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Generate impression based on findings. | Reason: evaluate for hematoma of the Left Lower Extremity Sonographic images of the anterior superficial soft tissues of the left leg demonstrate a discrete area of soft tissue echogenicity measuring up to 4.8 cm which lacks internal vascularity and is associated with edema in the surrounding superficial soft tissues. The appearance is somewhat atypical for an abscess or hematoma, and is favored to represent a neoplastic process such as a lipoma. | Discrete soft tissue focus within the anterior superficial soft tissues of the leg with associated surrounding soft tissue edema. Appearance is somewhat atypical for a hematoma or abscess, and a neoplastic etiology such as a lipoma is favored. MRI may be considered for additional evaluation as clinically warranted. |
Generate impression based on findings. | History of multinodular goiter, evaluate for change in nodules. RIGHT LOBE MEASUREMENTS: 6.9 x 3.4 x 3.1 cm.LEFT LOBE MEASUREMENTS: 5.6 x 2.2 x 2.3 cm.ISTHMUS MEASUREMENTS: Up to 0.6 cm in thickness.RIGHT LOBE: Heterogeneous echotexture with multiple nodules. Dominant mixed solid and cystic nodule centered in the mid pole measures 3.3 x 2.0 x 2.5 cm, unchanged.LEFT LOBE: Heterogeneous echotexture with multiple nodules. Dominant mixed solid and cystic inferior pole nodule measures 2.2 x 2.2 x 1.4 cm, previously 1.9 x 1.8 x 1.6 cm, perhaps minimally increased in size when allowing for differences in technique.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter appearing similar to prior examination. Minimal increase in size of benign-appearing left inferior pole dominant nodule. |
Generate impression based on findings. | Reason: Hashimoto's, history of subcentimeter thyroid nodules, assess need for FNA RIGHT LOBE MEASUREMENTS: 4.5 x 1.3 x 1.5 cm.LEFT LOBE MEASUREMENTS: 3.8 x 1.0 x 1.6 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Mildly heterogeneous background parenchymal echotexture. Multiple nodules. Superior pole heterogeneous but predominantly hyperechoic nodule measuring 0.9 x 0.7 x 1.1 cm. Midpole hypoechoic nodule with internal coarse calcification measuring 0.7 x 0.5 x 0.8 cm. Inferior pole hyperechoic nodule with hypoechoic halo measuring 0.8 x 0.7 x 0.8 cm. LEFT LOBE: Mildly heterogeneous background parenchymal echotexture. Multiple nodules. Midpole hyperechoic nodule measuring 1.2 x 0.8 x 1.1 cm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Single benign morphology right level 2 cervical lymph node.OTHER: No significant abnormality noted. | 1.Heterogeneous thyroid gland with multiple hyperechoic nodules compatible with clinical history of Hashimoto's thyroiditis.2.Subcentimeter hypoechoic nodule with coarse calcification in right midpole. Continued attention is recommended on subsequent follow-up examinations. |
Generate impression based on findings. | Reason: pre-total pancreatectomy with autologous islet cell transplant due to chronic pancreatitis. Please evaluate abdominal organs and doppler portal vein of the liver to r/o clots and portal vein hypertension. LIVER: The liver measures at least 16 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 0.27 m/s. The right and left portal veins also appear patent.BILIARY TRACT: Gallbladder surgically absent. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: Decreased echogenicity within the visualized portions of the pancreas nonspecific but may be related to chronic pancreatitis.SPLEEN: The measures 12.3 cm in length. RIGHT KIDNEY: Kidney measures 10.4 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.8 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Normal hepatic parenchyma without mass or duct dilatation. Patent portal vein with normal directional flow. |
Generate impression based on findings. | Ms. Pritchett is a 41-year-old female with history of head and neck cancer as well as right breast IDC status post right lumpectomy in 2015 followed by chemotherapy and radiation therapy. Patient also has a history of left breast reconstruction. Patient presenting for short-term evaluation of a prominent left axillary lymph node identified on CT dated 9/2/2016. Ultrasound evaluation of the left axilla redemonstrates a normal morphology lymph node measuring 1.1 x 0.6 x 1.1 cm, with normal hilar vascular flow. This lymph node appears stable in appearance dating back to prior ultrasound study of 9/14/2016. | Normal-appearing left axillary lymph node stable in appearance dating back to 9/14/2016. No sonographic evidence for malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually, due May 2017. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | Reason: evaluate thyroid cysts History: evaluate for growth RIGHT LOBE MEASUREMENTS: 6.7 x 3.3 x 2.9 cm.LEFT LOBE MEASUREMENTS: Asymmetrically small measuring 3.4 x 1.1 x 1.0 cm.ISTHMUS MEASUREMENTS: Up to 2 mm in thickness.RIGHT LOBE: Mildly heterogeneous background parenchymal echotexture. Multiple predominantly cystic nodules. The largest is in the superior pole measuring 2.3 x 1.3 x 1.5 cm and is entirely cystic, compatible with benignity. LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Calcified plaque incidentally noted in the right carotid artery near the bifurcation. | 1.Multiple benign morphology predominantly cystic nodules within the right thyroid.2.Calcified plaque incidentally noted in the right carotid artery near the bifurcation. Dedicated vascular imaging can be considered as clinically warranted. |
Generate impression based on findings. | Reason: Cholelithiasis? History: Abdominal pain Examination mildly limited due to body habitus.LIVER: The liver measures 18.6 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 without gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: Not well-visualized.SPLEEN: No significant abnormalities noted. The spleen measures 11.8 cm in length. RIGHT KIDNEY: Kidney measures 12.4 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 13.5 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis or biliary ductal dilatation.2.Mild hepatomegaly and increased hepatic echogenicity raising possibility of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | Reason: patient w/ etoh history, elevated LFTs, INR, evaluate for cirrhosis History: elevated LFTs LIVER: The liver measures 18.0 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.15 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 3 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 9.5 cm in length. RIGHT KIDNEY: Kidney measures 13.5 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 12.2 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Trace perihepatic ascites. | Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. Trace perihepatic ascites. |
Generate impression based on findings. | Reason: assess for liver lesions History: HCV and mild cirrhosis LIVER: The liver measures 13.3 cm in length and is mildly nodular in contour. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.17 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 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 7.1 cm in length. RIGHT KIDNEY: Kidney measures 9.4 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.5 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | Mildly cirrhotic liver morphology without suspicious focal lesions identified. No ascites. |
Generate impression based on findings. | Reason: Looking for an explanation of this woman's epigastric and left upper abdominal pain that radiates into her back. History: 31 year old woman with recent onset of a dull pain in the epigastrium and left upper quadrant pain that radiates into her back. EGD yesterday gave no explanation. Pancreatic enzymes were normal. LIVER: The liver measures 15.8 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 0.35 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 2 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.1 cm in length. RIGHT KIDNEY: Kidney measures 10.4 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.1 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of acute cholecystitis or other specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: 51 y.o. F with thyroid nodule. Please evaluate. RIGHT LOBE MEASUREMENTS: 4.5 x 2.1 x 2.6 cm.LEFT LOBE MEASUREMENTS: 2.6 x 0.9 x 1.1 cm.ISTHMUS MEASUREMENTS: Measures up to 0.2 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture. Predominantly solid nodule within the mid pole measures 3.0 x 1.7 x 2.6 cm, is predominantly isoechoic, demonstrates internal vascularity, and lacks suspicious microcalcifications. Overall, nodule is of intermediate suspicion for neoplasm.LEFT LOBE: Normal background parenchymal echotexture. Subcentimeter solid, hypoechoic nodule within the inferior pole measuring 0.4 x 0.3 x 0.4 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are couple mildly prominent left cervical lymph nodes which demonstrate fatty hila, favor reactive. Left level 3 lymph node measures 1.2 x x 0.6 x 0.9 cm. Left level 4 lymph node measures 1.0 x 2.2 x 1.0 cm.OTHER: No significant abnormality noted. | Dominant right thyroid nodule measuring up to 3.0 cm of intermediate suspicion for neoplasm and which would be amenable to fine-needle aspiration. |
Generate impression based on findings. | History of esophageal cancer with prior lymph node metastases status post treatment, evaluate for cervical lymphadenopathy or thyroid nodules. RIGHT LOBE MEASUREMENTS: 5.2 x 1.4 x 2.3 cm.LEFT LOBE MEASUREMENTS: 4.3 x 1.6 x 2.1 cm.ISTHMUS MEASUREMENTS: Up to 0.4 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture. Hypoechoic nodule within the midpole measuring 0.8 x 0.5 x 0.6 cm with internal reflectors suggestive of colloid, favor benign.LEFT LOBE: Normal background parenchymal echotexture. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No cervical lymphadenopathy identified.OTHER: No significant abnormality noted. | Single right subcentimeter thyroid nodule, favor benign. No cervical lymphadenopathy identified. |
Generate impression based on findings. | Reason: abnormal liver function tests LIVER: The liver measures 15.0 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.21 m/s.BILIARY TRACT: Sludge is present within the gallbladder without associated significant gallbladder wall thickening. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.1 cm in length. RIGHT KIDNEY: Kidney measures 9.9 cm in length. Increased cortical echogenicity. No hydronephrosis. Renal sinus cyst.LEFT KIDNEY: Kidney measures 12.0 cm in length. Increased cortical echogenicity. No hydronephrosis. OTHER: Mild ascites. | 1.Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. 2.Gallbladder sludge without evidence of cholecystitis.3.Mild ascites, new from April 2016 CT.4.Echogenic kidneys suggestive of medical renal disease. |
Generate impression based on findings. | Reason: Cirrhosis History: hx of hepatitis C with high viral load LIVER: The liver measures 20.3 cm in length and is mildly nodular in contour. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.37 m/s.BILIARY TRACT: Gallbladder surgically absent. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11.4 cm in length. RIGHT KIDNEY: Kidney measures 10.1 cm in length. Increased cortical echogenicity. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.6 cm in length. Increased cortical echogenicity. No hydronephrosis. Renal cyst measuring up to 2.2 cmOTHER: Trace ascites. | 1.Cirrhotic liver without focal lesions identified. Trace ascites.2.Increased renal echogenicity raising possibility of medical renal disease. |
Generate impression based on findings. | Reason: familial adenomatous polyposis; increased risk of thyroid cancer. RIGHT LOBE MEASUREMENTS: 6.1 x 2.1 x 2.2 cm.LEFT LOBE MEASUREMENTS: 4.9 x 2.0 x 1.5 cm.ISTHMUS MEASUREMENTS: Measures up to 0.2 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture without discrete nodules.LEFT LOBE: Normal background parenchymal echotexture without discrete nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious cervical lymphadenopathy identified.OTHER: No significant abnormality noted. | No worrisome thyroid nodule or regional adenopathy. |
Generate impression based on findings. | Reason: 75 yo F with EtOH abuse presents with acute onset thrombocytopenia, evaluate for cirrhosis/liver pathology. Examination mildly limited by patient motion.LIVER: The liver measures 15.5 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Gallbladder sludge and cholelithiasis without associated wall thickening or pericholecystic fluid. 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 6.7 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | 1.Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration.2.Cholelithiasis without evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Reason: rule out change in size of nodules RIGHT LOBE MEASUREMENTS: 5.7 x 2.2 x 2.8 cm.LEFT LOBE MEASUREMENTS: 4.9 x 1.9 x 2.0 cm.ISTHMUS MEASUREMENTS: Up to 0.8 cm in thickness.RIGHT LOBE: Heterogeneous parenchymal echotexture with increased vascularity. No suspicious focal nodules identified.LEFT LOBE: Heterogeneous parenchymal echotexture with increased vascularity. No suspicious focal nodules identified.ISTHMUS: Heterogeneous parenchymal echotexture with increased vascularity. No suspicious focal nodules identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mildly enlarged, heterogeneous thyroid gland with increased vascularity suggestive of thyroiditis. No suspicious discrete nodules identified. |
Generate impression based on findings. | Cirrhosis LIVER: Cirrhotic morphology again noted without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 16 cm.BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 20 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 12.9 cm in lengthOTHER: Left kidney 12.8 cm in length. No ascites. | Stable cirrhotic morphology without mass or ductal dilatation. No ascites. Cholelithiasis without acute inflammation. |
Generate impression based on findings. | Reason: history of right nodule + FNA for papillary carcinoma, need for lymph node mapping (central and lateral neck) RIGHT LOBE MEASUREMENTS: 4.8 x 1.5 x 1.4 cm.LEFT LOBE MEASUREMENTS: 3.0 x 1.0 x 1.0 cm.ISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: Right inferior pole nodule measuring 2.0 x 1.7 x 1.2 cm which demonstrates irregular margins, heterogeneous internal echotexture, microcalcifications, and internal vascularity. This nodule is compatible with reported history of papillary carcinoma. LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are several abnormal morphology lymph nodes which are suspicious for metastatic disease, many of which contain microcalcifications. Abnormal lymph nodes are located within the right level 2, right level 3, right level 4, and bilateral level 6 stations. Furthermore, the abnormal level 6 lymph nodes extend inferior to the sternal notch, and the inferior extent is not visualized.No abnormal lymph nodes are identified within the left level 2, left level 3, left level 4, or bilateral level 5 stations.OTHER: No significant abnormality noted. | Right inferior pole dominant nodule compatible with history of papillary thyroid carcinoma. Associated lymphadenopathy suspicious for metastatic disease in the right level 2, right level 3, right level 4, and bilateral level 6 stations. The abnormal level 6 lymph nodes extend inferior to the sternal notch, and the inferior extent is not visualized. |
Generate impression based on findings. | Reason: Hepatitis C, evaluate for cirrhosis and splenomegaly. LIVER: The liver measures 19.2 cm in length and is nodular in contour. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.18 m/s.BILIARY TRACT: Cholelithiasis without 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 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.1 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.3 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Cirrhotic liver morphology without suspicious focal mass. No ascites. Cholelithiasis without acute inflammation. |
Generate impression based on findings. | Multiple myeloma with increasing LFTs LIVER: Mildly coarse echogenic liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 13.2 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 8 cm in length.RIGHT KIDNEY: No significant abnormalities noted. 9.8 cm in length.OTHER: Left kidney 8.1 cm in length. No ascites. | Mildly heterogeneous and coarse liver echotexture; these findings may be representativeof fatty infiltration or parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Reason: evaluate left facial mass; r/o parotid mass History: left facial swelling At the site of the patient's reported palpable abnormality in the superficial soft tissues of the left preauricular area, there is an ovoid mass measuring 2.7 x 1.4 x 2.4 cm which is heterogeneous but predominantly hypoechoic and lacks internal vascularity. The mass demonstrates an apparent "tail" extending to the skin surface. | Avascular mass within the superficial left preauricular region, favor benign etiology such as a sebaceous cyst. |
Generate impression based on findings. | Reason: is there hepatic/GB abnormality History: epigastric pain LIVER: The liver measures 15.3 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. There is a round, hypoechoic area within the right lobe of the liver measuring up to approximately 4 cm seen only on a single image; it is unclear whether this is artifactual or represents a focal hepatic lesion. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.34 m/s.BILIARY TRACT: Cholelithiasis without associated significant gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic biliary ductal dilatation. The common bile duct is mildly prominent both proximally and distally measuring up to 9 mm. No shadowing choledocholithiasis identified.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 10.3 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.8 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis. Prominent common bile duct without shadowing choledocholithiasis identified but distal CBD not well assessed due to adjacent bowel gas. MRCP may be considered for additional evaluation as clinically warranted.2.Increased hepatic echogenicity raising the possibility of parenchymal dysfunction/fatty infiltration.3.Possible hepatic lesion versus artifact in the right hepatic lobe (or possibly the right kidney).Findings discussed with the inpatient service, APN Anna at 8:48 a.m. on 12/15/16; possible hepatic lesion to be evaluated on forthcoming contrast-enhanced MRI/MRCP using liver protocol. |
Generate impression based on findings. | Reason: h/o liver cyst s/p drainage please evaluate for cyst History: rare RUQ pain LIVER: The liver measures 15.8 cm in length, decreased from previously. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. Multiple hepatic cysts are again noted, some of which demonstrate minimal internal complexity such as thin septations. The previously described largest right lobe cyst is no longer visualized. The largest currently is in the right lobe measuring up to 12.4 x 11.8 x 10.6 cm, similar to prior. Additional smaller cysts are present in the right and left hepatic lobes. The previously seen left hepatic lobe cystic lesion with internal complex contents is no longer visualized. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 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 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 11.2 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Decrease in number of hepatic cysts following drainage as described above. The largest cyst currently is in the right hepatic lobe measuring up to 12.4 cm.2.Increased hepatic echogenicity suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | Female 33 years old follow-up right renal mass (1.3 cm), stable on MRI. RIGHT KIDNEY: The right kidney measures 10.5 cm in length. There is a 1.6 x 1.6 x 1.4 cm hypoechoic lesion in the midpole of the right kidney with low-level internal echoes and no vascularity. The superior pole of the right kidney appears heterogeneous which may be due to a prominent medullary pyramid. No lesion was present at this location on the prior MRI. No shadowing renal stone hydronephrosis.LEFT KIDNEY: The left kidney measures 11.4 cm in length. There is no suspicious renal mass, shadowing renal stone or hydronephrosis.OTHER: The bladder was mildly distended and unremarkable in appearance.A 2.4 x 1.5 x 1.9 cm well marginated hyperechoic subcapsular hepatic segment 7 lesion which correlates with a hemangioma seen on the previous MRI. | 1. Right midpole renal lesion is likely unchanged in size from the prior MRI after allowing for differences in technique.2. The superior pole of the right kidney appears heterogeneous which is nonspecific and may be due to a prominent medullary pyramid. No lesion was present at this location on the prior MRI. |
Generate impression based on findings. | Reason: elevated LFTs - assess for fatty change and cirrhosis History: Occasional RUQ pain LIVER: The liver measures 19.8 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.17 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 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: The spleen measures 11.7 cm in length. There is a slightly hypoechoic, round lesion within the spleen measuring 4.1 x 3.6 x 3.9 cm which demonstrates mild internal vascularity and lacks posterior acoustic enhancement, suggesting that this is a solid lesion.RIGHT KIDNEY: Kidney measures 12.8 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 13.5 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Increased hepatic echogenicity suggestive of fatty infiltration/parenchymal dysfunction.2.Indeterminant solid appearing lesion within the spleen. In the absence of known malignancy, statistically this most likely represents a benign lesion. |
Generate impression based on findings. | Reason: evaluate for HCC History: HCV cirrhosis LIVER: The liver measures 14.3 cm in length and is nodular in contour. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: The spleen measures 14.7 cm in length. Coarse calcification within the spleen.RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.3 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | Cirrhotic liver morphology without focal lesions identified. Mild splenomegaly. No ascites. |
Generate impression based on findings. | Reason: renal cyst RIGHT KIDNEY: Kidney measures 8.4 cm in length. Increased cortical echogenicity. No hydronephrosis or shadowing calculus. Lower pole subcentimeter cyst, not definitively visualized on the prior examination.LEFT KIDNEY: Kidney measures 10.1 cm in length. Increased cortical echogenicity. No hydronephrosis or shadowing calculus. Midpole exophytic cyst measuring 1.2 x 1.1 x 1.0 cm, not significantly changed. Lower pole exophytic cyst measuring 1.5 x 1.7 x 1.5 cm, not significant changed.OTHER: No significant abnormalities noted. | 1.Renal cysts, as described above and not significantly changed.2.Increased renal echogenicity suggestive of medical renal disease. |
Generate impression based on findings. | Reason: Diagnosed with papillary carcinoma, please evaluate lymph nodes History: PTC RIGHT LOBE MEASUREMENTS: 4.7 x 1.6 x 1.7 cm.LEFT LOBE MEASUREMENTS: 4.8 x 1.4 x 1.3 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture. Nodule within the midpole measuring 1.3 x 1.3 x 1.5 cm which is predominantly isoechoic, contains internal vascularity, and has a hypoechoic halo. Per electronic medical record, this nodule reportedly corresponds to biopsy-proven papillary carcinoma.LEFT LOBE: Normal background parenchymal echotexture. Nodule within the lower pole measuring 1.6 x 1.4 x 1.4 cm which is predominantly isoechoic, demonstrates peripheral vascularity, has a hypoechoic halo, and lacks definite suspicious microcalcifications. Per electronic medical record, this nodule reportedly corresponds to a biopsy-proven benign follicular nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No cervical lymph nodes are identified.OTHER: No significant abnormality noted. | Bilateral dominant thyroid nodules as described above. No lymphadenopathy identified. |
Generate impression based on findings. | 25-year-old female presenting for ultrasound evaluation of a right periareolar palpable lump, first detected approximately 1 month ago. Targeted ultrasound at the area of palpable concern as indicated by the patient, 3:00 position 2 cm from the nipple, reveals no suspicious solid or cystic mass. | No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: Gallbladder activity on PET done for lymphoma staging-evaluate for inflammation vs solid mass. Asymptomatic. LIVER: The liver measures 15.7 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 0.2 m/s.BILIARY TRACT: No cholelithiasis. Gallbladder mildly contracted which somewhat limits evaluation, but no abnormal gallbladder wall thickening identified; visualized lumen unremarkable. 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 7.1 cm in length. RIGHT KIDNEY: Limited visualization. Kidney measures 8.5 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.1 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of acute cholecystitis or abnormal gallbladder wall thickening. |
Generate impression based on findings. | Reason: Nodules or abnormal nodes? History: Germline ret mutation (MEN2) RIGHT LOBE MEASUREMENTS: 4.6 x 0.9 x 2.0 cm.LEFT LOBE MEASUREMENTS: 3.9 x 1.1 x 1.5 cm.ISTHMUS MEASUREMENTS: Up to 14 mm in thickness.RIGHT LOBE: Background parenchymal echotexture within normal limits without suspicious nodules.LEFT LOBE: Background parenchymal echotexture within normal limits without suspicious nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No lymphadenopathy identified.OTHER: No significant abnormality noted. | Unremarkable appearance of the thyroid gland without suspicious nodule or lymphadenopathy. |
Generate impression based on findings. | Reason: thyroid nodule on left thyroid lobe seen on CT. RIGHT LOBE MEASUREMENTS: 5.0 x 1.6 x 1.5 cm.LEFT LOBE MEASUREMENTS: 4.4 x 1.3 x 1.5 cm.ISTHMUS MEASUREMENTS: Up to 0.35 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture without suspicious nodules.LEFT LOBE: Normal background parenchymal echotexture. Inferior pole nodule which appears to be within the thyroid gland measuring 1.5 x 1.3 x 1.3 cm and which is slightly hypoechoic, contains internal vascularity, and has a hypoechoic halo. Overall, this nodule is of intermediate suspicion for neoplasm. Alternatively but less likely, this nodule could be extrathyroidal.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Few mildly prominent benign morphology left cervical lymph nodes, favor reactive.OTHER: No significant abnormality noted. | Left inferior pole nodule, probably within thyroid, of intermediate suspicion for neoplasm and which would be amenable to fine-needle aspiration. Correlation with patient's clinical history/laboratory values also recommended to exclude possibility of parathyroid adenoma, for which further evaluation with nuclear medicine scintigraphic imaging may be pursued if clinically indicated. |
Generate impression based on findings. | 35-year-old female with history of left lower inner palpable lump, previously negative diagnostic ultrasound examination at outside hospital. Patient denies any residual palpable abnormality in her left breast, and presents for repeat left breast ultrasound. Targeted ultrasound along the 9:00, 8:00, 7:00 and 6:00 radiants reveals no solid or cystic mass. | No sonographic evidence of malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 1 - Negative.RECOMMENDATION: CD - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: history of liver disease, ?cirrhosis History: abnormal liver function tests LIVER: The liver measures 15.8 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.31 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 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 7.9 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | Reason: rule out hepatic abnormality. Pt with elevated liver enzymes, history of hepatitis B. LIVER: The liver measures 17.6 cm in length. The liver demonstrates mildly increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.22 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 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.2 cm in length. RIGHT KIDNEY: Kidney measures 12.0 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.8 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Mildly increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. No evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Reason: Right thyroid nodule RIGHT LOBE MEASUREMENTS: 6.9 x 2.2 x 2.1 cm.LEFT LOBE MEASUREMENTS: 6.2 x 2.3 x 1.5 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Numerous nodules are present within the right lobe of the thyroid, the majority of which are partially solid/cystic. There is a dominant nodule within the upper pole measuring 3.6 x 1.5 x 2.9 cm which is predominantly solid, slightly hypoechoic, contains internal vascularity, and lacks definite suspicious microcalcifications. Overall, the nodule is of intermediate suspicion for neoplasm.LEFT LOBE: Normal background parenchymal echotexture. No suspicious nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No cervical lymphadenopathy identified.OTHER: No significant abnormality noted. | Multiple nodules within the right thyroid. Right upper pole dominant nodule measuring up to 3.6 cm of intermediate suspicion for neoplasm and would be amenable to fine needle aspiration. |
Generate impression based on findings. | Reason: history of thyroid nodules History: enlargement of neck RIGHT LOBE MEASUREMENTS: 4.4 x 1.3 x 1.4 cm.LEFT LOBE MEASUREMENTS: 4.4 x 1.1 x 1.1 cmISTHMUS MEASUREMENTS: Up to 0.2 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture without suspicious nodules.LEFT LOBE: Normal background parenchymal echotexture. Single hypoechoic nodule within the upper pole measuring 0.3 x 0.2 x 0.4 cm which contains punctate reflectors, favor benign colloid nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology subcentimeter right level 3 cervical lymph node. OTHER: No significant abnormality noted. | Thyroid normal in size without suspicious nodules. |
Generate impression based on findings. | 31-year-old male with history of kidney transplant now with elevated creatinine. Two passes were made. Please refer to procedural report for additional details. | Ultrasound guidance provided for renal biopsy by nephrology service. |
Generate impression based on findings. | History of hepatic adenoma status post excision now with epigastric abdominal pain. LIVER: The liver measures 12.8 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 0.29 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Sonographic Murphy's sign was negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.8 cm in length. RIGHT KIDNEY: Kidney measures 11.7 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.8 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No focal hepatic lesions or forthcoming cause of patient's pain identified. |
Generate impression based on findings. | Reason: s/p LVAD, drive line infection, please assess fluid collection around drive line site History: pain and drainage at site Within the superficial soft tissues of the right lower quadrant anterior abdominal wall, there is a 2.8 x 2.6 x 1.2 cm complex fluid collection medial to the LVAD drive line with increased vascularity in the surrounding soft tissues. | Findings concerning for superinfected fluid collection or abscess measuring up to 2.8 cm around and adjacent to the drive line.Findings were communicated to the emergency department staff via the stat consult system and acknowledged by Dr. Shah. |
Generate impression based on findings. | Reason: distended abdomen; r/o hepatomegaly, ascites LIVER: The liver measures 17.8 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.27 m/s.BILIARY TRACT: Gallbladder not visualized and may be surgically absent. 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 8.5 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.7 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. No ascites. |
Generate impression based on findings. | Reason: history of total thyroidectomy T3N1b thyroid cancer, now with recurrent disease. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy.LEFT LOBE: Status post thyroidectomy. Within the inferior thyroidectomy bed, there is an irregular shaped hypoechoic region measuring approximately 2.0 x 2.1 x 1.0 cm which is thought to correspond with the area of increased metabolic activity on recent outside PET scan.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level IV 1.1 x 0.4 x 0.9 cm and left level V 1.0 x 0.3 x 0.7 cm lymph nodes, favor benign morphology.OTHER: No significant abnormality noted. | Irregular soft tissue mass within left inferior thyroidectomy bed which appears to correspond to hypermetabolic activity on outside PET, suspicious for recurrent or residual disease and was subsequently biopsied. |
Generate impression based on findings. | 19-year-old female with history of right breast palpable lump, with history of bilateral benign morphology masses, one of which revealed fibroadenoma on prior FNA. Patient presenting for follow-up evaluation of both breast masses to ensure stability. A new area of palpable concern indicated by patient's physician is located in the lower inner right breast. On physical examination, a mobile smooth surfaced palpable lump is identified in the right upper outer breast, and left upper breast, in patient's palpable area of concern.Targeted ultrasound of the right breast, 10:00 position 5 cm from the nipple, reveals a 1.4 x 0.8 x 1.4 cm oval parallel hypoechoic mass with posterior acoustic enhancement and mild internal vascularity. Findings are stable in size and appearance and compatible with fibroadenoma.Targeted ultrasound of the right breast, 8:00 position 3 cm from the nipple, patient's physician area of concern. There is no underlying cystic or solid mass.Targeted ultrasound of the left breast at the 12:00 position 5 cm from the nipple, redemonstrates a 2.0 x 1.4 x 1.4 cm gently lobulated circumscribed hypoechoic avascular mass, FNA proven fibroadenoma. This mass also appears stable in size. | Stable bilateral benign morphology masses bilaterally, the left mass corresponding to FNA proven fibroadenoma. No sonographic correlate at new area of concern indicated by patient's physician in the right breast. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: Evaluate for cholecystitis/docholithiasis History: Abdominal pain. Pancreatic and cbd dilation on ct. Possible ampullary cancer vs impacted gallstone. BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter. No shadowing choledocholithiasis identified.PANCREAS: Pancreas is largely obscured. There appears to be mild prominence of the proximal pancreatic duct as seen on recent CT. | No evidence of acute cholecystitis or significant biliary ductal dilatation. Mildly prominent proximal pancreatic duct as seen on same-day CT. If there is continued clinical concern for an ampullary process or choledocholithiasis, MRCP can be considered as clinically warranted. |
Generate impression based on findings. | Reason: r/o growth, adenopathy History: bilateral thyroid nodules. 1 year follow up study RIGHT LOBE MEASUREMENTS: 5.0 x 1.9 x 1.5 cm.LEFT LOBE MEASUREMENTS: 4.9 x 1.3 x 1.8 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Mid pole partially solid, partially cystic nodule measuring 1.5 x 1.6 x 1.4 cm, not significantly changed.LEFT LOBE: Upper pole predominantly solid, hyperechoic nodule measuring 1.5 x 0.6 x 1.0 cm, previously 1.3 x 0.9 x 0.8 cm, not significantly changed in size allowing for differences in technique. Overall, nodule is of low suspicion for neoplasm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology left cervical lymph node.OTHER: No significant abnormality noted. | No significant change in bilateral thyroid nodules as described above. |
Generate impression based on findings. | Reason: Abdominal U/S to help rule out gallstones; Ongoing pelvic and abdominal pain. Recent abdominal xray suggestive of gallstones. LIVER: The liver measures 14.7 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 0.35 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 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 6.0 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | No evidence of cholelithiasis, acute cholecystitis, or biliary ductal dilatation. |
Generate impression based on findings. | Reason: liver lesion, ? cyst, renal cysts LIVER: The liver measures 14.3 cm in length. The liver parenchymal echotexture is normal. Two hyperechoic sharply marginated lesions are present within the right hepatic lobe. The first measures 0.9 x 1.0 x 0.7 cm and the second measures 1.8 x 1.2 x 1.2 cm which appear to correspond to hypoattenuating lesions on 2014 CT and appear similar in size. These are most compatible with a benign etiology such as hemangiomas. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.17 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 1 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 6 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal cortical echotexture. No hydronephrosis. Subcentimeter interpolar simple cyst.OTHER: No significant abnormalities noted. | Two hyperechoic hepatic lesions, favor benign etiology such as hemangiomas given apparent stability compared to 2014 CT. Left simple renal cyst. |
Generate impression based on findings. | History of proteinuria and hematuria, ultrasound guidance for renal biopsy. Ultrasound guidance was provided for percutaneous biopsy of left kidney. Three passes were performed. | Ultrasound guidance for percutaneous biopsy of left kidney. |
Generate impression based on findings. | History of acute kidney injury on chronic kidney disease. Ultrasound guidance was provided for percutaneous biopsy of right kidney. Three passes were performed. | Ultrasound guidance for percutaneous biopsy of right kidney. |
Generate impression based on findings. | Ms. Johnson is a 48 year old female with a personal history of right breast mastectomy with implant-based reconstruction in 03/2014 for IDC/DCIS. She presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for the left breast and images were reviewed on an independent workstation. In the left inferior breast, there is a lobulated hypoechoic mass identified measuring approximately 0.8 x 0.4 cm. Left breast implant partially visualized. | Incompletely characterized 0.8 cm mass in the left inferior breast. Additional imaging, including spot compression views and dedicated ultrasound, are recommended for further evaluation. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Reason: Abdominal fullness in RLQ with history of multiple abdominal surgeries. Within the superficial soft tissues of the lower anterior abdominal wall, there is a large ovoid hypoechoic collection with thin internal septations as well as low level internal echoes. Overall, the collection measures approximately 28 x 5 cm. The collection is composed of a larger right component measuring approximately 17.8 cm in length and is smaller left component measuring 9.6 cm in length. The collection lacks internal vascularity or surrounding increased vascularity. | Large collection within the anterior abdominal wall measuring up to 28 cm, favor postoperative collection such as seroma. |
Generate impression based on findings. | Reason: r/o growth of nodule, adenopathy History: h/o nodule with coarse calcifications RIGHT LOBE MEASUREMENTS: 4.3 x 1.3 x 1.3 cm.LEFT LOBE MEASUREMENTS: 5.0 x 1.2 x 1.4 cm.ISTHMUS MEASUREMENTS: Up to 0.1 cm in thickness.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: Predominantly hypoechoic nodule with peripheral calcifications measures 1.4 x 0.8 x 0.9 cm, unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant lymphadenopathy seen.OTHER: No significant abnormality noted. | No significant change in left lower pole thyroid nodule. |
Generate impression based on findings. | Reason: assess for liver dysfunction History: elevated liver enzymes, history of hepatitis C LIVER: The liver measures 14.3 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.24 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 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.3 cm in length. RIGHT KIDNEY: Kidney measures 11.5 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration without focal masses identified. No ascites. |
Generate impression based on findings. | History of HCV, screening for hepatocellular carcinoma. LIVER: The liver measures 14.2 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.8 cm in length. RIGHT KIDNEY: Kidney measures 10.1 cm in length. Normal cortical echotexture. No hydronephrosis. Unchanged cortical cyst measuring up to 1.0 cm.LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Echogenic hepatic parenchyma suggesting chronic liver disease without focal hepatic lesion. No ascites. |
Generate impression based on findings. | Reason: splenomegaly-evaluate liver, spleen and portal flow. LIVER: The liver measures 19.3 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 m/s.BILIARY TRACT: Gallbladder surgically absent. Mild prominence of the common bile duct measuring up to 10 mm, not unexpected status post cholecystectomy. No intrahepatic biliary ductal dilatation.PANCREAS: Obscured by bowel gas.SPLEEN: The spleen is enlarged measuring 16.3 cm in length.RIGHT KIDNEY: Kidney measures 12.2 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 13.2 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | 1.Mild hepatomegaly. Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration. No ascites.2.Mild prominence of the common bile duct which is not unexpected status post cholecystectomy. |
Generate impression based on findings. | Reason: Evaluate for cholecystitis History: Abdominal pain, nausea, vomiting. Also history of pancreatitis. LIVER: The liver measures 12.9 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.27 m/s.BILIARY TRACT: Cholelithiasis without 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: Within the proximal pancreatic body, there is a well-defined hypoechoic mass measuring 3.4 x 3.0 x 3.5 cm which appears solid but lacks visible internal vascularity. The more distal pancreas is obscured by bowel gas. The more proximal pancreatic duct does not appear dilated.SPLEEN: No significant abnormalities noted. The spleen measures 9.2 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Cholelithiasis without sonographic evidence of acute cholecystitis.2.Pancreatic lesion measuring up to 3.5 cm which is incompletely characterized. Differential considerations include pancreatic cancer or pseudocyst. MRCP is recommended for additional evaluation.3.Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration.Discussed with Dr. JACOBS, JEFFREY. |
Generate impression based on findings. | 66-year-old male with question of abnormal mass over the left lateral epicondyle. Physical examination demonstrates a hard, palpable abnormality overlying the lateral epicondyle.No soft tissue mass is evident as clinically queried. Irregular cortical margin of the lateral epicondyle corresponding to that seen on the prior radiograph is compatible with history of prior trauma. Shadowing foci overlying the radiocapitellar joint correlates with well-corticated ossicles seen on radiograph. | No soft tissue mass is evident as clinically queried. Findings reflecting prior trauma and osteoarthritis as described above correlating with that seen on the prior radiograph. An orthopedic consult/MR elbow may be considered if clinically warranted. |
Generate impression based on findings. | 71-year-old female. Evaluate thyroid nodules and parathyroid adenoma. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 2.3 x 2.1 x 5.9 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 2.7 x 2.4 x 6.1 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.3 cm in thickness.RIGHT LOBE: The right thyroid lobe has a heterogenous echotexture without discrete nodules.LEFT LOBE: The left thyroid lobe has a heterogenous echotexture. In the left lower pole, there is a 1 x 1.4 x 1 cm spongiform nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Posterior to the left upper thyroid pole is a 1.2 x 1 x 1.8 cm hypoechoic nodule concerning for a parathyroid adenoma candidate.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Posterior to the left upper thyroid pole is a 1.2 x 1 x 1.8 cm hypoechoic nodule concerning for a parathyroid adenoma candidate. Correlation with the same day nuclear medicine parathyroid scan is recommended.2. Spongiform nodule in the left lower pole.3. Enlarged thyroid gland with nonspecific heterogenous echotexture. Clinical correlation is needed for possible thyroiditis. |
Generate impression based on findings. | 19-year-old female with family history of breast cancer in maternal and paternal grandmother. Patient has a history of left upper outer benign appearing, compatible with fibroadenoma. Targeted ultrasound of the left breast 11:00 6 cm from the nipple, redemonstrates a 1.2 x 0.7 x 1.3 cm oval circumscribed parallel predominately hypoechoic mass with posterior acoustic enhancement and mild internal vascularity.There is no suspicious solid or cystic mass. | Stable benign-appearing left upper inner breast mass, with imaging characteristics compatible with fibroadenoma.No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Alcoholic cirrhosis LIVER: Cirrhotic morphology without mass. Limited Doppler interrogation the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 16.7 cm.BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.9 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.4 cm in lengthOTHER: Left kidney 11.2 cm in length. Mild ascites. | Cirrhotic morphology without mass or ductal dilatation. Gallbladder sludge without acute inflammation. Mild ascites. |
Generate impression based on findings. | HBV LIVER: Mildly heterogeneous liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 21 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 12.7 cm in lengthOTHER: Left kidney 12.6 cm in length. No ascites. | Heterogeneous liver echotexture with mild hepatomegaly again noted without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Evaluate left renal cyst RIGHT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Right kidney 11.3 cm in lengthLEFT KIDNEY: Stable minimally complex left renal cyst measuring 6.9 x 6 x 5.4 cm. Normal parenchymal echogenicity without worrisome mass, stone, or hydronephrosis. Left kidney 13.1 cm in length.OTHER: No significant abnormalities noted. | Stable minimally complex left renal cyst. |
Generate impression based on findings. | HBV LIVER: Coarse liver echotexture again noted without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 13.8 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 8.3 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10 cm in lengthOTHER: Left kidney 10.2 cm in length no ascites | Mildly coarse liver echotexture again noted without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Elevated LFTs with abdominal pain LIVER: Normal parenchymal echogenicity without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 16.1 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.5 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 11.3 cm in lengthOTHER: Left kidney 10.4 cm in length. No ascites | Negative right upper quadrant abdominal ultrasound. No evidence for acute hepatobiliary abnormality. No ascites. |
Generate impression based on findings. | Possible hepatitis C and thrombocytopenia with edema LIVER: 6.1 x 4.1 x 5.2 cm heterogeneous solid mass arising from segments 2/3 left lobe of the liver. Multiple well-circumscribed bilobar echogenic foci; the largest within the right lobe measures 3.2 x 3.6 x 3 cm.Background liver demonstrates normal morphology without cirrhosis. Limited main portal vein Doppler interrogation demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.5 cm in lengthRIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. Right kidney 8.1 cm in length. OTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. Left kidney 9 cm in length. No ascites. | Heterogeneous mass arising from left lobe of the liver; a malignant etiology, either primary or metastatic, must be considered. Would recommend correlation with contrast CT examination.Multiple bilobar well-circumscribed echogenic foci; favor hemangiomas.Background liver morphology unremarkable. Gallbladder sludge without acute inflammation or ductal dilatation. No ascites.Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis.Results communicated to Dr. Frohne 12/20/2016; 13:30. |
Generate impression based on findings. | Papillary thyroid carcinoma RIGHT LOBE MEASUREMENTS: 5.1 x 1.8 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.5 x 1.3 x 1.2 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: 0.9 x 0.8 x 1.2 cm hypoechoic mid gland nodule with indistinct borders.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Hypoechoic mid right gland nodule with indistinct borders presumably representing the clinically known appendectomy thyroid carcinoma. No other thyroid nodules appreciated. No regional adenopathy. |
Generate impression based on findings. | Neck discomfort RIGHT LOBE MEASUREMENTS: 6.1 x 2.3 x 3.4 cmLEFT LOBE MEASUREMENTS: 5 x 2.3 x 2.5 cmISTHMUS MEASUREMENTS: 1.7 cmRIGHT LOBE: Diffusely heterogeneous and enlarged right thyroid gland with increased vascularity. No convincing discrete nodule could be appreciated.LEFT LOBE: Diffusely heterogeneous enlarged left thyroid gland with increased vascularity. No convincing discrete nodule could be appreciatedISTHMUS: Diffusely heterogeneous enlarged isthmus with increased vascularity without convincing discrete nodulePARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous enlarged thyroid gland with increased vascularity. Findings suggestive for thyroiditis or Graves. No convincing discrete nodule. No regional adenopathy. |
Generate impression based on findings. | 20-year-old pregnant female complaining of left upper inner breast tenderness. Patient denies any new palpable lump. Targeted ultrasound of the left upper inner breast, 11:00 12 cm from the nipple in patient's area of concern, reveals no cystic or solid mass. | No sonographic evidence of malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Left neck mass RIGHT LOBE MEASUREMENTS: 4 x 1.8 x 1.4 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.4 x 1 cmISTHMUS MEASUREMENTS: 0.25 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 0.8 x 0.5 x 0.7 cm well-circumscribed hypoechoic nodule upper pole ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Subcentimeter well-circumscribed hypoechoic upper pole left thyroid nodule. This lesion is amenable to ultrasound-guided percutaneous biopsy. No regional adenopathy. |
Generate impression based on findings. | Status post liver transplant with increasing LFTs LIMITED ABDOMENLIVER: Status post liver transplant. No mass lesion. Small porta hepatis gallbladder fossa bland postoperative fluid collection. Liver length 20.2 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 12.8 cm in length. RIGHT KIDNEY: No significant abnormalities noted. Right kidney 11.1 cm in lengthOTHER: Left kidney 12.3 cm in length. Trace ascites | Patent hepatic vessels with normal directional flow. Trace ascites. No ductal dilatation. |
Generate impression based on findings. | Male 63 years old Reason: eval cirrhosis and for ascites History: AMS, hx of NASH cirrhosis LIVER: Background liver parenchyma is hyperechogenic compatible with history of cirrhosis, with corresponding morphology. There is a 1.7 x 1.4 x 2.6 cm hypoechoic mass in the right hepatic lobe. In the setting of a cirrhotic liver, this is concerning for HCC. Although the main portal vein appears patent with hepatopedal flow, there is decreased Doppler velocity, and much of the lumen is not opacified with color Doppler. Therefore partial thrombosis cannot be entirely excluded on this exam. Portal vein branches are patent with appropriate flow direction.BILIARY TRACT: Minimally thickened gallbladder wall, which is may be seen in the setting of cirrhosis. Common bile duct measures 4 mm. No intrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are within normal limits.SPLEEN: The spleen is enlarged measuring 15.8 cm. There are perisplenic and splenorenal varices present.KIDNEYS: Right kidney measures 10.3 cm. Left kidney measurement is limited by bowel gas. No shadowing calculi or hydronephrosis.OTHER: No significant abnormalities noted. | 1.Hypoechoic lesion in a cirrhotic liver suspicious for HCC. Recommend dedicated cross-sectional liver imaging for further evaluation.2.Partial thrombus of the main portal vein cannot be excluded as there is decreased Doppler flow.3.Sequela of portal hypertension including splenomegaly and varices are present. |
Generate impression based on findings. | Hepatitis C LIVER: Coarse echogenic liver parenchyma without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 18.2 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 12.8 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.8 cm in lengthOTHER: Left kidney 11.9 cm in length. No ascites. | Coarse echogenic liver parenchyma suggestive for fatty infiltration without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Metastatic colon cancer with liver metastases with worsening right upper quadrant pain LIVER: Multiple liver metastasis again noted and not largely changed from prior CT exam. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 18.4 cm.BILIARY TRACT: No ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Left kidney 11.1 cm in length. No ascites. | No significant change in multiple hepatic metastatic lesions. No ductal dilatation. No ascites. |
Generate impression based on findings. | Female 57 years old Reason: right upper quadrant pain with previous possible hemangioma but dye allergy History: right upper quadrant pain LIVER: Liver has normal homogeneous echogenicity. There is a hyperechoic lesion in the liver compatible with hemangioma, previously seen on CT measuring 1.2 x 1.2 x 1.4 cm. Main portal vein is patent with normal directional flow and a with a peak velocity of 24.7 cm/s. No evidence of hemorrhage or perihepatic fluid.BILIARY TRACT: No intra or extravascular dilatation. The gallbladder wall is normal. No pericholecystic fluid. Negative Murphy's sign.PANCREAS: The visualized portions of the pancreas are normal.SPLEEN: Spleen is normal in appearance measuring 7.1 cm.KIDNEYS: Right kidney measures 9.47 m. Kidney measures 10.1 cm. No shadowing calculus or hydronephrosis.OTHER: No significant abnormalities noted. | 1.No evidence of cholelithiasis or cholecystitis.2.Unchanged hemangioma in the liver without evidence of complication. |
Generate impression based on findings. | 62-year-old female with some dysphasia. Rule out thyroid nodules. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 4.9 x 1.8 x 1.7 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 5.5 x 2.7 x 2.5 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.6 cm in thickness.RIGHT LOBE: In the right mid thyroid pole, there is a 1.1 x 0.6 x 0.8 cm spongiform nodule.LEFT LOBE: Heterogenous echotexture the left thyroid lobe. In the left mid pole, there is a 2 x 1.8 x 2.3 cm spongiform nodule. In the left lower pole, there is a solid and cystic nodule measuring 1.2 x 0.8 x 0.9 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious cervical lymphadenopathy.OTHER: No significant abnormality noted. | Bilateral thyroid nodules with the largest on the left measuring up to 2.3 cm in diameter and has a spongiform appearance, favoring benign etiology |
Generate impression based on findings. | Transaminitis LIVER: Coarse echogenic liver echotexture without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 19.2 cm.BILIARY TRACT: Gallbladder sludge and stones without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10.6 cm in length RIGHT KIDNEY: No significant abnormalities noted. 12.5 cm in lengthOTHER: Left kidney 12.6 cm in length. Trace ascites. | Mild hepatomegaly associated with coarse echogenic liver echotexture raises the possibility of parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Trace ascites. Gallbladder sludge and stones without acute inflammation. |
Generate impression based on findings. | History of goiter RIGHT LOBE MEASUREMENTS: 3.2 x 0.9 x 1.6 cmLEFT LOBE MEASUREMENTS: 2.8 x 1 x 1.1 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Somewhat small gland without discrete nodule or increased vascularityLEFT LOBE: Somewhat small gland without discrete nodule or increased vascularityISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Somewhat small thyroid gland without discrete nodule or increased vascularity. No regional adenopathy. |
Generate impression based on findings. | Female 68 years old Reason: eval CKD History: renal insufficiency - hx of CKD RIGHT KIDNEY: Right kidney measures 9.6 cm. There is diffusely increased echogenicity of the renal cortex. No hydronephrosis or shadowing calculus. Anechoic cyst measures 1.3 x 1.5 x 1.3 cm.LEFT KIDNEY: Left kidney measures 9.5 cm. There is diffuse increased echogenicity of the renal cortex. No hydronephrosis or shadowing calculus. Incompletely evaluated hypoechoic focus, likely representing a small cyst measures 1.1 x 1.1 cm.URINARY BLADDER: The patient had just urinated. Urinary bladder is collapsed.OTHER: No significant abnormalities noted. | Bilateral increased echogenicity of the renal cortex compatible with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Coarse echogenic liver echotexture again noted without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 14.8 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in lengthOTHER: Left kidney 12.4 cm in length. No ascites. | Coarse echogenic liver echotexture again noted consistent with fatty infiltration without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | CNS lymphoma with FDG uptake right testis RIGHT TESTIS: Testis dimensions 3.7 x 2.3 x 3.2 cm. 1.6 x 1.3 x 1.4 cm discrete hypoechoic lesion within the right testicle with indistinct margins corresponding to the PET-positive lesion seen on the recent PET/CT scan.LEFT TESTIS: Testis dimensions 3.5 x 2.1 x 2.9 cm. No intratesticular mass.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Bilateral hydroceles, left greater than right | 1.6 x 1.3 x 1.4 cm hypoechoic lesion within the right testicle with indistinct margins corresponding to the PET-positive lesion seen on the recent PET/CT scan. Findings consistent with intratesticular lymphoma focus, although a primary neoplasm cannot be excluded. |
Generate impression based on findings. | Epigastric pain and nausea LIVER: Unremarkable parenchymal echogenicity without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 15.6 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.2 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 9.9 cm in lengthOTHER: Left kidney 10.6 cm in length. No ascites. | Negative right upper quadrant ultrasound. No acute hepatobiliary abnormality. No ascites. |
Generate impression based on findings. | Hyperthyroidism RIGHT LOBE MEASUREMENTS: 4.4 x 1.9 x 1.5 cmLEFT LOBE MEASUREMENTS: 3.8 x 1.8 x 1.5 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Diffusely heterogeneous gland without discrete mass. Mildly increased vascularityLEFT LOBE: Diffusely heterogeneous gland without discrete mass. Mildly increased vascularityISTHMUS: Diffusely heterogeneous gland without discrete mass. Mildly increased vascularityPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland without discrete mass. Associated with mildly increased vascularity. Findings consistent with thyroiditis. |
Generate impression based on findings. | Female 44 years old Reason: acute liver failure History: acetaminophen toxicity, LFTs uptrending LIVER: Liver measures 16.7 cm. No focal hepatic lesion. Mildly increased hepatic echogenicity.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallstones are present. No evidence of cholecystitis.PANCREAS: The visualized portions of the pancreas are within normal limits.SPLEEN: The spleen is normal in appearance measuring 11.2 cm. There is a small amount of ascites near the spleen.KIDNEYS: Left kidney is 11.5 cm. Right kidney is 11.2 cm. No shadowing calculus or hydronephrosis.OTHER: No significant abnormalities noted. | 1.Increased echogenicity of the liver which may be seen in the setting of diffuse hepatic parenchymal dysfunction.2.Hepatic vessels are patent. |
Generate impression based on findings. | Status post thyroidectomy for papillary thyroid carcinoma RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Two slightly enlarged left level 3/4 lymph nodes. The largest measures 0.7 x 0.4 x 0.4 cm. Internal morphology of these lymph nodes demonstrates effacement of normal fatty hilum.OTHER: No significant abnormality noted. | Status post thyroidectomy. 2 slightly enlarged left level 3/4 lymph nodes with effacement of normal fatty hilum. While these may represent reactive lymph nodes, would recommend follow-up ultrasound in 4-6 months to document stability. |
Generate impression based on findings. | Follow-up gallbladder polyp LIVER: Normal parenchymal echogenicity without mass. Liver length 16 cmBILIARY TRACT: Stable gallbladder polyp measuring 0.7 x 0.6 x 0.6 cm. Midportion of common bile duct obscured by gas. No evidence for intrahepatic ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.6 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.1 cm in lengthOTHER: Left kidney 10 cm in length. No ascites. | Stable gallbladder polyp. |
Generate impression based on findings. | Epigastric pain LIVER: Normal parenchymal echogenicity without mass. Liver length 16.1 cm. Limited Doppler interrogation the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. Spleen 7.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. Right renal cyst. 9.3 cm in lengthOTHER: Left kidney 9.3 cm in length. No ascites. Bilateral pleural effusions. | Cholelithiasis without acute inflammation or ductal dilatation. |
Generate impression based on findings. | Hepatitis B LIVER: Coarse echogenic liver echotexture without mass. Liver length 16.4 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.3 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 11.5 cm in lengthOTHER: Left kidney 13 cm in length. No ascites. | Coarse echogenic liver echotexture consistent with fatty infiltration without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Ms. Miller is a 46 year old female with a personal history of 2 prior excisional biopsies of the right breast and 4 prior excisional biopsies of the left breast, one of which showed atypia. Patient previously took tamoxifen for 5 years and stopped in 2012. She presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Numerous benign simple cysts are identified bilaterally. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Ms. David is a 40 year old female with a personal history of left breast lumpectomy in 2014 for IDC followed by adjuvant chemotherapy and radiation. She presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Unfortunately, due to a technical error, the top half of the skin/breast anatomy is not included in the field-of-view on imaging. | Technical repeat necessary due to incomplete evaluation of both breasts. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: R - Technical Repeat Views. |
Generate impression based on findings. | Ms. Torres is a 48 year old female with known bilateral cysts. She presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Numerous benign simple and complicated cysts are identified bilaterally. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Technical repeat study. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Male 62 years old Reason: MTC; mapping ultrasound History: MTC; mapping ultrasound RIGHT LOBE MEASUREMENTS: 5.4 x 2.2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.3 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.12 cmRIGHT LOBE: In the mid right thyroid lobe is a hypoechoic irregular nodule measuring 0.9 x 0.9 x 0.9 cm with questionable punctate calcifications. Adjacent and deep to this hypoechoic nodule is a more solid-appearing nodule measuring 1.2 x 0.8 x 0.9 cm.LEFT LOBE: Hypoechoic nodule in the left inferior thyroid lobe measures 0.6 x 0.6 x 1.0 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a very large heterogeneous right level 2 lymph node measuring 5.3 x 3.8 x 3.3 cm. There is a enlarged right level 3 lymph node measuring 2.0 x 1.0 x 2.3 cm. There is also an enlarged left level 3 lymph node measuring 1.1 x 0.5 x 1.0 cm.OTHER: No significant abnormality noted. | 1.Hypoechoic irregular nodule in the right thyroid lobe is concerning for malignancy, and may be the primary, given history of MTC. 2.Very large right neck lymph nodes are concerning for metastatic disease. Enlarged left neck lymph nodes are also concerning for metastatic disease. |
Generate impression based on findings. | 26-year-old female with new palpable right breast mass, currently breast feeding, presenting for diagnostic sonographic evaluation. No family history of breast cancer. Targeted ultrasound of the left lower inner breast, 7:00 7 cm from the nipple, in patient's area of palpable concern reveals a solid or cystic mass. | No sonographic evidence of malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 25-year-old pregnant female with new palpable left breast lump, presenting for sonographic evaluation. Family history of postmenopausal breast cancer in paternal grandmother. No current breast complaints. Targeted ultrasound of the left upper breast, 12:00 5 cm from the nipple, in patient's area of palpable concern reveals no suspicious solid or cystic mass. | No sonographic evidence of malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Please evaluate the right breast, upper lateral area for abscess/signs of soft tissue infection. Patient is admitted for abscess, unclear source. She has area of mild induration and redness in the right upper lateral area approximately 10:00 position from the areola. On physical examination, a superficial skin ulcer (patient has a habit of picking herself) in the right breast medially approximately 4:00 position, 5 cm from the nipple. A 3 cm mobile palpable lump is identified in the right breast 10:00 position, 8 cm from the nipple. Right breast appears red and warm.A targeted right ultrasound was performed for the patient’s area of concern at 10:00 position. Ultrasound demonstrates skin thickening and edema. At 10:00 position there are 2 adjacent oval to round hypoechoic to anechoic areas with few areas of through transmission, measuring 1.6 x 1.3 x 1.6 cm and 1.6 x 1.1 x 1.1 cm. Adjacent to these 2 hypoechoic areas is an area of increased echogenicity. Patient denies history of trauma and is not on any blood thinners. | 2 adjacent hypoechoic areas with adjacent hyperechogenicity in the right breast 10:00 position corresponding to the palpable abnormality most likely represents area of hematoma/fat necrosis versus abscess. Also noted is right breast skin thickening and edema consistent with cellulitis.Surgical consultation to be performed if clinically indicated. Findings and recommendations were discussed with Dr. Ram Krishnamoorthi at pager 4111.After patient completes her course of antibiotics if things resolve, follow-up ultrasound can be performed.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 68-year-old male with renal failure. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 11.5 cm in length. No hydronephrosis. Increased echogenicity of the renal parenchyma.LEFT KIDNEY: The left kidney measures 13.1 cm in length. No hydronephrosis. Increased echogenicity of the renal parenchyma.URINARY BLADDER: The urinary bladder is distended and shows no acute abnormality. Bilateral ureteral jets are not clearly visualized.OTHER: Hepatic parenchyma is echogenic. | 1. No hydronephrosis.2. Increased echogenicity of the renal parenchyma is nonspecific and could represent chronic medical renal disease. |
Generate impression based on findings. | 72-year-old male with chronic viral hepatitis C, confusion and ascites on physical exam. Exam is somewhat limited by the patient's inability to cooperate.LIVER:Liver is small, echogenic and nodular in contour consistent with cirrhosis. No gross, focal hepatic abnormality although the patient was unable to fully cooperate. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder contains a stone in the region of the neck, minimally mobile, but without significant gallbladder distention or wall thickening. The visualized biliary tract is normal in caliber.PANCREAS: Limited due to bowel gas.SPLEEN: Enlarged, measuring 18.3 cm in length.KIDNEYS: The right kidney measures approximately 12.3 cm in length. Kidney appears mildly echogenic as noted on the prior exam consistent with parenchymal disease. In the extreme lower pole of the right kidney, there is a small cystic area that may have a focus of calcification. This is unchanged from the prior exam.The left kidney demonstrates significant parenchymal loss and associated caliectasis, particularly in the lower pole. There are likely small cortical cysts as well. Renal length is difficult to assess. No obvious dilatation of the upper pole collecting system or renal pelvis. Patient has a history of significant, obstructive left nephrolithiasis and this is likely chronic. Previously noted calcification in the extreme lower pole not visualized on today's exam.ABDOMINAL AORTA: Normal in caliber without aneurysm.INFERIOR VENA CAVA: Visualized inferior vena cava is patent by color Doppler.OTHER: No ascites. Bladder decompressed with Foley catheter in place. Right pleural effusion. | Cirrhotic appearing liver with patent main portal vein.. There is associated splenomegaly.Renal parenchymal disease with renal cysts as well as chronic caliectasis involving the lower pole of the left kidney.Gallstone in the gallbladder neck without wall thickening or pericholecystic fluid.Right pleural effusion. |
Generate impression based on findings. | Acute kidney failure. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.1 cm in length. Cortical echogenicity again may be mildly increased. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures approximately 8.9 cm in length. The upper pole is not well visualized due to position of the kidney. Cortical echogenicity again may be mildly increased. No hydronephrosis, shadowing calculus or mass.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Stable examination. Mildly echogenic kidneys without hydronephrosis. |
Generate impression based on findings. | Male 65 years old Reason: Is there abscess or pocket of fluid in L elbow? History: L elbow cellulitis.Additional history from ultrasound technologist indicates patient has pain and swelling for one month. There are ill-defined hypoechoic areas within the muscle of the posterior elbow without a discrete loculated drainable fluid collection. This is along the posterior aspect of the elbow. This is consistent with induration or possible cellulitis without discrete drainable abscess. There are some comparison images to the right side. Subjectively I think the abnormal left side is slightly hyperemic. | No drainable abscess. Small ill-defined hypoechoic areas suggestive of cellulitis. |