm Mean for age: 8 cm Range for age: 6.8 - 9 cmADDITIONAL OBSERVATIONS: None. | Small amount of debris within the bladder. Otherwise normal examination with no evidence of perinephric abscesses.*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 findings. | 63-year-old female with thyroid nodules. Please evaluate for changes. RIGHT LOBE MEASUREMENTS: 4.0 x 1.3 x 1.9 cm.LEFT LOBE MEASUREMENTS: 2.5 x 4.1 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.4 cm in thickness.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: Hyperechoic nodule of the left mid thyroid measuring 1.8 x 2.3 x 1.8 cm (prior 1.8 x 2.4 x 1.5 cm). Additional hyperechoic nodule of the anterior lower pole and measures 0.8 x 0.8 x 0.8 cm (prior 0.9 x 0.9 x 1.2 cm).ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable left-sided hyperechoic nodules. |
Generate impression based on findings. | Ms. Kasper is a 41 year old female presenting with a palpable lump in the left collar bone area. Personal history of right breast lumpectomy in 8/2016 for IDC/DCIS treated with chemotherapy and radiation. Targeted left ultrasound was performed for the patient's area of concern.In the left supraclavicular region, there is a superficially located, reniform shaped hypoechoic lesion identified with hilar vascular flow measuring approximately 0.7 x 0.4 cm. Sonographic findings are compatible with a benign supraclavicular lymph node. | Benign lymph node of the left supraclavicular region. No sonographic evidence of malignancy. Patient should continue to follow up with her breast surgeon as clinically warranted. 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. | 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 findings. | 74-year-old male with hematuria. RIGHT KIDNEY: The right kidney measures 13.8 cm in length. No hydronephrosis. Numerous cysts are again seen some with minimal internal complexity. No definite solid lesion is identified. No shadowing calculi.LEFT KIDNEY: The left kidney measures 13.1 cm in length. No hydronephrosis. Multiple cysts are again seen, some with minimal internal complexity. No definite solid lesion is identified. No shadowing calculi.URINARY BLADDER: No acute abnormality of the urinary bladder.OTHER: No significant abnormalities noted. | Multiple bilateral renal cysts. No dominant mass is identified. Consider further evaluation with CT or MRI as the multiplicity of nodules makes any single nodule difficult to evaluate. |
Generate impression based on findings. | Reason: Follow-up on history of hydronephrosis History: previous ultrasound with hydronephrosis BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 6.3 cm Left: 6.8 cm Mean for age: 6.2 cm Range for age: 5 - 7.6 cmADDITIONAL OBSERVATIONS: None. | Normal examination.*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 findings. | 31-year-old female one day post renal and pancreatic transplant with anuria and elevated glucose. RENAL TRANSPLANT: Left iliac fossa transplantLOCATION: Left iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality notedCOLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels Peak systolic velocity in the adjacent iliac artery of 152 cm/s. Iliac vein is patent.Peak systolic velocity at the level of the anastomosis of 341 cm/s in the transplant renal artery and resistive index of 0.68.Parenchymal tracings demonstrate an average resistive index of 0.6. No parvus to this waveform.Transplant renal vein is patent.OTHER: No significant abnormality noted | Elevated anastomotic velocity in the transplant renal artery. Given recent surgery, this is most likely due to anastomotic edema which typically resolves. |
Generate impression based on findings. | 63-year-old male with hepatitis C and cirrhosis. Evaluate for hepatocellular carcinoma. LIVER: Liver is normal in size. The echotexture is mildly and coarsely echogenic without significant change. There is no focal hepatic mass identified. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Intrahepatic very tract is normal in caliber. Common duct is mildly prominent without change and within normal limits for this patient.PANCREAS: No significant abnormalities noted.SPLEEN: Normal in size.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No ascites. | Stable examination without evidence for hepatic mass. |
Generate impression based on findings. | 22-year-old female with right flank pain. Early pregnancy. RIGHT KIDNEY: Right kidney measures 10.2 cm in length. Echotexture is normal. There is no hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Left kidney measures 10.1 cm in length. Echotexture is normal. There is no hydronephrosis, shadowing calculus or mass.OTHER: Limited views of the bladder demonstrate no abnormality.Early intrauterine pregnancy noted. Complete OB study not performed.Mildly echogenic liver, likely due to fatty infiltration. | Normal kidneys.Mild fatty liver.Early IUP.US RENAL LTD, 11/18/2016 10:08 AMCLINICAL INFORMATION:22-year-old female with right flank pain. Early pregnancy.COMPARISON: Limited views from 11/26/2011 ultrasound TECHNIQUE: Real-time ultrasound images were obtainedFINDINGS:RIGHT KIDNEY: Right kidney measures 10.7 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Left kidney measures 10.1 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.OTHER: Mildly echogenic liver likely due to fatty infiltration.Early IUP noted but not evaluated. |
Generate impression based on findings. | 60-year-old male with advanced heart failure possible transplant. LIVER:Liver echotexture normal to slightly increased. Mild hepatomegaly. No focal hepatic abnormality. Hepatic contour appears within normal limits. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein. Waveform is pulsatile consistent with congestive heart failure. GALLBLADDER, BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Inadequately visualized due to bowel gas.SPLEEN: No significant abnormality noted.KIDNEYS: The right kidney measures 12 cm in length. Echotexture is mildly increased consistent with parenchymal disease. Very small right renal cyst. No hydronephrosis, shadowing calculus or solid mass.Left kidney measures approximately 10.8 cm in length although is less well-visualized than the right due to limited scanning field related to cutaneous pads. Echotexture appears increased. There is a 2 cm simple-appearing left renal cyst. No hydronephrosis, obvious shadowing calculus or mass.ABDOMINAL AORTA: Inadequately visualized due to bowel gas.INFERIOR VENA CAVA: Distal abdominal inferior vena cava is normal and patent.OTHER: Right pleural effusion. Urinary bladder decompressed with Foley catheter. | 1. Mild hepatomegaly with borderline increased echogenicity2. Echogenic kidneys with cysts.3. Right pleural effusion.4. Limited visualization of pancreas and aorta.. |
Generate impression based on findings. | 42-year-old female with lateral parotid swelling and left cervical adenopathy. Evaluate for parotitis. There is massive adenopathy involving both sides of the face and neck. The majority of the nodes have normal morphology although largest node on the right has a somewhat rounded appearance. The right parotid gland is enlarged and cystic-appearing. Left parotid gland is less well-visualized although enlarged and cystic-appearing. Both submandibular glands are enlarged and cystic-appearing.No focal fluid collection suggest abscess. Neck vasculature not evaluated. | Extensive adenopathy within the face and neck.Enlarged parotid and submandibular glands.No evidence for focal abscess. |
Generate impression based on findings. | 37-year-old male post thyroidectomy for papillary thyroid carcinoma with nodal metastases. 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: Morphologically normal lymph nodes bilaterally. A level 2 node on the right which is mildly abnormal in shape with poor visualization of fatty hilum is completely unchanged from prior exam, measuring 0.4 x 1 x 1.1 cm.OTHER: No significant abnormality noted. | No evidence for local recurrence or metastatic disease. |
Generate impression based on findings. | 66-year-old male with history of complex renal cyst for follow-up. RIGHT KIDNEY: Right kidney measures approximately 10.6 cm in length. Renal cortex is highly echogenic consistent with parenchymal disease. Simple and mildly complex cysts are identified, little changed from the prior exam. The largest which has a single fine septation measures approximately 1.8 x 2.1 x 2.5 cm without change. No hydronephrosis or shadowing calculus.LEFT KIDNEY: The left kidney measures slightly over 10 cm in length. The parenchyma is highly echogenic consistent with parenchymal disease.Simple and mildly complex cysts are again identified, little changed from the prior exam. Mid pole cyst measures 1.3 cm in greatest diameter without change. No solid mass or obvious nephrolithiasis. There is again noted mild dilatation of renal pelvis and lower pole collecting system, decreased compared to prior exam. Echogenic, peripheral focus in the midportion of the right kidney appears stable as well, most consistent with a focal calcification.OTHER: No gross bladder abnormality. | Stable, mildly complex renal cysts that by appearance do not require follow-up.Stable, mild dilatation of the left renal collecting system. |
Generate impression based on findings. | 57-year-old male for follow-up of right thyroid cystic mass. RIGHT LOBE MEASUREMENTS: 4.3 x 1.6 x 2.3 cmLEFT LOBE MEASUREMENTS: 4.0 x 1.3 x 2.2 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Homogeneous in echotexture. In the right lobe there is again noted a predominately cystic mass with slight eccentric nodularity and calcification. This is most likely benign, and measures 0.7 x 1 x 1 cm, unchanged from the prior exam.LEFT LOBE: Homogeneous in echotexture. In the most inferior left lobe of the thyroid and poorly visualized as a predominantly cystic mass with small eccentric echogenic focus measuring 0.4 x 0.6 x 0.7 cm, highly likely benign.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Stable complex cystic right thyroid mass likely benign.2. Smaller complex cystic left thyroid mass highly likely benign. Although not noted on the prior exam, the inferior left lobe is very difficult to visualize to this may have been present. |
Generate impression based on findings. | 64-year-old male for follow-up thyroid nodules. Thyroiditis. RIGHT LOBE MEASUREMENTS: 2.4 x 2.8 x 6.9 cmLEFT LOBE MEASUREMENTS: 2.8 x 2.4 x 6.1 cmISTHMUS MEASUREMENTS: 0.8 cmRIGHT LOBE: Heterogeneous echotexture. There is again noted in the medial right lobe/isthmus a complex cystic nodule which is unchanged in size, measuring 0.4 x 0.8 x 1 cm with eccentric, moderately echogenic material and focal reflectors, likely, tail artifact.LEFT LOBE: Heterogeneous echotexture. Within the left lobe there is a spongiform nodule which is not significantly changed measuring 0.5 x 0.6 x 0.7 cm.ISTHMUS: As abovePARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Thyromegaly with heterogeneous thyroid parenchyma.Stable complex cystic right isthmus nodule likely benign.Spongiform, small left lobe nodule, benign. |
Generate impression based on findings. | 68-year-old male with abnormal sestamibi scan in the region of the lower pole of the left lobe of the thyroid. Patient has primary hyperparathyroidism with hypercalcemia. RIGHT LOBE MEASUREMENTS: The right lobe measures approximately 1.4 x 1.7 x 4.1 cmLEFT LOBE MEASUREMENTS: The left lobe measures approximately 1.5 x 1.5 x 4.8 cm.ISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Homogeneous without mass.LEFT LOBE: Homogeneous without mass. However, the left lobe extends low in the neck.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Caudal to the left lobe of the thyroid is a complex cystic mass with internal vascularity measuring approximately 1 x 1.1 x 1.7 cm.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Complex cystic and vascular mass caudal to the left lobe of the thyroid consistent with atypical parathyroid adenoma and corresponding to the location of the abnormality on the sestamibi scan. |
Generate impression based on findings. | 65-year-old female with history of thyroid cancer post thyroidectomy. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: ThyroidectomyRIGHT LOBE: No massesLEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for local recurrence or nodal disease. |
Generate impression based on findings. | 34-year-old male with prior thyroidectomy for thyroid cancer and subsequent surgical removal of metastatic nodal disease with nonsuppressed thyroglobulin level. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massLEFT LOBE: No massISTHMUS: No massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 2 small but somewhat rounded lymph node measuring 0.2 x 0.4 x 0.4 cm may have a fatty hilum. No recurrent adenopathy in the left.OTHER: No significant abnormality noted. | Small, rounded right level 2 lymph node without gross abnormal morphology. |
Generate impression based on findings. | sacral cellulitis concern for abscessVIEW: Ultrasound of the gluteal region Dedicated ultrasound of the gluteal region superior to the gluteal cleft was performed. There is a small hypoechoic area measuring 2.2 x 1 cm at this region. There is marked soft tissue edema. | Hypoechoic area superior to the gluteal cleft which may represent a phlegmon. There is no drainable fluid collection. |
Generate impression based on findings. | Acute right upper quadrant colicky pain for one month. LIVER: The liver measures 15.0 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.29 m/s.BILIARY TRACT: Cholelithiasis. No associated gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.The spleen measures 8.2 cm in length. RIGHT KIDNEY: Kidney measures 10.7 cm in length. LEFT KIDNEY: Kidney measures 11.1 cm in length. Subcentimeter simple cyst within the interpolar left kidney.OTHER: No significant abnormalities noted. | Cholelithiasis without sonographic evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Ms. Edwards submitted outside mammogram/ultrasound examinations dated 7/3/2014, 8/15/2014, and 8/29/2014, from Northwestern Memorial Hospital. Submitted outside studies were compared to the current mammogram dated 11/4/2016. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution.Previously identified circumscribed mass in the right lower inner breast is stable when compared to prior examinations (mammograms + ultrasounds) dating back to 7/2014 and with a benign pathology result of UDH/fibroadenomatous change (per outside pathology report).Previously identified asymmetry in the left upper breast is also stable when compared to prior mammogram from 07/2014.There is no significant change between these studies. | Benign biopsy of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in November 2017.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Right upper quadrant pain and elevated bilirubin. LIVER: The liver measures 19.5 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. There is hepatopetal flow in the main portal vein with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.The spleen measures 11.3 cm in length. RIGHT KIDNEY: Kidney measures 13.0 cm in length. Normal echotexture. LEFT KIDNEY: Kidney measures 13.5 cm in length. Normal echotexture. OTHER: No significant abnormalities noted. | 1.Hepatomegaly.2.No sonographic evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Ms. Edwards submitted outside mammogram/ultrasound examinations dated 7/3/2014, 8/15/2014, and 8/29/2014, from Northwestern Memorial Hospital. Submitted outside studies were compared to the current mammogram dated 11/4/2016. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution.Previously identified circumscribed mass in the right lower inner breast is stable when compared to prior examinations (mammograms + ultrasounds) dating back to 7/2014 and with a benign pathology result of UDH/fibroadenomatous change (per outside pathology report).Previously identified asymmetry in the left upper breast is also stable when compared to prior mammogram from 07/2014.There is no significant change between these studies. | Benign biopsy of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in November 2017.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Right upper quadrant tenderness. Evaluate liver in the setting of congestive heart failure. LIVER: The liver measures 16.8 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.25 m/s. The hepatic veins are prominent which can be seen with elevated right heart pressures.BILIARY TRACT: The gallbladder appears contracted and contains gallstones. No associated gallbladder wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: There is an ovoid soft tissue echogenicity structure adjacent to the pancreas measuring 3.0 x 1.5 x 2.1 cm which appears to have a fatty hilum and thus is favored to reflect a reactive lymph node, however this could be better evaluated with contrast-enhanced CT or MRI if clinically indicated.SPLEEN: No significant abnormalities noted.The spleen measures 10.0 cm in length. RIGHT KIDNEY: Kidney measures 12.2 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.7 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. There is an ovoid structure interposed between the left kidney and spleen which may be a splenule as seen on prior CT.ABDOMINAL AORTA: The abdominal aorta appears patent and is normal in caliber measuring 2.1 x 1.7 cm, 1.7 x 1.6 cm, and 1.9 x 1.8 cm in the proximal, middle, and distal portions.INFERIOR VENA CAVA: Slightly dilated but patent.BLADDER: Not well distended.OTHER: No significant abnormality noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis.2.Echogenic kidneys suggestive of medical renal disease.3.Findings suggestive of elevated right heart pressures.4.Probable peripancreatic prominent lymph node, favor reactive, although could be further evaluated with dedicated cross-sectional imaging as clinically warranted. |
Generate impression based on 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 findings. | 71-year-old male. Assess change in left lower pole complex cyst. GFR 37. Contrast relatively contraindicated. RIGHT KIDNEY: The right kidney measures 9.8 cm in length. No hydronephrosis. Increased echogenicity of the renal parenchyma. Multiple renal cysts are again seen. The largest cyst on the right measures 6 x 6.5 x 7.3 cm (prior 6.1 x 6.3 x 6.1 cm). LEFT KIDNEY: The left kidney measures 12.1 cm in length. No hydronephrosis. Increased echogenicity of the renal parenchyma. Left lower pole heterogenous lesion measuring 1.3 x 1.2 x 1.3 cm (prior 1.5 x 1.3 x 1.4 cm).URINARY BLADDER: The urinary bladder is collapsed and incompletely evaluated.OTHER: No significant abnormalities noted. | Stable appearance of the left lower pole heterogenous lesion. Further evaluation with dedicated CT or MRI is recommended (half dose contrast administration is available for GFR between 30 and 60). |
Generate impression based on findings. | Reason: Evaluate for possible sources of infection LIVER: The liver measures 18.9 cm in length. The liver parenchymal echotexture is normal. In the right hepatic lobe, there is a cyst measuring 3.3 x 2.3 cm which appears to contain thin internal septations and is similar in size to 2007 CT. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.35 m/s.BILIARY TRACT: The gallbladder is surgically absent. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2.5 mm in diameter.PANCREAS: The pancreas is largely obscured.SPLEEN: The spleen is enlarged and measures 16.0 cm in length. RIGHT KIDNEY: Kidney measures 11.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.No forthcoming cause of infection identified as clinically questioned.2.Splenomegaly.3.Hepatic cyst appearing similar to 2007 CT. |
Generate impression based on findings. | Reason: assess for cirrhosis, biliary tree abnormalities History: chronic hepatitis c with transaminitis LIVER: The liver measures 17.9 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 m/s.BILIARY TRACT: Cholelithiasis including stone in gallbladder neck. No gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. The spleen measures 8.6 cm in length. RIGHT KIDNEY: Kidney measures 10.0 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis or shadowing calculi. In the superior pole of the right kidney, there is a cystic structure with suggestion of fine internal septations.LEFT KIDNEY: Kidney measures 12.2 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis or shadowing calculi. Simple appearing cyst in the left kidney measuring 4.2 x 4.2 x 3.7 cm.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis or biliary ductal dilatation.2.Echogenic kidneys suggestive of medical renal disease.3.Minimally complex right renal cyst, with thin internal septations suggested. |
Generate impression based on findings. | Reason: Abnormal lymph nodes? History: Thyroid microcarcinoma and atypical adenoma RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. No discrete nodules are identified in the thyroidectomy bed.LEFT LOBE: Status post thyroidectomy. No discrete nodules are identified in the thyroidectomy bed.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are several mildly prominent lymph nodes in the bilateral level 2 and level 3 regions which retain their fatty hila and are favored to be reactive. The most prominent lymph node on the right is in the level 2 region and measures 1.3 x 0.4 x 1.6 cm. The most prominent lymph node on the left is in the level 2 region and measures 1.7 x 0.8 x 1.0 cm. OTHER: No significant abnormality noted. | 1.No suspicious lesion within the thyroidectomy bed.2.Mildly prominent cervical lymph nodes, favor reactive, with continued attention on subsequent follow-up examinations recommended. |
Generate impression based on findings. | Reason: 66 y/o man with a right thyroid nodule. RIGHT LOBE MEASUREMENTS: 8.1 x 4.3 x 2.9 cm.LEFT LOBE MEASUREMENTS: 5.7 x 3.1 x 1.8 cm.ISTHMUS MEASUREMENTS: Up to 3 mm in thickness.RIGHT LOBE: Mildly heterogeneous background parenchymal echogenicity. Partially visualized heterogeneous predominantly hypoechoic solid nodule at the inferior pole measuring 4.5 x 4.0 x 4.0 cm which extends substernally. The nodule demonstrates some internal vascularity, and a single dystrophic appearing calcification is noted.LEFT LOBE: Mildly heterogeneous background parenchymal echogenicity. No discrete nodules identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Partially imaged dominant thyroid nodule in the right inferior pole extending substernally which is of intermediate suspicion for neoplasm. |
Generate impression based on findings. | Reason: CT abdomen with innumerable hepatic hypodensities on 11/11/16 History: AML s/p chemotherapy complicated by prolonged pancytopenia. LIVER: The liver measures 14.4 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. The portal triads are perhaps mildly echogenic. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.26 m/s.BILIARY TRACT: The gallbladder appears contracted. No gallbladder wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted.The spleen measures 6.3 cm in length. RIGHT KIDNEY: Kidney measures 10.6 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.7 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: Right pleural effusion. The IVC is mildly dilated. | Mildly coarse liver echotexture, may represent nonspecific fatty infiltration/parenchymal dysfunction. No focal liver lesion identified. Dedicated cross-sectional imaging may be considered for further evaluation as clinically warranted. |
Generate impression based on findings. | Right upper quadrant pain. LIVER: The liver measures 24.6 cm in length. The background liver parenchymal echotexture is normal. There are several focal hypoechoic lesions within the liver some of which demonstrate a targetoid appearance. An example lesion within the left lobe measures 2.1 x 1.9 x 1.6 cm. There are also multiple cystic structures primarily in the right lobe of the liver several of which contain fine internal septations. The largest cystic structure is in the right lobe measuring 7.9 x 9.0 x 12.0 cm. The portal vein is patent demonstrating normal hepatopetal flow with an elevated velocity of 0.64 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. There is a non-shadowing, nonmobile structure along the body of the gallbladder wall measuring up to 8 mm which lacks internal vascularity and is compatible with a polyp. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11.5 cm in length. RIGHT KIDNEY: Kidney measures 12.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.2 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Several hypoechoic hepatic lesions, which are nonspecific but could reflect metastases. Dedicated cross-sectional imaging of the abdomen and pelvis with intravenous contrast is recommended for further characterization.2.Mildly increased flow velocity in the main portal vein which is nonspecific but which could suggest narrowing.3.Several hepatic cysts.4.No evidence of acute cholecystitis or biliary ductal dilatation.5.8 mm gallbladder polyp, continued surveillance is recommended.Findings discussed with ordering ER physician at 2:14 PM on 11/21/2016. |
Generate impression based on findings. | 86-year-old female with hyperparathyroidism. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5.7 x 2.1 x 2 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 7.1 x 2.6 x 3.5 cm.ISTHMUS MEASUREMENTS: The isthmus measures 2.1 cm in thickness.RIGHT LOBE: Multinodular appearance. Partially cystic nodule with eccentric solid component of the right lower pole measuring 1.7 x 1.1 x 1.2 cm, and the solid portion of this nodule measures 1 x 0.7 x 0.7 cm.LEFT LOBE: Multinodular appearance. Heterogeneity of the enlarged left thyroid lobe limits visualization for accurate measurement of discrete nodules.ISTHMUS: Heterogenous predominantly hyperechoic nodule of the thyroid isthmus measuring 2.1 x 3.2 x 2.3 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Multinodular thyroid goiter. The measured nodules of the thyroid isthmus and right lower pole demonstrate characteristics most compatible with "low suspicion" nodules per ATA criteria. These nodules are amenable to percutaneous biopsy as clinically recommended.2. No definite candidates for a parathyroid adenoma. Please refer to the same day nuclear medicine exam for more details. |
Generate impression based on findings. | Reason: Evaluate for choledocholithiasis, cholecystitis History: hyperbilirubinemia Examination limited by patient body habitus.LIVER: The liver measures 19.9 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.43 m/s.BILIARY TRACT: The gallbladder is contracted with diffuse gallbladder wall thickening measuring up to 6 mm. Debris/sludge is present within the gallbladder lumen. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: Not visualized.RIGHT KIDNEY: Kidney measures 13.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Not visualized.OTHER: No significant abnormalities noted. | 1.Limited exam.2.Hepatomegaly. Diffusely coarse and echogenic liver, compatible with fatty infiltration/parenchymal dysfunction.3.Contracted gallbladder which contains sludge. No biliary duct dilatation. |
Generate impression based on findings. | Ms. Herts is a 27-year-old female with a personal history of Crohn's disease on immunosuppressant therapy, complaining of new palpable tender right breast lump. No family history of breast cancer. A targeted right ultrasound was performed for the patient’s area of concern.In the right breast 8:00 location, approximately 2 cm from the nipple, there is a thick-walled unilocular hypoechoic lesion with floating internal debris, posterior acoustic enhancement and peripheral vascularity, measuring approximately 1.3 x 0.8 x 0.9 cm. | Sonographic findings are compatible with a right periareolar abscess. No sonographic evidence of malignancy. Patient should be seen by a breast surgeon for further evaluation and treatment. All results and recommendations were discussed with patient and Dr. Bao at time of dictation. The patient was subsequently seen by Dr. Bao and immediately redirected for a surgical consult.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Reason: 57M s/p OLT now with concern for large amount of ascites in the setting of fever. History: Large amount of ascites There is large volume ascites with the largest apparent pocket noted in the left lower quadrant. Partially visualized right pleural effusion. | Large volume ascites. |
Generate impression based on findings. | Calf pain following injury The images demonstrate the presence of a focal hypoechoic defect of the distal medial portion of the medial head of the gastrocnemius along the aponeurosis at the interface with the soleus. This defect measures approximately 2 cm in length and is compatible with a hematoma at the site of a partial-thickness tear. There is no evidence of a full-thickness rupture. There is diffuse subcutaneous edema particularly of the medial calf. Lateral head of the gastrocnemius and Achilles tendon are unremarkable. | Small partial-thickness tear / hematoma of the medial head of the gastrocnemius as above with associated diffuse subcutaneous edema. |
Generate impression based on findings. | History of hepatitis C, evaluate liver function. LIVER: The liver measures 19.3 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.21 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common hepatic duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.The spleen measures 8.9 cm in length. RIGHT KIDNEY: Kidney measures 14.2 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. Lower pole renal cyst.LEFT KIDNEY: Kidney measures 12.1 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. Upper pole renal cyst.OTHER: No significant abnormalities noted. | Echogenic liver compatible with fatty infiltration/parenchymal dysfunction without focal liver lesions identified. |
Generate impression based on findings. | History of abdominal pain and transaminitis, evaluate for cholecystitis. BILIARY TRACT: The gallbladder is mildly hydropic but lacks significant wall thickening or associated pericholecystic fluid. No gallstones identified. No biliary ductal dilatation. The common bile duct measures up to 5.5 mm in diameter. The sonographic Murphy's sign is negative. | Hydropic gallbladder. Given lack of associated inflammatory changes or cholelithiasis, acute cholecystitis is considered less likely. |
Generate impression based on findings. | Reason: HCV, evaluate for HCC. LIVER: The liver measures 13.9 cm in length and demonstrates a nodular 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 0.29 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.2 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.4 cm in length. RIGHT KIDNEY: Kidney measures 10.1 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 11.6 cm in length. Normal echotexture. There is a questionable solid mass in the mid to lower pole of the left kidney.OTHER: No significant abnormalities noted. | 1.Cirrhotic liver morphology without focal lesions identified.2.Questionable mass in the left kidney; dedicated contrast-enhanced cross-sectional imaging is recommended for further evaluation. Recommendation entered into the Follow-Up Tool. |
Generate impression based on findings. | History of poor oral intake and acute kidney injury, evaluate for postrenal obstruction. Also history of Hb-SS. RIGHT KIDNEY: Kidney measures 9.5 cm in length. Increased parenchymal echogenicity. No hydronephrosis. No shadowing stones or masses identified.LEFT KIDNEY: Left kidney difficult to visualize. Kidney measures approximately 8.3 cm in length. Increased parenchymal echogenicity. No hydronephrosis. No shadowing stones or masses identified.URINARY BLADDER: Foley catheter present. OTHER: No significant abnormalities noted. | Increased renal echogenicity compatible with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Reason: 58 yo F with newly diagnosed colon cancer with metastases to liver now having fever, evaluate for biliary digitation History: fever, abdominal pain LIVER: The liver is enlarged and measures 20.8 cm in length. Innumerable predominantly hyperechoic hepatic lesions in both lobes compatible with metastatic disease. Additional scattered hepatic cysts of varying sizes. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.22 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 9.2 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: Abdominal ascites. Bilateral pleural effusions, increased from recent CT. | 1.Diffuse hepatic metastatic disease.2.No evidence of acute cholecystitis or biliary ductal dilatation.3.Ascites. Increasing bilateral pleural effusions. |
Generate impression based on findings. | Transaminitis with fibrosis noted at OSH, evaluate for liver disease. LIVER: The liver measures 12.1 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 somewhat pulsatile hepatopetal flow with a velocity of 0.25 m/s.BILIARY TRACT: Cholelithiasis without significant gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 8.5 cm in length. RIGHT KIDNEY: Kidney measures 9.7 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 9.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: Bilateral pleural effusions. | 1.Findings suggestive of chronic liver disease without focal lesions identified.2.Cholelithiasis without secondary evidence of acute cholecystitis.3.Bilateral pleural effusions. |
Generate impression based on findings. | Reason: assess for HCC History: Cystic fibrosis related cirrhosis LIVER: The liver measures 13.9 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 0.2 m/s.BILIARY TRACT: The gallbladder is not visualized. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: The pancreas is partially obscured.SPLEEN: The spleen is mildly enlarged and measures 14.6 cm in length.RIGHT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. No hydronephrosis. Several shadowing nonobstructive stones are noted, the largest of which measures 7 mm.LEFT KIDNEY: Kidney measures 13.1 cm in length. Normal echotexture. No hydronephrosis or shadowing stones. Simple cyst in the lower pole.OTHER: No ascites noted. | 1.Cirrhotic liver morphology without focal lesions. Splenomegaly. No ascites.2.Nonobstructing right nephrolithiasis. |
Generate impression based on findings. | Reason: please assess liver for cirrhosis, please assess for hydronephrosis; decreased UOP Examination limited due to constraints positioning patient. LIVER: The liver measures 13.7 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 hepatopetal flow with a velocity of 0.31 m/s.BILIARY TRACT: Cholelithiasis without significant gallbladder wall thickening. Gallbladder is relatively collapsed. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 11.6 cm in length. RIGHT KIDNEY: Kidney measures 9.7 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Not well visualized.ABDOMINAL AORTA: Proximal aorta measures 2.4 cm in AP dimension. Middle and distal aorta not well visualized.INFERIOR VENA CAVA: Not well visualized.OTHER: Moderate ascites. Foley catheter. | 1.Limited exam.2.Cirrhotic liver morphology. No focal hepatic lesions identified.3.Cholelithiasis.4.Echogenic right kidney suggestive of medical renal disease. No right hydronephrosis. Left kidney not visualized.5.Moderate ascites. |
Generate impression based on findings. | 21-year-old female with history of left breast mass, presenting for short interval sonographic follow-up. No family history of breast cancer. Patient reporting interim enlargement of palpable left breast lump. Targeted ultrasound of the left breast 4:00 position 3 cm from the nipple reveals a macrolobulated slightly heterogeneous hypoechoic mass measuring 3.0 x 2.6 cm, previously 1.9 cm in longest dimension. There is redemonstrated posterior acoustic enhancement and internal vascularity. | Enlarging left lower outer breast mass for which surgical consult is recommended, especially given the interval increase in size to 3 cm. The patient will see Dr. Jaskowiak later today. BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | sacral cellulitis concern for abscessVIEW: Ultrasound of the gluteal region Dedicated ultrasound of the gluteal region superior to the gluteal cleft was performed. There is a small hypoechoic area measuring 2.2 x 1 cm at this region. There is marked soft tissue edema. | Hypoechoic area superior to the gluteal cleft which may represent a phlegmon. There is no drainable fluid collection. |
Generate impression based on findings. | Reason: Patient with weakness and mild transaminitis History: Weakness LIVER: The liver measures 17.7 cm in length. Increased parenchymal echogenicity is compatible with fatty infiltration/parenchymal dysfunction. Hepatic cyst as seen on prior CT without additional focal hepatic lesions identified, though sensitivity limited. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Cholelithiasis including stones in the gallbladder neck without associated significant gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.7 cm in length. RIGHT KIDNEY: Kidney measures 18.6 cm in length (including cyst). Normal echotexture. No frank hydronephrosis. Large upper pole cyst.LEFT KIDNEY: Kidney measures 13.0 cm in length. Normal echotexture. Mild hydroureteronephrosis appearing similar to recent CT.OTHER: No significant abnormalities noted. | 1.Echogenic liver compatible hepatic steatosis/parenchymal dysfunction. No suspicious focal hepatic lesions are identified, however, sensitivity is limited.2.Cholelithiasis without evidence of acute cholecystitis or biliary ductal dilatation.3.Mild left hydroureteronephrosis appearing similar to recent CT. |
Generate impression based on findings. | History of epidermal inclusion cyst status post excision under right breast in 4/2016, pt experiencing recurrent swelling and pain in area intermittently, no skin changes today. Evaluate for hernia or recurrent epidermal inclusion cyst. No abnormal cysts or masses are identified within the superficial soft tissues at the area of patient's concern inferior to the right breast. | No abnormal masses or fluid collections identified. |
Generate impression based on findings. | 56-year-old male with history of chronic liver disease recently on spironolactone complaining of new bilateral nipple sensations and enlargement, and pulling sensation along the lateral aspect of the left breast. Family history is positive for premenopausal breast cancer in mother. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. Bilateral central subareolar glandular tissue extending into posterior adipose tissue in a fanlike configuration slightly asymmetric to the right, compatible with gynecomastia.Triangular marker overlying the left upper outer breast indicates area of palpable concern as indicated by the patient. There is no underlying correlating mammographic finding.LEFT BREAT ULTRASOUND:Targeted ultrasound of the left upper outer breast was performed in the area of concern as indicated by the patient.No solid or cystic mass was identified. | Bilateral gynecomastia. No evidence of malignancy in either breast. Suggest clinical correlation for potential causes of gynecomastia. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: Evaluate for cirrhosis vs hcc, eval for renal disease worsening Cr History: hcv cirrhosis, acute renal failure Examination mildly limited by constraints positioning patient.LIVER: The liver measures 14.3 cm in length. 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 0.17 m/s.BILIARY TRACT: Sludge/debris is present within the gallbladder. No significant gallbladder wall thickening. Common tail artifact associated with the gallbladder wall suggesting adenomyomatosis. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameter.PANCREAS: Pancreas poorly visualized.SPLEEN: No significant abnormalities noted. The spleen measures 8.5 cm in length. RIGHT KIDNEY: Kidney measures 7.3 cm in length. Increased parenchymal echogenicity. No frank hydronephrosis.LEFT KIDNEY: Left kidney is not well-visualized.ABDOMINAL AORTA: The proximal aorta measures 1.0 cm AP x 0.7 cm transverse. The middle aorta measures 1.1 cm in AP dimension. The distal aorta is not well-visualized.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Large amount of ascites, increased from prior. Foley catheter in collapsed bladder. | 1.Limited exam.2.Cirrhotic liver morphology without focal lesions identified. Large amount of ascites, increased.3.Increased echogenicity of right kidney compatible with medical renal disease. Left kidney not well visualized. No frank hydronephrosis on the right. |
Generate impression based on findings. | Reason: History of renal transplant with worsening Cr and poor UOP. Please evaluate. History: As above, evaluate transplant concern for hydronephrosis RENAL TRANSPLANT:LOCATION: Left iliac fossa.PERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality noted..COLLECTING SYSTEM/URETER: Mild expected prominence of the collecting system, not significantly changed. No significant hydronephrosis.URINARY BLADDER: No significant abnormality notedOTHER: No significant abnormality noted | No significant hydronephrosis of the transplant kidney. |
Generate impression based on findings. | Reason: 83M with soft mass on LLQ area, ? Spigelian hernia History: soft LLQ abdominal mass In the left inguinal region, there is an apparent defect in the abdominal wall which appears to contain peristaltic bowel compatible with an inguinal hernia. | Findings compatible with left inguinal hernia. CT abdomen/pelvis with intravenous and enteric contrast may be considered for additional evaluation as clinically warranted.Findings discussed with patient and daughter. Patient not currently experiencing acute obstructive symptoms and was counseled to seek care at the emergency department if symptoms worsen. |
Generate impression based on findings. | Reason: left renal mass, evaluate for change in size or characteristics. RIGHT KIDNEY: Kidney measures 10.5 cm in length. Normal parenchymal echotexture. No hydronephrosis, shadowing calculus or mass. Multiple cysts including septated cyst in the lower pole measuring up to 1.7 cm, not significantly changed.LEFT KIDNEY: Kidney measures 10.3 cm in length. Normal parenchymal echotexture. Heterogeneous predominately solid left renal mass with vascularity measuring 2.4 x 2.2 x 2.0 cm, previously 2.3 x 2.5 x 2.3 cm, not significantly changed.OTHER: No significant abnormalities noted. Bilateral ureteral jets are visualized. | Solid left renal mass which remains highly suspicious for neoplasm, not significantly changed in size. |
Generate impression based on findings. | Reason: Nodules? History: Thyroid cancer s/p resection of residual thyroid tissue identified on previous ultrasound. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. No suspicious nodules in the thyroidectomy bed.LEFT LOBE: Status post thyroidectomy. No suspicious nodules in the thyroidectomy bed. Previously seen solid mass is no longer present.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A few morphologically normal cervical lymph nodes are present.OTHER: No significant abnormality noted. | No suspicious masses within the thyroidectomy bed. |
Generate impression based on findings. | Reason: evaluate hepatomegaly History: RUQ pressure, increased liver span LIVER: The liver measures 16.7 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.33 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 13.6 cm in length. RIGHT KIDNEY: Kidney measures 12.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | No evidence of hepatomegaly or other significant abnormality. |
Generate impression based on findings. | 15-year-old female with history of right breast mass, presenting for short-term sonographic follow-up. No family history of breast cancer. On the physical exam there is a mobile oval mass at the right 11:00 position.Targeted ultrasound of the right upper outer breast, 11:00 position 3 cm from the nipple reveals an oval circumscribed parallel hypoechoic mass measuring 2.2 x 1.1 x 1.9 cm (largely stable in size using similar measuring techniques), with internal vascularity and posterior acoustic enhancement. | No enlargement of the high probability benign right 11:00 mass, with imaging characteristics suggestive of a fibroadenoma. As long as the mass remains clinically stable and will be followed, sonographic follow-up in 6-12 months is suggested. BIRADS: 3 - Probably benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female 64 years old with epigastric/RUQ pain. History of open cholecystectomy in 1970s. LIVER:The liver has a smooth contour and measures 16.3 cm in length. The parenchyma is somewhat coarse and echogenic. No focal liver lesion is identified. The main portal vein is patent with a velocity of 22.4 cm/s. There is no ascites.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common duct measures 4 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreatic head and body are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.9 cm in length.KIDNEYS: The right kidney measures 11.0 cm in length and the left measures 11.2 cm. The renal cortices are normal in echogenicity. There is no shadowing renal stone, hydronephrosis or evidence of renal mass. OTHER: No significant abnormality noted. | Mild hepatomegaly and increased echogenicity of the liver parenchyma suggestive of hepatic steatosis/parenchymal dysfunction. |
Generate impression based on findings. | Rule out ascites. Bloating. Large volume ascites in both lower quadrants. | Large volume ascites in both lower quadrants. |
Generate impression based on findings. | 49-year-old male with acute kidney injury. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.3 cm in length. No hydronephrosis, shadowing calculi, or suspicious lesions. Normal renal echogenicity.LEFT KIDNEY: The left kidney measures 12 cm in length. No hydronephrosis, shadowing calculi, or suspicious lesions. Normal renal echogenicity.URINARY BLADDER: The urinary bladder is collapsed and not well evaluated.OTHER: No significant abnormalities noted. | No hydronephrosis. |
Generate impression based on findings. | 15-year-old female with lupus nephritis. Assist with native kidney biopsy. Ultrasound guidance was provided for a right kidney biopsy. The procedure was performed by the nephrology service. | Ultrasound guidance was provided for a right kidney biopsy. The procedure was performed by the nephrology service. |
Generate impression based on findings. | 20-year-old female with history of bilateral palpable breast lumps. Patient denies any breast lump at the time of this diagnostic ultrasound evaluation. Bilateral breast ultrasound was performed for the areas of previous palpable concern as indicated by the patient. Patient denies any breast lump at the time of this diagnostic study.Targeted ultrasound of the medial and lateral breasts reveals no cystic or solid mass. | Normal targeted diagnostic ultrasound evaluation of both breasts. No sonographic evidence for malignancy. Clinical follow up is recommended. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female 45 years old follow-up thyroid nodules. RIGHT LOBE MEASUREMENTS: 4.8 x 1.4 x 2.2 cmLEFT LOBE MEASUREMENTS: 3.8 x 1.2 x 1.8 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: The right thyroid lobe contains at least 3 nodules. The largest measures 1.0 by 1.0 x 1.1 cm and is mixed cystic and solid. There is no flow on color Doppler imaging. This nodule is low suspicion and does not meet criteria for FNA, per ATA guidelines. LEFT LOBE: There are 2 nodules on the left both of which are spongiform in appearance. The largest measures 1.0 x 0.6 x 1.1 centimeters and has no flow on color Doppler imaging.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal appearing cervical lymph nodes are seen bilaterally.OTHER: No significant abnormality noted. | Bilateral thyroid nodules measuring less than 1 cm as described above. |
Generate impression based on findings. | 53-year-old female with thyroid nodules. Please evaluate. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.7 x 1.7 x 1.8 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.6 x 1.7 x 2.2 cm.ISTHMUS MEASUREMENTS: The thyroid isthmus measures 0.5 cm in thickness.RIGHT LOBE: 1.4 x 1.1 x 1 cm right upper pole nodule is stable in size and again demonstrates a multicystic appearance compatible with a benign colloid nodule. Additional right lower thyroid pole nodule not measured on the prior exam but similar in appearance measuring 1.6 x 1.4 x 1.5 cm.LEFT LOBE: Multinodular appearance of the left thyroid lobe. Left lower pole thyroid nodule measuring 2.5 x 1.5 x 2.5 cm mildly hypoechoic nodule with small cystic component is similar in size when accounting for changes in technique. Additional spongiform type nodule in the left mid pole measuring 0.9 x 0.6 x 0.9 cm is noted.ISTHMUS: Heterogenous partially cystic nodule of the isthmus measuring 1.2 x 1.2 x 0.6 cm is similar in size (prior 1.4 x 1.4 x 0.7 cm).PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter. Bilateral nodules without significant change in size. |
Generate impression based on findings. | Male 55 years old with acute kidney injury of unclear cause. Evaluate for obstructive uropathy. RIGHT KIDNEY: The right kidney measures 10.0 cm in length. There is no hydronephrosis, shadowing renal stone or suspicious renal mass. The renal parenchyma is normal in echogenicity.LEFT KIDNEY: The left kidney measures 9.8 cm in length. There is no hydronephrosis, shadowing renal stone or suspicious renal mass. The renal parenchyma is normal in echogenicity.OTHER: The bladder is mildly distended and without sonographic abnormality. | Slightly atrophic kidneys. No hydronephrosis. |
Generate impression based on findings. | Female 54 years old Reason: pls study liver, spleen in pt w severe CHF and 1 month h/o abd 'bloating' History: no periph edema; no crackles in lungs, but increasing upper abd fullness x 1 mo in pt w severe CHF LIMITED ABDOMENLIVER: Liver is enlarged measuring 15 cm. Hepatic veins and IVC are dilated. These findings are secondary to patient's known congestive heart failure. No evidence of focal liver lesions. Liver echogenicity is unremarkable.BILIARY TRACT: Gallbladder wall is thickened likely secondary to heart failure. No evidence of cholelithiasis.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Spleen measures 12 cm. There is a hyperechoic area within the spleen measuring 7 mm likely representing a hemangioma. RIGHT KIDNEY: Right kidney measures 11.7 cm. Normal echogenicity. No focal lesions or hydronephrosis.OTHER: Left kidney measures 12 cm. | Hepatomegaly, dilated hepatic veins and IVC secondary to patient's known history of congestive heart failure. Mild splenomegaly. Likely a small hemangioma within the spleen. |
Generate impression based on findings. | Male 26 years old; Reason: 26 yo M with hx of L epididymal cyst and enlarging R epididymal cyst History: Right posterior testicular cyst RIGHT TESTIS: Right testes measures 2.7 x 4.1 x 1.9 cm. Normal color Doppler flow. No focal intratesticular lesion.LEFT TESTIS: Left testes measures 2.7 x 2.7 x 1.9 cm. Normal color Doppler flow. No focal intratesticular lesion.RIGHT EPIDIDYMIS: Right epididymis measures 0.9 x 1.2 x 1.0 cm.LEFT EPIDIDYMIS: Left epididymis measures 1.0 x 1.0 x 1.5 cm. A small anechoic cyst within the epididymis measures 8 x 6 mm representing a small epididymal head cyst. This previously measured 8 x 6 mm and is unchanged.OTHER: No hydrocele. | No evident right epididymal head cyst.Stable 8 mm left epididymal head cyst.No evident intratesticular mass. |
Generate impression based on findings. | Male 64 years old Reason: at the site of port-a-cath, check for abscess/ hematoma History: swelling at the site of port-a-cath There is a complex fluid collection the port pocket. This may represent hematoma, however, an abscess cannot be excluded. The collection measures 3.4 x 1.9 cm. | Complex hematoma sepsis surrounding the port. |
Generate impression based on findings. | Female 83 years old Reason: ?cholecystitis History: ct scan suggestive LIVER: There is a simple cyst measuring 1.6 cm in the right lobe of the liver. There are other small cystic lesions within the liver.GALLBLADDER, BILIARY TRACT: Gallbladder is significantly distended with significant wall thickening, sludge and stones. Sonographic Murphy sign is positive. These findings are consistent with acute cholecystitis. Small amount of sludge is noted.Common bile duct measures 7 mm. There are internal echoes within the common bile duct suggestive of cortical ascites.PANCREAS: Cannot be evaluated due to overlying bowel gas.RIGHT KIDNEY: Slightly echogenic kidney with multiple cysts. No evidence of hydronephrosis.OTHER: No significant abnormalities noted. | Cholelithiasis and acute cholecystitis with small amount of sludge in the common bile duct.Multiple small hepatic cysts. |
Generate impression based on findings. | Abdominal pain and evidence of pancreatitis, please evaluate gallbladder and CBD LIVER: Liver measures 20.8 cm, mildly increased in size with mild increased echogenicity suggestive of hepatic steatosis. No evidence of liver lesions. Hepatic vessels appear patent. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallbladder is well distended with gallbladder wall thickness measuring up to 2 mm. Multiple stones noted within the gallbladder. Common hepatic duct and common bile duct measure 3 and 6 mm respectively, no evidence of any sludge or stones noted within it.PANCREAS: Not visualized due to overlying bowel gas.SPLEEN: Spleen measures 8.5 cm without any focal lesions.RIGHT KIDNEY: Right kidney measures 11.2 and left kidney measures 10.9 cm. No focal lesions noted. No hydronephrosis. OTHER: No ascites | 1. Mild hepatic steatosis.2. Cholelithiasis without evidence of acute cholecystitis. Common bile duct is not dilated without evidence of any sludge or stones within it. If clinically warranted, MRCP can be performed for thorough evaluation of the common bile duct. |
Generate impression based on findings. | Rising bilirubin LIVER: Liver measures 15.9 cm with mild coarse echotexture. No focal lesions noted. Portal vein is patent with normal flow directionality and patency. Common hepatic duct measures up to 4 mm. Mild fluid noted in the Morison's pouch.BILIARY TRACT: No intrahepatic blurred ductal dilatation. Gallbladder is well-distended with normal gallbladder wall thickness measuring up to 2.3 mm.PANCREAS: Head of pancreas visualized appears unremarkable. Body and tail of pancreas is not visualized.SPLEEN: Spleen measures 9 cm without any focal lesions.RIGHT KIDNEY: Right kidney measures 9.6 cm and left kidney measures 11 cm. No hydronephrosis or hydroureter. Normal echotexture noted.OTHER: No significant abnormalities noted. | Mild fluid noted in the Morison's pouch. Gallbladder appears unremarkable. Mildly coarse and echogenic liver, may represent nonspecific fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | NASH staging per intercept, 303 protocol LIVER: Liver measures 17.2 cm with increased echogenicity and coarseness consistent with fatty infiltration not significant changed from prior examination. Limited Doppler interrogation of the main portal vein demonstrates normal flow directionality and patency, 21.4 cm/s.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallbladder appears unremarkable. No evidence of gallstones. Common hepatic duct measures up to 3 mm.PANCREAS: Head of pancreas as visualized appears slightly hyperechoic probably fatty infiltration. Body and tail of pancreas is not visualized due to overlying bowel gas.SPLEEN: Spleen measures 10.3 cm without any abnormality.RIGHT KIDNEY: Right kidney measures 11.2 cm left kidney measures 11 cm. No hydronephrosis OTHER: No ascites | Moderate fatty infiltration of the liver unchanged from prior examination. No ascites |
Generate impression based on findings. | Nonspecific elevation of transaminases and LDH, rule out liver structural abnormalities LIVER: Liver measures 16.4 cm with normal echotexture. No focal lesions noted. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Gallbladder is well-distended without any focal lesions. Gallbladder wall thickness measures up to 3 mm. No evidence of gallstones.PANCREAS: Head and body of pancreas is visualized and appears unremarkable. Tail of pancreas is not visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 9 cmRIGHT KIDNEY: No significant abnormalities noted. Right kidney measures 10 cm and left kidney measures 9.7 cm. No hydronephrosis. Normal echotexture.OTHER: No ascites | Normal echotexture of the liver and kidneys. Portal vein is patent. |