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CT-MRI_metrics_validation_dataset

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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Colorectal cancer. COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 14 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 97 sec. Scan field of view: 340 mm. DLP: 639 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Hepatic cyst is noted within the inferior right hepatic lobe. Otherwise, no suspicious hepatic lesions. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Mild bilateral adrenal thickening without discrete nodularity. KIDNEYS: Right lower pole renal cyst. Otherwise, bilateral kidneys are normal without hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Mild mucosal thickening and hyperenhancement of a short segment of colon within the hepatic flexure with associated pericolonic fat stranding (series 3, image 197). No significant upstream dilatation is seen to suggest functional obstruction. PERITONEUM / MESENTERY: Few pericolonic mesenteric nodules are seen within the left upper quadrant (series 3, image 145 and 156). No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Diffuse urinary bladder wall thickening. REPRODUCTIVE ORGANS: The uterus is surgically absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions. CONCLUSION: 1. Mucosal thickening and pericolonic stranding within the hepatic flexure potentially corresponding to known colonic mass. 2. Few small nodules within the left upper quadrant; these are adjacent to the spleen and could represent tiny splenules. However, metastasis cannot be excluded. Further evaluation with PET/CT may be of benefit, if clinically indicated. 3. Diffuse urinary bladder wall thickening which may be secondary to underdistention. However, cystitis cannot be excluded and correlation with urinalysis may be of benefit, if clinically indicated. 4. Incidental findings as above. Please see separately dictated report for dedicated chest findings.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Hepatic cyst is noted within the inferior right hepatic lobe. Otherwise, no suspicious hepatic lesions. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Mild bilateral adrenal thickening without discrete nodularity. KIDNEYS: Right lower pole renal cyst. Otherwise, bilateral kidneys are normal without hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Mild mucosal thickening and hyperenhancement of a short segment of colon within the hepatic flexure with associated pericolonic fat stranding (series 3, image 197). No significant upstream dilatation is seen to suggest functional obstruction. PERITONEUM / MESENTERY: Few pericolonic mesenteric nodules are seen within the left upper quadrant (series 3, image 145 and 156). No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Diffuse urinary bladder wall thickening. REPRODUCTIVE ORGANS: The uterus is surgically absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions.
FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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CT head without contrast Clinical Information: COVID confirmed. AMS. Comparison: None. Technique: Axial helical images of the head were obtained. Coronal and sagittal reformatted images were obtained from the axial data set. DLP: 1104 mGy cm. Findings: There are motion artifacts. There is slight diffuse atrophy but the ventricles are not enlarged. There is no mass, hemorrhage, visible infarct or extracerebral collection. There is preservation of gray-white margins. The posterior fossa contents appear normal. The nasal passages are narrow and obstructed. There is mucosal thickening in the right maxillary sinus and left sphenoid sinus. The remainder the paranasal sinuses are clear. There are bilateral mastoid effusions. The middle ears are clear. No defect is seen in the calvarium or skull base. ---------------- Conclusion: No acute parenchymal abnormality identified.
Findings: There are motion artifacts. There is slight diffuse atrophy but the ventricles are not enlarged. There is no mass, hemorrhage, visible infarct or extracerebral collection. There is preservation of gray-white margins. The posterior fossa contents appear normal. The nasal passages are narrow and obstructed. There is mucosal thickening in the right maxillary sinus and left sphenoid sinus. The remainder the paranasal sinuses are clear. There are bilateral mastoid effusions. The middle ears are clear. No defect is seen in the calvarium or skull base. ----------------
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Indeterminate thyroid nodule in the left lobe which measures 1.4 x 1.0 cm (image 69, series 601. CHEST: LUNGS / AIRWAYS / PLEURA: Right lower lobe atelectasis. Few scattered micronodules in the right upper lobe. Otherwise no pleural effusion or pneumothorax. HEART / VESSELS: Three vessel coronary artery calcifications and calcifications of the thoracic aorta.. MEDIASTINUM / ESOPHAGUS: Normal. Patulous esophagus. DIAPHRAGM: Intact. LYMPH NODES: . Enlarged paratracheal node developing central calcification related to prior granulomatous disease. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Diffuse parenchymal atrophy. SPLEEN: Unchanged calcified granulomata. Accessory spleen. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcification of the abdominal aorta and its branches. URINARY BLADDER: Intraluminal gas is present within the bladder, likely iatrogenic. REPRODUCTIVE ORGANS: The uterus is absent. BODY WALL: No significant abnormality. SOFT TISSUES: No significant abnormality. Atrophic changes of the right gluteus medius and minimus. THORACIC AND LUMBAR SPINES: VERTEBRA: No thoracic spine fracture. T12 vertebral plana. Redemonstrated levocurvature of the thoracolumbar spine. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes of the thoracolumbar spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: COVID confirmed post ECMO cannulation. COMPARISON: Multiple prior chest radiographs, most recently same day. TECHNIQUE: CT Chest wo contrast. Scan field of view: 423 mm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Edema of the anterior lower neck soft tissues. CHEST: LUNGS / AIRWAYS / PLEURA: Dense consolidation in the bilateral dependent lungs. Scattered groundglass opacities in the left lung lobe. Small to moderate bilateral pleural effusions. No pneumothorax. Endotracheal tube is present terminating in the mid trachea. HEART / VESSELS: Normal heart size. Trace pericardial effusion. Left upper extremity PICC terminates in the right atrium. Right common femoral vein pacemaker lead terminates in the right ventricle. Right common femoral artery intra-aortic balloon pump is inflated and terminates in the proximal descending thoracic aorta, beyond the origin of the left subclavian artery. Left common femoral vein ECMO cannula terminates in the intrahepatic IVC. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube is present. LYMPH NODES: None enlarged. CHEST WALL: Anasarca. UPPER ABDOMEN: Please see separately reported same day CT abdomen and pelvis. MUSCULOSKELETAL: Mild multilevel degenerative changes. CONCLUSION: 1. Dense consolidation in the bilateral dependent lungs with small to moderate bilateral effusions suggestive of atelectasis. A superimposed infectious process cannot be excluded. Scattered groundglass opacities in the left lung, likely infectious versus inflammatory in etiology. Overall, these findings are somewhat atypical of COVID-19 pneumonia. Alternative diagnoses should be considered. 2. LInes and tubes as above. 3. Intra-aortic balloon terminates in the proximal descending thoracic aorta, beyond the origin of left subclavian. This can be retracted 1-2 cm for optimal positioning. 4. Other incidental findings as above. Please see separately reported same day CT abdomen and pelvis. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Edema of the anterior lower neck soft tissues. CHEST: LUNGS / AIRWAYS / PLEURA: Dense consolidation in the bilateral dependent lungs. Scattered groundglass opacities in the left lung lobe. Small to moderate bilateral pleural effusions. No pneumothorax. Endotracheal tube is present terminating in the mid trachea. HEART / VESSELS: Normal heart size. Trace pericardial effusion. Left upper extremity PICC terminates in the right atrium. Right common femoral vein pacemaker lead terminates in the right ventricle. Right common femoral artery intra-aortic balloon pump is inflated and terminates in the proximal descending thoracic aorta, beyond the origin of the left subclavian artery. Left common femoral vein ECMO cannula terminates in the intrahepatic IVC. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube is present. LYMPH NODES: None enlarged. CHEST WALL: Anasarca. UPPER ABDOMEN: Please see separately reported same day CT abdomen and pelvis. MUSCULOSKELETAL: Mild multilevel degenerative changes.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Indeterminate thyroid nodule in the left lobe which measures 1.4 x 1.0 cm (image 69, series 601. CHEST: LUNGS / AIRWAYS / PLEURA: Right lower lobe atelectasis. Few scattered micronodules in the right upper lobe. Otherwise no pleural effusion or pneumothorax. HEART / VESSELS: Three vessel coronary artery calcifications and calcifications of the thoracic aorta.. MEDIASTINUM / ESOPHAGUS: Normal. Patulous esophagus. DIAPHRAGM: Intact. LYMPH NODES: . Enlarged paratracheal node developing central calcification related to prior granulomatous disease. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Diffuse parenchymal atrophy. SPLEEN: Unchanged calcified granulomata. Accessory spleen. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcification of the abdominal aorta and its branches. URINARY BLADDER: Intraluminal gas is present within the bladder, likely iatrogenic. REPRODUCTIVE ORGANS: The uterus is absent. BODY WALL: No significant abnormality. SOFT TISSUES: No significant abnormality. Atrophic changes of the right gluteus medius and minimus. THORACIC AND LUMBAR SPINES: VERTEBRA: No thoracic spine fracture. T12 vertebral plana. Redemonstrated levocurvature of the thoracolumbar spine. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes of the thoracolumbar spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Covid, post ECMO cannulation COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 423 mm. DLP: 1487 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately reported chest CT. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: No abnormality. GALLBLADDER: No abnormality. Contrast is seen filling the gallbladder. PANCREAS: Mild fatty atrophy. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing stones are seen in the bilateral renal pelvises, the largest measuring up to 1.3 cm and seen within the right renal pelvis (series 3 image 219). No hydroureteronephrosis.. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube is visualized with tip projecting over the proximal stomach. There is residual oral contrast within the fundus of the stomach. The small bowel is normal. COLON / APPENDIX: Scattered diverticula without surrounding inflammation. Otherwise, the large bowel is unremarkable. The appendix is normal. PERITONEUM / MESENTERY: There is diffuse fat stranding seen within the abdomen and pelvis. RETROPERITONEUM: Stranding surrounding the bilateral kidneys. Presacral fat stranding. VESSELS: Bilateral inguinal approach vascular access catheters are visualized originating within the bilateral common femoral arteries and veins. Left inguinal approach ECMO cannulae terminates within the intrahepatic IVC. Left inguinal approach arterial access catheter terminates within the left external iliac artery. The right inguinal approach IABP device, caudally terminates at the level of renal arteries. No significant vascular abnormality is visualized on this noncontrast exam. URINARY BLADDER: Decompressed bladder with Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Diffuse body wall edema, worse surrounding the lower abdomen. MUSCULOSKELETAL: No acute or aggressive osseous abnormality. CONCLUSION: 1. Recent placement of ECMO cannula and IABP device. There is diffuse small to moderate volume retroperitoneal hemorrhage in the lower abdomen/pelvis extending along the pelvic sidewall and bilateral groin regions. If continued drop in hemoglobin is seen, further evaluation with CT angiogram should be considered for assessment of active bleed. 2. Left femoral approach ECMO cannula terminates in the intrahepatic IVC. An additional right femoral venous catheter terminates in the right ventricle. Lower tip of the IABP device terminates at the level of renal arteries and can be repositioned slight cranially to prevent mesenteric occlusion. 3. Other findings as described above. These findings were informed to Dr.Gerding Emily by Dr. Reeves at 3:40 PM on 01/05/2022 As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately reported chest CT. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: No abnormality. GALLBLADDER: No abnormality. Contrast is seen filling the gallbladder. PANCREAS: Mild fatty atrophy. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing stones are seen in the bilateral renal pelvises, the largest measuring up to 1.3 cm and seen within the right renal pelvis (series 3 image 219). No hydroureteronephrosis.. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube is visualized with tip projecting over the proximal stomach. There is residual oral contrast within the fundus of the stomach. The small bowel is normal. COLON / APPENDIX: Scattered diverticula without surrounding inflammation. Otherwise, the large bowel is unremarkable. The appendix is normal. PERITONEUM / MESENTERY: There is diffuse fat stranding seen within the abdomen and pelvis. RETROPERITONEUM: Stranding surrounding the bilateral kidneys. Presacral fat stranding. VESSELS: Bilateral inguinal approach vascular access catheters are visualized originating within the bilateral common femoral arteries and veins. Left inguinal approach ECMO cannulae terminates within the intrahepatic IVC. Left inguinal approach arterial access catheter terminates within the left external iliac artery. The right inguinal approach IABP device, caudally terminates at the level of renal arteries. No significant vascular abnormality is visualized on this noncontrast exam. URINARY BLADDER: Decompressed bladder with Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Diffuse body wall edema, worse surrounding the lower abdomen. MUSCULOSKELETAL: No acute or aggressive osseous abnormality.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Indeterminate thyroid nodule in the left lobe which measures 1.4 x 1.0 cm (image 69, series 601. CHEST: LUNGS / AIRWAYS / PLEURA: Right lower lobe atelectasis. Few scattered micronodules in the right upper lobe. Otherwise no pleural effusion or pneumothorax. HEART / VESSELS: Three vessel coronary artery calcifications and calcifications of the thoracic aorta.. MEDIASTINUM / ESOPHAGUS: Normal. Patulous esophagus. DIAPHRAGM: Intact. LYMPH NODES: . Enlarged paratracheal node developing central calcification related to prior granulomatous disease. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Diffuse parenchymal atrophy. SPLEEN: Unchanged calcified granulomata. Accessory spleen. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcification of the abdominal aorta and its branches. URINARY BLADDER: Intraluminal gas is present within the bladder, likely iatrogenic. REPRODUCTIVE ORGANS: The uterus is absent. BODY WALL: No significant abnormality. SOFT TISSUES: No significant abnormality. Atrophic changes of the right gluteus medius and minimus. THORACIC AND LUMBAR SPINES: VERTEBRA: No thoracic spine fracture. T12 vertebral plana. Redemonstrated levocurvature of the thoracolumbar spine. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes of the thoracolumbar spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: Lung nodule, ION NAVIGATIONAL BRONCHOSCOPY PROTOCOL COMPARISON: Outside chest CT dated 10/6/2021.. TECHNIQUE: CT Chest wo contrast. Scan field of view: 350 mm. DLP: 352.60 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. The right prevascular node remains mildly enlarged at 12 mm in short axis on series 201 image 299. Lower right paratracheal node is also enlarged at 12 mm in short axis. Small right hilar node is 11 mm in short axis on image 303 increased from the prior exam where it was 8 mm. Subcarinal node on image 360 is also increased now measuring 13 mm in short axis. A few additional enlarged mediastinal nodes are seen. No axillary adenopathy. Scattered calcified nodes are seen in both hila. Dilatation of the esophagus is seen. Calcific atherosclerosis is noted in the aorta and coronary arteries. The main pulmonary artery remains dilated at 35 mm. Within the limits of a noncontrast exam, the heart size and mediastinum are otherwise normal. Small right pleural effusion has increased in size. Breathing motion artifact is present. RUL soft tissue just adjacent to the fiducial markers appears unchanged. There is an increased size of a band of soft tissue lateral to the fiducial markers in the RUL measuring 14 x 47 mm on series 201 image 222. This was 12 x 31 mm on the prior. Additional post radiation findings are seen at this level. A new small nodule is seen in the inferior RUL on image 369. The known right lower lobe nodules cannot be separated from the large area of opacified lung now seen in the anterior RUL. Unclear how much of this is nodular mass versus postobstructive atelectasis and pneumonia. Subpleural RLL nodule on image 449 is unchanged. Tree-in-bud opacities in the posterior RUL are redemonstrated. A few calcified granuloma are seen. Upper lobe centrilobular emphysema and mild subpleural reticulation are present in the left lung. There is increased intra-abdominal ascites around the liver and spleen. Liver has a mildly cirrhotic configuration with apparent larger area of low attenuation within the left hepatic lobe on image 704 concerning for metastatic disease. Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions. CONCLUSION: 1. Large area of parenchymal opacity is now seen in the RLL and includes the areas of the two previously measured nodules. Unclear how much of this is tumor versus post obstructive atelectasis/pneumonitis. Repeat PET/CT may be needed to define active tumor. 2. Irregular bandlike opacification laterally in the RUL has also increased in size and again unclear what is scar versus possible tumor. A new small RUL nodule is noted. 3. Interval increase in right pleural effusion. 4. Slight increase in size of enlarged mediastinal and right hilar lymph nodes. 5. Increased intra-abdominal ascites. Question enlarged low-attenuation area in the left hepatic lobe concerning for metastasis but not well defined without contrast.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. The right prevascular node remains mildly enlarged at 12 mm in short axis on series 201 image 299. Lower right paratracheal node is also enlarged at 12 mm in short axis. Small right hilar node is 11 mm in short axis on image 303 increased from the prior exam where it was 8 mm. Subcarinal node on image 360 is also increased now measuring 13 mm in short axis. A few additional enlarged mediastinal nodes are seen. No axillary adenopathy. Scattered calcified nodes are seen in both hila. Dilatation of the esophagus is seen. Calcific atherosclerosis is noted in the aorta and coronary arteries. The main pulmonary artery remains dilated at 35 mm. Within the limits of a noncontrast exam, the heart size and mediastinum are otherwise normal. Small right pleural effusion has increased in size. Breathing motion artifact is present. RUL soft tissue just adjacent to the fiducial markers appears unchanged. There is an increased size of a band of soft tissue lateral to the fiducial markers in the RUL measuring 14 x 47 mm on series 201 image 222. This was 12 x 31 mm on the prior. Additional post radiation findings are seen at this level. A new small nodule is seen in the inferior RUL on image 369. The known right lower lobe nodules cannot be separated from the large area of opacified lung now seen in the anterior RUL. Unclear how much of this is nodular mass versus postobstructive atelectasis and pneumonia. Subpleural RLL nodule on image 449 is unchanged. Tree-in-bud opacities in the posterior RUL are redemonstrated. A few calcified granuloma are seen. Upper lobe centrilobular emphysema and mild subpleural reticulation are present in the left lung. There is increased intra-abdominal ascites around the liver and spleen. Liver has a mildly cirrhotic configuration with apparent larger area of low attenuation within the left hepatic lobe on image 704 concerning for metastatic disease. Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
FINDINGS: STRUCTURED REPORT: CTA Upper Extremity FINDINGS: VASCULATURE: AORTIC ARCH: Atherosclerotic calcification is present in the arch and at the origin of all three great vessels, however no significant stenosis is seen. PROXIMAL ASPECT OF ARCH VESSELS: No significant abnormality. RIGHT SUBCLAVIAN ARTERY: No significant abnormality. RIGHT AXILLARY ARTERY: No significant abnormality. RIGHT BRACHIAL ARTERY: Scattered calcification are present throughout the brachial artery, however no significant stenosis is seen RIGHT RADIAL ARTERY: Scattered atherosclerotic calcification is present throughout the radial artery. It does appear to be patent to the wrist where there is an apparent stenosis. RIGHT ULNAR ARTERY: The ulnar artery is severely calcified with several areas of near occlusive stenosis especially at the level of the wrist. Some flow is seen from the ulnar artery into the palmar arch. RIGHT HAND ARTERIES: The arteries of the hand are not well visualized the palmar arch appears to be incomplete, however the images are nondiagnostic. OTHER VASCULATURE: No significant abnormality. PARTIALLY IMAGED HEAD AND NECK: No abnormality. PARTIALLY IMAGED CHEST: No abnormality. SUPERFICIAL SOFT TISSUES: No abnormality. MUSCULOSKELETAL: No significant abnormality.
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CTA Coronary Artery CLINICAL INFORMATION: 62-year-old female with history of Chest pain, nonspecific, R07.9 Chest pain, unspecified, R06.00 Dyspnea, unspecified, R00.2 Palpitations TECHNIQUE: Precontrast axial images through the heart were acquired for calcium score evaluation. Postcontrast images were helically acquired in retrospective ECG gating to the heart with dual source 256 detectors Siemens CT scanner (Somatom FORCE). Images reviewed in multiple phases of the cardiac cycle. Source images, multiplanar reformatted images, MIP and volume rendered images were also reviewed. Patient was given 0.4 mg of sublingual nitrate for coronary arterial vasodilatation. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 5 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 160 mm. Heart Rate: 73 bpm. DLP: 646 mGy cm. COMPARISON: No prior relevant study available for comparison. FINDINGS: CALCIUM SCORE: Using a modified Agatston scoring method, the coronary artery calcification score is 0. CORONARY ARTERIES: * Dominance: Right dominant coronary arterial circulation, with both PDA and posterolateral arteries are seen arising from the distal RCA. * LM: It is seen arising normally from the left coronary sinus of Valsalva. Patent artery without evidence of significant atherosclerotic plaque or stenosis. It bifurcates into LAD and LCx. * LAD: It has normal course and caliber, without evidence of atherosclerotic plaque or stenosis. It gives origin into multiple patent diagonal and septal arteries. * LCx: It has normal course and caliber, without significant atherosclerotic plaque or stenosis. It gives origin into patent obtuse marginal arteries. * RCA: It is seen arising normally from the right coronary sinus of Valsalva. It has normal course and caliber, without significant atherosclerotic plaque or stenosis. It gives origin into patent PDA and posterolateral arteries. HEART AND GREAT VESSELS: Cardiac chambers: Cardiac chambers are normal in size. No pericardial effusion. No evidence of intracardiac masses or thrombi. There is a blind ended accessory pulmonary vein seen arising from the medial inferior wall of the left atrium (series 10, image 53). LVEF: 64 % LVED volume: 136 ml LVES volume: 49 ml LV Stroke volume: 87 ml The visualized thoracic aorta is normal in caliber. The visualized pulmonary arteries are normal in caliber, without evidence of large central pulmonary thromboembolic disease. LUNGS AND EXTRACARDIAC STRUCTURES: The scanned part of the mediastinum shows possible small sliding hiatal hernia, but otherwise unremarkable. The scanned trachea and central bronchi are patent and clear. The scanned lungs are clear bilaterally without evidence of focal pulmonary opacities or suspicious pulmonary nodules or masses. The scanned part of the upper abdomen is without acute abnormalities. The scanned chest wall soft tissues and skeletal structures are unremarkable, apart from degenerative bony changes. CONCLUSION: 1. No evidence of atherosclerotic coronary artery disease, CAD-RADS 0. 2. Possible small sliding hiatal hernia. 3. Other incidental findings as described.
FINDINGS: CALCIUM SCORE: Using a modified Agatston scoring method, the coronary artery calcification score is 0. CORONARY ARTERIES: * Dominance: Right dominant coronary arterial circulation, with both PDA and posterolateral arteries are seen arising from the distal RCA. * LM: It is seen arising normally from the left coronary sinus of Valsalva. Patent artery without evidence of significant atherosclerotic plaque or stenosis. It bifurcates into LAD and LCx. * LAD: It has normal course and caliber, without evidence of atherosclerotic plaque or stenosis. It gives origin into multiple patent diagonal and septal arteries. * LCx: It has normal course and caliber, without significant atherosclerotic plaque or stenosis. It gives origin into patent obtuse marginal arteries. * RCA: It is seen arising normally from the right coronary sinus of Valsalva. It has normal course and caliber, without significant atherosclerotic plaque or stenosis. It gives origin into patent PDA and posterolateral arteries. HEART AND GREAT VESSELS: Cardiac chambers: Cardiac chambers are normal in size. No pericardial effusion. No evidence of intracardiac masses or thrombi. There is a blind ended accessory pulmonary vein seen arising from the medial inferior wall of the left atrium (series 10, image 53). LVEF: 64 % LVED volume: 136 ml LVES volume: 49 ml LV Stroke volume: 87 ml The visualized thoracic aorta is normal in caliber. The visualized pulmonary arteries are normal in caliber, without evidence of large central pulmonary thromboembolic disease. LUNGS AND EXTRACARDIAC STRUCTURES: The scanned part of the mediastinum shows possible small sliding hiatal hernia, but otherwise unremarkable. The scanned trachea and central bronchi are patent and clear. The scanned lungs are clear bilaterally without evidence of focal pulmonary opacities or suspicious pulmonary nodules or masses. The scanned part of the upper abdomen is without acute abnormalities. The scanned chest wall soft tissues and skeletal structures are unremarkable, apart from degenerative bony changes.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Tiny hypodensities are in the gallbladder neck, possibly small stones. PANCREAS: There are postsurgical changes from distal pancreatectomy with a small amount of nonloculated fluid in the surgical bed. SPLEEN: Surgically absent. ADRENALS: Normal. KIDNEYS: Unchanged benign renal cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from prior partial gastrectomy. Transgastric stent has been removed. Perigastric fluid collection has resolved. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: A trace amount of nonloculated fluid is adjacent to the proximal stomach in the left subdiaphragmatic region. There are changes from omental infarction in the upper ventral abdomen. RETROPERITONEUM: There is trace intraperitoneal fluid adjacent to the pancreatectomy surgical bed. VESSELS: Moderate aortoiliac calcified atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There are postsurgical changes in the ventral abdomen. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain. Paraplegic COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 160 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 80 sec Scan field of view: 334 mm. DLP: 458.20 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: There is a small dependent density in the gallbladder which could represent gallbladder polyp or stone measuring approximately 6 mm. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: There is a small bowel anastomosis in the left upper quadrant. There is no convincing evidence of obstruction. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: There are few surgical clips seen within the mesentery. No free fluid or free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No acute abnormality is identified within the abdomen or pelvis. 2. Gallbladder stone versus polyp. No CT evidence of cholecystitis. Nonemergent ultrasound recommended for further evaluation, as clinically indicated. 3. Additional findings above.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: There is a small dependent density in the gallbladder which could represent gallbladder polyp or stone measuring approximately 6 mm. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: There is a small bowel anastomosis in the left upper quadrant. There is no convincing evidence of obstruction. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: There are few surgical clips seen within the mesentery. No free fluid or free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Pelvis Renal Transplant VASCULATURE: LOWER ABDOMINAL AORTA: Mild arterial wall calcifications. RIGHT COMMON / INTERNAL ILIAC ARTERIES: Mild calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: Mild calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LOWER ABDOMEN: BOWEL: No abnormality. Chronic fatty infiltration of the colonic wall. PERITONEUM: Moderate free fluid in the pelvis. Peritoneal dialysis catheter overlies the midline deep pelvis immediately anterior to the uterus. OTHER: Polycystic kidneys are partially visualized. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. Small amount of fluid tracks into the left inguinal canal. MUSCULOSKELETAL: Mild lumbar facet degenerative changes. No significant abnormality.
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CT Head wo contrast 1/5/2022 12:35 PM Clinical Information: PUI for COVID syncope Comparison: 2/4/2020 and MRI dated 10/19/2020 Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 230 mm. DLP: 1345.20 mGy cm. Findings: There is a small amount of encephalomalacia seen within the left frontal lobe, grossly similar to the prior MRI. There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is a mucus retention cyst seen within the left maxillary sinus. There is bilateral ethmoidal and sphenoid sinus mucosal thickening. There is a small amount of mucosal thickening also seen within the right maxillary sinus. Otherwise, the visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: 1. No CT evidence of acute intracranial abnormality. 2. Paranasal sinus disease.
Findings: There is a small amount of encephalomalacia seen within the left frontal lobe, grossly similar to the prior MRI. There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is a mucus retention cyst seen within the left maxillary sinus. There is bilateral ethmoidal and sphenoid sinus mucosal thickening. There is a small amount of mucosal thickening also seen within the right maxillary sinus. Otherwise, the visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
FINDINGS: The left frontoparietal residual subdural hemorrhagic collection after craniotomy evacuation shows no gross interval change. There are continued 7 mm rightward midline shift and severe effacement of the left lateral ventricle. The gray-white differentiation of the brain is normally visualized. There is no evidence of large vascular territory infarction or acute hemorrhage.
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RADIOLOGIC EXAM: CT Cervical Spine wo contrast CLINICAL INFORMATION: Syncope COMPARISON: 2/4/20 TECHNIQUE: CT Cervical Spine wo contrast Scan field of view: 268 mm. DLP: 317.80 mGy cm. STRUCTURED REPORT: CT Cervical Spine Trauma FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: Head: Distal internal carotid artery (ICA) : Patent. Petrous carotid artery : Patent. Cavernous carotid artery : Patent. Supraclinoid ICA : Patent. Circle of Willis: No evidence of aneurysm. Middle cerebral artery (MCA) : Patent. Anterior cerebral artery (ACA) : Rightward deviation. Posterior cerebral artery (PCA) : Patent. Fetal origin right PCA. Basilar artery (BA): Patent. Dural venous sinuses and cortical veins: Unremarkable. Neck: Aortic arch: Normal great vessel origin anatomy. No great vessel origin stenosis. CCA: No flow-limiting stenosis or luminal irregularity. ICA: No flow-limiting stenosis or luminal irregularity. Vertebral artery: No flow-limiting stenosis or luminal irregularity.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: Lung nodule COMPARISON: 6/23/2021. TECHNIQUE: CT Chest wo contrast with 1.25 mm axial reconstructions per super dimension protocol. Scan field of view: 331 mm. DLP: 347 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. No enlarged intrathoracic lymph nodes are identified. Calcific atherosclerosis is seen in the aorta with marked calcific atherosclerosis and possible stent in the coronary arteries. Within the limits of a noncontrast exam, the heart size and the mediastinum are otherwise normal. No pleural effusion. Considerable breathing motion artifact is again seen. The RML nodule has decreased in size measuring 4 x 6 mm on series 301 image 208 and this was 5 x 7 mm on the prior. A new ill-defined RML nodule measures 5 x 9 mm on image 188. Tiny anterior RUL groundglass nodule on image 129 appears visually slightly larger. Nodule along the right major fissure on image 165 is visually unchanged. Subpleural RUL nodule on image 82 is also unchanged. The RLL subpleural nodule on image 230 is unchanged with additional new tiny basilar RML nodules seen on images 211-216, image 230 and image 236... A few areas of mucous plugging are present such as in the LUL on image 143. A new 5 mm lingular nodule is seen on image 206. Tiny subpleural LLL nodules on images 201, 206, 211 and 219 also appear new. Mild bronchial wall thickening is present. Retained secretions are seen dependently in the trachea. Oral contrast is seen in the stomach and colon. Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions. CONCLUSION: Again multiple small pulmonary nodules are seen several of which are new. The previously identified RML nodule is smaller and anterior RUL nodule appears slightly bigger with the other pre-existing nodules unchanged. The findings suggest an infectious or inflammatory process. Continued follow-up as clinically indicated.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. No enlarged intrathoracic lymph nodes are identified. Calcific atherosclerosis is seen in the aorta with marked calcific atherosclerosis and possible stent in the coronary arteries. Within the limits of a noncontrast exam, the heart size and the mediastinum are otherwise normal. No pleural effusion. Considerable breathing motion artifact is again seen. The RML nodule has decreased in size measuring 4 x 6 mm on series 301 image 208 and this was 5 x 7 mm on the prior. A new ill-defined RML nodule measures 5 x 9 mm on image 188. Tiny anterior RUL groundglass nodule on image 129 appears visually slightly larger. Nodule along the right major fissure on image 165 is visually unchanged. Subpleural RUL nodule on image 82 is also unchanged. The RLL subpleural nodule on image 230 is unchanged with additional new tiny basilar RML nodules seen on images 211-216, image 230 and image 236... A few areas of mucous plugging are present such as in the LUL on image 143. A new 5 mm lingular nodule is seen on image 206. Tiny subpleural LLL nodules on images 201, 206, 211 and 219 also appear new. Mild bronchial wall thickening is present. Retained secretions are seen dependently in the trachea. Oral contrast is seen in the stomach and colon. Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
FINDINGS: Head: Distal internal carotid artery (ICA) : Patent. Petrous carotid artery : Patent. Cavernous carotid artery : Patent. Supraclinoid ICA : Patent. Circle of Willis: No evidence of aneurysm. Middle cerebral artery (MCA) : Patent. Anterior cerebral artery (ACA) : Rightward deviation. Posterior cerebral artery (PCA) : Patent. Fetal origin right PCA. Basilar artery (BA): Patent. Dural venous sinuses and cortical veins: Unremarkable. Neck: Aortic arch: Normal great vessel origin anatomy. No great vessel origin stenosis. CCA: No flow-limiting stenosis or luminal irregularity. ICA: No flow-limiting stenosis or luminal irregularity. Vertebral artery: No flow-limiting stenosis or luminal irregularity.
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RADIOLOGIC EXAM: Maxillofacial CT scan with contrast CLINICAL INFORMATION: Maxillary facial abscess COMPARISON: Complete CT dated 12/8/2021 TECHNIQUE: CT of the maxillofacial region without intravenous contrast. IV contrast: Omnipaque 350, 100 ml, per protocol. DLP: 1130.60 mGy cm. FINDINGS: Status post extraction of the left mandibular premolar teeth with trace amount of fluid adjacent to the extraction socket on the buccal aspect. There is edema and thickening of the left masseter muscle with surrounding fascial thickening and subcutaneous stranding, cellulitis. There is a small wound with air in the submental region extending from the skin surface to the superficial fascia but no surrounding fluid collection. There is slight soft tissue thickening in the left retromolar trigone. There are bilateral mylohyoid muscle defects, normal variant. There is a cystic lesion in the right submandibular space with mildly thickened rim measuring approximately 1.2 x 1 cm (series 202 image 27). The left submandibular gland is slightly enlarged compared to the contralateral side. -------------------- CONCLUSION: 1. Status post left mandibular premolar teeth extraction with fluid adjacent to the extraction socket on the buccal side. No drainable fluid collection. Edematous left masseter muscle with surrounding inflammatory changes but no fluid collection, likely reactive to patient's history of abscess vs post incision and drainage changes. Marked overlying soft tissue swelling with stranding in subcutaneous fat, cellulitis 2. Small cystic lesion in the right submandibular space tracking along the mylohyoid defect from the sublingual space, possible cystic vs suppurative lymph node. Direct oral examination and possibly dedicated neck MRI with contrast is recommended. 3. Soft tissue thickening of the left retromolar trigone which can be also evaluated with an MR scan. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: Status post extraction of the left mandibular premolar teeth with trace amount of fluid adjacent to the extraction socket on the buccal aspect. There is edema and thickening of the left masseter muscle with surrounding fascial thickening and subcutaneous stranding, cellulitis. There is a small wound with air in the submental region extending from the skin surface to the superficial fascia but no surrounding fluid collection. There is slight soft tissue thickening in the left retromolar trigone. There are bilateral mylohyoid muscle defects, normal variant. There is a cystic lesion in the right submandibular space with mildly thickened rim measuring approximately 1.2 x 1 cm (series 202 image 27). The left submandibular gland is slightly enlarged compared to the contralateral side. --------------------
Findings/
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EXAM: CT Abdomen wo+w contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Abdomen wo+w contrast. Patient weight: 174 lbs. IV contrast: Omnipaque 350, 143 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: 390 sec. Scan field of view: 390 mm. DLP: 2381.09 mGy cm. FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 8 - Size: 1.6 x 1.3 cm (series 5/image 60), previously similar size. - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: - Enhancing "capsule": Present. - Nonperipheral "washout": Present. (Series 13, image 54) - Threshold growth (>= 50% in <= 6 months): Not present. - Other features: None. - LI-RADS: LR-5 LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Replaced right hepatic artery arising from SMA. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: None. - Other varices or collaterals: Multiple mesenteric and splenic hilar portosystemic venous collaterals. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: Surgically absent LYMPH NODES: None enlarged. SPLEEN: Stable splenomegaly. PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Atrophic pancreas ADRENALS: Normal. KIDNEYS: Small nonobstructing left renal calculus. Subcentimeter bilateral renal cortical hypoattenuating foci too small to characterize, probably represent simple cysts. No hydronephrosis. STOMACH / SMALL BOWEL: Stomach is partially distended. There is abnormal dilatation of small bowel loops. Small gas containing periampullary duodenal diverticulum. COLON / APPENDIX: No abnormality. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: A portacaval collateral is visualized in the posterior right hepatic lobe. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings. Generalized bony demineralization. CONCLUSION: 1. Liver cirrhosis and sequelae of portal venous hypertension. 2. Stable 1.6 cm LR5 lesion in the segment 8 right hepatic lobe. No new hepatic lesions. Other stable findings as described above.
FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 8 - Size: 1.6 x 1.3 cm (series 5/image 60), previously similar size. - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: - Enhancing "capsule": Present. - Nonperipheral "washout": Present. (Series 13, image 54) - Threshold growth (>= 50% in <= 6 months): Not present. - Other features: None. - LI-RADS: LR-5 LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Replaced right hepatic artery arising from SMA. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: None. - Other varices or collaterals: Multiple mesenteric and splenic hilar portosystemic venous collaterals. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: Surgically absent LYMPH NODES: None enlarged. SPLEEN: Stable splenomegaly. PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Atrophic pancreas ADRENALS: Normal. KIDNEYS: Small nonobstructing left renal calculus. Subcentimeter bilateral renal cortical hypoattenuating foci too small to characterize, probably represent simple cysts. No hydronephrosis. STOMACH / SMALL BOWEL: Stomach is partially distended. There is abnormal dilatation of small bowel loops. Small gas containing periampullary duodenal diverticulum. COLON / APPENDIX: No abnormality. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: A portacaval collateral is visualized in the posterior right hepatic lobe. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings. Generalized bony demineralization.
FINDINGS: STRUCTURED REPORT: CT Pelvis LOWER ABDOMEN: BOWEL: Diverticulosis. The appendix is normal. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: Multiple borderline enlarged inguinal lymph nodes bilaterally. PERIRECTAL / PERIANAL REGION: Midline peripherally enhancing gas-filled collection extending superiorly from the right gluteal cleft to the lower sacrum. It measures 4.7 x 4.2 x 10.3 cm. URINARY BLADDER: Moderately distended. REPRODUCTIVE ORGANS: Fibroid uterus. Two right corpus luteal cysts. BODY WALL: Overlying skin thickening and fat stranding surrounding the midline gluteal collection. MUSCULOSKELETAL: No periosteal reaction or aggressive osseous destruction to suggest osteomyelitis. Bilateral sacroiliitis, left greater than right.
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EXAM: CT Angio Abdomen and or Pelvis w Runoff CLINICAL INFORMATION: 66-year-old female patient with peripheral vascular disease and claudication. COMPARISON: None. TECHNIQUE: CT Angio Abdomen and or Pelvis w Runoff. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 4 ml per sec. Scan delay: BOLUS TRACK sec. Scan field of view: 420 mm. DLP: 2716.82 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Aorta Runoff VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Moderate circumferential atherosclerotic disease involving the abdominal aorta with noncalcified mural plaques resulting in mild aortic narrowing for example axial image 100-113 series 305. CELIAC AXIS: No significant abnormality. There is a replaced left hepatic artery arising from left gastric artery. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: Patent. RIGHT ILIAC ARTERIES: Extensive atherosclerotic disease with moderate stenosis of the common iliac artery. The external iliac artery is patent. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Common femoral artery is patent. Superficial and profunda femoris arteries are patent. There are multifocal mild narrowing of the superficial femoral artery. The popliteal artery is patent with moderate short segment stenosis distally. RIGHT TIBIAL AND PERONEAL ARTERIES: Anterior tibial and peroneal arteries are patent proximally, however no distal opacification, possibly due to contrast bolus timing. The posterior tibial artery is not opacified. Extensive atherosclerotic disease involving the leg vessels. RIGHT FOOT ARTERIES: Poorly visualized due to contrast bolus timing. LEFT ILIAC ARTERIES: Moderate atherosclerotic disease involving the common iliac artery. The external iliac artery is patent. LEFT FEMORAL \T\ POPLITEAL ARTERIES: Common, superficial and deep femoral arteries are patent. There is an eccentric atherosclerotic plaque involving the common femoral artery before its bifurcation with moderate stenosis of the common femoral artery. Multifocal mild narrowing involving the superficial femoral artery. The popliteal artery is occluded. LEFT TIBIAL AND PERONEAL ARTERIES: Extensive atherosclerotic disease involving the leg vessels. There is reconstitution of a short segment of the proximal anterior tibial artery from collateral circulation, however the artery is occluded distally. There is reconstitution of the peroneal artery distally with likely one visible runoff to the foot through the peroneal artery LEFT FOOT ARTERIES: Poorly visualized. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild coronary artery atherosclerotic disease. Mild aortic root calcification. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. A small accessory splenule is seen. ADRENALS: Normal. KIDNEYS: Small left renal hypodensities, likely cysts. The right kidney is normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Normal. MUSCULOSKELETAL: There is a Schmorl's node with old compression deformity at L3 vertebral body. L4-L5 disc space narrowing with disc space vacuum phenomenon. CONCLUSION: 1. Extensive atherosclerotic disease as described above. 2. Likely one vessel runoff to bilateral feet. 3. Moderate atherosclerotic stenosis involving the right common iliac artery. Moderate stenosis of the left common femoral artery. 4. Mild multifocal narrowing involving bilateral superficial femoral arteries. 5. Occluded left popliteal artery with reconstitution of the distal left peroneal artery. 6. Additional CT scan findings as described.
FINDINGS: STRUCTURED REPORT: CTA Aorta Runoff VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Moderate circumferential atherosclerotic disease involving the abdominal aorta with noncalcified mural plaques resulting in mild aortic narrowing for example axial image 100-113 series 305. CELIAC AXIS: No significant abnormality. There is a replaced left hepatic artery arising from left gastric artery. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: Patent. RIGHT ILIAC ARTERIES: Extensive atherosclerotic disease with moderate stenosis of the common iliac artery. The external iliac artery is patent. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Common femoral artery is patent. Superficial and profunda femoris arteries are patent. There are multifocal mild narrowing of the superficial femoral artery. The popliteal artery is patent with moderate short segment stenosis distally. RIGHT TIBIAL AND PERONEAL ARTERIES: Anterior tibial and peroneal arteries are patent proximally, however no distal opacification, possibly due to contrast bolus timing. The posterior tibial artery is not opacified. Extensive atherosclerotic disease involving the leg vessels. RIGHT FOOT ARTERIES: Poorly visualized due to contrast bolus timing. LEFT ILIAC ARTERIES: Moderate atherosclerotic disease involving the common iliac artery. The external iliac artery is patent. LEFT FEMORAL \T\ POPLITEAL ARTERIES: Common, superficial and deep femoral arteries are patent. There is an eccentric atherosclerotic plaque involving the common femoral artery before its bifurcation with moderate stenosis of the common femoral artery. Multifocal mild narrowing involving the superficial femoral artery. The popliteal artery is occluded. LEFT TIBIAL AND PERONEAL ARTERIES: Extensive atherosclerotic disease involving the leg vessels. There is reconstitution of a short segment of the proximal anterior tibial artery from collateral circulation, however the artery is occluded distally. There is reconstitution of the peroneal artery distally with likely one visible runoff to the foot through the peroneal artery LEFT FOOT ARTERIES: Poorly visualized. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild coronary artery atherosclerotic disease. Mild aortic root calcification. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. A small accessory splenule is seen. ADRENALS: Normal. KIDNEYS: Small left renal hypodensities, likely cysts. The right kidney is normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Normal. MUSCULOSKELETAL: There is a Schmorl's node with old compression deformity at L3 vertebral body. L4-L5 disc space narrowing with disc space vacuum phenomenon.
FINDINGS: Index lesions are measured on series 301: 1. Right upper lobe solid noncalcified nodule on image 36 measures 10 x 10 compared to 7 x 7 previously. 2. Posterior basal right lower lobe solid noncalcified nodule measuring 18 x 14 mm on image 82 measured 11 x 8 mm previously. 3. Right lower lobe solid noncalcified nodule measuring 14 x 13 mm on image 69 measured 11 x 9 mm previously. 4. Previously described 3 mm superior segment left lower lobe nodule on image 33 is similar in size but appears less solid. Other solid lung nodules bilaterally also show some interval increase in size. Surgical changes related to wedge resection of the right lower lobe again noted without abnormal soft tissue thickening or nodularity along the staple lines. No pleural effusion or pleural thickening. The supraclavicular region is unremarkable. Central Patent. Thoracic aorta is nonaneurysmal scattered atherosclerotic calcifications. The pulmonary dilated. The heart is not enlarged. Mild coronary calcifications. No enlarged supraclavicular, axillary, mediastinal or hilar lymph nodes. The esophagus is not dilated. The CT of the abdomen and pelvis will be dictated separately. Soft tissue thickening within the right anterolateral intercostal space between the seventh and eighth ribs is not significantly changed prior examination. This measures 4.0 x 1.5 cm compared to 4.7 x 1.7 cm previously. No acute or aggressive osseous abnormality.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 74-year-old male with diffuse large B-cell lymphoma. COMPARISON: Outside PET/CT dated 11/11/2021. TECHNIQUE: CT Chest with contrast. Patient weight: 151 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 240 mm. DLP: 883.11 mGy cm. FINDINGS: LOWER NECK: Reported separately. CHEST: LUNGS / AIRWAYS / PLEURA: Examination is in expiration. Large right pleural effusion has worsened in the interval. Near-complete atelectasis of the right lower lobe. Small left pleural effusion. Within the limitations of motion and technique, no suspicious pulmonary nodule. HEART / VESSELS: Left-sided portacatheter terminates in the right atrium. Mildly prominent right ventricle. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: No significant abnormality in the esophagus for the technique LYMPH NODES: Multiple enlarged paraesophageal, left lower cervical/supraclavicular, bilateral internal mammary, cardiophrenic lymph nodes again seen, overall unchanged from recent PET. A representative enlarged node adjacent to the esophagus measures 2.7 x 1.9 cm on axial image 202; series 2. A 1.1 x 0.9 cm right internal mammary node on axial image 111; series 2. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Will be reported separately. MUSCULOSKELETAL: No destructive osseous lesion. CONCLUSION: 1. Enlarged paraesophageal, left supraclavicular, internal mammary and cardiophrenic lymph nodes related to patient's lymphoma. 2. Interval worsening of the large right pleural effusion with near complete collapse of the right lower lobe. Small left pleural effusion.
FINDINGS: LOWER NECK: Reported separately. CHEST: LUNGS / AIRWAYS / PLEURA: Examination is in expiration. Large right pleural effusion has worsened in the interval. Near-complete atelectasis of the right lower lobe. Small left pleural effusion. Within the limitations of motion and technique, no suspicious pulmonary nodule. HEART / VESSELS: Left-sided portacatheter terminates in the right atrium. Mildly prominent right ventricle. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: No significant abnormality in the esophagus for the technique LYMPH NODES: Multiple enlarged paraesophageal, left lower cervical/supraclavicular, bilateral internal mammary, cardiophrenic lymph nodes again seen, overall unchanged from recent PET. A representative enlarged node adjacent to the esophagus measures 2.7 x 1.9 cm on axial image 202; series 2. A 1.1 x 0.9 cm right internal mammary node on axial image 111; series 2. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Will be reported separately. MUSCULOSKELETAL: No destructive osseous lesion.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: See separate chest CT report. ABDOMEN and PELVIS: LIVER: Multiple liver hypodensities, probably cysts, are unchanged in size and number. No new hepatic lesions or gross cirrhotic morphology. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Cystic lesion in the pancreas uncinate is not well visualized. No focal pancreatic lesion or ductal dilatation. SPLEEN: Small hypoattenuating lesion in the inferior splenic parenchyma appears unchanged. Spleen is otherwise unremarkable. ADRENALS: Normal. KIDNEYS: Absent right kidney without local recurrence. Normal left kidney with peripelvic cysts. LYMPH NODES: Multiple subcentimeter periportal and para-aortic lymph nodes, unchanged. STOMACH / SMALL BOWEL: Stomach and duodenum partially distended. Small periampullary duodenal diverticulum is unchanged. Otherwise normal. COLON / APPENDIX: Colonic diverticula without diverticulitis. Normal appendix. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: No abnormality. VESSELS: Aorta is nonaneurysmal. Circumaortic left renal vein, unchanged. URINARY BLADDER: Unremarkable. REPRODUCTIVE ORGANS: Prostatomegaly, unchanged BODY WALL: Stranding near the right anterior costal margin (image 96 series 303) appears unchanged. No new abnormality. Umbilical and other midline hernias are small and unchanged. MUSCULOSKELETAL: No osseous metastases.
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NECK CT WITH IV CONTRAST CLINICAL INDICATION: Follow-up lymphoma. PROCEDURE: 1.25 mm images were obtained from the lower orbits through the thoracic inlet. Patient weight: 151 lbs. IV contrast: Omnipaque 350, 25 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 240 mm. DLP: 883.11 mGy cm. COMPARISON: PET 11/11/2021 and 9/15/2021. FINDINGS: Evaluation of the oral cavity is limited due to streak artifact. Within this limitation, there is no suspicious oral cavity mass. No suspicious laryngeal or pharyngeal masses are identified. There are no enlarged, or morphologically abnormal cervical lymph nodes. The parotid and submandibular glands are unremarkable. Thyroid gland is within normal limits. The visualized paranasal sinuses are clear. The included intracranial contents and orbits are grossly unremarkable. The visualized osseous structures demonstrate no suspicious lytic or blastic lesions. There are multilevel disc height loss and endplate remodeling changes. No high-grade bony canal stenosis. Multilevel up to moderate neuroforaminal stenosis There is a left chest wall MediPort. Please refer to the CT chest report for the assessment of thoracic findings, such as large right pleural effusion. There is moderate calcifications at bilateral carotid bifurcations, without flow-limiting stenosis. IMPRESSION: No enlarged or morphologically abnormal cervical lymph nodes. Please refer to the CT chest report for the assessment of thoracic findings, such as large right pleural effusion.
FINDINGS: Evaluation of the oral cavity is limited due to streak artifact. Within this limitation, there is no suspicious oral cavity mass. No suspicious laryngeal or pharyngeal masses are identified. There are no enlarged, or morphologically abnormal cervical lymph nodes. The parotid and submandibular glands are unremarkable. Thyroid gland is within normal limits. The visualized paranasal sinuses are clear. The included intracranial contents and orbits are grossly unremarkable. The visualized osseous structures demonstrate no suspicious lytic or blastic lesions. There are multilevel disc height loss and endplate remodeling changes. No high-grade bony canal stenosis. Multilevel up to moderate neuroforaminal stenosis There is a left chest wall MediPort. Please refer to the CT chest report for the assessment of thoracic findings, such as large right pleural effusion. There is moderate calcifications at bilateral carotid bifurcations, without flow-limiting stenosis.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Nodules in the lung bases with central cavitation. DISTAL ESOPHAGUS: Air-fluid level, compatible with gastroesophageal reflux disease. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Trace fatty infiltration along the falciform ligament BILIARY TRACT: Normal. GALLBLADDER: Collapsed. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right upper pole cortical scarring, likely sequela of prior infection. LYMPH NODES: Soft tissue nodule anterior to the left iliac artery, measuring 1.7 x 3.5 may represent lymph node. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Appendix is not visualized. Sigmoid diverticulosis with stranding along the left paracolic gutter. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Nonocclusive thrombus in the left common femoral and external iliac veins. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Enlarged hypoattenuating prostate. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Scattered low attenuating fluid collections are seen within the musculature of the left hip, primarily involving the adductor muscles as well as the ischiocavernosus.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Lymphoma COMPARISON: None available. Reference is made to outside PET/CT from 11/11/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 151 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 385 mm. DLP: 848.02 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis The chest portion of the exam will be reported separately ABDOMEN and PELVIS: LIVER: Serosal implants are present along the liver capsule and along the fissure for the falciform ligament. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: None enlarged. Small hypoattenuating lesion along the anterior aspect of the spleen. ADRENALS: Normal. KIDNEYS: Nonobstructing bilateral renal stones. There is moderate left hydronephrosis with a double-J ureteral stent in place coursing through the large pelvic mass and terminating within the urinary bladder. LYMPH NODES: Large nodal conglomerate in the abdomen and pelvis (below) with additional enlarged lymph nodes throughout the periaortic regions, iliac chains, and mesentery. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Displacement of the sigmoid colon by the left pelvic mass. The sigmoid colon colon appears circumferentially thickened. No evidence of obstruction. PERITONEUM / MESENTERY: Diffuse peritoneal nodularity as well as omental thickening. Moderate ascites RETROPERITONEUM: Left pelvic mass encases the left iliac vasculature and measures 9.7 x 8.4 cm on image 443, series 2. Extensive periaortic adenopathy measures 8.1 x 4.5 cm on image 325, series 2) VESSELS: IVC filter is in place in the infrarenal IVC. URINARY BLADDER: Predominantly collapsed and mildly thick-walled. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Diffuse peritoneal carcinomatosis and large nodal conglomerate in the retroperitoneum and left pelvis, as above. 2. Moderate left hydronephrosis despite the presence of a ureteral stent. 3. Circumferential thickening of the sigmoid colon may be secondary to lymphomatous involvement. 4. Moderate ascites. 5. Additional findings as above.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis The chest portion of the exam will be reported separately ABDOMEN and PELVIS: LIVER: Serosal implants are present along the liver capsule and along the fissure for the falciform ligament. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: None enlarged. Small hypoattenuating lesion along the anterior aspect of the spleen. ADRENALS: Normal. KIDNEYS: Nonobstructing bilateral renal stones. There is moderate left hydronephrosis with a double-J ureteral stent in place coursing through the large pelvic mass and terminating within the urinary bladder. LYMPH NODES: Large nodal conglomerate in the abdomen and pelvis (below) with additional enlarged lymph nodes throughout the periaortic regions, iliac chains, and mesentery. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Displacement of the sigmoid colon by the left pelvic mass. The sigmoid colon colon appears circumferentially thickened. No evidence of obstruction. PERITONEUM / MESENTERY: Diffuse peritoneal nodularity as well as omental thickening. Moderate ascites RETROPERITONEUM: Left pelvic mass encases the left iliac vasculature and measures 9.7 x 8.4 cm on image 443, series 2. Extensive periaortic adenopathy measures 8.1 x 4.5 cm on image 325, series 2) VESSELS: IVC filter is in place in the infrarenal IVC. URINARY BLADDER: Predominantly collapsed and mildly thick-walled. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: Minimal Left cerebral hemisphere atrophy with corresponding subdural hygroma. Foci of a small extra-axial calcification in the left cerebral hemisphere is likely sequela of previous old subdural hemorrhage. Mild ex vacuo dilatation of the left lateral ventricle without hydrocephalus. No abnormal enhancing lesions. The overlying left calvarium is thinned with with retained non-metallic shunt fragment adjacent to the internal vault (series 8, 430). Chronic dural calcifications. The skull base segments of the internal carotid arteries are normal in course, caliber, and contour. The anterior, middle, and posterior cerebral arteries are normal in course, caliber, and contour. The intradural segments of the vertebral arteries as well as the basilar artery are normal in course, caliber, and contour. There is no evidence for saccular aneurysm, vascular malformation, or large vessel occlusion.
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EXAM: CT Abdomen with contrast CLINICAL INFORMATION: History of pancreatitis and prior fluid collections. COMPARISON: 10/12/2021. TECHNIQUE: CT Abdomen with contrast. Patient weight: 160 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Oral contrast Omnipaque: 16.9 oz. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 97sec Scan field of view: 400 mm. DLP: 284 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: There has been interval resolution of the previously noted pancreatic fluid collection, with residual soft tissue irregularity visualized (series 3, image 67). There is persistent upstream ductal dilatation in the distal pancreatic body and pancreatic tail which measures up to 4 mm (series 3, image 68). The pancreatic head appears overall normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions. CONCLUSION: Interval resolution of the previously noted pancreatic walled off necrosis with residual soft tissue stranding noted. There is persistent ductal dilatation upstream, similar to prior. No definite abnormal parenchymal enhancement or findings to suggest acute pancreatitis.
FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: There has been interval resolution of the previously noted pancreatic fluid collection, with residual soft tissue irregularity visualized (series 3, image 67). There is persistent upstream ductal dilatation in the distal pancreatic body and pancreatic tail which measures up to 4 mm (series 3, image 68). The pancreatic head appears overall normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Residual thymic tissue in the anterior mediastinal fat is slightly decreased from the previous exam along the inferior edge of the suture line. Parenchymal atelectasis against the upper right mediastinal border has also decreased. Calcified mediastinal and right hilar nodes are redemonstrated. No enlarged intrathoracic lymph nodes are identified. Small hiatal hernia is seen with some dilatation of the mid esophagus. Within the limits of a noncontrast exam, the heart size and the mediastinum are otherwise normal. No pleural effusion. A few calcified granuloma are present in the right lung. Slight scarring and atelectasis in the medial RUL and RML is decreased from the prior exam as previously noted. Small groundglass nodule is seen in the peripheral RUL on series 301 image 154 and is unchanged from series 4 image 190 on the prior. Additional tiny RUL nodule on image 160 appears to be focal secretions within the bronchus. A cluster of tiny nodules are seen peripherally in the LLL on image 188 appear overall unchanged from the prior exam on series 4 image 230 . The lungs are otherwise normal. Previous surgery to the stomach and surgical removal of the gallbladder. Within the limits of a noncontrast exam the upper abdomen is otherwise unremarkable. Bilateral breast implants are redemonstrated. No focal destructive osseous lesions.
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CT Thoracic Spine w Myelogram Clinical Information: possible arachnoid cyst of T6 spinal cord, D49.2 Neoplasm of unspecified behavior of bone, soft tissue, and skin Spec Inst: please do immediate CT T-spine myelogram and also a 2 hour post injection myelogram of CT T-spine Technique: CT of the thoracic spine without IV contrast was performed approximately 70 minutes after intrathecal contrast administration. Patient weight: 179 lbs. Scan delay: 0 sec. Scan field of view: 162 mm. DLP: 1020 mGy cm. Comparison: MRI of the thoracic spine dated 1/4/2022 Findings: Approximately 70 minutes after administration of intrathecal contrast, thoracic spine CT myelogram was performed. CT myelogram images demonstrate focal distortion of the dorsal spinal cord at the level of T6 with slight ventral cord displacement. The dorsal cord distortion has the appearance of a "scalpel sign" suggestive of a dorsal arachnoid web. Intrathecal contrast is seen within the ventral and dorsal CSF spaces at this level. Cord appears to be confined within the thecal borders. No contrast is seen within the epidural space. There is diffuse bony demineralization. Multilevel discogenic degenerative changes of the thoracic spine without significant spinal canal or foraminal stenosis throughout the thoracic spinal levels. Conclusion: Focal distortion of the dorsal spinal cord at the level of T6 with appearance of a "scalpel sign" most suggestive of a dorsal arachnoid web. However, given lack of immediate post-intrathecal contrast imaging, arachnoid cyst with early filling could have very similar appearance. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
Findings: Approximately 70 minutes after administration of intrathecal contrast, thoracic spine CT myelogram was performed. CT myelogram images demonstrate focal distortion of the dorsal spinal cord at the level of T6 with slight ventral cord displacement. The dorsal cord distortion has the appearance of a "scalpel sign" suggestive of a dorsal arachnoid web. Intrathecal contrast is seen within the ventral and dorsal CSF spaces at this level. Cord appears to be confined within the thecal borders. No contrast is seen within the epidural space. There is diffuse bony demineralization. Multilevel discogenic degenerative changes of the thoracic spine without significant spinal canal or foraminal stenosis throughout the thoracic spinal levels.
FINDINGS: There has been interval placement of a right deep brain stimulator electrode which terminates within the right subthalamic nucleus. The left frontal deep brain stimulator is unchanged in position, terminating in the left subthalamic nucleus. There is mild right anterior cranial fossa pneumocephalus and postsurgical changes in the right scalp soft tissues. There is no midline shift or intracranial hemorrhage identified. Persistent age-appropriate frontoparietal brain parenchymal volume loss. The white-gray matter differentiation is preserved. There is no hydrocephalus or basal cistern effacement. Punctate atherosclerotic calcifications of the left carotid siphon and bilateral vertebral arteries. The orbits are normal in appearance. The paranasal sinuses, including the mastoid air cells, are clear.
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EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Evaluate for dissection COMPARISON: None. TECHNIQUE: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 135 lbs. IV contrast: Omnipaque 350, 70 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.70 ml per sec. Scan delay: bolus tracking Scan field of view: 367.90 mm. KVP: 100 DLP: 2797.40 mGy cm. (accession CT220002539), Patient weight: 135 lbs. IV contrast: Omnipaque 350, 70 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.70 ml per sec. Scan delay: bolus tracking Scan field of view: 367.90 mm. DLP: 2797.40 mGy cm. (accession CT220002540) FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: Mild atherosclerotic disease. CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Mild atherosclerotic narrowing of the celiac origin. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC: No significant abnormality. LEFT COMMON ILIAC: No significant abnormality. RIGHT EXTERNAL ILIAC: No significant abnormality LEFT EXTERNAL ILIAC: No significant abnormality ------------------------------------------------------------ CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Few small simple renal cysts. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. URINARY BLADDER: No abnormality REPRODUCTIVE ORGANS: Enlarged prostate gland. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute fracture. CONCLUSION: 1. No aortic dissection or other acute aortic syndrome. No acute abnormality in the chest, abdomen, or pelvis. 2. Mild aortoiliac atherosclerotic disease and additional chronic incidental findings as above.
FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: Mild atherosclerotic disease. CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Mild atherosclerotic narrowing of the celiac origin. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC: No significant abnormality. LEFT COMMON ILIAC: No significant abnormality. RIGHT EXTERNAL ILIAC: No significant abnormality LEFT EXTERNAL ILIAC: No significant abnormality ------------------------------------------------------------ CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Few small simple renal cysts. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. URINARY BLADDER: No abnormality REPRODUCTIVE ORGANS: Enlarged prostate gland. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute fracture.
FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Emphysematous changes with mild atelectasis redemonstrated within bilateral lung bases. No pleural effusion. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Noncirrhotic. Small regions of arterial hyperenhancement seen within the anterior right hepatic lobe and inferior left hepatic lobe, which does not demonstrate washout on portal venous phase. Mild hypoenhancement is seen along the gallbladder fossa, likely secondary to focal fat. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal in size. Cyst is seen within the inferior spleen. ADRENALS: Normal. KIDNEYS: Simple left renal cyst. Otherwise, bilateral kidneys are normal without hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. The appendix is not definitively visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcification of the abdominal aorta which is normal in caliber. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions.
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EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Evaluate for dissection COMPARISON: None. TECHNIQUE: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 135 lbs. IV contrast: Omnipaque 350, 70 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.70 ml per sec. Scan delay: bolus tracking Scan field of view: 367.90 mm. KVP: 100 DLP: 2797.40 mGy cm. (accession CT220002539), Patient weight: 135 lbs. IV contrast: Omnipaque 350, 70 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.70 ml per sec. Scan delay: bolus tracking Scan field of view: 367.90 mm. DLP: 2797.40 mGy cm. (accession CT220002540) FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: Mild atherosclerotic disease. CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Mild atherosclerotic narrowing of the celiac origin. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC: No significant abnormality. LEFT COMMON ILIAC: No significant abnormality. RIGHT EXTERNAL ILIAC: No significant abnormality LEFT EXTERNAL ILIAC: No significant abnormality ------------------------------------------------------------ CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Few small simple renal cysts. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. URINARY BLADDER: No abnormality REPRODUCTIVE ORGANS: Enlarged prostate gland. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute fracture. CONCLUSION: 1. No aortic dissection or other acute aortic syndrome. No acute abnormality in the chest, abdomen, or pelvis. 2. Mild aortoiliac atherosclerotic disease and additional chronic incidental findings as above.
FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: Mild atherosclerotic disease. CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Mild atherosclerotic narrowing of the celiac origin. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC: No significant abnormality. LEFT COMMON ILIAC: No significant abnormality. RIGHT EXTERNAL ILIAC: No significant abnormality LEFT EXTERNAL ILIAC: No significant abnormality ------------------------------------------------------------ CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Few small simple renal cysts. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. URINARY BLADDER: No abnormality REPRODUCTIVE ORGANS: Enlarged prostate gland. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute fracture.
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Interval development of bilateral peripheral predominant groundglass opacities. Small calcified granuloma in the left lower, right middle, and right lower lobes. No pleural effusion or pneumothorax. HEART / OTHER VESSELS: Coronary artery calcifications. The left common carotid arises from the brachiocephalic trunk, normal variant. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: The gallbladder is absent. MUSCULOSKELETAL: No significant abnormality.
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NECK CT WITH IV CONTRAST CLINICAL INDICATION: Squamous cell carcinoma of the conjunctival surface of left eyelid, status post resection PROCEDURE: 1.25 mm images were obtained from the lower orbits through the thoracic inlet. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 25 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 45sec Scan field of view: 250 mm. DLP: 759 mGy cm. COMPARISON: CT 6/3/2021, 2/24/2021. FINDINGS: There is unchanged mild soft tissue thickening involving the lower eyelid with a small indentation (findings are best seen on series 5 image 98-108). There are no enlarged, or morphologically abnormal cervical lymph nodes. No suspicious laryngeal or pharyngeal masses are identified. The parotid and submandibular glands are unremarkable. Again seen is a small calcified subcentimeter left thyroid nodule. The visualized paranasal sinuses are clear. The included intracranial contents and orbits are grossly unremarkable. The visualized osseous structures demonstrate no suspicious lytic or blastic lesions. Please refer to the dedicated CT chest report for the assessment of thoracic contents, including the 7 mm right upper lobe subpleural nodule. IMPRESSION: Unchanged mild soft tissue thickening involving the lower eyelid with a small indentation. This was found to be scar on tissue diagnosis. No enlarged or morphologically abnormal cervical lymph nodes. Please refer to the dedicated CT chest report for the assessment of thoracic contents, including the 7 mm right upper lobe subpleural nodule.
FINDINGS: There is unchanged mild soft tissue thickening involving the lower eyelid with a small indentation (findings are best seen on series 5 image 98-108). There are no enlarged, or morphologically abnormal cervical lymph nodes. No suspicious laryngeal or pharyngeal masses are identified. The parotid and submandibular glands are unremarkable. Again seen is a small calcified subcentimeter left thyroid nodule. The visualized paranasal sinuses are clear. The included intracranial contents and orbits are grossly unremarkable. The visualized osseous structures demonstrate no suspicious lytic or blastic lesions. Please refer to the dedicated CT chest report for the assessment of thoracic contents, including the 7 mm right upper lobe subpleural nodule.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: There is patchy bilateral groundglass opacity. There is a right lower lobe calcified granuloma. No pleural effusions are seen. DISTAL ESOPHAGUS: Unremarkable. HEART / VESSELS: The visualized heart is normal in size. ABDOMEN and PELVIS: LIVER: There is a probable cyst in the left lobe of the liver. BILIARY TRACT: Normal. GALLBLADDER: Status post cholecystectomy. PANCREAS: Status post distal pancreatectomy. SPLEEN: Status post splenectomy. ADRENALS: Normal. KIDNEYS: No hydronephrosis or nephrolithiasis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach appears unremarkable. The loops of small bowel are normal in caliber COLON / APPENDIX: There is thickening of the mid to distal transverse colon and descending colon with adjacent stranding. There is colonic diverticulosis. There are postoperative changes of the sigmoid colon. The appendix is surgically absent. PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Normal. VESSELS: Moderate to severe calcified atherosclerotic disease. URINARY BLADDER: Unremarkable. REPRODUCTIVE ORGANS: Status post hysterectomy. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: There is an intrathecal stimulator. There are degenerative changes of the spine, hips and pubic symphysis. There is anterolisthesis of L4 on L5.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 52-year-old female with history of orbit cancer. COMPARISON: CT chest with contrast dated 6/3/2021. TECHNIQUE: CT Chest with contrast. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 35sec Scan field of view: 330 mm. DLP: 267 mGy cm. FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. A subcentimeter groundglass nodule in the peripheral right upper lobe measuring 7 x 6 mm on axial image 23; series 3, previously 8 x 5 mm. A few other calcified and noncalcified pulmonary nodules, overall unchanged. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. No central PE. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Diffuse hepatic steatosis. Low-attenuation adrenal nodules, unchanged. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. A few calcified and noncalcified pulmonary nodules, overall unchanged. No convincing evidence of intrathoracic metastasis. 2. Hepatic steatosis, low-attenuation adrenal nodules and other incidental findings as above.
FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. A subcentimeter groundglass nodule in the peripheral right upper lobe measuring 7 x 6 mm on axial image 23; series 3, previously 8 x 5 mm. A few other calcified and noncalcified pulmonary nodules, overall unchanged. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. No central PE. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Diffuse hepatic steatosis. Low-attenuation adrenal nodules, unchanged. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Heterogenous exophytic nodule arising from the right lobe of the thyroid inferiorly is again seen. CHEST: LUNGS / AIRWAYS / PLEURA: Redemonstrated postsurgical changes of right upper lobectomy. Peripheral small wedge-shaped opacity in the right lower lobe, likely an area of scarring appears unchanged. No suspicious pulmonary nodules. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Mediastinum is shifted to the right secondary to the right upper lobectomy. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous lesions..
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EXAM: CT Abdomen wo+w contrast CLINICAL INFORMATION: Evaluate hepatic lesions. COMPARISON: None. TECHNIQUE: CT Abdomen wo+w contrast. Patient weight: 240 lbs. IV contrast: Omnipaque 350, 180 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracker Scan field of view: 410 mm. DLP: 3591.50 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: There is diffuse hepatic steatosis. No CT evidence of cirrhosis. Numerous hypoattenuating lesions are seen throughout the liver which measure fluid density and do not demonstrate suspicious enhancement. The largest is within the inferior right hepatic lobe which measures 4.8 x 5.2 cm (series 601, image 113). No internal septations or suspicious enhancing mural nodularity is visualized. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Small cyst is seen within the superior spleen. ADRENALS: Normal. KIDNEYS: Right renal sinus cyst. Otherwise, bilateral kidneys are normal without hydronephrosis. LYMPH NODES: Borderline prominent pericaval node which does not meet size criteria for lymphadenopathy. Few prominent lower quadrant mesenteric nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON: Scattered diverticulosis without evidence of diverticulitis. Otherwise, the colon, including the appendix, is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: Ventral abdominal wall defect in the epigastric region contains herniated fat which demonstrates mild associated stranding. MUSCULOSKELETAL: No aggressive osseous lesions. CONCLUSION: 1. Diffuse hepatic steatosis without evidence of cirrhosis. Multiple hepatic cysts as detailed above. 2. Fat containing ventral abdominal wall hernia with associated stranding. Correlation with physical exam is recommended to ensure reducibility. 3. Additional incidental findings as above.
FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: There is diffuse hepatic steatosis. No CT evidence of cirrhosis. Numerous hypoattenuating lesions are seen throughout the liver which measure fluid density and do not demonstrate suspicious enhancement. The largest is within the inferior right hepatic lobe which measures 4.8 x 5.2 cm (series 601, image 113). No internal septations or suspicious enhancing mural nodularity is visualized. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Small cyst is seen within the superior spleen. ADRENALS: Normal. KIDNEYS: Right renal sinus cyst. Otherwise, bilateral kidneys are normal without hydronephrosis. LYMPH NODES: Borderline prominent pericaval node which does not meet size criteria for lymphadenopathy. Few prominent lower quadrant mesenteric nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON: Scattered diverticulosis without evidence of diverticulitis. Otherwise, the colon, including the appendix, is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: Ventral abdominal wall defect in the epigastric region contains herniated fat which demonstrates mild associated stranding. MUSCULOSKELETAL: No aggressive osseous lesions.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Pelvis Renal Transplant VASCULATURE: LOWER ABDOMINAL AORTA: Moderate calcified atherosclerotic disease. RIGHT COMMON / INTERNAL ILIAC ARTERIES: Moderate calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: Mild calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: Moderate calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: Mild calcified atherosclerotic disease. LOWER ABDOMEN: BOWEL: Moderate colonic diverticulosis. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Diffuse urinary bladder wall thickening with under distention. REPRODUCTIVE ORGANS: Prostate is enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 70-year-old man with provided history of SCLC. COMPARISON: PET/CT dated 11/5/2021 and Chest CT 1/16/2021 TECHNIQUE: CT Chest with contrast. Patient weight: 290 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 40sec Scan field of view: 460 mm. DLP: 862 mGy cm. FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: Left chest wall dual chamber pacemaker transvenous terminate at the right atrial appendage and right ventricular apex. Lung parenchyma and pleura: Redemonstrated right-sided volume loss with consolidative opacities in the right paramediastinal region, similar to prior. Redemonstrated moderate right loculated pleural effusion with mild pleural thickening, unchanged. This is associated right atelectasis and hyper inflation of the left lung. Difficult to assess previously noted right hilar hypermetabolic lesions secondary to volume loss and overlying consolidative opacities. Previously noted peripheral left lung small nodular opacities slightly improved from prior. No new or enlarging suspicious pulmonary nodule. The trachea and main bronchi are patent. Thoracic inlet, heart, and mediastinum: A 19 x 17 right lower paratracheal nodule (image 37, series 3) is similar to prior. No new lymphadenopathy in the thorax has been identified. The esophagus is nondilated. The thoracic aorta is normal in caliber with mild atherosclerotic calcifications. Main pulmonary artery is dilated, measures 3.2 cm. The overall heart size is normal. No pericardial effusion. Moderate coronary calcification. Bones and soft tissues: No destructive bone lesion. Bilateral gynecomastia. Upper abdomen: Postcholecystectomy changes. Stable partially visualized left renal probably cyst. CONCLUSION: 1. Unchanged postradiation changes in the right lung with loculated right pleural effusion and right hilar mediastinal consolidative opacities with volume loss. 2. Unchanged right lower paratracheal lymph node. No new lymphadenopathy is been identified. No new or enlarging suspicious pulmonary nodule. 3. Other findings as described.
FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: Left chest wall dual chamber pacemaker transvenous terminate at the right atrial appendage and right ventricular apex. Lung parenchyma and pleura: Redemonstrated right-sided volume loss with consolidative opacities in the right paramediastinal region, similar to prior. Redemonstrated moderate right loculated pleural effusion with mild pleural thickening, unchanged. This is associated right atelectasis and hyper inflation of the left lung. Difficult to assess previously noted right hilar hypermetabolic lesions secondary to volume loss and overlying consolidative opacities. Previously noted peripheral left lung small nodular opacities slightly improved from prior. No new or enlarging suspicious pulmonary nodule. The trachea and main bronchi are patent. Thoracic inlet, heart, and mediastinum: A 19 x 17 right lower paratracheal nodule (image 37, series 3) is similar to prior. No new lymphadenopathy in the thorax has been identified. The esophagus is nondilated. The thoracic aorta is normal in caliber with mild atherosclerotic calcifications. Main pulmonary artery is dilated, measures 3.2 cm. The overall heart size is normal. No pericardial effusion. Moderate coronary calcification. Bones and soft tissues: No destructive bone lesion. Bilateral gynecomastia. Upper abdomen: Postcholecystectomy changes. Stable partially visualized left renal probably cyst.
Findings: Brain parenchyma: Interval development of confluent cortical-based, wedge-shaped, hypoattenuation involving the right temporo-occipital lobe, extending into the right corona radiata, suggestive of developing right MCA territory infarct, without evidence of hemorrhagic transformation. Evolving known left MCA territory infarct with associated serpiginous hyperattenuation, consistent with left MCA territory infarct and cortical laminar necrosis. Diffuse age-appropriate brain parenchymal volume loss is again seen, resulting in ex vacuo dilatation of the ventricular system. Additional periventricular and subcortical white matter hypoattenuation is unchanged, suggestive of mild chronic microvascular ischemic disease. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No confluent intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Punctate atherosclerotic calcifications of the bilateral carotid siphons.. Soft tissues: Unremarkable without discrete fluid collections. Orbits: Normal appearance. Unchanged bilateral lens replacements. Calvarium and skull base: No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Persistent moderate opacification of the right sphenoid sinus, with scattered ethmoid air cell, left sphenoid and bilateral maxillary sinus mucosal thickening. Otherwise, remain well aerated.
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CT Head wo contrast 1/5/2022 7:06 PM Clinical information: ams Comparison: CT head 10/20/2021 Technique: 5 mm axial images were obtained without contrast from the base of the skull to the vertex with sagittal and coronal reformats. Scan field of view: 230 mm. DLP: 1370.10 mGy cm. Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Previously seen right convexity subdural collection has resolved. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal. Improving small soft tissue contusion in left frontal scalp. Impression: No CT evidence of acute intracranial abnormality. Previously seen right convexity subdural collection has resolved.
Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Previously seen right convexity subdural collection has resolved. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal. Improving small soft tissue contusion in left frontal scalp.
Findings: Lines and Tubes: None. Body Wall and Abdomen: No destructive osseous lesions. Fracture callus is present at the posterolateral seventh-10th ribs. Large hiatal hernia which contains some of the ascites present within the remainder of the abdomen and pelvis Lymph Nodes, Mediastinum and Neck: A few shotty axillary lymph nodes are present bilaterally. Lower left paratracheal lymph node measures 1.9 x 0.8 cm image 89 series 201. Right paratracheal lymph node measures 1.1 cm short axis image 66. A few other shotty mediastinal lymph nodes are present. Lungs and Pleura: Small left pleural effusion. A few tiny scattered nodules are present, for instance subpleural right upper lobe image 88, 4 mm left upper lobe nodule image 98, 4 mm right lower lobe nodule image 145. There are a few patchy groundglass opacities bilaterally. Cardiovascular: Mild cardiomegaly. Low-density blood pool. No large pericardial effusion.
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EXAM: CT Angio Abdomen and or Pelvis w Runoff CLINICAL INFORMATION: 77-year-old female with history of peripheral artery disease status post multiple stents and left common femoral artery to peroneal artery in March 2021. COMPARISON: CT dated 7/16/2021 TECHNIQUE: CT Angio Abdomen and or Pelvis w Runoff. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 125 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 2.60 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 360 mm. DLP: 1296.23 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Aorta Runoff VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Circumferential atheromatous disease. ABDOMINAL AORTA: Multifocal ectasia of the infrarenal abdominal aorta to 2.4 cm. Near circumferential atherosclerotic calcification is seen throughout. Three severe atherosclerotic disease involving the distal abdominal aorta with severe stenosis at the bifurcation. CELIAC AXIS: Mild ostial atherosclerotic disease without significant narrowing. Left gastric artery appears to arise directly from the aorta. SMA: Moderate ostial stenosis with distal patency. There is near circumferential atherosclerotic disease of the mid SMA. RIGHT RENAL: Patent. LEFT RENAL: Patent. IMA: Patent. RIGHT ILIAC ARTERIES: There is severe atherosclerotic calcification of the aortic bifurcation resulting in diminutive/stenotic appearance of the proximal right common iliac and internal iliac arteries. Mild multifocal atherosclerosis is seen throughout the external iliac artery. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Scattered eccentric atherosclerotic calcification without occlusion. RIGHT TIBIAL AND PERONEAL ARTERIES: No significant abnormality. RIGHT FOOT ARTERIES: No significant abnormality. Three vessels runoff to the foot. Multiple calcified lung granulomas are seen bilaterally. Multiple bilateral calcified lung granulomas admission CT scan findings as described including findings of perivesicular stranding and circumferential LEFT ILIAC ARTERIES: Severe atherosclerotic calcification of the aortic bifurcation resulting in moderate proximal left common iliac artery stenosis. Scattered atherosclerotic calcification is seen throughout the remainder of the left common and external iliac arteries. LEFT FEMORAL \T\ POPLITEAL ARTERIES: There is occlusion of the left common femoral artery to peroneal artery bypass stent graft. The native left superficial and popliteal arteries are chronically occluded. The distal popliteal artery reconstitutes from collateral circulation with diminutive caliber. Profunda femoris arteries patent. LEFT TIBIAL AND PERONEAL ARTERIES: The posterior tibial artery is occluded. Anterior tibial and peroneal arteries are patent with short segment occlusion involving the anterior tibial artery. LEFT FOOT ARTERIES: Two vessels runoff to the foot. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Multiple calcified granulomas are seen bilaterally. Prominent pneumatocele adjacent to the left heart border. No focal consolidation or pleural effusion. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Large cyst in the inferior right hepatic lobe which measures 5.9 x 5.2 cm and attenuates slightly higher than expected for simple fluid. Focal fatty deposition adjacent to the falciform ligament. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal for technique. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without diverticulitis. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Marked perivesicular stranding with circumferential wall thickening, may be related to cystitis versus underdistention. REPRODUCTIVE ORGANS: Uterus is absent. No suspicious adnexal mass. BODY WALL: Prominent bilateral lower extremity edema, left worse than right. MUSCULOSKELETAL: Status post right total hip arthroplasty. Bones appear demineralized. CONCLUSION: 1. Severe atherosclerotic disease, most prominent at the aortic bifurcation with resultant severe stenosis of the distal abdominal aorta at the bifurcation and moderate proximal bilateral common iliac artery stenosis. 2. Occluded left common femoral to peroneal artery stent graft. 3. Occluded left popliteal artery with distal reconstitution however with diminutive caliber. 4. Occluded left posterior tibial artery with two vessels runoff to the left foot. 5. Three vessels runoff to the right foot. 6. Perivesicular stranding and circumferential mild wall thickening, may be related to cystitis versus underdistention. Correlation with urinalysis is recommended. 7. Additional CT scan findings as described. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: STRUCTURED REPORT: CTA Aorta Runoff VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Circumferential atheromatous disease. ABDOMINAL AORTA: Multifocal ectasia of the infrarenal abdominal aorta to 2.4 cm. Near circumferential atherosclerotic calcification is seen throughout. Three severe atherosclerotic disease involving the distal abdominal aorta with severe stenosis at the bifurcation. CELIAC AXIS: Mild ostial atherosclerotic disease without significant narrowing. Left gastric artery appears to arise directly from the aorta. SMA: Moderate ostial stenosis with distal patency. There is near circumferential atherosclerotic disease of the mid SMA. RIGHT RENAL: Patent. LEFT RENAL: Patent. IMA: Patent. RIGHT ILIAC ARTERIES: There is severe atherosclerotic calcification of the aortic bifurcation resulting in diminutive/stenotic appearance of the proximal right common iliac and internal iliac arteries. Mild multifocal atherosclerosis is seen throughout the external iliac artery. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Scattered eccentric atherosclerotic calcification without occlusion. RIGHT TIBIAL AND PERONEAL ARTERIES: No significant abnormality. RIGHT FOOT ARTERIES: No significant abnormality. Three vessels runoff to the foot. Multiple calcified lung granulomas are seen bilaterally. Multiple bilateral calcified lung granulomas admission CT scan findings as described including findings of perivesicular stranding and circumferential LEFT ILIAC ARTERIES: Severe atherosclerotic calcification of the aortic bifurcation resulting in moderate proximal left common iliac artery stenosis. Scattered atherosclerotic calcification is seen throughout the remainder of the left common and external iliac arteries. LEFT FEMORAL \T\ POPLITEAL ARTERIES: There is occlusion of the left common femoral artery to peroneal artery bypass stent graft. The native left superficial and popliteal arteries are chronically occluded. The distal popliteal artery reconstitutes from collateral circulation with diminutive caliber. Profunda femoris arteries patent. LEFT TIBIAL AND PERONEAL ARTERIES: The posterior tibial artery is occluded. Anterior tibial and peroneal arteries are patent with short segment occlusion involving the anterior tibial artery. LEFT FOOT ARTERIES: Two vessels runoff to the foot. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Multiple calcified granulomas are seen bilaterally. Prominent pneumatocele adjacent to the left heart border. No focal consolidation or pleural effusion. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Large cyst in the inferior right hepatic lobe which measures 5.9 x 5.2 cm and attenuates slightly higher than expected for simple fluid. Focal fatty deposition adjacent to the falciform ligament. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal for technique. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without diverticulitis. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Marked perivesicular stranding with circumferential wall thickening, may be related to cystitis versus underdistention. REPRODUCTIVE ORGANS: Uterus is absent. No suspicious adnexal mass. BODY WALL: Prominent bilateral lower extremity edema, left worse than right. MUSCULOSKELETAL: Status post right total hip arthroplasty. Bones appear demineralized.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Cirrhotic. Numerous hepatic cystic lesions are unchanged in size and distribution compared to prior examination. Instability for the additional previously described hepatic lesions is limited due to noncontrast technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Splenomegaly. ADRENALS: Normal. KIDNEYS: Left renal cyst. Otherwise, bilateral kidneys are normal for technique without hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Moderate hiatal hernia. The small bowel appears normal. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is not definitively visualized. PERITONEUM / MESENTERY: Moderate volume ascites, increased compared to prior CT. No free intraperitoneal air. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate diffuse anasarca. Left inguinal hernia containing ascitic fluid. MUSCULOSKELETAL: Questionable lytic lesion in the proximal left femur (series 201, image 526; series 203, image 185).
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EXAM: CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Giant cell arteritis, weight loss and abdominal pain COMPARISON: None. TECHNIQUE: CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 122 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Track Scan field of view: 350 mm. DLP: 439 mGy cm. FINDINGS: VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. Mild atherosclerotic wall calcifications. CELIAC AXIS: No significant abnormality. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: Focal calcification at the left renal artery origin without any critical stenosis. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Small hypoattenuating lesion measuring 1.3 x 1.2 cm in the posterior right hepatic lobe (series 3/image 32 with tiny focus of enhancement in the anterior aspect. Small hypoattenuating lesion measuring 1.6 cm in the medial segment of left lobe (on series 3/image 91). Few other tiny, subcentimeter hypoattenuating lesions in the liver, not well evaluated on single-arterial phase CT. Liver is noncirrhotic. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Surgically absent uterus. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings. Multilevel degenerative changes in lumbar spine predominantly at L5-S1. CONCLUSION: 1. Except for few scattered atherosclerotic wall calcifications of abdominal aorta, iliac arteries and major visceral arteries, CT angiogram abdomen is otherwise unremarkable. 2. Incidental finding of multiple hypoattenuating hepatic lesions, not well characterized on current single phase CT and may represent benign lesions like simple cyst/hemangioma. This can be confirmed by nonemergent multiphasic MRI.
FINDINGS: VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. Mild atherosclerotic wall calcifications. CELIAC AXIS: No significant abnormality. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: Focal calcification at the left renal artery origin without any critical stenosis. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Small hypoattenuating lesion measuring 1.3 x 1.2 cm in the posterior right hepatic lobe (series 3/image 32 with tiny focus of enhancement in the anterior aspect. Small hypoattenuating lesion measuring 1.6 cm in the medial segment of left lobe (on series 3/image 91). Few other tiny, subcentimeter hypoattenuating lesions in the liver, not well evaluated on single-arterial phase CT. Liver is noncirrhotic. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Surgically absent uterus. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings. Multilevel degenerative changes in lumbar spine predominantly at L5-S1.
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: Unremarkable. CHEST: PULMONARY ARTERIES: Positive for pulmonary embolus. - Pulmonary Embolus Distribution: Right upper, right middle and right lower lobe segmental and subsegmental pulmonary emboli. Left upper and left lower lobe subsegmental pulmonary emboli. - Pulmonary Artery Diameter: Enlarged. - Ascending Aortic Diameter: Normal. - RV:LV Ratio: Normal. - Interventricular Septum: Normal. - Contrast reflux into IVC: Abnormal reflux into the IVC. LUNGS / AIRWAYS / PLEURA: Trace bilateral pleural effusions, left greater than right. Bilateral dependent atelectasis. Central airways are patent. HEART / OTHER VESSELS: Cardiomegaly. MEDIASTINUM / ESOPHAGUS: There is thickening of the mid to distal esophagus. LYMPH NODES: None enlarged. CHEST WALL: No significant acute abnormality UPPER ABDOMEN: Unremarkable. MUSCULOSKELETAL: Status post reverse right shoulder arthroplasty. Degenerative changes of the spine. L1 compression fracture, similar to the prior exam.
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CT Head wo contrast 1/6/2022 12:17 AM Clinical Information: severe HA w thrombocytopenia Comparison: CT head 8/16/2017 Technique: Unenhanced axial brain CT. Bone and soft tissue windows were reviewed. Sagittal and coronal images were generated from the axial data. Scan field of view: 230 mm. DLP: 958.60 mGy cm. Findings: Streak artifact at the skull base limits evaluation. No evidence for large vascular territory acute stroke. No intracranial hemorrhage, intracranial mass, mass effect or midline shift. No evidence for significant brain edema. Lacunar infarct in the right hemicerebellum, old. No hydrocephalus. Basal cisterns are patent. Mild atherosclerotic changes in the intracranial vasculature. Bilateral eyes demonstrate proptosis. Otherwise bilateral orbits are unremarkable. Visualized paranasal sinuses, bilateral mastoid air cells and middle ear cavities are within normal limits. No acute skull fractures. Conclusion: No acute intracranial abnormality.
Findings: Streak artifact at the skull base limits evaluation. No evidence for large vascular territory acute stroke. No intracranial hemorrhage, intracranial mass, mass effect or midline shift. No evidence for significant brain edema. Lacunar infarct in the right hemicerebellum, old. No hydrocephalus. Basal cisterns are patent. Mild atherosclerotic changes in the intracranial vasculature. Bilateral eyes demonstrate proptosis. Otherwise bilateral orbits are unremarkable. Visualized paranasal sinuses, bilateral mastoid air cells and middle ear cavities are within normal limits. No acute skull fractures.
Findings: No enlarged intrathoracic nodes are present. Calcific atherosclerosis is again seen in the aorta, coronary arteries and the mitral valve annulus. The heart size and mediastinum are otherwise normal. Increased elevation the right hemidiaphragm is seen. No pleural effusion is identified. Focal area of patchy consolidation in the posterior RLL is similar to prior with some retraction of the pleura and subpleural fat again noted. Again the small RLL density adjacent to the fiducial marker is hard to measure but is approximately 6 x 7 mm on image 49 and was 5 x 10 mm on the prior. Adjacent more posterior 6 mm nodule on image 43 is unchanged. A new 5 mm nodule seen peripherally in the RLL on image 48. A total of four new nodules are seen in left lower lobe on images 61 and 62. Additional tiny peripheral nodules such as in the LUL on image 56 and the LLL on image 62 are unchanged. Mild bronchial wall thickening is seen. No focal destructive osseous lesions identified. Bilateral renal cysts are redemonstrated. Hepatic steatosis is noted. Limited images the upper abdomen are otherwise unremarkable. 2002
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EXAM: CT Chest wo contrast, CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Fall COMPARISON: None. TECHNIQUE: CT Chest wo contrast, CT Abdomen and Pelvis wo IV contrast. Scan field of view: 378 mm. DLP: 287 mGy cm. (accession CT220002553), Scan field of view: 378 mm. (accession CT220002554) FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Biapical scarring is noted. There is a 5 mm pulmonary nodule seen in the lingula on image 50, series 301. The lungs are otherwise clear. No pleural effusion or pneumothorax. HEART / VESSELS: There is moderate coronary artery atherosclerotic calcification. There is an aberrant right subclavian artery. No pericardial effusion is seen. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast calcifications are noted. ABDOMEN and PELVIS: LIVER: Unremarkable for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Unremarkable for technique SPLEEN: Unremarkable for technique ADRENALS: Normal. KIDNEYS: Unremarkable for technique LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not well-visualized but there are no secondary signs of appendicitis. There are scattered noninflamed colonic diverticula. The colon is redundant. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is moderate severe aortoiliac atherosclerosis with mild tortuosity but no aneurysm. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: There is moderate severe multilevel discogenic degenerative changes seen within the spine with a moderate dextroscoliotic deformity of the thoracolumbar spine. No displaced fracture is identified.. CONCLUSION: 1. No acute traumatic injuries identified within the chest, abdomen, or pelvis given the limitations of noncontrast CT. 2. Indeterminate 5 mm pulmonary nodule within the left upper lobe. Consider follow-up chest CT in 12 months to ensure stability, as clinically indicated. 3. Bilateral breast calcifications, nonspecific. Correlate with prior mammography, as clinically indicated. 4. Additional findings above.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Biapical scarring is noted. There is a 5 mm pulmonary nodule seen in the lingula on image 50, series 301. The lungs are otherwise clear. No pleural effusion or pneumothorax. HEART / VESSELS: There is moderate coronary artery atherosclerotic calcification. There is an aberrant right subclavian artery. No pericardial effusion is seen. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast calcifications are noted. ABDOMEN and PELVIS: LIVER: Unremarkable for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Unremarkable for technique SPLEEN: Unremarkable for technique ADRENALS: Normal. KIDNEYS: Unremarkable for technique LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not well-visualized but there are no secondary signs of appendicitis. There are scattered noninflamed colonic diverticula. The colon is redundant. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is moderate severe aortoiliac atherosclerosis with mild tortuosity but no aneurysm. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: There is moderate severe multilevel discogenic degenerative changes seen within the spine with a moderate dextroscoliotic deformity of the thoracolumbar spine. No displaced fracture is identified..
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Stable nodular/reticular densities in the right middle lobe probably related to old infection. No focal lung consolidation, pleural effusion or pneumothorax. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Circumferential edematous wall thickening of the rectum and sigmoid colon. There is small pericolonic abscess measuring about 3.2 x 3.0 cm in the posterior aspect of the rectosigmoid junction (on series 602, image 155). There is associated perirectal inflammatory stranding. Large bowel loops are not distended. There is small amount of colonic stool burden.. PERITONEUM / MESENTERY: No ascites or pneumoperitoneum. RETROPERITONEUM: Mild presacral soft tissue stranding/edema. VESSELS: Note is nonaneurysmal. Aorta, IVC, iliac vasculature, portal, splenic and spin mesenteric veins and hepatic veins are patent. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Surgically absent uterus. No adnexal solid masses or pelvic fluid collection. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings. Multilevel degenerative changes in lumbar spine.
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EXAM: CT Chest wo contrast, CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Fall COMPARISON: None. TECHNIQUE: CT Chest wo contrast, CT Abdomen and Pelvis wo IV contrast. Scan field of view: 378 mm. DLP: 287 mGy cm. (accession CT220002553), Scan field of view: 378 mm. (accession CT220002554) FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Biapical scarring is noted. There is a 5 mm pulmonary nodule seen in the lingula on image 50, series 301. The lungs are otherwise clear. No pleural effusion or pneumothorax. HEART / VESSELS: There is moderate coronary artery atherosclerotic calcification. There is an aberrant right subclavian artery. No pericardial effusion is seen. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast calcifications are noted. ABDOMEN and PELVIS: LIVER: Unremarkable for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Unremarkable for technique SPLEEN: Unremarkable for technique ADRENALS: Normal. KIDNEYS: Unremarkable for technique LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not well-visualized but there are no secondary signs of appendicitis. There are scattered noninflamed colonic diverticula. The colon is redundant. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is moderate severe aortoiliac atherosclerosis with mild tortuosity but no aneurysm. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: There is moderate severe multilevel discogenic degenerative changes seen within the spine with a moderate dextroscoliotic deformity of the thoracolumbar spine. No displaced fracture is identified.. CONCLUSION: 1. No acute traumatic injuries identified within the chest, abdomen, or pelvis given the limitations of noncontrast CT. 2. Indeterminate 5 mm pulmonary nodule within the left upper lobe. Consider follow-up chest CT in 12 months to ensure stability, as clinically indicated. 3. Bilateral breast calcifications, nonspecific. Correlate with prior mammography, as clinically indicated. 4. Additional findings above.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Biapical scarring is noted. There is a 5 mm pulmonary nodule seen in the lingula on image 50, series 301. The lungs are otherwise clear. No pleural effusion or pneumothorax. HEART / VESSELS: There is moderate coronary artery atherosclerotic calcification. There is an aberrant right subclavian artery. No pericardial effusion is seen. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast calcifications are noted. ABDOMEN and PELVIS: LIVER: Unremarkable for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Unremarkable for technique SPLEEN: Unremarkable for technique ADRENALS: Normal. KIDNEYS: Unremarkable for technique LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not well-visualized but there are no secondary signs of appendicitis. There are scattered noninflamed colonic diverticula. The colon is redundant. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is moderate severe aortoiliac atherosclerosis with mild tortuosity but no aneurysm. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: There is moderate severe multilevel discogenic degenerative changes seen within the spine with a moderate dextroscoliotic deformity of the thoracolumbar spine. No displaced fracture is identified..
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: The visualized lung bases are clear. No pleural effusions are seen. DISTAL ESOPHAGUS: Unremarkable. HEART / VESSELS: The visualized heart is normal in size. ABDOMEN and PELVIS: LIVER: No suspicious liver lesion identified. BILIARY TRACT: Normal. GALLBLADDER: Unremarkable. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No hydronephrosis. There is a 2 cm angiomyolipoma. Multiple bilateral low-attenuation lesions are seen, too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach appears unremarkable. The loops small bowel are normal in caliber. COLON / APPENDIX: There is colonic diverticulosis. There is focal stranding adjacent to the sigmoid colon (series 301#299-303). The appendix appears unremarkable. PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcified atherosclerotic disease. URINARY BLADDER: Unremarkable. REPRODUCTIVE ORGANS: Status post hysterectomy. BODY WALL: Minimal fat-containing umbilical hernia. MUSCULOSKELETAL: There are degenerative changes spine. There is mild anterior wedging of the L2 vertebral body.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 28-year-old male with provided history of testicular cancer. COMPARISON: Chest CT 4/20/2021 TECHNIQUE: CT Chest wo contrast. Scan field of view: 420 mm. DLP: 1856.20 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: A tiny right lower lobe nodule (image 75, series 2), and a tiny left upper lobe nodule (image 56) are unchanged. No new or enlarging suspicious pulmonary nodule. No focal consolidation. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: Stable right hilar/bronchial lymph node (image 64). No lymphadenopathy in the supraclavicular, axillary, or mediastinal regions. The esophagus is nondilated. Fat interspersed thymic tissue in the anterior mediastinum, similar to prior. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. Stable small sclerotic focus in the right lateral six rib. Right C7 cervical rib is again noted. Chest wall is unremarkable. Upper abdomen: Reported separately. CONCLUSION: No metastatic disease in the chest.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: A tiny right lower lobe nodule (image 75, series 2), and a tiny left upper lobe nodule (image 56) are unchanged. No new or enlarging suspicious pulmonary nodule. No focal consolidation. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: Stable right hilar/bronchial lymph node (image 64). No lymphadenopathy in the supraclavicular, axillary, or mediastinal regions. The esophagus is nondilated. Fat interspersed thymic tissue in the anterior mediastinum, similar to prior. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. Stable small sclerotic focus in the right lateral six rib. Right C7 cervical rib is again noted. Chest wall is unremarkable. Upper abdomen: Reported separately.
FINDINGS: The supraclavicular region is unremarkable. Central airways are patent. The thoracic aorta is nonaneurysmal. The pulmonary arteries are not dilated. The heart is not enlarged. No enlarged thoracic lymph nodes. Residual thymic tissue is seen within the anterior mediastinum. The esophagus is not dilated. There is no acute lung abnormality. No suspicious lung nodules. No pleural effusion or pleural thickening. No acute abnormality within the imaged upper abdomen. No acute or aggressive osseous abnormality. There is no focal abnormality of the sternum or manubrium. However, there does appear to be increased anterior posterior dimension of the chest.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: History of testicular cancer. COMPARISON: 8/31/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 225 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: 82 sec Scan field of view: 420 mm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Numerous surgical clips are again seen throughout the retroperitoneum, unchanged. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Midline prior incisional changes. MUSCULOSKELETAL: Sclerosis within the right iliac body is unchanged. No new osseous lesions. CONCLUSION: 1. Post surgical changes consistent with prior retroperitoneal lymph node dissection. No abdominopelvic lymphadenopathy or metastatic disease is visualized. 2. Please see separately dictated report for dedicated chest findings.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Numerous surgical clips are again seen throughout the retroperitoneum, unchanged. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Midline prior incisional changes. MUSCULOSKELETAL: Sclerosis within the right iliac body is unchanged. No new osseous lesions.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Tiny peripheral filling defects within the trachea, likely retained secretions. Small nodular opacity adjacent to the minor fissure (series 3; image 48), likely a fissural lymph node. A couple of nonspecific 1 to 2 mm pulmonary nodules, one in the right upper lobe (series 3; image 21), and one in the left upper lobe (series 3; image 41). No suspicious pulmonary nodules. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen wo+w contrast CLINICAL INFORMATION: Cirrhosis. HCC screening. COMPARISON: Chest CT 9/28/2021 TECHNIQUE: CT Abdomen wo+w contrast. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 143 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 3 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 4630 mm. DLP: 1103 mGy cm. FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Pulmonary fibrosis changes in the lung bases, left greater than right. Trace right pleural effusion with pleural thickening and pleural calcifications are noted. HEART / VESSELS: Trace pericardial fluid. ABDOMEN: LIVER: Cirrhotic. No steatosis. LIVER LESIONS: No arterially enhancing lesions are visualized. There is peripheral hypoattenuation near the dome best seen on series 15 image 26 of unclear significance, potentially exterior to the liver. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: Large (>5 mm diameter). - Other varices or collaterals: Perigastric collaterals are also noted. Recanalized paraumbilical collateral. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: No abnormality. LYMPH NODES: None enlarged. SPLEEN: Enlarged PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Multiple punctate nonobstructive bilateral renal calculi. Hypoattenuating foci bilaterally are consistent with a cyst in the left upper pole and too small to characterize on the right series 15 image 101. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. There is mild stranding along the paracolic gutters however is nonfocal and is seen bilaterally. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BODY WALL: Minute umbilical hernia. MUSCULOSKELETAL: No destructive lesions. Degenerative changes in the spine. CONCLUSION: 1. Cirrhotic liver with sequelae of portal hypertension without convincing evidence of hepatocellular carcinoma. A hypoattenuating areas seen near the hepatic dome however is not convincingly within the liver on the coronal images and could reflect heterogeneity of the diaphragm/peridiaphragmatic fat. Attention on follow-up. 2. UIP pattern pulmonary fibrosis is similar to prior study. Chronic trace right pleural effusion with wall thickening and pleural calcification. 3. Other incidental and noncontributory findings as described above.
FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Pulmonary fibrosis changes in the lung bases, left greater than right. Trace right pleural effusion with pleural thickening and pleural calcifications are noted. HEART / VESSELS: Trace pericardial fluid. ABDOMEN: LIVER: Cirrhotic. No steatosis. LIVER LESIONS: No arterially enhancing lesions are visualized. There is peripheral hypoattenuation near the dome best seen on series 15 image 26 of unclear significance, potentially exterior to the liver. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: Large (>5 mm diameter). - Other varices or collaterals: Perigastric collaterals are also noted. Recanalized paraumbilical collateral. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: No abnormality. LYMPH NODES: None enlarged. SPLEEN: Enlarged PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Multiple punctate nonobstructive bilateral renal calculi. Hypoattenuating foci bilaterally are consistent with a cyst in the left upper pole and too small to characterize on the right series 15 image 101. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. There is mild stranding along the paracolic gutters however is nonfocal and is seen bilaterally. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BODY WALL: Minute umbilical hernia. MUSCULOSKELETAL: No destructive lesions. Degenerative changes in the spine.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: A 4 mm and a 3 mm left lower lobe pulmonary nodule. Otherwise normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis without cirrhotic morphology or focal lesion. There is focal sparing of fat adjacent to the gallbladder and posterior surface of the medial segment. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. Small accessory spleen. ADRENALS: Normal. KIDNEYS: Normal size and configuration. Bilateral nonobstructing renal stones are present without hydronephrosis or significant perinephric stranding. There is no hydroureter, ureteral stone, or urinary bladder calculus. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Inflammatory stranding involves a descending colonic diverticulum (image 154 series 201) without drainable collection. Numerous other diverticula are present without inflammatory change. Appendix is not visualized. PERITONEUM / MESENTERY: Normal. No free air. RETROPERITONEUM: Stranding and thickening of the left lateral conal fascia is present adjacent to the inflamed diverticulum. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small inguinal hernias contain fat. No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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CT Head wo contrast CLINICAL INFORMATION: Other- Spec Inst: CODE STROKE: Acute Symptoms COMPARISON: None available TECHNIQUE: CT Head wo contrastScan field of view: 262 mm. DLP: 1413.90 mGy cm. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CONCLUSION: No acute intracranial process.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
Findings: Mildly enlarged bilateral paratracheal nodes are redemonstrated. No axillary adenopathy.. Lingular nodule measures approximately 11 x 9 mm image 270 series 3. This measured approximately 11 x 7 mm 1/30/2019 by my measurements and showed no FDG uptake on the PET/CT 3/6/2019. There is interval complete middle lobe atelectasis with the middle lobe bronchus, medial and lateral segmental bronchi demonstrating no obstructing nodules. A few partially calcified pleural plaques are present in unchanged. Airway secretions within the left upper lobe bronchi are increased. Mild paraseptal and centrilobular emphysema is seen. Coronary artery calcification: The visual score of calcification is 5. (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: No destructive osseous lesions.
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EXAM: CT Pelvis with contrast CLINICAL INFORMATION: Inguinal hernia vs. Scrotal mass COMPARISON: None. TECHNIQUE: CT Pelvis with contrast. Patient weight: 196 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 100 sec. Scan field of view: 350 mm. DLP: 512.90 mGy cm. FINDINGS: STRUCTURED REPORT: CT Pelvis LOWER ABDOMEN: BOWEL: No abnormality. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a 4.0 x 2.4 x 3.8 cm fat attenuation lesion in the lateral aspect of right scrotal sac (series 201, image 182 and series 202, image 37). This lesion is extrinsic to the right inguinal canal or scrotal sac with mild extrinsic compression of the right spermatic cord. Both testicles are visualized in normal in appearance. There is no inguinal hernia. No hydrocele. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings. Multilevel degenerative changes at L5-S1.. CONCLUSION: 1. CT findings consistent with a 4.0 cm soft tissue lipoma in the lateral aspect of the right scrotal sac, extrinsic to the inguinal canal and scrotal sac. No evidence of scrotal mass or inguinal hernia. 2. Remainder of the pelvic soft tissues are unremarkable.
FINDINGS: STRUCTURED REPORT: CT Pelvis LOWER ABDOMEN: BOWEL: No abnormality. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a 4.0 x 2.4 x 3.8 cm fat attenuation lesion in the lateral aspect of right scrotal sac (series 201, image 182 and series 202, image 37). This lesion is extrinsic to the right inguinal canal or scrotal sac with mild extrinsic compression of the right spermatic cord. Both testicles are visualized in normal in appearance. There is no inguinal hernia. No hydrocele. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings. Multilevel degenerative changes at L5-S1..
FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Right lower lobe branch pulmonary artery aneurysm is best visualized on image 18 series 12. ABDOMEN: LIVER: Hepatic steatosis without cirrhotic morphology or focal lesion. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Distal pancreatectomy has similar appearance. Unchanged focal enhancing nodule at the margin of the resection measures 1.4 cm (image 121 series 12), previously 1.4 cm (image 112 series 900). No new lesion. SPLEEN: Surgically absent. ADRENALS: Normal. KIDNEYS: Tiny punctate calculus in each kidney. Otherwise normal. LYMPH NODES: Unchanged gastrohepatic lymph node measures 9 mm (image 13 series 12), previously 0.9 x 0.9 cm on image 103 series. No new adenopathy. STOMACH / SMALL BOWEL: Partial gastrectomy. A small incisional hernia contains the anterior wall of a short segment of small bowel (image 162 series 12) without wall thickening or stranding. No bowel obstruction. COLON / APPENDIX: Colonic diverticula without diverticulitis. Normal appendix. PERITONEUM / MESENTERY: Nonspecific mesenteric stranding without focal mass. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: L5 pars defects are unchanged. No osseous metastases.
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Maxillofacial CT scan without contrast. Clinical: Maxillofacial CT protocol. DLP: 596 mGy cm. Comparison: None. Findings: There is almost complete opacification of the sphenoid sinuses with sclerotic thickening of its walls, chronic sinusitis. There is also almost opacification of the left ethmoid cells and opacification of the left sphenoethmoidal recess. The sphenoid and left ethmoid opacities are slightly hyperdense, inspissated secretions vs fungal disease. The paranasal sinuses are normally formed and developed. No fluid retention is seen. There is slight mucosal thickening in the frontal and maxillary sinuses. There may have been prior right ethmoidectomy and large right ethmoid cavity is clear. The maxillofacial bones, orbits and orbital contents are unremarkable. No defect is seen in the anterior skull base or calvarium. --------------- Conclusion: Extensive opacification of the sphenoid sinuses and left ethmoid cells. Chronic sphenoid sinusitis. Slight hyperdensity of the sinus contents, inspissated secretions vs fungal disease.
Findings: There is almost complete opacification of the sphenoid sinuses with sclerotic thickening of its walls, chronic sinusitis. There is also almost opacification of the left ethmoid cells and opacification of the left sphenoethmoidal recess. The sphenoid and left ethmoid opacities are slightly hyperdense, inspissated secretions vs fungal disease. The paranasal sinuses are normally formed and developed. No fluid retention is seen. There is slight mucosal thickening in the frontal and maxillary sinuses. There may have been prior right ethmoidectomy and large right ethmoid cavity is clear. The maxillofacial bones, orbits and orbital contents are unremarkable. No defect is seen in the anterior skull base or calvarium. ---------------
FINDINGS: Scattered small lung nodules are again seen bilaterally. Index lesions are measured on series 2: 1. Solid 10 mm left upper lobe nodule on image 59 measured 9 mm previously. 2. Solid 8 mm nodule within the medial aspect of the middle lobe on image 72 measured 9 mm previously. 3. 5 mm nodule within the lingula on image 69 measured 6 mm previously. Other small lung nodules bilaterally are unchanged. No new or enlarging lung nodules. No acute lung abnormality. No pleural effusion or pleural thickening. A right chest port is present with its catheter tip extending to the upper right atrium. The thyroid gland is surgically absent. The supraclavicular region is otherwise unremarkable. Central airways are patent. The thoracic aorta is nonaneurysmal. The pulmonary arteries are not dilated. The heart is not enlarged. No pericardial effusion. No enlarged supraclavicular, axillary, mediastinal or hilar lymph nodes are identified. The esophagus is not dilated. There is a small hiatal hernia. Large hepatic hemangioma is unchanged. No acute or aggressive osseous abnormality.
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CT head without contrast Clinical Information: Possible mucor infection Comparison: None. Technique: Axial helical images of the head were obtained. Coronal and sagittal reformatted images were obtained from the axial data set. DLP: 997 mGy cm. Findings: The parenchyma appears normal with no mass, hemorrhage, visible infarct or extracerebral collection. There is minor diffuse atrophy but the ventricles are small with normal appearance. There is preservation of gray-white margins. No hypodensity seen in the white matter. Posterior fossa contents appear normal. Opacification of the sphenoid sinuses and left ethmoid cells is again noted. --------------- Conclusion: No acute intracranial abnormality identified.
Findings: The parenchyma appears normal with no mass, hemorrhage, visible infarct or extracerebral collection. There is minor diffuse atrophy but the ventricles are small with normal appearance. There is preservation of gray-white margins. No hypodensity seen in the white matter. Posterior fossa contents appear normal. Opacification of the sphenoid sinuses and left ethmoid cells is again noted. ---------------
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Collapsed, but otherwise normal. REPRODUCTIVE ORGANS: The uterus is surgically absent. No adnexal mass lesions. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions.
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Lung Cancer Screening Clinical Information: Lung cancer screening. 55-year-old female with past history of right breast cancer diagnosed in 2014 status post lumpectomy, radiation and hormonal therapy. Technique: Scan field of view: 380 mm. Height: 64 in. Patient weight: 234 lbs. CTDI vol: 3.26 mGy. DLP: 106.21 mGy cm. 0.60 mm images were obtained through the chest. The CT is jointly interpreted by Drs. Manapragada and Abozeed Smoking Status: Former If not current, quit years ago: 6 Pack Years: 30 Screen Year: 1 Comparison: CT angiogram chest dated 12/11/2016. Interpretation and recommendations are based on 2019 version of ACR LungRads recommendations Findings: Normal sized cardiac chambers. Normal caliber pulmonary artery and thoracic aorta. No enlarged hilar or mediastinal nodes are present. Tiny hiatal hernia. Minimal centrilobular emphysema. Central airways are patent. No suspicious pulmonary nodules. Linear scarring/atelectasis in the left upper lobe. There are a few scattered noncalcified pulmonary nodules, all less 6 mm. A 5 mm linear nodular opacity in the peripheral left lower lobe on axial image 306; series 2 and 3 mm peripheral left lower lobe nodule on axial image 323; series 2. A 5 mm peripheral left lower lobe nodule on axial image 312; series 2 A few additional tiny nodules abutting the fissure, likely represent fissural nodes. Coronary artery calcification: The visual score of calcification is 2. (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized spleen, and bowel are unremarkable. Left adrenal gland is nodular, overall unchanged. Subcentimeter low-attenuation hepatic lesions/cysts, unchanged. Bones: No significant abnormality. Impression: No CT findings to suggest lung cancer. A few scattered noncalcified pulmonary nodules, all less than 6 mm, described as above. LungRads category: 2 Lung-Rads Modifier S: No clinically significant or potentially clinically significant findings. Recommendation: Continue annual lung cancer screening CT ====================================================================================== REFERENCES: http://www.acr.org/\R\/media/ACR/Documents/PDF/QualitySafety/Resources/LungRADS/AssessmentCateg ries http://www.acr.org/Quality-Safety/Lung-Cancer-Screening-Center Category 0: Incomplete. Category 1: Negative - No nodules or definitely benign nodules. Category 2: Benign Appearance or Behavior - Nodules with a very low likelihood of becoming a clinically active cancer due to size or lack of growth. Category 3: Probably benign finding(s) - Short term follow-up suggested; includes nodules with a low likelihood of becoming a clinically active cancer. Category 4A: Suspicious - Findings for which additional diagnostic testing is recommended. Category 4B and 4X: Very Suspicious - Findings for which additional diagnostic testing and/or tissue sampling is recommended. Modifier S: Other Findings - Clinically significant or potentially clinically significant findings (non-lung cancer). References: http://www.acr.org/\R\/media/ACR/Documents/PDF/QualitySafety/Resources/LungRADS/AssessmentCateg ries http://www.acr.org/Quality-Safety/Lung-Cancer-Screening-Center
Findings: Normal sized cardiac chambers. Normal caliber pulmonary artery and thoracic aorta. No enlarged hilar or mediastinal nodes are present. Tiny hiatal hernia. Minimal centrilobular emphysema. Central airways are patent. No suspicious pulmonary nodules. Linear scarring/atelectasis in the left upper lobe. There are a few scattered noncalcified pulmonary nodules, all less 6 mm. A 5 mm linear nodular opacity in the peripheral left lower lobe on axial image 306; series 2 and 3 mm peripheral left lower lobe nodule on axial image 323; series 2. A 5 mm peripheral left lower lobe nodule on axial image 312; series 2 A few additional tiny nodules abutting the fissure, likely represent fissural nodes. Coronary artery calcification: The visual score of calcification is 2. (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized spleen, and bowel are unremarkable. Left adrenal gland is nodular, overall unchanged. Subcentimeter low-attenuation hepatic lesions/cysts, unchanged. Bones: No significant abnormality.
Findings: Soft tissues thickening is seen around the proximal right mainstem bronchus which also is most likely postradiation findings. No enlarged intrathoracic nodes are present. Mild calcific atherosclerosis is seen in the aorta and coronary arteries. Main pulmonary artery is borderline enlarged at 31 mm. The heart size and mediastinum are otherwise normal. The areas of right perihilar consolidation show further decrease from 12/2/2021 and no significant change from 1/13/2022. This change is consistent with postradiation findings. Again the patchy bilateral areas of consolidation seen in 2021 have resolved. The 4 mm LUL nodule on series 2 image 103 remains unchanged back to October 2020. This appears to be along the major fissure consistent with an intrapulmonary lymph node. The lungs are otherwise normal without new nodules or masses. No pleural effusion. No focal destructive osseous lesions identified. CT abdomen and pelvis will be dictated separately.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 54-year-old female with provided history of shortness of breath. COMPARISON: Chest CT 3/30/2007 TECHNIQUE: CT Chest with contrast. Patient weight: 174 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 35 sec Scan field of view: 350 mm. DLP: 243.27 mGy cm. FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: No consolidation. Scattered calcified granulomas. No suspicious pulmonary nodule. No pleural effusion. Central airways are patent. Thoracic inlet, heart, and mediastinum: Right thyroid lobe 14 mm low-attenuation nodule is noted. No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: No abnormality in the imaged upper abdomen. CONCLUSION: No acute or chronic disease in the chest.
FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: No consolidation. Scattered calcified granulomas. No suspicious pulmonary nodule. No pleural effusion. Central airways are patent. Thoracic inlet, heart, and mediastinum: Right thyroid lobe 14 mm low-attenuation nodule is noted. No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: No abnormality in the imaged upper abdomen.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Indeterminate thyroid nodule in the left lobe which measures 1.4 x 1.0 cm (image 69, series 601. CHEST: LUNGS / AIRWAYS / PLEURA: Right lower lobe atelectasis. Few scattered micronodules in the right upper lobe. Otherwise no pleural effusion or pneumothorax. HEART / VESSELS: Three vessel coronary artery calcifications and calcifications of the thoracic aorta.. MEDIASTINUM / ESOPHAGUS: Normal. Patulous esophagus. DIAPHRAGM: Intact. LYMPH NODES: . Enlarged paratracheal node developing central calcification related to prior granulomatous disease. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Diffuse parenchymal atrophy. SPLEEN: Unchanged calcified granulomata. Accessory spleen. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcification of the abdominal aorta and its branches. URINARY BLADDER: Intraluminal gas is present within the bladder, likely iatrogenic. REPRODUCTIVE ORGANS: The uterus is absent. BODY WALL: No significant abnormality. SOFT TISSUES: No significant abnormality. Atrophic changes of the right gluteus medius and minimus. THORACIC AND LUMBAR SPINES: VERTEBRA: No thoracic spine fracture. T12 vertebral plana. Redemonstrated levocurvature of the thoracolumbar spine. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes of the thoracolumbar spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: Shortness of breath with persistent bilateral opacities noted on chest x-ray COMPARISON: Chest x-ray 1/3/2020. TECHNIQUE: Helical multidetector noncontrast CT of the chest was performed. Axial, sagittal, and coronal multiplanar reformats were subsequently obtained.. Scan field of view: 350 mm. DLP: 689.80 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LINES AND TUBES: Right IJ central venous catheter tip terminates at the cavoatrial junction. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Patchy peripheral predominantly groundglass opacities with some tree-in-bud nodularity and areas of crazy paving is noted in all five lobes most pronounced in the left upper lobe, left lower lobe, and right upper lobe. Minimal bandlike left lower lobe consolidation. HEART / VESSELS: Moderate coronary artery calcifications. Normal cardiac size. No pericardial effusions. The aorta is normal in caliber with scattered atherosclerotic disease most pronounced in the arch. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality. IMPRESSION: Multifocal patchy groundglass opacities in all five lobes which are likely infectious or inflammatory in nature. COVID-19 pneumonia should be considered. Follow-up CT scan in three months is recommended to ensure resolution.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LINES AND TUBES: Right IJ central venous catheter tip terminates at the cavoatrial junction. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Patchy peripheral predominantly groundglass opacities with some tree-in-bud nodularity and areas of crazy paving is noted in all five lobes most pronounced in the left upper lobe, left lower lobe, and right upper lobe. Minimal bandlike left lower lobe consolidation. HEART / VESSELS: Moderate coronary artery calcifications. Normal cardiac size. No pericardial effusions. The aorta is normal in caliber with scattered atherosclerotic disease most pronounced in the arch. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No focal consolidation, pleural effusion, or pneumothorax. Central airways are patent. Calcified granuloma is seen. No suspicious pulmonary nodule is identified. HEART / VESSELS: Heart size is normal. No pericardial effusion. Mild atherosclerotic disease of the thoracic aorta, mild coronary artery calcifications involving the left anterior descending artery. MEDIASTINUM / ESOPHAGUS: Focal indeterminate hyperdense body in the periesophageal region near the GE junction measuring 0.4 cm on series 2 image 100, stable compared to prior CT abdomen on 12/13/2021. This appears calcified and of uncertain clinical significance. Otherwise normal. LYMPH NODES: None enlarged. CHEST WALL: Bilateral retroglandular breast prostheses are present. Metallic foreign body is present in the subcutaneous medial right breast soft tissues. UPPER ABDOMEN: Please see same-day MRI abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain COMPARISON: 5/7/20 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 290 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 88 sec. Scan field of view: 500 mm. DLP: 780 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Unchanged adrenal nodules. No new abnormality KIDNEYS: Stable right lower pole cyst. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Unchanged mild wall thickening of the distal rectum. Few noninflamed colonic diverticula. Otherwise normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Unchanged position of IVC filter. URINARY BLADDER: Decompressed renal Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild skin thickening and subcutaneous stranding overlying both ischial tuberosities, significantly improved since prior. No soft tissue gas or penetrating soft tissue ulceration. MUSCULOSKELETAL: No acute fracture, suspicious osseous lesion, or evidence of osteomyelitis. CONCLUSION: 1. No acute abdominal or pelvic abnormality. 2. Chronic and incidental findings as above.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Unchanged adrenal nodules. No new abnormality KIDNEYS: Stable right lower pole cyst. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Unchanged mild wall thickening of the distal rectum. Few noninflamed colonic diverticula. Otherwise normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Unchanged position of IVC filter. URINARY BLADDER: Decompressed renal Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild skin thickening and subcutaneous stranding overlying both ischial tuberosities, significantly improved since prior. No soft tissue gas or penetrating soft tissue ulceration. MUSCULOSKELETAL: No acute fracture, suspicious osseous lesion, or evidence of osteomyelitis.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated CT chest. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Similar fatty lesion in the central right hepatic lobe. Arterially enhancing focus in the inferior right hepatic lobe measures 1.4 x 1.1 cm on image 121 series 4, previously measuring similarly by my measurements. This lesion is isoattenuating to hepatic parenchyma on more delayed phase images and has been present since 2019. No new liver lesions. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Post surgical changes from distal pancreatectomy with similar multiloculated collections in the pancreatic tail/splenectomy surgical bed. There are a few small associated septations and calcifications. No suspicious solid pancreatic lesions. SPLEEN: Absent. ADRENALS: Right adrenal nodule measuring up to 1.3 cm on image 213 series 9 is unchanged since 2019. KIDNEYS: Right upper pole cyst. Subcentimeter foci of hypoattenuation are too small for accurate characterization. LYMPH NODES: Enhancing lymph node cranial to the distal pancreatectomy similar in size measuring 1.7 x 1.0 cm on image 204 series 9. No new lymphadenopathy. STOMACH / SMALL BOWEL: Stomach is normal. Duodenal diverticulum is present. Small bowel is normal in caliber. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate calcified and noncalcified atherosclerotic plaque of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Left chest wall pain COMPARISON: None. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 201 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 299 mm. KVP: 100 DLP: 215.40 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is a 3 mm nodule seen in the lingula on image 73, series 402. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: There are multiple low attenuated lesion seen within the liver. There is a low attenuated mass also seen in the splenic hilum and abutting the greater curvature of the stomach which measures 5.0 x 4.3 cm on image 119, series 402. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No pulmonary thromboembolism is identified. 2. Multiple indeterminate liver lesions, concerning for metastasis. CT recommended. 3. Low attenuated mesenteric mass, possibly necrotic, seen in the left upper quadrant, concerning for peritoneal carcinomatosis. CT recommended. 4. Indeterminate 3 mm lingular pulmonary nodule. Metastasis is not excluded. 5. Additional findings above. Final report findings discussed with Dr. Shabshak at 1/5/2022 2:40 PM by Dr. Little by telephone.
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is a 3 mm nodule seen in the lingula on image 73, series 402. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: There are multiple low attenuated lesion seen within the liver. There is a low attenuated mass also seen in the splenic hilum and abutting the greater curvature of the stomach which measures 5.0 x 4.3 cm on image 119, series 402. MUSCULOSKELETAL: No significant abnormality.
Findings: No enlarged intrathoracic nodes are present. Calcified and noncalcified plaque in the thoracic aorta with an aberrant right subclavian artery noted. The heart size and mediastinum are otherwise normal. A tiny nodule is seen at the junction of the right major and minor fissures on series 9 image 69 and most likely an intrapulmonary lymph node. The lungs are otherwise normal without suspicious nodules or masses. No pleural effusion. No focal destructive osseous lesions identified. CT of the abdomen and pelvis will be reported separately
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RADIOLOGIC EXAM: CT Head wo+w contrast CLINICAL INFORMATION: Trauma. COMPARISON: 11/30/21 TECHNIQUE: CT Head wo+w contrastPatient weight: 200 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 300 sec Scan field of view: 223 mm. DLP: 2674.20 mGy cm. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: Unchanged size of the enhancing extra-axial mass along the floor of the right anterior cranial fossa measuring approximately 3.2 x 2.7 cm. Mild surrounding vasogenic edema within the inferior right frontal lobe also appears similar to prior. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild, right greater than left, maxillary sinus mucosal thickening. There is also mild frontal sinus mucosal disease. CONCLUSION: 1. Meningioma overlying the right inferior frontal lobe with mild surrounding vasogenic edema is noted significantly changed. 2. No new intracranial abnormality.
FINDINGS: BRAIN PARENCHYMA: Unchanged size of the enhancing extra-axial mass along the floor of the right anterior cranial fossa measuring approximately 3.2 x 2.7 cm. Mild surrounding vasogenic edema within the inferior right frontal lobe also appears similar to prior. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild, right greater than left, maxillary sinus mucosal thickening. There is also mild frontal sinus mucosal disease.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Chest findings to be dictated separately; please see separate chest CT report same day. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate aortobiiliac atherosclerosis without aneurysm URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multilevel degenerative changes in the lumbar spine.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Shortness of breath COMPARISON: None. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 400 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. IV contrast injection rate: 4.50 ml per sec. Scan delay: bt sec. Scan field of view: 350 mm. KVP: 120 DLP: 383 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Streaky opacities in the bilateral lungs probably represent atelectasis/scarring versus respiratory motion. No definite focal consolidation or pleural effusion. No pneumothorax. HEART / OTHER VESSELS: There is cardiomegaly without pericardial effusion. There is moderate coronary artery atherosclerotic calcification. The main pulmonary arteries enlarged which could suggest pulmonary arterial hypertension MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Moderate degenerative changes are seen within the spine. No focal destructive osseous lesion is identified. CONCLUSION: 1. No central pulmonary thromboembolism is identified. Evaluation of the distal segmental and subsegmental pulmonary arteries is limited. 2. Cardiomegaly. Additional findings above.
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Streaky opacities in the bilateral lungs probably represent atelectasis/scarring versus respiratory motion. No definite focal consolidation or pleural effusion. No pneumothorax. HEART / OTHER VESSELS: There is cardiomegaly without pericardial effusion. There is moderate coronary artery atherosclerotic calcification. The main pulmonary arteries enlarged which could suggest pulmonary arterial hypertension MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Moderate degenerative changes are seen within the spine. No focal destructive osseous lesion is identified.
FINDINGS: The study is mildly degraded by metallic streak artifact from dental amalgam. SINOCRANIAL AND SINOORBITAL JUNCTIONS: The bones adjacent to the sinuses, including the lamina papyracea, cribriform plates and fovea ethmoidalis, are intact. The right olfactory fossa depth measures up to 6 mm in the left up to 5 mm (bilateral Keros type II). NASAL SEPTUM/NASAL CAVITY: Midline nasal septum without significant deviation. FRONTAL SINUSES, DRAINAGE PATHWAYS, AND ASSOCIATED ANATOMIC VARIANTS: Mild bilateral frontal sinus floor and frontoethmoidal recess mucosal thickening. The frontal sinuses are otherwise well-developed and aerated. There are bilateral aerated Agger nasi cells. ETHMOID SINUSES: The ethmoid air cells are free of mucosal disease. The anterior ethmoidal artery canals are covered by bone. SPHENOID SINUSES, DRAINAGE PATHWAYS, AND ASSOCIATED VARIANTS: The sphenoid sinuses and sphenoethmoidal recesses are free of mucosal disease. The intersinus septum inserts at the right anterior orbital fissure. The carotid canals are covered by bone. Sellar variant of sphenoid sinus pneumatization. MAXILLARY SINUSES, DRAINAGE PATHWAYS, AND ASSOCIATED VARIANTS: Trace right and mild left maxillary sinus floor mucosal thickening. The maxillary sinuses are otherwise well-developed and aerated. Inferomedial extension of bilateral ethmoid bullae anatomically narrow both infundibular channels which are otherwise free of significant mucosal disease. MASTOID AIR CELLS: The mastoid air cells are well-developed and aerated. OTHER: Limited evaluation of the brain parenchyma is unremarkable.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Evaluate hydronephrosis. COMPARISON: 10/29/2018. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 384 mm. DLP: 749.30 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Trace pneumobilia, unchanged. GALLBLADDER: Absent. PANCREAS: Diffusely atrophic. Otherwise normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Sensitivity for abnormal parenchymal lesions is limited by noncontrast technique. There is left pelvocaliectasis, improved compared to 2018. No right hydronephrosis is visualized. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Numerous metallic densities are seen throughout the abdomen with significant streak artifact, unchanged compared to prior examination. No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Numerous injection granulomas throughout bilateral flanks. MUSCULOSKELETAL: Right femoral fixation rod is noted with associated heterotopic ossification. No aggressive osseous lesions. CONCLUSION: 1. Left pelvocaliectasis is improved compared to 2018. No hydronephrosis bilaterally. 2. Chronic and incidental findings as above.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Trace pneumobilia, unchanged. GALLBLADDER: Absent. PANCREAS: Diffusely atrophic. Otherwise normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Sensitivity for abnormal parenchymal lesions is limited by noncontrast technique. There is left pelvocaliectasis, improved compared to 2018. No right hydronephrosis is visualized. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Numerous metallic densities are seen throughout the abdomen with significant streak artifact, unchanged compared to prior examination. No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Numerous injection granulomas throughout bilateral flanks. MUSCULOSKELETAL: Right femoral fixation rod is noted with associated heterotopic ossification. No aggressive osseous lesions.
FINDINGS: SOFT TISSUES: Postsurgical findings of right mandibulectomy with left fibula free flap to right mandible with extensive mandibular hardware and dental implants. Streak artifact limits evaluation of adjacent structures. No evidence of hardware consultation. No mass enhancing lesion identified. Interval resolution of soft tissue defect status post soft tissue grafting. LYMPH NODES: No pathologic adenopathy by imaging size criteria. AERODIGESTIVE STRUCTURES: No asymmetric contrast enhancement or asymmetric soft tissue nodularity. PAROTID GLANDS: Normal. SUBMANDIBULAR GLANDS: Have been removed THYROID GLAND: Normal. VASCULAR STRUCTURES: Atherosclerotic calcification of the bilateral carotid bulbs with mild proximal ICA narrowing. Atherosclerotic calcifications of the carotid siphons without evidence of narrowing. OSSEOUS STRUCTURES: Mild multilevel degenerative changes of the spine with uncovertebral hypertrophy at C5-C6 on the left. Normal alignment. No aggressive osseous lesions identified. Small anterior osteophytes at C4-C5. ORBITS: Normal. PARANASAL SINUSES AND MASTOID AIR CELLS: Mucosal thickening of the left maxillary sinus with hyperdense material, similar to prior. No underlying osseous changes or retromaxillary fat stranding. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: Normal. LUNG APICES: Normal.
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CLINICAL HISTORY: Assess nasal mass TECHNIQUE: Thin postcontrast axial images were obtained through the facial bones and reformatted in multiple planes. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 70 sec Scan field of view: 240 mm. DLP: 1119.28 mGy cm. COMPARISON: None available FINDINGS: There is a 1.7 x 1.1 x 2.1 cm cystic lesion along the left side of the nose. There is no appreciable underlying bone erosion. There are no enlarged, or morphologically abnormal cervical lymph nodes in the visualized neck. Unremarkable appearance of the orbits. Visualized brain parenchyma is unremarkable. There is a small right maxillary sinus mucous cyst. There is opacification of one right ethmoid air cells. There are ORIF changes involving the mandibular symphysis. There are small periapical lucencies at the root of the left maxillary incisor, and first left mandibular molar teeth. IMPRESSION: A 2.1 cm cystic lesion along the left side of the nose. No appreciable underlying bone erosion. Findings are favored to represent an epidermoid inclusion cyst.
FINDINGS: There is a 1.7 x 1.1 x 2.1 cm cystic lesion along the left side of the nose. There is no appreciable underlying bone erosion. There are no enlarged, or morphologically abnormal cervical lymph nodes in the visualized neck. Unremarkable appearance of the orbits. Visualized brain parenchyma is unremarkable. There is a small right maxillary sinus mucous cyst. There is opacification of one right ethmoid air cells. There are ORIF changes involving the mandibular symphysis. There are small periapical lucencies at the root of the left maxillary incisor, and first left mandibular molar teeth.
FINDINGS: The left ICA bulb shows a 0.4 x 0.7 x 1 cm thrombosis. The left ICA and MCA shows no evidence of dislodged thrombus or occlusion. Bilateral anterior and posterior circulation arteries are normally patent. The bilateral proximal ICAs are medialized passing retropharyngeal course. Included aortic arch is unremarkable. Multifocal airspace consolidations in the bilateral upper lung fields are additionally noted.
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrastScan field of view: 230 mm. DLP: 1444 mGy cm. STRUCTURED REPORT: CT Head Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. There is a metallic fragment seen just inferior to the left lobe without adjacent stranding, possibly chronic. CONCLUSION: No acute intracranial process. Metallic radiopaque foreign body seen inferior to the left ocular globe, probably chronic. Clinical correlation recommended.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. There is a metallic fragment seen just inferior to the left lobe without adjacent stranding, possibly chronic.
FINDINGS: The left ICA bulb shows a 0.4 x 0.7 x 1 cm thrombosis. The left ICA and MCA shows no evidence of dislodged thrombus or occlusion. Bilateral anterior and posterior circulation arteries are normally patent. The bilateral proximal ICAs are medialized passing retropharyngeal course. Included aortic arch is unremarkable. Multifocal airspace consolidations in the bilateral upper lung fields are additionally noted.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec. Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002577), per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 seconds Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002578) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma. CONCLUSION: 1. Severe distracted fracture dislocation of the T11-T12 disc space with involvement of the T12 superior endplate and posterior elements of T11, as described. Possible bilateral 12 and right 11th rib fractures. There is suspected small epidural hematoma and probable spinal cord injury. MRI recommended for further evaluation, as clinically indicated. 2. Periaortic mural thickening and periaortic stranding is concerning for a acute aortic syndrome/injury of the distal thoracic aorta, possibly representing intramural hematoma and/or intimal injury. No active extravasation is seen. 3. Subcutaneous stranding and thickening of the right diaphragmatic crus, possibly represents underlying diaphragmatic injury. Stranding is also seen adjacent to the distal esophagus and an underlying esophageal injury is difficult to exclude although there is no free air. 4. Indeterminate prevertebral hematoma at T1-T2 without definite fracture. Underlying ligamentous injury cannot be excluded and should be correlated with physical exam and/or MRI. 5. Seatbelt contusions. Right flank subcutaneous contusion. 6. Indeterminate thyroid nodules. Nonemergent outpatient thyroid ultrasound recommended as clinically indicated. 7. Spine findings are suggestive of ankylosing spondylitis. Additional findings above. Final report findings discussed with trauma resident Dr. Josh Day at 1/5/2022 2:22 PM by Dr. Little by telephone.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma.
Findings/
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec. Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002577), per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 seconds Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002578) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma. CONCLUSION: 1. Severe distracted fracture dislocation of the T11-T12 disc space with involvement of the T12 superior endplate and posterior elements of T11, as described. Possible bilateral 12 and right 11th rib fractures. There is suspected small epidural hematoma and probable spinal cord injury. MRI recommended for further evaluation, as clinically indicated. 2. Periaortic mural thickening and periaortic stranding is concerning for a acute aortic syndrome/injury of the distal thoracic aorta, possibly representing intramural hematoma and/or intimal injury. No active extravasation is seen. 3. Subcutaneous stranding and thickening of the right diaphragmatic crus, possibly represents underlying diaphragmatic injury. Stranding is also seen adjacent to the distal esophagus and an underlying esophageal injury is difficult to exclude although there is no free air. 4. Indeterminate prevertebral hematoma at T1-T2 without definite fracture. Underlying ligamentous injury cannot be excluded and should be correlated with physical exam and/or MRI. 5. Seatbelt contusions. Right flank subcutaneous contusion. 6. Indeterminate thyroid nodules. Nonemergent outpatient thyroid ultrasound recommended as clinically indicated. 7. Spine findings are suggestive of ankylosing spondylitis. Additional findings above. Final report findings discussed with trauma resident Dr. Josh Day at 1/5/2022 2:22 PM by Dr. Little by telephone.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma.
FINDINGS/CONCLUSION: Nondisplaced fracture of the distal radius extending to the radiocarpal joint. No other acute fracture of the hand or wrist is seen. The joint spaces are maintained. Soft tissue swelling about the wrist.
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RADIOLOGIC EXAM: CT Cervical Spine From Reformat, CT Angio Neck CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Cervical Spine From Reformat, CT Angio Neck 3-D CT MIP and Volume rendered angiographic images were generated in post processing. Patient weight: 260 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus traking Scan field of view: 296.60 mm. DLP: 871.80 mGy cm. STRUCTURED REPORT: CT Cervical Spine Trauma, CT Angiogram Neck FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS/CONCLUSION: Nondisplaced fracture of the distal radius extending to the radiocarpal joint. No other acute fracture of the hand or wrist is seen. The joint spaces are maintained. Soft tissue swelling about the wrist.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec. Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002577), per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 seconds Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002578) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma. CONCLUSION: 1. Severe distracted fracture dislocation of the T11-T12 disc space with involvement of the T12 superior endplate and posterior elements of T11, as described. Possible bilateral 12 and right 11th rib fractures. There is suspected small epidural hematoma and probable spinal cord injury. MRI recommended for further evaluation, as clinically indicated. 2. Periaortic mural thickening and periaortic stranding is concerning for a acute aortic syndrome/injury of the distal thoracic aorta, possibly representing intramural hematoma and/or intimal injury. No active extravasation is seen. 3. Subcutaneous stranding and thickening of the right diaphragmatic crus, possibly represents underlying diaphragmatic injury. Stranding is also seen adjacent to the distal esophagus and an underlying esophageal injury is difficult to exclude although there is no free air. 4. Indeterminate prevertebral hematoma at T1-T2 without definite fracture. Underlying ligamentous injury cannot be excluded and should be correlated with physical exam and/or MRI. 5. Seatbelt contusions. Right flank subcutaneous contusion. 6. Indeterminate thyroid nodules. Nonemergent outpatient thyroid ultrasound recommended as clinically indicated. 7. Spine findings are suggestive of ankylosing spondylitis. Additional findings above. Final report findings discussed with trauma resident Dr. Josh Day at 1/5/2022 2:22 PM by Dr. Little by telephone.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Please note that the concurrently obtained CT scan of the neck will be dictated separately. CHEST: LUNGS / AIRWAYS / PLEURA: Mild bilateral upper lung predominant centrilobular emphysema. Left lower lobe pulmonary nodule measuring under a centimeter (series 2; image 103 is unchanged. A few scattered tiny calcified and noncalcified peripheral tree-in-bud type of nodules may represent the sequela of atypical infection, and appear unchanged. No new or growing pulmonary nodules. HEART / VESSELS: Top normal heart size. Trace pericardial effusion. Dense coronary artery calcifications. Right chest port terminates in the right atrium. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please note that the concurrently obtained CT scan of the Abdomen will be dictated separately. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec. Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002577), per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 seconds Scan field of view: 497.50 mm. DLP: 2057.50 mGy cm. (accession CT220002578) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma. CONCLUSION: 1. Severe distracted fracture dislocation of the T11-T12 disc space with involvement of the T12 superior endplate and posterior elements of T11, as described. Possible bilateral 12 and right 11th rib fractures. There is suspected small epidural hematoma and probable spinal cord injury. MRI recommended for further evaluation, as clinically indicated. 2. Periaortic mural thickening and periaortic stranding is concerning for a acute aortic syndrome/injury of the distal thoracic aorta, possibly representing intramural hematoma and/or intimal injury. No active extravasation is seen. 3. Subcutaneous stranding and thickening of the right diaphragmatic crus, possibly represents underlying diaphragmatic injury. Stranding is also seen adjacent to the distal esophagus and an underlying esophageal injury is difficult to exclude although there is no free air. 4. Indeterminate prevertebral hematoma at T1-T2 without definite fracture. Underlying ligamentous injury cannot be excluded and should be correlated with physical exam and/or MRI. 5. Seatbelt contusions. Right flank subcutaneous contusion. 6. Indeterminate thyroid nodules. Nonemergent outpatient thyroid ultrasound recommended as clinically indicated. 7. Spine findings are suggestive of ankylosing spondylitis. Additional findings above. Final report findings discussed with trauma resident Dr. Josh Day at 1/5/2022 2:22 PM by Dr. Little by telephone.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules are noted. There is a heavily calcified right thyroid nodule.. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis is seen within the lower lobes. No focal consolidation or pleural effusion. No pneumothorax. HEART / VESSELS: The heart size is mildly enlarged. There is no pericardial effusion. There is moderate aortoiliac atherosclerosis with mild tortuosity. There is thickening of the descending thoracic aorta as seen on image 199, series 501. There is extensive stranding and hematoma seen in the lower posterior mediastinum directly adjacent to the aorta and diaphragm near the level of the hiatus. MEDIASTINUM / ESOPHAGUS: Periaortic hematoma is seen adjacent to the descending aorta near the hiatus. There is stranding also seen adjacent to the diaphragmatic crus. There is stranding also seen anterior to the T1-T2 vertebral bodies which is indeterminate without definite fracture. DIAPHRAGM: There is stranding adjacent to the diaphragmatic hiatus which likely represents hematoma. There is no active extravasation. The diaphragmatic crus is perhaps slightly thickened on the right posteriorly but otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: There is subcutaneous stranding seen along the anterior chest which likely represents a seatbelt injury. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent bilateral inguinal lymph nodes, probably reactive.. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Distal thoracic aortic injury is described above. No active extravasation. Otherwise, there is mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild abdominal wall rectus diastases. Stranding in subcutaneous tissues overlying the abdomen probably represented a seatbelt contusion. There is a right flank contusion. MUSCULOSKELETAL: There are suspected fractures of the bilateral 12th ribs. Possible right 11th rib fracture. THORACIC AND LUMBAR SPINE CT: THERE IS A SEVERE DISTRACTION FRACTURE DISLOCATION THROUGH THE T11-T12 disc space and likely involves the posterior aspect of the T12 superior endplate. There is significant widening of the disc space measuring 2.1 cm anteriorly. There are fractures extending through the T11 spinous process and bilateral T11 inferior facets. There are smooth flowing syndesmophytes throughout the thoracic spine. No additional fracture or dislocation is identified. There is thickening of the epidural space at the level of the T11-T12 injury which probably represents a small epidural hematoma.
FINDINGS: SOFT TISSUES: Normal. LYMPH NODES: Mildly enlarged bilateral cervical lymph nodes is seen without obvious change in visual evaluation. AERODIGESTIVE STRUCTURES: No asymmetric contrast enhancement or asymmetric soft tissue nodularity. PAROTID GLANDS: Normal. SUBMANDIBULAR GLANDS: Normal. THYROID GLAND: Normal. VASCULAR STRUCTURES: Right-sided chemotherapy port is noted which ends in the SVC out of field of view. Advanced calcification of the coronary arteries is seen. Calcified atherosclerotic plaque of the aortic arch and origin of the main arteries is noted. Atherosclerosis of the carotid bifurcations is seen without obvious narrowing. Evidence of intracranial atherosclerosis is also seen. OSSEOUS STRUCTURES: There is heterogenous density of the skull base in the maxillary bones, clivus and anterior portion of the temporal bones bilaterally most likely sequela of previous radiation. Posterior disc osteophyte at C6-C7 is seen with mild spinal canal stenosis. ORBITS: There is persistent soft tissue in the right orbital apex. PARANASAL SINUSES AND MASTOID AIR CELLS: There is persistent mucosal thickening involving the bilateral maxillary sinuses. Postsurgical changes status post right-sided uncinectomy, resection of the right-sided turbinates, resection of the right-sided ethmoidal air cells and right sphenoidal osteotomy is again seen. Erosion of right aspect of the sphenoidal sinus is seen. Mucosal thickening is again seen covering the residual sphenoidal air cells with extension to the right orbital apex and abutting the bilateral cavernous sinuses. The cavernous sinuses are prominent in size especially on right side. There is persistent osseous destruction involving the right maxillary alveolar ridge with involvement of the roots of the right-sided maxillary molar teeth. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: Normal. LUNG APICES: For the left lower lobe pulmonary nodules please refer to the dedicated chest CT of same date.
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RADIOLOGIC EXAM: CT Cervical Spine From Reformat, CT Angio Neck CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Cervical Spine From Reformat, CT Angio Neck 3-D CT MIP and Volume rendered angiographic images were generated in post processing. Patient weight: 260 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus traking Scan field of view: 296.60 mm. DLP: 871.80 mGy cm. STRUCTURED REPORT: CT Cervical Spine Trauma, CT Angiogram Neck FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
Findings: Pharyngolaryngectomy, tracheostomy, tracheoesophageal voice prosthesis, and bilateral modified radical neck dissection changes are redemonstrated. Previous supraglottic submucosal edema is reduced and collapsed oropharyngeal lumen is now open. A 9 mm hyoid bone remnant is again seen. Beam hardening artifact from the C4-C7 anterior cervical fusion hardware hampers evaluation of infrahyoid tumor recurrence. However, the reconstructed neopharynx demonstrates suspected enhancing soft tissue thickening measuring approximately 1.3 x 1.6 cm axially and 3 cm craniocaudally. The right submental enhancing lymph nodes are mildly enlarged measuring 1 cm in long-axis diameter. Right enucleation with ocular prosthesis is unchanged.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 80-year-old male with provided history of RCC. COMPARISON: Chest CT 6/11/2021 TECHNIQUE: CT Chest with contrast. Patient weight: 180 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 400 mm. DLP: 1184.23 mGy cm. FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Redemonstrated right upper lobe wedge resection with no residual or recurrent mass lesion along the suture line. No new or enlarging suspicious pulmonary nodule. No focal consolidation. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: Index lesions: Measured on series 9. 1. Enlarged right hilar node measures 17 x 12 mm (image 122), previously 14 x 16 mm. 2. The lower right paraesophageal node measures 20 x 12 mm (image 204), previously 13 x 23 mm. Multiple borderline enlarged and subcentimeter supraclavicular and left axillary lymph nodes, similar to prior. Calcified right hilar lymph nodes, likely related to prior granulomatous disease. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. Mild coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. Mild pericardial effusion, unchanged. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Reported separately. CONCLUSION: 1. Unchanged right hilar, paraesophageal and left axillary lymph nodes. No new lymphadenopathy. 2. No new or enlarging suspicious pulmonary nodule.
FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Redemonstrated right upper lobe wedge resection with no residual or recurrent mass lesion along the suture line. No new or enlarging suspicious pulmonary nodule. No focal consolidation. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: Index lesions: Measured on series 9. 1. Enlarged right hilar node measures 17 x 12 mm (image 122), previously 14 x 16 mm. 2. The lower right paraesophageal node measures 20 x 12 mm (image 204), previously 13 x 23 mm. Multiple borderline enlarged and subcentimeter supraclavicular and left axillary lymph nodes, similar to prior. Calcified right hilar lymph nodes, likely related to prior granulomatous disease. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. Mild coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. Mild pericardial effusion, unchanged. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Reported separately.
FINDINGS: SINOCRANIAL AND SINOORBITAL JUNCTIONS: Postsurgical changes is seen is status post bilateral uncinectomy and partial ethmoidectomy. There is Keros anatomy type II bilaterally. NASAL SEPTUM/NASAL CAVITY: There is no significant nasal septal deviation. FRONTAL SINUSES, DRAINAGE PATHWAYS, AND ASSOCIATED ANATOMIC VARIANTS: The frontal sinuses are well developed and aerated. The frontal recesses are free of mucosal disease. ETHMOID SINUSES: The ethmoid air cells are free of mucosal disease. SPHENOID SINUSES, DRAINAGE PATHWAYS, AND ASSOCIATED VARIANTS: There is a small retention cyst in left the sphenoidal sinus. The intersinus septum inserts at midline. The carotid canals are covered by bone. Pneumatization of the right anterior clinoid process is seen. MAXILLARY SINUSES, DRAINAGE PATHWAYS, AND ASSOCIATED VARIANTS: Maxillary sinuses are clear. There is a tiny retention cyst in left maxillary sinus. MASTOID AIR CELLS: The mastoid air cells are well developed and aerated. OTHER: Limited evaluation of the brain parenchyma is unremarkable.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: History of RCC and CLL. COMPARISON: 6/11/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 180 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 400 mm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: The left adrenal is surgically absent. The right adrenal is normal. KIDNEYS: Left kidney is surgically absent. No definite soft tissue abnormality is seen within the nephrectomy bed. The right kidney is normal without abnormal parenchymal enhancement or hydronephrosis. LYMPH NODES: Retroperitoneal and mesenteric lymphadenopathy is redemonstrated. These are similar in size compared to prior examination. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticulosis without evidence of diverticulitis. The appendix is not definitively visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Numerous surgical clips throughout the left retroperitoneum. VESSELS: Minimal atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Contains excreted contrast; otherwise normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: No abnormality. MUSCULOSKELETAL: Right femoral fixation screws. No aggressive osseous lesions. CONCLUSION: 1. Unchanged retroperitoneal and mesenteric lymphadenopathy. 2. Post surgical changes consistent with prior left nephrectomy. No soft tissue abnormality within the surgical bed or evidence of abdominopelvic metastasis. 3. Chronic and incidental findings as above.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: The left adrenal is surgically absent. The right adrenal is normal. KIDNEYS: Left kidney is surgically absent. No definite soft tissue abnormality is seen within the nephrectomy bed. The right kidney is normal without abnormal parenchymal enhancement or hydronephrosis. LYMPH NODES: Retroperitoneal and mesenteric lymphadenopathy is redemonstrated. These are similar in size compared to prior examination. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticulosis without evidence of diverticulitis. The appendix is not definitively visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Numerous surgical clips throughout the left retroperitoneum. VESSELS: Minimal atherosclerotic calcification of the abdominal aorta which is normal in caliber. URINARY BLADDER: Contains excreted contrast; otherwise normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: No abnormality. MUSCULOSKELETAL: Right femoral fixation screws. No aggressive osseous lesions.
FINDINGS: No acute fracture or dislocation. Degenerative changes of the glenohumeral and acromioclavicular joints are noted. No joint effusion. There is a fluid collection within the right pectoralis major muscle with an internal fluid fluid level this collection measures approximately 2.3 x 7.9 cm (image 24, series 3). Stranding is noted within the fat overlying the right pectoralis major muscle. The remaining soft tissues about the shoulder are unremarkable. Mild dependent atelectasis within the right lung. Partial visualization of the left lung lower lobe demonstrates opacity. There is a 0.8 cm hypointense nodule within the left lobe of thyroid.
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EXAM: CT Rsh Chest with contrast METRIC CLINICAL INFORMATION: History of recurrent ovarian cancer, evaluate disease status. COMPARISON: Multiple prior CT chest, 10/4/2021. TECHNIQUE: CT Rsh Chest with contrast METRIC. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 66 sec. Scan field of view: 300 mm. DLP: 597.80 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Tiny pleural-based nodule in the right upper lobe is unchanged. The previously noted right lower lobe pleural-based nodules are no longer visualized. No new suspicious pulmonary nodule or mass. Left lower lobe calcified granuloma, unchanged. No pleural effusion. No pneumothorax. Unchanged pleuroparenchymal scarring in the right costophrenic angle. Central airways are patent. HEART / VESSELS: Mild left atrial enlargement, unchanged. No pericardial effusion. Left subclavian Mediport catheter is present with tip terminating at the cavoatrial junction. MEDIASTINUM / ESOPHAGUS: Small sliding hiatal hernia. Fluid in the esophagus, likely secondary to reflux. LYMPH NODES: Small subcentimeter right hilar lymph node, unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please see separate lumbar same day CT abdomen and pelvis. MUSCULOSKELETAL: No new aggressive osseous lesions. Mild multilevel degenerative changes of the thoracic spine. Unchanged left humeral neck deformity from prior fracture and ill-defined lucencies in the humeral head. CONCLUSION: 1. No evidence of intrathoracic disease progression. 2. Unchanged left humeral neck fracture deformity with ill-defined lucencies in the humeral head. This patient is participating in a clinical trial and a separate Tumor Metrics report will be provided and include tumor measurements as applicable for response assessment. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Tiny pleural-based nodule in the right upper lobe is unchanged. The previously noted right lower lobe pleural-based nodules are no longer visualized. No new suspicious pulmonary nodule or mass. Left lower lobe calcified granuloma, unchanged. No pleural effusion. No pneumothorax. Unchanged pleuroparenchymal scarring in the right costophrenic angle. Central airways are patent. HEART / VESSELS: Mild left atrial enlargement, unchanged. No pericardial effusion. Left subclavian Mediport catheter is present with tip terminating at the cavoatrial junction. MEDIASTINUM / ESOPHAGUS: Small sliding hiatal hernia. Fluid in the esophagus, likely secondary to reflux. LYMPH NODES: Small subcentimeter right hilar lymph node, unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please see separate lumbar same day CT abdomen and pelvis. MUSCULOSKELETAL: No new aggressive osseous lesions. Mild multilevel degenerative changes of the thoracic spine. Unchanged left humeral neck deformity from prior fracture and ill-defined lucencies in the humeral head.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated CT chest. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Similar nodularity of the left adrenal gland. Right adrenal gland is absent. KIDNEYS: Left kidney is normal. Right kidney is absent. LYMPH NODES: Similar calcified pericaval lymph node. No new lymphadenopathy. STOMACH / SMALL BOWEL: Stomach is normal. Right retroperitoneal mass abuts the mid duodenum. Enteric contrast material traverses to the mid small bowel. COLON / APPENDIX: Scattered noninflamed colonic or particular. Portions of the ascending colon are involved by the right retroperitoneal mass. Similar Richter type hernia of the transverse colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Large right retroperitoneal mass appears similar to the prior exam measuring 11.3 x 8.8 cm on image 276 series 2, previously 13.9 x 9.7 cm. Cranial rounded component measures 6.3 x 6.3 cm on image 247 series 2, previously 6.5 x 5.9 cm. Nodular more hyperattenuating component adjacent to the cecum measures 4.2 x 3.1 cm on image 321 series 2, previously 4.0 x 3 6 cm. Scattered calcifications consistent with the mass appears similar. There is similar involvement of the descending colon and effacement of several loops of small bowel. VESSELS: Advanced atherosclerotic calcifications of the abdominal aorta and branch vessels. Right retroperitoneal mass contacts the infrarenal IVC. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Similar fat-containing ventral hernia that also contains anterior wall of a loop of transverse colon. MUSCULOSKELETAL: Lower lumbar spine degenerative changes. No destructive osseous lesions.
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EXAM: CT Rsh Body with contrast METRIC CLINICAL INFORMATION: Ovarian cancer COMPARISON: 10/4/2021 TECHNIQUE: CT Rsh Body with contrast METRIC. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 66 sec. Scan field of view: 350 mm. DLP: 597.80 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately reported chest CT. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There are two well-circumscribed, hypoattenuating lesions in the spleen, the larger of the two measuring approximately 1.4 x 1.3 cm (series 202 image 208). These lesions are unchanged compared to prior exam. ADRENALS: Normal. KIDNEYS: Stable appearing bilateral simple renal cysts. Mild right-sided pelviectasis. No obstructing mass or lesion visualized. LYMPH NODES: There is a peritoneal nodule adjacent to the right border of the rectum that has grown in size compared to prior exam (series 202 image 409). Otherwise, scattered intraperitoneal lymph nodes are unchanged. STOMACH / SMALL BOWEL: Small type I hiatal hernia. The small bowel is unremarkable. COLON / APPENDIX: Scattered diverticula without surrounding inflammation. The appendix is unremarkable. PERITONEUM / MESENTERY: Two left adnexal nodules are seen, the larger of the two nodules seen on series 202 image 414 appears to have enlarged in size. Additionally there is a new peritoneal nodule in the left hemipelvis on series 202, image 401. Interval enlargement of small peritoneal nodules in the right (on series 202, image 409 and image 395. No additional suspicious metastatic disease elsewhere in the abdomen. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic disease involving the descending aorta. The common hepatic and splenic arteries both originate directly off the aorta. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus and bilateral ovaries are surgically absent. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality. There is an age indeterminate compression fracture involving the L1 vertebral body. Mild degenerative changes involving the lumbar spine. CONCLUSION: 1. Compared to recent CT 10/04/2021, interval enlargement of small metastatic peritoneal nodules in the pelvis. No metastasis elsewhere in the abdomen. 2. Other stable findings as outlined above. This patient is participating in a clinical trial and a separate Tumor Metrics report will be provided and include tumor measurements as applicable for response assessment. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately reported chest CT. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There are two well-circumscribed, hypoattenuating lesions in the spleen, the larger of the two measuring approximately 1.4 x 1.3 cm (series 202 image 208). These lesions are unchanged compared to prior exam. ADRENALS: Normal. KIDNEYS: Stable appearing bilateral simple renal cysts. Mild right-sided pelviectasis. No obstructing mass or lesion visualized. LYMPH NODES: There is a peritoneal nodule adjacent to the right border of the rectum that has grown in size compared to prior exam (series 202 image 409). Otherwise, scattered intraperitoneal lymph nodes are unchanged. STOMACH / SMALL BOWEL: Small type I hiatal hernia. The small bowel is unremarkable. COLON / APPENDIX: Scattered diverticula without surrounding inflammation. The appendix is unremarkable. PERITONEUM / MESENTERY: Two left adnexal nodules are seen, the larger of the two nodules seen on series 202 image 414 appears to have enlarged in size. Additionally there is a new peritoneal nodule in the left hemipelvis on series 202, image 401. Interval enlargement of small peritoneal nodules in the right (on series 202, image 409 and image 395. No additional suspicious metastatic disease elsewhere in the abdomen. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic disease involving the descending aorta. The common hepatic and splenic arteries both originate directly off the aorta. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus and bilateral ovaries are surgically absent. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality. There is an age indeterminate compression fracture involving the L1 vertebral body. Mild degenerative changes involving the lumbar spine.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: Status post CABG. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please note that the concurrently obtained CT scan of the Abdomen will be dictated separately. MUSCULOSKELETAL: No significant abnormality.
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CT Head wo contrast 1/5/2022 5:07 PM Clinical information: altered mental status Comparison: None available. Technique: 5 mm axial images were obtained without contrast from the base of the skull to the vertex with sagittal and coronal reformats. Scan field of view: 229 mm. DLP: 1031 mGy cm. Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Prominent prevascular spaces in medial temporal lobe. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Staphyloma of left globe. Right orbit appears normal. Impression: No CT evidence of acute intracranial abnormality.
Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Prominent prevascular spaces in medial temporal lobe. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Staphyloma of left globe. Right orbit appears normal.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal. No suspicious lesion. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Small well-circumscribed 10 x 9 mm hypoattenuating lesion in the head of the pancreas (series 3, image 200) is unchanged from exams dating back to 12/10/2020. SPLEEN: Normal. ADRENALS: Left adrenal nodule is unchanged, measuring 1.4 cm. KIDNEYS: Unchanged small nonobstructing left inferior pole renal calculus. Redemonstrated benign cyst arising from the inferior pole left kidney is unchanged. Multiple subcentimeter hypoattenuating lesions in the right kidney are unchanged from prior. LYMPH NODES: None enlarged. No suspicious inguinal lymphadenopathy. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Postsurgical changes of right orchiectomy. Persistent soft tissue prominence within the right inguinal canal likely represents postsurgical changes/scarring (series 3 image 410). Scattered calcifications in the prostate gland. BODY WALL: Tiny fat-containing umbilical hernia. Otherwise no significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesion.
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EXAM: CT Cervical Spine wo contrast, CT Head wo contrast CLINICAL INFORMATION: Fall, head injury COMPARISON: None. TECHNIQUE: CT Cervical Spine wo contrast, CT Head wo contrast 3-D CT MIP images were generated in post processing. Scan field of view: 200 mm. DLP: 888 mGy cm. (accession CT220002591), Scan field of view: 250 mm. DLP: 1178 mGy cm. (accession CT220002590) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild chronic white matter microangiopathic changes and volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild chronic white matter microangiopathic changes and volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: Borderline heart size. Left dual lead pacer with intact leads. Mild coronary artery calcifications. Aortic valve calcifications without significant dilation of the ascending aorta. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Prominent AP window/left paratracheal lymph node measures about 1.3 x 1.1 cm (series 3; image 74), not significantly changed. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please note that the concurrently obtained CT scan of the Abdomen will be dictated separately. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Cervical Spine wo contrast, CT Head wo contrast CLINICAL INFORMATION: Fall, head injury COMPARISON: None. TECHNIQUE: CT Cervical Spine wo contrast, CT Head wo contrast 3-D CT MIP images were generated in post processing. Scan field of view: 200 mm. DLP: 888 mGy cm. (accession CT220002591), Scan field of view: 250 mm. DLP: 1178 mGy cm. (accession CT220002590) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild chronic white matter microangiopathic changes and volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild chronic white matter microangiopathic changes and volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: Intracranially there is no evidence of acute vascular territory ischemia, hemorrhage, mass or mass effect. The ventricles are normal in size and configuration. The cortical sulci and subarachnoid cisterns are symmetric and age-appropriate. There is no extra-axial pathology. The calvarium and skull base show no focal bony abnormality. Visualized paranasal sinus and mastoid aerations are clear.
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CLINICAL HISTORY: Shunted hydrocephalus follow-up COMPARISON: CT head 9/13/2021, 6/2/2021 TECHNIQUE: CT of the head was performed without intravenous contrast at 2.5mm slice thickness. Scan field of view: 240 mm. DLP: 898.53 mGy cm. FINDINGS: Redemonstration of a right frontal approach ventriculostomy catheter with tip near the right foramen of Monro. The ventricular caliber and configuration are stable with slitlike right lateral ventricle. Low-lying cerebellar tonsils again noted. Redemonstration of a small left choroidal fissure cyst. There is no acute territorial loss of gray-white differentiation. There is no intracranial hemorrhage or extra-axial collection. There is no intracranial mass effect or midline shift. Basal cisterns are patent. Imaged portions of the orbits are grossly unremarkable. The visualized paranasal sinuses are clear. The mastoid air cells are clear. No calvarial fracture is appreciated. IMPRESSION: No acute intracranial process. Stable low-lying cerebellar tonsils. Stable configuration of the shunted ventricles, without hydrocephalus.
FINDINGS: Redemonstration of a right frontal approach ventriculostomy catheter with tip near the right foramen of Monro. The ventricular caliber and configuration are stable with slitlike right lateral ventricle. Low-lying cerebellar tonsils again noted. Redemonstration of a small left choroidal fissure cyst. There is no acute territorial loss of gray-white differentiation. There is no intracranial hemorrhage or extra-axial collection. There is no intracranial mass effect or midline shift. Basal cisterns are patent. Imaged portions of the orbits are grossly unremarkable. The visualized paranasal sinuses are clear. The mastoid air cells are clear. No calvarial fracture is appreciated.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Similar appearance of focal area of hyperdensity to the left of the intrasegmental fissure, which may represent hemangioma or perfusional anomaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent mesenteric nodes are unchanged. None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Surgically absent appendix. Similar appearance of soft tissue prominence at the ileocecal valve (coronal image 65 series 601). Scattered colonic diverticuli without adjacent inflammation. PERITONEUM / MESENTERY: Normal. No ascites or pseudomyxoma is identified. RETROPERITONEUM: Normal. VESSELS: Mild scattered atherosclerotic disease. URINARY BLADDER: Wall thickening is likely related to collapsed state. REPRODUCTIVE ORGANS: Calcified uterine fibroids. No adnexal mass. BODY WALL: Small fat-containing periumbilical hernia. MUSCULOSKELETAL: Mild levoscoliosis. Retrolisthesis of L1 on L2 and L2 on L3. Advanced degenerative changes of the thoracolumbar spine. No suspicious osseous lesion.
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EXAM: CT Angio Abdomen and Pelvis, CT Chest with contrast CLINICAL INFORMATION: 62-year-old male with dyspnea and concern for splenic infarct. Patient is status post open exploration and ligation of proximal splenic artery aneurysm. COMPARISON: Ultrasound of the abdomen dated 1/4/2022. TECHNIQUE: CT Angio Abdomen and Pelvis, CT Chest with contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 298 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 478 mm. DLP: 3489 mGy cm. (accession CT220002593), Patient weight: 298 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 75sec Scan field of view: 444 mm. DLP: 3489 mGy cm. (accession CT220002659) FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: Scattered mild atherosclerosis. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Suspected splenic artery aneurysm aneurysm is seen measuring 5.3 x 5.1 cm (series 11, image 134) containing hemorrhage without significant opacification on arterial and venous imaging. Surgical clips are seen surrounding the celiac trunk with patent common hepatic artery. There is partial opacification of the splenic artery. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: Accessory left renal artery without significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: 2.7 cm nodule of the left lobe thyroid gland. CHEST: LUNGS / AIRWAYS / PLEURA: Small left greater than right pleural effusions and associated atelectasis. No suspicious pulmonary nodule. HEART / VESSELS: Mild CAD. Heart is normal in size. Trace Effusion. No central pulmonary embolism. Scattered mild atherosclerosis of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia with wall thickening of the distal esophagus which can be seen in esophagitis.. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. Diaphragm: Complex partially rim-enhancing fluid collection seen along the right diaphragmatic crura measuring 3.5 x 1.1 cm (series 11, image 76) with additional fluid tracking along the corona of the upper abdomen. ABDOMEN and PELVIS: LIVER: Mixed areas of decreased attenuation in the caudate lobe near the intraperitoneal fluid. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating material in the lumen may represent sludge. PANCREAS: Mixed attenuating round lesion is seen in the pancreatic body likely representing splenic artery aneurysm described above. Fatty atrophy of the head. Remaining pancreas is unremarkable. SPLEEN: Wedge-shaped areas of decreased attenuation throughout spleen. ADRENALS: Normal. KIDNEYS: Left renal cyst. Nonspecific perinephric stranding. Left renal pelviectasis without hydronephrosis. No suspicious lesion. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Stomach is unremarkable. The mid small bowel is dilated with air-fluid levels and without transition point seen. COLON / APPENDIX: Mild diverticulosis. The appendix is noninflamed. PERITONEUM / MESENTERY: Pneumoperitoneum (series 11, image 75). Tiny volume of perihepatic and pelvic ascites. RETROPERITONEUM: Fluid tracking along the diaphragmatic pleura. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Partially collapsed with Foley catheter in place. Wall thickening likely secondary to underdistention. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes of the ventral abdominal wall. Tiny fat-containing periapical hernia. MUSCULOSKELETAL: Spondylosis of the visualized spine. No destructive osseous lesion. CONCLUSION: 1. Postsurgical changes of splenic artery aneurysm ligation are seen without significant opacification on the postcontrast images. Splenic infarcts are seen with partial opacification of the splenic artery. 2. Fluid collection is seen along the splenic artery aneurysm in the retroperitoneum extending along the right diaphragmatic pleura. Peripheral enhancement seen in the fluid along the right diaphragmatic hernia with additional mixed attenuation of the caudate lobe. Findings are likely postsurgical related and reactive, although infection is difficult to exclude. 3. Areas of dilated small bowel without transition point likely represent developing adynamic ileus. 4. Small left greater than right pleural effusions and associated atelectasis. 5. Diverticulosis. 6. Left thyroid nodule measuring up to 2.7 cm. Recommend nonemergent/outpatient thyroid ultrasound for further evaluation. *****IMPORTANT INCIDENTAL IMAGING FINDINGS REPORTED***** As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: Scattered mild atherosclerosis. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Suspected splenic artery aneurysm aneurysm is seen measuring 5.3 x 5.1 cm (series 11, image 134) containing hemorrhage without significant opacification on arterial and venous imaging. Surgical clips are seen surrounding the celiac trunk with patent common hepatic artery. There is partial opacification of the splenic artery. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: Accessory left renal artery without significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: 2.7 cm nodule of the left lobe thyroid gland. CHEST: LUNGS / AIRWAYS / PLEURA: Small left greater than right pleural effusions and associated atelectasis. No suspicious pulmonary nodule. HEART / VESSELS: Mild CAD. Heart is normal in size. Trace Effusion. No central pulmonary embolism. Scattered mild atherosclerosis of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia with wall thickening of the distal esophagus which can be seen in esophagitis.. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. Diaphragm: Complex partially rim-enhancing fluid collection seen along the right diaphragmatic crura measuring 3.5 x 1.1 cm (series 11, image 76) with additional fluid tracking along the corona of the upper abdomen. ABDOMEN and PELVIS: LIVER: Mixed areas of decreased attenuation in the caudate lobe near the intraperitoneal fluid. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating material in the lumen may represent sludge. PANCREAS: Mixed attenuating round lesion is seen in the pancreatic body likely representing splenic artery aneurysm described above. Fatty atrophy of the head. Remaining pancreas is unremarkable. SPLEEN: Wedge-shaped areas of decreased attenuation throughout spleen. ADRENALS: Normal. KIDNEYS: Left renal cyst. Nonspecific perinephric stranding. Left renal pelviectasis without hydronephrosis. No suspicious lesion. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Stomach is unremarkable. The mid small bowel is dilated with air-fluid levels and without transition point seen. COLON / APPENDIX: Mild diverticulosis. The appendix is noninflamed. PERITONEUM / MESENTERY: Pneumoperitoneum (series 11, image 75). Tiny volume of perihepatic and pelvic ascites. RETROPERITONEUM: Fluid tracking along the diaphragmatic pleura. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Partially collapsed with Foley catheter in place. Wall thickening likely secondary to underdistention. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes of the ventral abdominal wall. Tiny fat-containing periapical hernia. MUSCULOSKELETAL: Spondylosis of the visualized spine. No destructive osseous lesion.
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Positive for pulmonary embolus. - Pulmonary Embolus Distribution: Pulmonary emboli involving bilateral lower lobe lobar segmental and subsegmental vessels. - Pulmonary Artery Diameter: Normal. - Ascending Aortic Diameter: Normal. - RV:LV Ratio: Normal. - Interventricular Septum: Normal. - Contrast reflux into IVC: No significant abnormality. LUNGS / AIRWAYS / PLEURA: Dense airspace opacities in the bilateral lower lobes may represent a combination of pneumonia and pulmonary infarctions. HEART / OTHER VESSELS: Borderline heart size. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Enlarged mediastinal lymph nodes, for example a precarinal lymph node measures about 1.3 cm in short axis (series 401; image 44). A subcarinal lymph node measures about 1.6 cm in short axis (series 401; image 47). CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Ventral hernia with prior mesh repair complicated by recurrent infections. COMPARISON: 6/15/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 273 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 90 sec. Scan field of view: 394 mm. DLP: 1459.20 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Left adrenal nodule measures 3.0 x 2.5 cm (series 201, image 78), previously 2.8 x 2.2 cm on prior CT. This demonstrates minimal internal enhancement and indeterminate attenuation. The right adrenal is normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes consistent with prior partial small bowel resection. Several loops of small bowel are adherent to the anterior abdominal wall review, likely secondary to adhesions. The stomach is normal. COLON / APPENDIX: No abnormality. The appendix is not definitively visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Significant atherosclerotic disease of the abdominal aorta which is normal in caliber. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal lesions. BODY WALL: Postsurgical changes consistent with prior ventral hernia repair. There is significant associated soft tissue thickening along the abdominal wall (series 201, image 176). No definite loculated fluid collection is visualized. Evaluation for recurrent hernia is somewhat limited due to significant soft tissue thickening. There is a suspected herniated loop of small bowel (series 201, image 181); sensitivity for enterocutaneous fistula is limited by lack of oral contrast. MUSCULOSKELETAL: No aggressive osseous lesions. Avascular necrosis of bilateral femoral heads. No aggressive osseous lesions. CONCLUSION: 1. Post surgical changes along the anterior abdominal wall with significant soft tissue thickening. Questionable herniated loop of nondilated small bowel. Evaluation for enterocutaneous fistula is limited due to lack of oral contrast. 2. Indeterminant left adrenal nodule questionably increased in size compared to prior. Characterization with adrenal protocol CT or MRI is recommended. 3. Additional incidental findings as above. *****IMPORTANT INCIDENTAL IMAGING FINDINGS REPORTED*****
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Left adrenal nodule measures 3.0 x 2.5 cm (series 201, image 78), previously 2.8 x 2.2 cm on prior CT. This demonstrates minimal internal enhancement and indeterminate attenuation. The right adrenal is normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes consistent with prior partial small bowel resection. Several loops of small bowel are adherent to the anterior abdominal wall review, likely secondary to adhesions. The stomach is normal. COLON / APPENDIX: No abnormality. The appendix is not definitively visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Significant atherosclerotic disease of the abdominal aorta which is normal in caliber. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal lesions. BODY WALL: Postsurgical changes consistent with prior ventral hernia repair. There is significant associated soft tissue thickening along the abdominal wall (series 201, image 176). No definite loculated fluid collection is visualized. Evaluation for recurrent hernia is somewhat limited due to significant soft tissue thickening. There is a suspected herniated loop of small bowel (series 201, image 181); sensitivity for enterocutaneous fistula is limited by lack of oral contrast. MUSCULOSKELETAL: No aggressive osseous lesions. Avascular necrosis of bilateral femoral heads. No aggressive osseous lesions.
FINDINGS: Supraclavicular region is unremarkable. Central airways are patent. The aortic root is not well assessed. The thoracic aorta is nonaneurysmal. The ascending thoracic aorta measures up to 2 cm. The pulmonary arteries are normal caliber. The heart is not enlarged. No enlarged thoracic lymph nodes. Residual thymic tissue within the anterior mediastinum. The esophagus is mildly patulous. There is a focal filling defect within the mid thoracic esophagus. No hiatal hernia. There is no acute lung abnormality. No suspicious lung nodules. No pleural effusion or pleural thickening. No acute or aggressive osseous abnormality.
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: Bladder cancer COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 221 lbs. IV contrast: Omnipaque 350, 180 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 60 sec. Scan field of view: 416 mm. DLP: 1849 mGy cm. FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Subcentimeter simple bilateral renal cortical cysts. No hydronephrosis or hydroureter. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Surgically absent. Right lower quadrant ileal conduit is seen, which is opacified on excretory phase without any obstruction. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Normal. MUSCULOSKELETAL: No acute osseous findings. Small lucent foci in the posterior right iliac blade probably degenerative. Sclerotic lesion in the anterior superior left femoral head probably represent avascular necrosis. CONCLUSION: 1. Surgically absent urinary bladder. No residual or metastatic disease. 2. Normal-appearing right lower quadrant ileal conduit. No hydronephrosis or hydroureter. Subcentimeter bilateral simple renal cysts. No suspicious renal or urothelial lesions. 3. Other incidental/chronic findings as described above.
FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Subcentimeter simple bilateral renal cortical cysts. No hydronephrosis or hydroureter. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Surgically absent. Right lower quadrant ileal conduit is seen, which is opacified on excretory phase without any obstruction. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Normal. MUSCULOSKELETAL: No acute osseous findings. Small lucent foci in the posterior right iliac blade probably degenerative. Sclerotic lesion in the anterior superior left femoral head probably represent avascular necrosis.
FINDINGS: BONES/JOINTS: There is a chronic appearing comminuted and impacted fracture deformity of the right humerus surgical neck. There is a small amount of bridging osteophyte formation and heterotopic ossification surrounding the humeral head. There are advanced degenerative changes of the acromioclavicular and glenohumeral joint with joint space narrowing, subchondral sclerosis, and marginal osteophyte formation. Calcifications are present at the insertion of the supraspinatus and infraspinatus. Calcifications are present within the glenohumeral joint space. Additionally, there are healing fractures of the left third through sixth ribs. SOFT TISSUES: No large hematoma or fluid collection. There are numerous scattered punctate foci of calcifications throughout the subcutaneous soft tissues. There is a noncalcified nodule within the posteriolateral right lung measuring up to 4 mm (series 4 image 154) with adjacent groundglass opacities.
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EXAM: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 255 mm. DLP: 1410.70 mGy cm. (accession CT220002597), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 271.80 mm. DLP: 893.20 mGy cm. (accession CT220002603) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pleural effusion with adjacent passive compressive atelectasis. Dependent atelectatic changes in the bilaterally. HEART / VESSELS: Coronary artery calcifications in the LAD, moderate. Mildly enlarged main pulmonary artery measuring up to 3.3 cm suggesting some element of pulmonary arterial hypertension. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Anterior chest wall fluid collection extending to the left of midline/external measuring about 6.9 x 2.6 cm (series 2; image 70) UPPER ABDOMEN: Tiny 1 to 2 mm nonobstructing calculus in the left renal lower pole. A few colonic diverticula without acute inflammatory changes. MUSCULOSKELETAL: Old healed right rib fractures. Subacute left fourth and fifth rib fractures laterally with some callus formation seen. Partially visualized cervical thoracic spinal fusion hardware.
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EXAM: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 255 mm. DLP: 1410.70 mGy cm. (accession CT220002597), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 271.80 mm. DLP: 893.20 mGy cm. (accession CT220002603) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: BONES/JOINTS: No acute fracture or malalignment. Joint spaces are well-maintained with mild degenerative changes of the midfoot. There is a focal area of increased density within the lateral distal tibia (series 6 image 132), likely representing a bone island. The talar dome is intact. There are several tiny ossific fragments adjacent to the inferior medial malleolus, likely representing remote trauma. Subchondral lucency is noted within the medial malleolus possibly representing a developing osteochondral lesion (image 83, series 903). Enthesopathic changes at the Achilles tendon insertion. SOFT TISSUES: No large hematoma or fluid collection. There is mild subcutaneous edema and dermal thickening overlying the dorsal lateral soft tissues (series 903 image 203).
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EXAM: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 255 mm. DLP: 1410.70 mGy cm. (accession CT220002597), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 271.80 mm. DLP: 893.20 mGy cm. (accession CT220002603) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: See separate chest CT report. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Amyand hernia contains noninflamed appendix extending into the right inguinal canal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: Tiny umbilical hernia contains fat. Small inguinal hernias contain fat. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 255 mm. DLP: 1410.70 mGy cm. (accession CT220002597), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 271.80 mm. DLP: 893.20 mGy cm. (accession CT220002603) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Redemonstration of right upper lobe nodular scarring with the nodular component measuring up to 0.8 cm (series 2; image 85), similar to prior. No new or growing pulmonary nodules. Mild biapical scarring. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please note that the concurrently obtained CT scan of the Abdomen will be dictated separately. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 255 mm. DLP: 1410.70 mGy cm. (accession CT220002597), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 271.80 mm. DLP: 893.20 mGy cm. (accession CT220002603) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: BRAIN PARENCHYMA: There is no acute intracranial hemorrhage or acute infarct. No brain edema or mass effect. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: No acute fracture
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EXAM: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 255 mm. DLP: 1410.70 mGy cm. (accession CT220002597), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 271.80 mm. DLP: 893.20 mGy cm. (accession CT220002603) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: BRAIN PARENCHYMA: There is no acute intracranial hemorrhage or acute infarct. No brain edema or mass effect. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: No acute fracture
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EXAM: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Angio Neck, CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 255 mm. DLP: 1410.70 mGy cm. (accession CT220002597), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 271.80 mm. DLP: 893.20 mGy cm. (accession CT220002603) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. Small dural calcification along the left tentorial leaflet. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: BRAIN PARENCHYMA: Postoperative changes from partial right frontal lobe mass resection with increased size of the residual heterogeneously enhancing now measuring 4.2 x 3.2 cm previously 3.3 x 1.8 cm. There is is also significant worsening vasogenic edema within the right frontal lobe with partial effacement of the right lateral ventricle and leftward midline shift/subfalcine herniation of 0.5 cm. There is also developing right uncal herniation. VENTRICULAR SYSTEM: Partial effacement of the right lateral ventricle with EXTRA-AXIAL SPACES: There are no extra-axial fluid collections identified. SKULL AND SKULL BASE: Redemonstrated postsurgical changes from right frontal craniotomy. No acute displaced fracture. Calvarium is intact. No acute osseous findings. SINUSES: Visualized paranasal sinuses are clear. MASTOIDS: Mastoid air cells are clear bilaterally. ORBITS: Globes are intact. Orbits unremarkable. SOFT TISSUE: Remaining visualized soft tissues are within normal limits.
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CT Head wo contrast CLINICAL INFORMATION: Bradycardia, irregular breathing, hypertension Spec Inst: presented in cardiac arrest, previous CT with cerebral edema. concern for possible herniation given hemodynamics COMPARISON: CT head earlier same date, 1/5/2022 at 1:15 AM TECHNIQUE: CT Head wo contrastScan field of view: 260 mm. DLP: 1064 mGy cm. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No evidence of intracranial hemorrhage or acute territorial infarction. There is persistent diffuse loss of gray-white differentiation consistent with diffuse cerebral edema/anoxic brain injury. Interval increase in hypodense appearance of the bilateral caudate heads and basal ganglia likely reflecting evolving edema/infarction. No midline shift or significant mass effect. Basilar cisterns are patent. No uncal or cerebellar tonsillar herniation. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Stable in size. No hydrocephalus. ORBITS: Normal. SINUSES: Mucosal thickening in the right greater than left sphenoid sinuses and minimal mucosal thickening within the maxillary sinuses. Mastoid air cells are clear. CONCLUSION: Redemonstrated findings consistent with diffuse cerebral edema/and anoxic brain injury. Probable evolving edema/infarcts involving the bilateral caudate heads and basal ganglia. No midline shift or significant mass effect. No evidence of herniation at this time.
FINDINGS: BRAIN PARENCHYMA: No evidence of intracranial hemorrhage or acute territorial infarction. There is persistent diffuse loss of gray-white differentiation consistent with diffuse cerebral edema/anoxic brain injury. Interval increase in hypodense appearance of the bilateral caudate heads and basal ganglia likely reflecting evolving edema/infarction. No midline shift or significant mass effect. Basilar cisterns are patent. No uncal or cerebellar tonsillar herniation. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Stable in size. No hydrocephalus. ORBITS: Normal. SINUSES: Mucosal thickening in the right greater than left sphenoid sinuses and minimal mucosal thickening within the maxillary sinuses. Mastoid air cells are clear.
FINDINGS: THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Discogenic degenerative changes and spondylosis of the lower thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. Upper lobe predominant paraseptal emphysema. Coronary artery disease. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and facet arthropathy, most pronounced at L4-L5 and L5-S1. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. Atherosclerosis.
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EXAM: CT Bone Pelvis wo contrast CLINICAL INFORMATION: Fall with concern for hip/pelvic fracture COMPARISON: 12/27/2021 TECHNIQUE: CT Bone Pelvis wo contrast Scan field of view: 360 mm. DLP: 159.49 mGy cm. FINDINGS: Nondisplaced, possibly mildly comminuted fracture of the anterior column of the right acetabulum. The right femoral head is well-seated within its acetabulum. Nondisplaced fracture of the right sacral alar extending into the right SI joint without diastasis. Diffuse decreased bone mineralization. No pubic symphyseal or left SI joint diastasis. Moderate degenerative changes of the bilateral hips. Multilevel degenerative changes of the visualized lumbar spine. No acute intra-abdominal or intrapelvic findings. Sigmoid diverticulosis without diverticulitis. Aortoiliac atherosclerosis. The uterus is surgically absent. Conclusion: 1. Nondisplaced, possibly mildly comminuted fracture of the anterior column of the right acetabulum. 2. Nondisplaced right sacral alar fracture extending into the right SI joint without diastasis. Findings discussed via telephone conversation between Dr. Euwer and Dr. Muller at 1323 hours on 1/5/2022.
FINDINGS: Nondisplaced, possibly mildly comminuted fracture of the anterior column of the right acetabulum. The right femoral head is well-seated within its acetabulum. Nondisplaced fracture of the right sacral alar extending into the right SI joint without diastasis. Diffuse decreased bone mineralization. No pubic symphyseal or left SI joint diastasis. Moderate degenerative changes of the bilateral hips. Multilevel degenerative changes of the visualized lumbar spine. No acute intra-abdominal or intrapelvic findings. Sigmoid diverticulosis without diverticulitis. Aortoiliac atherosclerosis. The uterus is surgically absent.
FINDINGS: THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Discogenic degenerative changes and spondylosis of the lower thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. Upper lobe predominant paraseptal emphysema. Coronary artery disease. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and facet arthropathy, most pronounced at L4-L5 and L5-S1. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. Atherosclerosis.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 76-year-old male with provided history of prostate cancer. COMPARISON: Chest CT 10/29/2018 TECHNIQUE: CT Chest wo contrast. Scan field of view: 420 mm. DLP: 1189.61 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: No consolidation. No suspicious pulmonary nodule. No pleural effusion. Central airways are patent. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: Redemonstrated sclerotic changes of the left scapula and left proximal humerus. No aggressive bone lesion. Chest wall is unremarkable. Upper abdomen: Reported separately. CONCLUSION: Stable CT exam with sclerotic changes of the left scapula and left proximal humerus. Otherwise, no new intrathoracic metastatic disease.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: No consolidation. No suspicious pulmonary nodule. No pleural effusion. Central airways are patent. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: Redemonstrated sclerotic changes of the left scapula and left proximal humerus. No aggressive bone lesion. Chest wall is unremarkable. Upper abdomen: Reported separately.
FINDINGS: The right parietotemporal ischemia demonstrates more distinctive hypoattenuation. Overlying cortical ribbon and sulci are preserved. No salient acute infarction is appreciated. Left frontal encephalomalacia and multifocal old lacunar infarcts are again noted. There is no intracranial hemorrhage or mass effect.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: History of prostate cancer COMPARISON: 10/29/2018 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 420 mm. Oral contrast Omnipaque: 16.9 oz. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately reported chest CT. ABDOMEN and PELVIS: LIVER: There are scattered hypoattenuating lesions within the liver, stable in appearance compared to prior exam performed approximately three years ago. These lesions are too small to accurately characterize but given stability over time and imaging findings, they likely represent simple hepatic cysts. Borderline hepatic steatosis. Noncirrhotic morphology. BILIARY TRACT: Normal. GALLBLADDER: Small punctate calcification along the anterior gallbladder wall, unchanged. PANCREAS: Mild diffuse fatty atrophy. SPLEEN: Normal. ADRENALS: Left greater than right adrenal nodules are unchanged. Both have been previously characterized as adrenal adenomas. KIDNEYS: Bilateral renal scarring is again visualized and unchanged. No obstructing mass or hydroureteronephrosis visualized. There is a small, stable calcification within the right renal pelvis, likely small nonobstructing stone versus vascular calcification. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticula without surrounding inflammation. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcified atherosclerosis involving the descending aorta and branching vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia and left-sided inguinal hernia. Small injection site granuloma along the right anterior abdominal wall. MUSCULOSKELETAL: No acute or aggressive osseous abnormality. Scattered punctate sclerotic foci are again seen involving the bilateral ilia, stable compared to prior exam. Mild degenerative changes involving the lumbar spine. CONCLUSION: 1. No new metastatic disease within the abdomen/pelvis. 2. Stable simple hepatic cysts and bilateral adrenal adenomas. Other stable findings as outlined above. Please see separately reported chest CT. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately reported chest CT. ABDOMEN and PELVIS: LIVER: There are scattered hypoattenuating lesions within the liver, stable in appearance compared to prior exam performed approximately three years ago. These lesions are too small to accurately characterize but given stability over time and imaging findings, they likely represent simple hepatic cysts. Borderline hepatic steatosis. Noncirrhotic morphology. BILIARY TRACT: Normal. GALLBLADDER: Small punctate calcification along the anterior gallbladder wall, unchanged. PANCREAS: Mild diffuse fatty atrophy. SPLEEN: Normal. ADRENALS: Left greater than right adrenal nodules are unchanged. Both have been previously characterized as adrenal adenomas. KIDNEYS: Bilateral renal scarring is again visualized and unchanged. No obstructing mass or hydroureteronephrosis visualized. There is a small, stable calcification within the right renal pelvis, likely small nonobstructing stone versus vascular calcification. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticula without surrounding inflammation. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcified atherosclerosis involving the descending aorta and branching vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia and left-sided inguinal hernia. Small injection site granuloma along the right anterior abdominal wall. MUSCULOSKELETAL: No acute or aggressive osseous abnormality. Scattered punctate sclerotic foci are again seen involving the bilateral ilia, stable compared to prior exam. Mild degenerative changes involving the lumbar spine.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Volume loss with changes of chronic ischemic microangiopathy. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Stable enlargement. ORBITS: Bilateral pseudophakia. Senescent scleral calcifications.. SINUSES: Opacities in the left ethmoid air cells. VESSELS: Atherosclerosis of the carotid siphons and vertebral arteries.
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CT Head wo contrast 1/5/2022 7:26 PM Clinical information: Known SDH; evaluate for progression of bleed Comparison: CT head 1/4/2022 Technique: 5 mm axial images were obtained without contrast from the base of the skull to the vertex with sagittal and coronal reformats. Scan field of view: 236 mm. DLP: 979 mGy cm. Findings: Overall stable size of the anterior parafalcine tiny subdural hemorrhage. There is no evidence of acute parenchymal hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Mild diffuse brain volume loss. Mild mucosal thickening in left sphenoid sinus. The remaining visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal. Impression: Overall stable size of the trace anterior parafalcine subdural hemorrhage. No definite new hemorrhage.
Findings: Overall stable size of the anterior parafalcine tiny subdural hemorrhage. There is no evidence of acute parenchymal hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Mild diffuse brain volume loss. Mild mucosal thickening in left sphenoid sinus. The remaining visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal.
FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subpleural reticulation. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: No abnormal bladder wall thickening or enhancement. No bladder mass. Diverticulum of the right posterior lateral bladder, similar to prior. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Right common iliac artery aneurysm with mural plaque measures 1.9 cm diameter (image 255 series 307). Narrowing of the origin of the celiac axis with mild poststenotic dilation. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Fat-containing right inguinal hernia. Right paramedian ventral hernia contains fat (image 147 series 307). Small fat-containing umbilical hernia. MUSCULOSKELETAL: Lower lumbar spine degenerative changes. No destructive osseous lesion.
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CLINICAL HISTORY: Subdural hemorrhage COMPARISON: CT head 9/9/2021, 7/18/2021, MRI 9/13/2021 TECHNIQUE: CT of the head was performed without intravenous contrast at 1 mm slice thickness. Images were acquired using the Stealth protocol. Scan field of view: 200 mm. DLP: 804 mGy cm. FINDINGS: There is interval removal of the bone flap of the right hemicraniectomy. The right cerebral convexity subacute subdural hemorrhage has resolved. Interval development of mild outer concavity involving the right frontal and parietal lobes. There is no new hemorrhage. There are multifocal chronic encephalomalacia involving the right frontal, bilateral temporal, right greater than left occipital lobes. There is no acute territorial loss of gray-white differentiation. There is no intracranial mass effect or midline shift. Interval removal of the right frontal approach ventriculostomy catheter. Ventricular size and decrease, without hydrocephalus. Basal cisterns are patent. Imaged portions of the orbits are grossly unremarkable. There is small amount of aerated secretion in the left maxillary sinus. The mastoid air cells are clear. Also chronic changes of left frontal parietal temporal craniotomy. IMPRESSION: Interval removal of the bone flap of the right hemicraniectomy, with resolution of the previously seen subdural hemorrhage. However interval development of mild outer concavity of the underlying right frontal and parietal lobes. Recommend close follow-up regarding developing sunken flap syndrome.
FINDINGS: There is interval removal of the bone flap of the right hemicraniectomy. The right cerebral convexity subacute subdural hemorrhage has resolved. Interval development of mild outer concavity involving the right frontal and parietal lobes. There is no new hemorrhage. There are multifocal chronic encephalomalacia involving the right frontal, bilateral temporal, right greater than left occipital lobes. There is no acute territorial loss of gray-white differentiation. There is no intracranial mass effect or midline shift. Interval removal of the right frontal approach ventriculostomy catheter. Ventricular size and decrease, without hydrocephalus. Basal cisterns are patent. Imaged portions of the orbits are grossly unremarkable. There is small amount of aerated secretion in the left maxillary sinus. The mastoid air cells are clear. Also chronic changes of left frontal parietal temporal craniotomy.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral dependent airspace disease. No pleural effusion. DISTAL ESOPHAGUS: Unremarkable. HEART / VESSELS: The heart is borderline enlarged. ABDOMEN and PELVIS: LIVER: No suspicious liver lesion is identified. BILIARY TRACT: Mild central biliary dilation. GALLBLADDER: Status post cholecystectomy. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No hydronephrosis or suspicious mass. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach appears unremarkable. The loops of small bowel are normal in caliber. COLON / APPENDIX: No evidence of acute colonic pathology. The appendix is not visualized. PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Normal. VESSELS: There is nonocclusive thrombus in the IVC extending from the right internal/common iliac veins. URINARY BLADDER: Nonspecific thickening of the urinary bladder. REPRODUCTIVE ORGANS: Status post hysterectomy. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: No suspicious lesion identified.
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EXAM: CT Abdomen wo+w contrast CLINICAL INFORMATION: Liver lesion COMPARISON: CT 08/25/2021. TECHNIQUE: CT Abdomen wo+w contrast. Patient weight: 110 lbs. IV contrast: Omnipaque 350, 99 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3.30 ml per sec. Scan delay: bt/70 sec. Scan field of view: 300 mm. DLP: 747.01 mGy cm. FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic and mild enlargement. No steatosis. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 2 - Size: 1.2 x 1.1 cm (series 5/image 51), previously 1.3 x 1.2 cm - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 2 - Enhancing "capsule": Present. - Nonperipheral "washout": Present. - Threshold growth (>= 50% in = 50% in <= 6 months): Not present. - Other features: None. - LI-RADS: LR-5 Additional arterial hyperenhancing hepatic foci without any definite delayed phase contrast washout, representing LR3 lesions. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: None. - Other varices or collaterals: None. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: No abnormality. LYMPH NODES: None enlarged. SPLEEN: Normal size and appearance. PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Normal. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Mild hepatomegaly, cirrhosis and sequelae of portal venous hypertension 2. Stable two LR5 lesions in segment 7 and segment 2. Additional small stable LR3 lesions as described above. No new hepatic lesions. 3. Other stable findings as described above.
FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic and mild enlargement. No steatosis. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 2 - Size: 1.2 x 1.1 cm (series 5/image 51), previously 1.3 x 1.2 cm - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 2 - Enhancing "capsule": Present. - Nonperipheral "washout": Present. - Threshold growth (>= 50% in = 50% in <= 6 months): Not present. - Other features: None. - LI-RADS: LR-5 Additional arterial hyperenhancing hepatic foci without any definite delayed phase contrast washout, representing LR3 lesions. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: None. - Other varices or collaterals: None. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: No abnormality. LYMPH NODES: None enlarged. SPLEEN: Normal size and appearance. PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Normal. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: Left forehead subgaleal hematoma again measure 8 mm in thickness. There is no intracranial hemorrhage or mass effect. Chronic ischemic encephalomalacia of the left corona radiata, right thalamic old lacunar infarct, and advanced leukoaraiosis with ventriculomegaly are redemonstrated. There is no evidence of large vascular territory acute infarction.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Hernia, increased pain. COMPARISON: CT abdomen/pelvis dated 6/16/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 172 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 80 sec Scan field of view: 352 mm. DLP: 555.20 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis. DISTAL ESOPHAGUS: Small hiatal hernia HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: Evaluation limited due to motion. LIVER: Normal. BILIARY TRACT: Mild intrahepatic and extrahepatic biliary ductal dilatation with smooth tapering towards the ampulla, likely secondary to postcholecystectomy state. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable probable left lower pole cyst. No focal enhancing lesion. No nephrolithiasis or hydroureteronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed diverticulosis. Normal appendix. PERITONEUM / MESENTERY: Mild mesenteric stranding within the hernia sac, possibly slightly worse near the base. RETROPERITONEUM: Trace aortoiliac atherosclerotic plaque. VESSELS: Mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Suboptimally evaluated due to underdistention. No significant perivesicular stranding. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate-sized fat-containing periumbilical hernia is slightly more distended possibly subtle increased associated mesenteric stranding. MUSCULOSKELETAL: L3 vertebral body intraosseous hemangioma. No aggressive osseous lesion. CONCLUSION: 1. Moderate-sized periumbilical fat-containing hernia is slightly enlarged/more distended. There is questionable subtle increased stranding which is nonspecific but could be secondary to chronic vascular congestion or early strangulation. Clinical correlation for pain/reducibility. 2. Ancillary findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis. DISTAL ESOPHAGUS: Small hiatal hernia HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: Evaluation limited due to motion. LIVER: Normal. BILIARY TRACT: Mild intrahepatic and extrahepatic biliary ductal dilatation with smooth tapering towards the ampulla, likely secondary to postcholecystectomy state. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable probable left lower pole cyst. No focal enhancing lesion. No nephrolithiasis or hydroureteronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed diverticulosis. Normal appendix. PERITONEUM / MESENTERY: Mild mesenteric stranding within the hernia sac, possibly slightly worse near the base. RETROPERITONEUM: Trace aortoiliac atherosclerotic plaque. VESSELS: Mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Suboptimally evaluated due to underdistention. No significant perivesicular stranding. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate-sized fat-containing periumbilical hernia is slightly more distended possibly subtle increased associated mesenteric stranding. MUSCULOSKELETAL: L3 vertebral body intraosseous hemangioma. No aggressive osseous lesion.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Persistent subcentimeter cyst in the lower right hepatic lobe. Liver is otherwise normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Simple cysts are in both kidneys. A punctate calcification in the upper pole of the left kidney could represent a nonobstructive calculus. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Laxity of the diaphragmatic hiatus suggestive presence of a sliding hiatal hernia. No abnormality of the small bowel. COLON / APPENDIX: There is mild colonic diverticulosis. CT is insensitive for detection of a colonic mass. Normal appendix. PERITONEUM / MESENTERY: A tiny subcentimeter nodule in the left omentum is slightly enlarged and measures 0.7 x 0.6 cm (image 140 series 302), previously 0.5 x 0.4 cm. RETROPERITONEUM: Normal. VESSELS: Incidental note is made of a duplicated IVC. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing right inguinal hernia. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 70-year-old female with endometrial cancer status post radiation. COMPARISON: CT Abdomen Pelvis with 7/21/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 181 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 411 mm. DLP: 883.90 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated same-day CT chest. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis without thickening or pericholecystic fluid. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Bilateral subcentimeter hypodensities, too small to characterize; however, likely representing cysts. Cortical scarring on the left is unchanged. No hydronephrosis bilaterally. LYMPH NODES: Interval decrease in size of the left iliac chain lymph node now measuring 1.1 x 0.8 cm (series 202 image 364), previously 1.9 x 1.2 cm. Prominent portacaval lymph node measuring 1.2 cm (series 202 image 243), similar to prior. STOMACH / SMALL BOWEL: Unchanged noninflamed duodenal diverticulum. Otherwise, the stomach and small bowel are normal. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic calcifications of the normal caliber abdominal aorta. The gonadal veins are prominent bilaterally, unchanged. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Postsurgical changes from prior hysterectomy. There has been interval resolution of the previously described fluid collection anterior to the left external iliac vessels. Interval decrease in size of the area of hypoattenuation posterior to the iliac vessels (series 202 image 407). BODY WALL: Rectus diastases. Tiny fat-containing periumbilical hernia. Unchanged focal body wall defect of the lateral rectus muscles measuring up to 1.4 cm (series 202 image 293). MUSCULOSKELETAL: Discogenic degenerative changes throughout the spine. Degenerative endplate changes at L1 is unchanged. CONCLUSION: 1. Interval resolution of the fluid collection within the left pelvis with similar post surgical changes otherwise. No evidence of metastatic disease within the abdomen or pelvis. 2. Interval decrease in size of the left iliac node compared to prior. Prominent portacaval node is similar. 3. Additional chronic and incidental findings as described above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated same-day CT chest. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis without thickening or pericholecystic fluid. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Bilateral subcentimeter hypodensities, too small to characterize; however, likely representing cysts. Cortical scarring on the left is unchanged. No hydronephrosis bilaterally. LYMPH NODES: Interval decrease in size of the left iliac chain lymph node now measuring 1.1 x 0.8 cm (series 202 image 364), previously 1.9 x 1.2 cm. Prominent portacaval lymph node measuring 1.2 cm (series 202 image 243), similar to prior. STOMACH / SMALL BOWEL: Unchanged noninflamed duodenal diverticulum. Otherwise, the stomach and small bowel are normal. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic calcifications of the normal caliber abdominal aorta. The gonadal veins are prominent bilaterally, unchanged. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Postsurgical changes from prior hysterectomy. There has been interval resolution of the previously described fluid collection anterior to the left external iliac vessels. Interval decrease in size of the area of hypoattenuation posterior to the iliac vessels (series 202 image 407). BODY WALL: Rectus diastases. Tiny fat-containing periumbilical hernia. Unchanged focal body wall defect of the lateral rectus muscles measuring up to 1.4 cm (series 202 image 293). MUSCULOSKELETAL: Discogenic degenerative changes throughout the spine. Degenerative endplate changes at L1 is unchanged.
FINDINGS: The supraclavicular region is unremarkable. Central airways are widely patent. The thoracic aorta is nonaneurysmal. The pulmonary arteries are normal in caliber. The previously seen extensive pulmonary embolus has resolved. No definite residual pulmonary thromboembolus is seen. The heart is not enlarged. No pericardial effusion. Mediastinal lymph nodes are not significantly changed from the prior examination. For example, a subcarinal lymph node measuring up to 11 mm in short axis on image 46 of series 2 and also measured 11 mm previously. No new or enlarging thoracic lymph nodes. The esophagus is not dilated. Small hiatal hernia. There is no acute lung abnormality. A 4 mm nodule within the posterior basal left lower lobe on image 65 is unchanged from 7/13/2021. No new or enlarging lung nodules. No pleural effusion or pleural thickening. The CT of the abdomen and pelvis will be dictated separately. There is no acute or aggressive osseous abnormality.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: Endometrial cancer status post radiation. Restaging. COMPARISON: Multiple priors most recently 7/21/2021 and 4/1/2021 TECHNIQUE: Helical multidetector CT of the chest was performed after the administration of intravenous contrast. Axial, sagittal, and coronal multiplanar reformats were subsequently obtained. Patient weight: 181 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 411 mm. FINDINGS: LINES AND TUBES: None. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Stable subpleural reticular changes along the lateral aspect of the left upper lobe. No suspicious or new pulmonary nodules. Minimal bandlike atelectasis versus scarring at the lung bases. No focal consolidation, effusion, or pneumothorax. HEART / VESSELS: Moderate coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Small sliding hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: Calcification probably fat necrosis in the right breast. UPPER ABDOMEN: See separate abdominal dictation. MUSCULOSKELETAL: No destructive osseous lesions. Radiation changes to T12. IMPRESSION: No evidence of intrathoracic metastatic disease.
FINDINGS: LINES AND TUBES: None. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Stable subpleural reticular changes along the lateral aspect of the left upper lobe. No suspicious or new pulmonary nodules. Minimal bandlike atelectasis versus scarring at the lung bases. No focal consolidation, effusion, or pneumothorax. HEART / VESSELS: Moderate coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Small sliding hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: Calcification probably fat necrosis in the right breast. UPPER ABDOMEN: See separate abdominal dictation. MUSCULOSKELETAL: No destructive osseous lesions. Radiation changes to T12.
Findings: Cardiac and Vascular Measurements: Aortic annulus average diameter: 26.2 mm Aortic annulus diameter pair: 27.3 x 25.2 mm Aortic annulus area: 556.5 mm2 Sinus of Valsalva diameter: L: 29.1 mm,R: 31.1 mm, N: 30.0 mm Sinotubular junction diameter: 30.0 x 27.2 mm Aortic annulus to left coronary artery distance: 12.2 mm Aortic annulus to right coronary artery distance: 30.1 mm Caudal angulation: LAO 18, CAU 2 Left atrial diameter: 37 mm Pulmonary artery diameter: 23 mm Ascending thoracic aorta diameter: 35.2 x 34.7 mm Aortic valve calcium score: 4163 Cardiac Function: Left ventricular end-diastolic volume (ml): 80 Left ventricular end-systolic volume (ml): 17 Left ventricular stroke volume (ml): 63 Left ventricular ejection fraction (%): 79 Wall motion: No regional wall motion abnormalities. Non-Coronary Cardiac Findings: Marked calcification of the aortic valve leaflets. Mild mitral annular calcifications. Left atrial and ventricular dilation. No intracardiac mass, thrombus, or other structural abnormality. No pericardial effusion. No abnormality of the thoracic aorta or vena cavae. The pulmonary veins are unremarkable. Please note this examination was not tailored for assessment of the coronary arteries. Coronary artery atherosclerotic calcification: None detected. Non Cardiac Findings: Lines and tubes: None. Lungs and pleura: Diffuse bronchial wall thickening bilaterally. Areas of mosaic attenuation bilaterally. Nodularity bilaterally (for example series 16 image 244). Dependent atelectasis bilaterally. No pulmonary consolidation. No pleural effusion. No pneumothorax. Esophagus, Mediastinum and neck: Mild distended distal esophagus. Mild thickening of the esophagus is nonspecific. Mild anterior mediastinal soft tissue is nonspecific, may be reactive thymus or thymic hyperplasia. The thyroid gland is normal. Lymph Nodes: Borderline enlarged AP window lymph node measuring 10 mm in short axis. Abdomen: Please refer to same day CT abdomen report for detailed findings below the diaphragm. Musculoskeletal/Body Wall: No soft tissue masses. No aggressive appearing skeletal lesions. Mild degenerative changes in spine.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Chest wall fluid collection evaluation. Patient is status post percutaneous gastrostomy tube placement on 1/5/2022. COMPARISON: None. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 229 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 404 mm. KVP: 100 DLP: 1147 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. UPPER ABDOMINAL AORTA: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Postsurgical changes of tracheostomy placement are seen. CHEST: LUNGS / AIRWAYS / PLEURA: Tracheostomy tube tip is seen 3.6 cm above the carina. Trace left pneumothorax, decreased from prior. Interval removal of left chest tube. Bilateral patchy groundglass opacities with increase in size of the left greater than right consolidations with air bronchograms. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Small volume pneumoperitoneum. MUSCULOSKELETAL: Redemonstrated bilateral rib fractures. Fracture of the left scapular body. Redemonstrated sternal body fracture. Hepatic steatosis. CONCLUSION: 1. Interval increase in size of the left chest wall fluid collection without CT evidence of active hemorrhage or acute vascular pathology. 2. Interval decrease in the left pneumothorax, increase in bilateral consolidations and groundglass opacities which are likely infectious/inflammatory. 3. Pneumoperitoneum is likely secondary to recent gastrostomy tube placement. 4. Stable post traumatic findings including left scapular fracture, left rib fractures, and sternal fracture. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. UPPER ABDOMINAL AORTA: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Postsurgical changes of tracheostomy placement are seen. CHEST: LUNGS / AIRWAYS / PLEURA: Tracheostomy tube tip is seen 3.6 cm above the carina. Trace left pneumothorax, decreased from prior. Interval removal of left chest tube. Bilateral patchy groundglass opacities with increase in size of the left greater than right consolidations with air bronchograms. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Small volume pneumoperitoneum. MUSCULOSKELETAL: Redemonstrated bilateral rib fractures. Fracture of the left scapular body. Redemonstrated sternal body fracture. Hepatic steatosis.
Findings: Thorax: The chest section of the examination is dictated separately. Abdomen/pelvis: No hepatic lesions or biliary dilatation. The gallbladder is surgically absent. Spleen, pancreas, and adrenals are normal. Kidneys reveal no hydronephrosis, nephrolithasis, or masses. Ureters and urinary bladder are normal. Gastrointestinal tract is normal. Osseous structures reveal no lesions. The uterus and adnexa are unremarkable. Vasculature: Scattered atherosclerotic calcifications are present. Aorta: Patent without dissection, stenosis or aneurysm. Celiac axis: Patent without stenosis. SMA: Patent without stenosis. IMA: Patent without stenosis. Renal: Single renal arteries and veins bilaterally with a preaortic left renal vein. Left: Patent common iliac artery. Patent internal iliac artery. External iliac artery is patent to the inguinal canal. Patent common, deep, and superficial femoral arteries. Common iliac dimensions: Max = 9.93, min = 7.33, avg = 8.58 mm External iliac dimensions: Max = 6.47, min = 5.89, avg = 6.20 mm Common femoral dimensions: Max = 6.84, min = 5.73, avg = 6.28 mm Right: Patent common iliac artery. Patent internal iliac artery. External iliac artery is patent to the inguinal canal. Patent common, deep, and superficial femoral arteries. Common iliac dimensions: Max = 8.96, min = 6.45, avg = 7.81 mm External iliac dimensions: Max = 6.65, min = 5.60, avg = 6.10 mm Common femoral dimensions: Max = 6.85, min = 5.47, avg = 6.25 mm
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EXAM: CT Abdomen Partial Study wo contrast CLINICAL INFORMATION: Incomplete colonoscopy with sigmoid stricture. COMPARISON: 7/15/2020. TECHNIQUE: CT Abdomen Partial Study wo contrast. Reason for partial study: unable to fill colon with air Patient weight: 205 lbs. Scan delay: 0 sec. Scan field of view: 500 mm. DLP: 196.77 mGy cm. FINDINGS: Multiple attempts to insufflate the colon were unsuccessful. STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Tiny hiatal hernia. HEART / VESSELS: Normal in size without pericardial effusion. Significant coronary artery atherosclerotic calcification. ABDOMEN: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: Despite multiple attempts to insufflate the colon, air was unable to be instilled into the colon upstream of the sigmoid. There is collapse of the sigmoid with associated mucosal thickening (series 3, image 308). Diverticulosis is also noted without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions. CONCLUSION: Despite multiple attempts to insufflate the colon air was unable to be instilled past the sigmoid colon and examination was converted to partial study. Mucosal thickening and collapse of the sigmoid colon consistent with stricture visualized on prior colonoscopy. Tissue sampling may be of benefit, if clinically indicated.
FINDINGS: Multiple attempts to insufflate the colon were unsuccessful. STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Tiny hiatal hernia. HEART / VESSELS: Normal in size without pericardial effusion. Significant coronary artery atherosclerotic calcification. ABDOMEN: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: Despite multiple attempts to insufflate the colon, air was unable to be instilled into the colon upstream of the sigmoid. There is collapse of the sigmoid with associated mucosal thickening (series 3, image 308). Diverticulosis is also noted without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the abdominal aorta which is normal in caliber. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No hemothorax or pneumothorax. Trace right pleural effusion and smooth interlobular septal thickening in the upper lobes as well as thickening along the fissures. Trace dependent atelectasis. Right middle lobe parenchymal changes with volume loss are stable HEART / VESSELS: Cardiomegaly. Multivessel coronary artery disease. Nondependent air within the left upper extremity and brachiocephalic veins, iatrogenic. Pulmonary trunk is dilated up to 3.7 cm common indicator of pulmonary arterial hypertension. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Multiple prominent mediastinal and axillary lymph nodes, but none are pathologically enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: No acute injury. Heterogeneous. Periportal edema with dilated IVC. Right posterior hypoattenuating lesions too small to characterize, likely cysts. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No acute injury. Bilateral renal cysts. LYMPH NODES: Para-aortic and left pelvic sidewall lymph nodes appear similar to prior. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Appendix is not visualized. Colonic diverticulosis and moderate fecal burden. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Absent uterus. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Minimally displaced fracture of the distal right clavicle without extension into the acromioclavicular joint. Bilateral reverse total shoulder arthroplasty hardware is present. Grade 1 anterolisthesis of L3/L4 and L4/L5. Dextroconvex scoliosis centered in the lower thoracic spine with levoconvex curvature of the lumbar spine. Multilevel discogenic degenerative changes and spondylosis. Intramuscular lipoma of the right rectus femoris. Incidentally noted extensive subchondral cystic changes of the right carpal bones. Volar subluxations of the finger MCP joints
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CARDIA - LUNG Research study Technique: Scan field of view: 380 mm. DLP: 138.84 mGy cm. Comparison: 9/2010. No enlarged hilar or mediastinal nodes are present. The mediastinum is normal. The lungs show nonspecific, bilateral groundglass opacities, worse in the right lung. There is no significant pleural disease. Dilatation of the ascending aorta, measuring 43 mm, is stable since the prior scan Coronary arterial calcification: The visual score of 6, increased from a prior score of 2 Visualized thoracic skeleton is unremarkable. Noncontrast views of the upper abdomen are unremarkable. Impression: New groundglass opacities in both lungs, more severe in the right lung, involving all the right lung lobes. There is significance/chronicity is uncertain. Increased, moderate coronary arterial calcification Stable mildly dilated ascending aorta
No enlarged hilar or mediastinal nodes are present. The mediastinum is normal. The lungs show nonspecific, bilateral groundglass opacities, worse in the right lung. There is no significant pleural disease. Dilatation of the ascending aorta, measuring 43 mm, is stable since the prior scan Coronary arterial calcification: The visual score of 6, increased from a prior score of 2 Visualized thoracic skeleton is unremarkable. Noncontrast views of the upper abdomen are unremarkable.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No hemothorax or pneumothorax. Trace right pleural effusion and smooth interlobular septal thickening in the upper lobes as well as thickening along the fissures. Trace dependent atelectasis. Right middle lobe parenchymal changes with volume loss are stable HEART / VESSELS: Cardiomegaly. Multivessel coronary artery disease. Nondependent air within the left upper extremity and brachiocephalic veins, iatrogenic. Pulmonary trunk is dilated up to 3.7 cm common indicator of pulmonary arterial hypertension. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Multiple prominent mediastinal and axillary lymph nodes, but none are pathologically enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: No acute injury. Heterogeneous. Periportal edema with dilated IVC. Right posterior hypoattenuating lesions too small to characterize, likely cysts. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No acute injury. Bilateral renal cysts. LYMPH NODES: Para-aortic and left pelvic sidewall lymph nodes appear similar to prior. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Appendix is not visualized. Colonic diverticulosis and moderate fecal burden. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Absent uterus. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Minimally displaced fracture of the distal right clavicle without extension into the acromioclavicular joint. Bilateral reverse total shoulder arthroplasty hardware is present. Grade 1 anterolisthesis of L3/L4 and L4/L5. Dextroconvex scoliosis centered in the lower thoracic spine with levoconvex curvature of the lumbar spine. Multilevel discogenic degenerative changes and spondylosis. Intramuscular lipoma of the right rectus femoris. Incidentally noted extensive subchondral cystic changes of the right carpal bones. Volar subluxations of the finger MCP joints
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EXAM: CT Chest High Resolution wo contrast CLINICAL INFORMATION: 63-year-old female with provided history of sarcoidosis and reduction in lung function. COMPARISON: Chest CT 2/20/2019 TECHNIQUE: CT Chest High Resolution wo contrast. Scan field of view: 285 mm. DLP: 261.49 mGy cm. High-resolution CT imaging of the chest was performed per protocol with inspiratory technique in supine position. FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: No consolidation. A 3 mm right lower lobe peribronchial nodule (image 131, series 2) and 5 mm inferior lingular nodule (image 113) are slightly conspicuous from prior. No significant nodules in perilymphatic distribution. Redemonstrated minimal medial left upper lobe scarring. No significant parenchymal changes. No pleural effusion. Central airways are patent. Thoracic inlet, heart, and mediastinum: No supraclavicular lymphadenopathy within the field of view. No axillary lymphadenopathy. Redemonstrated mildly enlarged and subcentimeter paratracheal, hilar, subcarinal and paraesophageal lymph nodes. The esophagus is nondilated. The thoracic aorta and main pulmonary arteries are normal in caliber. The overall heart size normal. No pericardial effusion. No coronary calcification. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Postcholecystectomy changes. CONCLUSION: 1. Few small peribronchial nodules, slightly conspicuous from prior. No significant nodules in perilymphatic distribution. No significant parenchymal lung changes or fibrosis. 2. Mildly enlarged and subcentimeter mediastinal and hilar lymph nodes. 3. Other findings as described.
FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: No consolidation. A 3 mm right lower lobe peribronchial nodule (image 131, series 2) and 5 mm inferior lingular nodule (image 113) are slightly conspicuous from prior. No significant nodules in perilymphatic distribution. Redemonstrated minimal medial left upper lobe scarring. No significant parenchymal changes. No pleural effusion. Central airways are patent. Thoracic inlet, heart, and mediastinum: No supraclavicular lymphadenopathy within the field of view. No axillary lymphadenopathy. Redemonstrated mildly enlarged and subcentimeter paratracheal, hilar, subcarinal and paraesophageal lymph nodes. The esophagus is nondilated. The thoracic aorta and main pulmonary arteries are normal in caliber. The overall heart size normal. No pericardial effusion. No coronary calcification. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Postcholecystectomy changes.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. No appendicitis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant atherosclerotic disease. Small phlebolith in the left hemipelvis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subcentimeter focal sclerosis in the right femoral neck, likely bone island. No suspicious osseous lesion.
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CLINICAL HISTORY: Assess for sinusitis TECHNIQUE: Thin unenhanced axial images were obtained through the paranasal sinuses using the Stealth protocol. Images were reformatted in multiple planes. Scan field of view: 250 mm. DLP: 1316.31 mGy cm. COMPARISON: None available. FINDINGS: The frontal sinuses are clear and the frontonasal recesses are patent. Minor scattered mucosal thickening in the ethmoid air cells. There are secondary ostia involving the bilateral medial maxillary sinus walls. There is minor scattered mucosal thickening in the maxillary sinuses. Both ostiomeatal complexes are patent. Sphenoid sinuses are clear and the sphenoethmoidal recesses are patent. No nasal cavity masses are seen. The anterior skull base is intact. Sellar pneumatization pattern of the sphenoid sinuses. There is no acute intracranial hemorrhage, territorial infarct or hydrocephalus. IMPRESSION: No evidence of acute or chronic sinusitis. Minor scattered mucosal thickening.
FINDINGS: The frontal sinuses are clear and the frontonasal recesses are patent. Minor scattered mucosal thickening in the ethmoid air cells. There are secondary ostia involving the bilateral medial maxillary sinus walls. There is minor scattered mucosal thickening in the maxillary sinuses. Both ostiomeatal complexes are patent. Sphenoid sinuses are clear and the sphenoethmoidal recesses are patent. No nasal cavity masses are seen. The anterior skull base is intact. Sellar pneumatization pattern of the sphenoid sinuses. There is no acute intracranial hemorrhage, territorial infarct or hydrocephalus.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Patchy atelectasis at the lung bases. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: Trace pericardial fluid. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Mild intrahepatic biliary prominence and extra hepatic dilation measuring up to 11 mm with slight distal tapering. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Scattered tiny hypoattenuating foci are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Dilated duodenum just past the C-loop measuring up to 4 cm, proximal to it crosses under the superior mesenteric artery. Remainder of the small bowel is unremarkable. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. Normal aortomesenteric angle measuring up to 39 degrees. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Cystic foci in bilateral adnexa posterior to this are likely ovarian in nature, similar to previous exam. BODY WALL: Minute umbilical hernia. MUSCULOSKELETAL: Scoliosis without destructive lesion.
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RADIOLOGIC EXAM: CT Angio Neck CLINICAL INFORMATION: Neck pain COMPARISON: 10/25/21 TECHNIQUE: CT Angio Neck 3-D CT MIP and Volume rendered angiographic images were generated in post processing. Patient weight: 196 lbs. IV contrast: Omnipaque 350, 125 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 269 mm. DLP: 820 mGy cm. FINDINGS: CTA NECK: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: No evidence of occlusion, dissection, or aneurysm. Unchanged chronic dissection of the right cervical ICA at the C2-3 level without associated aneurysm, interval thrombus formation, or perivascular hematoma. LEFT CAROTID: No evidence of dissection, aneurysm, or occlusion. RIGHT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. No contrast extravasation or pseudoaneurysm is identified. Stable mildly enlarged multinodular thyroid gland including a stable 1.0 cm hypoattenuating nodule in the left thyroid lobe. Multilevel degenerative changes of the cervical spine, most prominent at C5-6 and C6-7 with small posterior disc osteophyte complex. There is also osseous fusion of the C2-3 and C3-4 facet joints. CONCLUSION: 1. Unchanged chronic dissection of the right cervical ICA at the C2-3 level without flow-limiting stenosis or new abnormality. 2. Remainder of the cervical arterial vasculature is unremarkable. No acute abnormality.
FINDINGS: CTA NECK: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: No evidence of occlusion, dissection, or aneurysm. Unchanged chronic dissection of the right cervical ICA at the C2-3 level without associated aneurysm, interval thrombus formation, or perivascular hematoma. LEFT CAROTID: No evidence of dissection, aneurysm, or occlusion. RIGHT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. No contrast extravasation or pseudoaneurysm is identified. Stable mildly enlarged multinodular thyroid gland including a stable 1.0 cm hypoattenuating nodule in the left thyroid lobe. Multilevel degenerative changes of the cervical spine, most prominent at C5-6 and C6-7 with small posterior disc osteophyte complex. There is also osseous fusion of the C2-3 and C3-4 facet joints.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Nonspecific heterogeneous arterial enhancement of the medial left lobe and right hepatic dome. No abnormal portal venous washout. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Large exophytic, solid and cystic mass directly abuts the left adrenal gland measures 11.4 x 8.7 cm (image 104 series 601). However, this mass does not appear to arise from the thyroid gland. Normal right adrenal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. No appendicitis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: A large retroperitoneal mass partially encases the celiac artery, splenic artery, and SMA. Similar tumor abutment of the left renal artery is present. No tumor thrombus is identified. URINARY BLADDER: Partially collapsed. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing periumbilical hernia. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: Covid confirmed dehydration, weakness and diarrhea COMPARISON: CT chest December 20, 2021. TECHNIQUE: CT Chest wo contrast. Scan field of view: 450 mm. DLP: 535 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Surgical clips are seen in the left thyroid resection bed. CHEST: LUNGS / AIRWAYS / PLEURA: There is been interval development of multifocal peripheral predominant patchy groundglass airspace opacities in all lung fields. Again demonstrated are findings of bilateral bronchiectasis, most pronounced in the right lower lobe in the setting of calcified bilateral hilar nodes and calcifications in both lower lobes. Postobstructive appearing consolidative changes in the superior segment of the right lower lobe appear improved from the prior CT December 20, 2021. Nodule in the right lower lobe right costophrenic angle measuring up to 5 mm axial image 76 series 301 and is demonstrated, perhaps slightly larger from prior. Previously demonstrated scattered tiny noncalcified nodules are not as well-demonstrated on this exam. HEART / VESSELS: Main pulmonary artery appears dilated up to 38 mm. Moderate coronary atherosclerotic calcifications. The heart size is within normal limits. There are mild to moderate atherosclerotic calcifications in the aorta. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: There are multiple calcified nodes in the hila. There are shotty axillary and mediastinal nodes. In the right hilum there is a nodule/possible lymph node measuring 1.7 x 1.2 cm not clearly attributable to a vascular structure at unenhanced CT. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: Multilevel degenerative changes. No acute osseous abnormality evident. CONCLUSION: 1. Interval development of multifocal groundglass opacities in the bilateral lung fields compatible with multifocal Covid pneumonia. 2. There has been some improvement in consolidation in the right lower lobe superior segment airspace disease/possible postobstructive pneumonitis. Possible right hilar lymph node/nodule and recommend consideration for PET-CT, bronchoscopy or short interval CT follow-up with a contrasted CT chest. Right lower lobe bronchiectasis and bilateral granulomatous disease related changes. Pulmonary consultation is recommended if not already obtained. Indeterminate right lower lobe nodule of the costophrenic angle. 3. Main pulmonary arterial dilatation can be seen with pulmonary arterial hypertension. Additional and ancillary findings are discussed above.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Surgical clips are seen in the left thyroid resection bed. CHEST: LUNGS / AIRWAYS / PLEURA: There is been interval development of multifocal peripheral predominant patchy groundglass airspace opacities in all lung fields. Again demonstrated are findings of bilateral bronchiectasis, most pronounced in the right lower lobe in the setting of calcified bilateral hilar nodes and calcifications in both lower lobes. Postobstructive appearing consolidative changes in the superior segment of the right lower lobe appear improved from the prior CT December 20, 2021. Nodule in the right lower lobe right costophrenic angle measuring up to 5 mm axial image 76 series 301 and is demonstrated, perhaps slightly larger from prior. Previously demonstrated scattered tiny noncalcified nodules are not as well-demonstrated on this exam. HEART / VESSELS: Main pulmonary artery appears dilated up to 38 mm. Moderate coronary atherosclerotic calcifications. The heart size is within normal limits. There are mild to moderate atherosclerotic calcifications in the aorta. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: There are multiple calcified nodes in the hila. There are shotty axillary and mediastinal nodes. In the right hilum there is a nodule/possible lymph node measuring 1.7 x 1.2 cm not clearly attributable to a vascular structure at unenhanced CT. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: Multilevel degenerative changes. No acute osseous abnormality evident.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Pelvis Renal Transplant VASCULATURE: LOWER ABDOMINAL AORTA: Moderate calcified atherosclerotic disease. RIGHT COMMON / INTERNAL ILIAC ARTERIES: Severe calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: Moderate calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: Severe calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: Moderate calcified atherosclerotic disease. LOWER ABDOMEN: BOWEL: No abnormality. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: No abnormality. URINARY BLADDER: Decompressed. REPRODUCTIVE ORGANS: Uterus is absent. Ovaries are not seen. BODY WALL: No significant abnormality. MUSCULOSKELETAL: There are erosive changes at the sacroiliac joints with bilateral sclerosis of the iliac bones adjacent to the joints.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Dehydration, weakness and diarrhea. Covid confirmed. COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 450 mm. DLP: 535 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Chest findings are reported separately. ABDOMEN and PELVIS: LIVER: The liver has a nodular and cirrhotic morphology without suspicious focal hepatic lesion evident at unenhanced CT. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Pancreas is unremarkable apart from areas of interdigitating fat and there is interdigitating fat versus small pancreatic lipoma in the pancreatic body for example on axial image 120 series 303. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There are simple appearing cysts in the left kidney and a left posterior upper pole exophytic lesion is indeterminate at unenhanced CT on axial image 103 series 303. LYMPH NODES: None enlarged. Shotty periportal nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: There is diverticulosis without acute diverticulitis. The appendix appears normal. Fluid is seen throughout the majority of the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic calcification of the aorta extending into the iliac territories. Mild SMA atherosclerotic calcification. URINARY BLADDER: Largely decompressed. Beam hardening artifact is present from a right-sided THA. REPRODUCTIVE ORGANS: Uterus is not visualized. No adnexal mass visualized. There is beam hardening artifact in this region related to right THA. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Right THA is present. Moderate degenerative changes of the left hip and multilevel degenerative changes in the lumbar spine are present and most pronounced at L3-L4 where degenerative changes produce bilateral foraminal stenosis. Multilevel foraminal stenosis is visualized in the lower lumbar spine. No acute osseous abnormality evident. There are degenerative changes of the SI joints. CONCLUSION: 1. No acute intra-abdominal or pelvic abnormality evident. 2. Indeterminate lesion in the upper pole posterior aspect of the left kidney. Nonemergent outpatient multiphasic MR/CT is recommended for follow-up. 3. Cirrhosis. 4. Atherosclerotic disease, additional and ancillary findings are described above. 5. Liquid stool throughout the colon can be seen with diarrhea. Chest findings are reported separately.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Chest findings are reported separately. ABDOMEN and PELVIS: LIVER: The liver has a nodular and cirrhotic morphology without suspicious focal hepatic lesion evident at unenhanced CT. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Pancreas is unremarkable apart from areas of interdigitating fat and there is interdigitating fat versus small pancreatic lipoma in the pancreatic body for example on axial image 120 series 303. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There are simple appearing cysts in the left kidney and a left posterior upper pole exophytic lesion is indeterminate at unenhanced CT on axial image 103 series 303. LYMPH NODES: None enlarged. Shotty periportal nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: There is diverticulosis without acute diverticulitis. The appendix appears normal. Fluid is seen throughout the majority of the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic calcification of the aorta extending into the iliac territories. Mild SMA atherosclerotic calcification. URINARY BLADDER: Largely decompressed. Beam hardening artifact is present from a right-sided THA. REPRODUCTIVE ORGANS: Uterus is not visualized. No adnexal mass visualized. There is beam hardening artifact in this region related to right THA. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Right THA is present. Moderate degenerative changes of the left hip and multilevel degenerative changes in the lumbar spine are present and most pronounced at L3-L4 where degenerative changes produce bilateral foraminal stenosis. Multilevel foraminal stenosis is visualized in the lower lumbar spine. No acute osseous abnormality evident. There are degenerative changes of the SI joints.
Findings: The right lateral facial skin nodule and ipsilateral parotid lymphadenopathy are no longer seen. No new skin lesion or cervical lymphadenopathy is identified. The oral cavity, pharyngeal mucosal space, and larynx are unremarkable. The salivary gland and thyroid gland are normally visualized. Grade 1 anterolisthesis of C3 on C4 and C4 on C5, and advanced spondylosis at C5-C6, C6-C7 and T1-T2 are again noted.
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EXAM: CT Knee Left wo contrast CLINICAL INFORMATION: 1/5/2022 COMPARISON: None. TECHNIQUE: CT Knee Left wo contrast Scan field of view: 190 mm. DLP: 269.30 mGy cm. FINDINGS/CONCLUSION: No acute fracture or dislocation of the knee. The joint spaces are maintained. No joint effusion. A mild anterior knee soft tissue swelling.
FINDINGS/CONCLUSION: No acute fracture or dislocation of the knee. The joint spaces are maintained. No joint effusion. A mild anterior knee soft tissue swelling.
FINDINGS: STRUCTURED REPORT: CT Pancreatic Mass FINDINGS: STUDY QUALITY: Satisfactory. LOWER CHEST: LUNG BASES / PLEURA: Mild scattered groundglass opacities in the visualized right lower lung. DISTAL ESOPHAGUS: There is laxity of the diaphragmatic hiatus suggestive of a sliding hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Previously identified right lobe hemangioma is unchanged. No other liver lesion. There are several focal areas of fat along the periphery of the liver. PERITONEUM: No peritoneal nodules. PANCREAS: Ill-defined lesion in the pancreatic head as described below Pancreatic mass: - Location: Head - Size: Approximately 3.2 cm x 2.5 cm, previously 3.1 x 2.6 cm. - Composition: Solid - Enhancement relative to pancreas: Hypoenhancing - Margins: Ill-defined with irregular margins. - Pancreatic duct: Interval resolution of the pancreatic ductal dilation. - Pancreatic atrophy: Moderate upstream pancreatic atrophy. - Biliary ducts: Metallic stent properly positioned within the common bile duct. Intrahepatic pneumobilia indicates patency of the stent. - Gallbladder: Absent. VASCULATURE: - Arterial anatomy: Conventional. - Celiac Axis (CA): No tumor contact. - Common Hepatic Artery (CHA): Tumor encasement with extension to proper hepatic artery. UNRESECTABLE - LOCALLY ADVANCED] - Superior Mesenteric Artery (SMA): No tumor contact. - Aorta: No tumor contact. - Main Portal Vein (PV): Tumor contact >=180 degrees NOT exceeding the inferior border of the duodenum. The main portal vein is narrowed (series 7, image 74) but still patent. There is greater than 180 degree involvement of the SMV at the level of the confluence with the splenic vein. - IVC and Renal Veins: No tumor contact. - Vessel thrombosis: None. - Venous collaterals: None. - Other peripancreatic vessel comment: None. LYMPH NODES: None enlarged. RETROPERITONEUM: Tumor invades the retroperitoneum locally to involve the vessels described above. Additionally, the mass is noted to extend anteriorly to abut the first portion the duodenum (series 7, image 82). MESENTERY: Encases mesenteric vessels as described above. ADRENALS: Normal. KIDNEYS: Benign cyst in the bilateral kidneys appear unchanged. SPLEEN: Normal. STOMACH: No abnormality. DUODENUM: Tumor contacts the duodenum. SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is not definitively visualized. OTHER VESSELS: Atherosclerotic calcifications of the infrarenal abdominal aorta. Vessels otherwise described above. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present appears normal. BODY WALL: Tiny fat-containing umbilical hernia MUSCULOSKELETAL: Redemonstrated degenerative changes in the lower thoracic and upper lumbar spine. Chronic compression deformity of the L2 vertebral body. No aggressive osseous lesion.
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CT Thoracic Spine wo contrast Indication: rule out T6 arachnoid cyst Comparison: No previous studies are available for comparison Procedure: Multiple contiguous axial images of the thoracic spine were formatted from helical acquisition. Sagittal and coronal reformatted images were also obtained for evaluation of alignment. Scan field of view: 176 mm. DLP: 1305 mGy cm. . Findings: There is faint opacification of the intrathecal CSF space secondary to CT myelogram procedure performed yesterday. There is poor visualization of previously seen distortion of the dorsal spinal cord level of T6 compared to prior study. There is however persistent contrast within the focal area of distortion along with interval appearance of contrast in the mid spinal cord at the level of T5, cephalad to the area of spinal cord distortion which likely represents contrast filling the syrinx. No other significant interval change from CT thoracic myelogram performed yesterday. Redemonstration of multilevel degenerative changes in the thoracic spine. No evidence for significant spinal canal stenosis or neural foraminal narrowing. Generalized decreased osseous mineralization. Scattered vascular atherosclerosis. Scattered groundglass opacities in bilateral upper lungs which may be infectious or inflammatory in etiology. For evaluation of bilateral lungs secondary to motion artifacts. Cardiomegaly. Coronary atherosclerosis. Small hiatal hernia. Significant abnormalities in the visualized soft tissues. Impression: 1. Interval decrease in intrathecal contrast attenuation compared to prior study limiting delineation of the spinal cord. Persistent extension of intrathecal contrast into the spinal cord deformity at T6 level suggesting arachnoid cyst versus arachnoid web. Interval appearance of contrast within the spinal cord at T5 level just above the above-described deformity suggesting contrast staining in the intraspinal syrinx seen on prior MRI.
Findings: There is faint opacification of the intrathecal CSF space secondary to CT myelogram procedure performed yesterday. There is poor visualization of previously seen distortion of the dorsal spinal cord level of T6 compared to prior study. There is however persistent contrast within the focal area of distortion along with interval appearance of contrast in the mid spinal cord at the level of T5, cephalad to the area of spinal cord distortion which likely represents contrast filling the syrinx. No other significant interval change from CT thoracic myelogram performed yesterday. Redemonstration of multilevel degenerative changes in the thoracic spine. No evidence for significant spinal canal stenosis or neural foraminal narrowing. Generalized decreased osseous mineralization. Scattered vascular atherosclerosis. Scattered groundglass opacities in bilateral upper lungs which may be infectious or inflammatory in etiology. For evaluation of bilateral lungs secondary to motion artifacts. Cardiomegaly. Coronary atherosclerosis. Small hiatal hernia. Significant abnormalities in the visualized soft tissues.
FINDINGS: A few small hypodense peripherally calcified left thyroid nodules are seen. The central airways are patent. The thoracic aorta is nonaneurysmal scattered atherosclerotic calcifications. The pulmonary arteries are not dilated. The heart is not enlarged. Moderate three-vessel coronary calcifications. No pericardial effusion. Small mediastinal lymph nodes are not pathologically enlarged. No enlarged supraclavicular, axillary, mediastinal or hilar lymph nodes. The esophagus is not dilated. Small left pleural effusion. Minimal linear scarring or atelectasis within the right lower lobe. No acute lung abnormality. No suspicious lung nodules. Shrunken, nodular liver with posttreatment changes within the right liver. Large volume ascites. No acute or aggressive osseous abnormality.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 76-year-old female with sternal wound dehiscence and pleural effusion evaluation. COMPARISON: CT chest dated 10/17/2021. TECHNIQUE: CT Chest with contrast. Patient weight: 115 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 35 sec Scan field of view: 300 mm. DLP: 233.90 mGy cm. FINDINGS: Partially limited exam secondary to motion artifact. STRUCTURED REPORT: CT Chest LOWER NECK: Multinodular thyroid gland with the largest nodule measuring up to 2.1 cm in the right lobe. CHEST: LUNGS / AIRWAYS / PLEURA: Nonspecific peribronchial thickening. Moderate left and small right pleural effusions with associated atelectasis. Interlobular thickening in the lung apices. Biapical scarring. No suspicious nodule. HEART / VESSELS: Postsurgical changes of CABG with CAD. Cardiac lead tips are seen in the right atrium and right ventricle. Dilated left ventricle and left atrium. No central pulmonary embolus. Moderate calcified and noncalcified atherosclerosis of the thoracic aorta and proximal great vessels. There is mild narrowing of the left common carotid origin. There is prominent mural atherosclerosis of the descending thoracic aorta that is partially visualized on the prior noncontrast CT exam. MEDIASTINUM / ESOPHAGUS: Postsurgical changes of CABG. LYMPH NODES: Prominent mediastinal lymph nodes are likely reactive. CHEST WALL: Postsurgical changes of CABG with sternotomy wires in place. Partial limited evaluation of the sternum secondary to motion artifact without definite cortical destruction. No soft tissue gas or drainable fluid collection seen. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Kyphotic curvature of the thoracic spine with mild spondylosis. No destructive osseous lesion. CONCLUSION: 1. Postsurgical changes of CABG without evidence of sternal dehiscence or cortical destruction. 2. Left greater than right pleural effusions with questionable trace pulmonary edema. 3. Multinodular thyroid gland with the largest nodule measuring up to 2.1 cm. Consider outpatient thyroid ultrasound. 4. Additional findings above. *****IMPORTANT INCIDENTAL IMAGING FINDINGS REPORTED***** As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: Partially limited exam secondary to motion artifact. STRUCTURED REPORT: CT Chest LOWER NECK: Multinodular thyroid gland with the largest nodule measuring up to 2.1 cm in the right lobe. CHEST: LUNGS / AIRWAYS / PLEURA: Nonspecific peribronchial thickening. Moderate left and small right pleural effusions with associated atelectasis. Interlobular thickening in the lung apices. Biapical scarring. No suspicious nodule. HEART / VESSELS: Postsurgical changes of CABG with CAD. Cardiac lead tips are seen in the right atrium and right ventricle. Dilated left ventricle and left atrium. No central pulmonary embolus. Moderate calcified and noncalcified atherosclerosis of the thoracic aorta and proximal great vessels. There is mild narrowing of the left common carotid origin. There is prominent mural atherosclerosis of the descending thoracic aorta that is partially visualized on the prior noncontrast CT exam. MEDIASTINUM / ESOPHAGUS: Postsurgical changes of CABG. LYMPH NODES: Prominent mediastinal lymph nodes are likely reactive. CHEST WALL: Postsurgical changes of CABG with sternotomy wires in place. Partial limited evaluation of the sternum secondary to motion artifact without definite cortical destruction. No soft tissue gas or drainable fluid collection seen. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Kyphotic curvature of the thoracic spine with mild spondylosis. No destructive osseous lesion.
FINDINGS: Again noted is arthrodesis hardware spanning the talonavicular, subtalar, and calcaneocuboid joints. There is mature osseous ankylosis of the calcaneocuboid joint. There is partial ankylosis of the talonavicular joint medially in the region of the screws. No mature osseous ankylosis seen involving the subtalar joint. There is a small amount lucency around the distal aspects of the screws spanning the subtalar joint, suggesting motion. No acute osseous abnormality. Unchanged appearance of the opposing osteochondral lesions of the posterior talar dome and tibial plafond.
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CT scan of the lumbar spine. Clinical: Multiple myeloma. Spine fracture. Technical: CT L-spine protocol. DLP: 791.10 mGy cm. Findings: Multiple lytic lesions are again seen throughout all lumbar and lower thoracic vertebra and in the upper sacrum on the left, consistent with multiple myeloma. Compression fractures of the upper endplates of L1, L2 and L4 are stable. Slight retrolisthesis of L4 over L5 is unchanged. Prior there is sclerosis in endplates adjacent to the L5-1 disc has resolved. There is extensive facet arthropathy from L3 to S1. There is spondylotic fusion of the posterior elements of L4 and L5 and possibly extending to S1. The large right renal cyst is again noted. The paraspinal soft tissues are otherwise unremarkable. --------------- Conclusion: Stable extensive lytic defects in all visible vertebral bodies and upper sacrum. Stable degenerative disc disease and facet arthropathy. No significant change.
Findings: Multiple lytic lesions are again seen throughout all lumbar and lower thoracic vertebra and in the upper sacrum on the left, consistent with multiple myeloma. Compression fractures of the upper endplates of L1, L2 and L4 are stable. Slight retrolisthesis of L4 over L5 is unchanged. Prior there is sclerosis in endplates adjacent to the L5-1 disc has resolved. There is extensive facet arthropathy from L3 to S1. There is spondylotic fusion of the posterior elements of L4 and L5 and possibly extending to S1. The large right renal cyst is again noted. The paraspinal soft tissues are otherwise unremarkable. ---------------
FINDINGS: SOFT TISSUES: There has been interval resection including a majority of the left mandible with associated right sternocleidomastoid flap. There is associated surgical absence of the right mylohyoid and digastric muscles. There is mild asymmetry of the right lateral and medial pterygoid muscles which is not unexpected given resection of their osseous attachment point on the left mandible. No new concerning enhancing soft tissue mass is identified. Redemonstrated extensive postsurgical changes of prior resection of a right buccal squamous cell carcinoma as well as a second focus of primary squamous cell carcinoma involving the lower lip status post flap reconstruction. Asymmetric stranding is noted within the supraclavicular fat which is likely related to radiation change. LYMPH NODES: No pathologic adenopathy by imaging size criteria. Mildly enlarged left-sided cervical lymph nodes are likely reactive changes given the CT size criteria. AERODIGESTIVE STRUCTURES: Extensive postsurgical change without asymmetric contrast enhancement or asymmetric soft tissue nodularity. Status post thoracostomy tube placement. PAROTID GLANDS/SUBMANDIBULAR GLANDS: The right submandibular gland is absent. Otherwise no significant abnormality. THYROID GLAND: Unchanged heterogeneous left thyroid nodule. VASCULAR STRUCTURES: No evidence of dissection, occlusion, or aneurysm. OSSEOUS STRUCTURES: Extensive postsurgical change of partial right maxillectomy and near complete right mandibulectomy. No acute osseous abnormality or concerning aggressive appearing osseous lesion. Mild multilevel discogenic degenerative change of loss of the expected cervical lordosis and mild facet arthropathy. ORBITS: Unremarkable. PARANASAL SINUSES AND MASTOID AIR CELLS: Right mastoid and middle ear effusions. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: Unremarkable. LUNG APICES: Mild apical predominant pleural parenchymal scarring. No suspicious nodule or mass.
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CT Head wo contrast 1/5/2022 2:27 PM Clinical Information: PUI for COVID Altered Mental Status Comparison: 11/16/2020 Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 230 mm. DLP: 1460 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is age-related atrophy with proportionate enlargement and ventricles and subarachnoid CSF spaces. There is periventricular white matter hypodensities which are similar to the prior exam and while nonspecific likely represent microangiopathy. There is an unchanged chronic infarct of the right basal ganglia. There is chronic irregularity to the anterior wall of the right maxillary sinus with hyperostosis and mucosal thickening, probably related to chronic sinusitis in the setting of remote trauma. Otherwise, the visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: No CT evidence of acute intracranial abnormality. Chronic changes as above.
Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is age-related atrophy with proportionate enlargement and ventricles and subarachnoid CSF spaces. There is periventricular white matter hypodensities which are similar to the prior exam and while nonspecific likely represent microangiopathy. There is an unchanged chronic infarct of the right basal ganglia. There is chronic irregularity to the anterior wall of the right maxillary sinus with hyperostosis and mucosal thickening, probably related to chronic sinusitis in the setting of remote trauma. Otherwise, the visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Unchanged 4 x 3 mm nodule in the right lower lobe (image three series 2). HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic liver with moderate liver surface nodularity. No steatosis. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 6 - Size: 1.0 x 1.0 cm (image 157 series 5) - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 0 - Enhancing "capsule": Not present. - Nonperipheral "washout": Not present. - Threshold growth (>= 50% in <= 6 months): Not present. - Other features: None. - LI-RADS: LR-3 LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Right, middle and left hepatic veins are not opacified and appear to be occluded. - Esophageal varices: Small (
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Post VPS Spec COMPARISON: CT dated 1/5/2022 TECHNIQUE: Stealth protocol. CT of the head without intravenous contrast. DLP: 1124 mGy cm. FINDINGS: BRAIN PARENCHYMA: Interval placement of a right frontal shunt catheter with catheter tip in the right anterior horn near foramen of Monro. Expected postsurgical changes in the right scalp and right upper neck. The ventricles are decompressed. Interval suspected minimal improvement in optic sheath distention. No intracranial hemorrhage. No midline shift. No visible infarct. Orbits are unremarkable. Paranasal sinuses and mastoid air cells are clear. -------------------- CONCLUSION: 1. Status post right frontal cholecystostomy catheter placement with expected postsurgical changes. Decompressed ventricles. 2. Improvement in optic sheath distention. 3 As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
FINDINGS: BRAIN PARENCHYMA: Interval placement of a right frontal shunt catheter with catheter tip in the right anterior horn near foramen of Monro. Expected postsurgical changes in the right scalp and right upper neck. The ventricles are decompressed. Interval suspected minimal improvement in optic sheath distention. No intracranial hemorrhage. No midline shift. No visible infarct. Orbits are unremarkable. Paranasal sinuses and mastoid air cells are clear. --------------------
FINDINGS: BONES/JOINTS: There has been interval placement of an intramedullary nail and lateral sideplate with screw fixation of the distal femur. No evidence of hardware loosening or malfunction. Redemonstration of a highly comminuted fracture of the distal femoral metaphysis with intra-articular extension into the intercondylar notch. There is mild medial displacement of the medial femoral condyle relative to the femoral diaphysis, unchanged. The femoral head remains well-seated within the acetabulum. There are moderate degenerative changes of the medial tibiofemoral compartment. The proximal tibia and fibula are unremarkable. SOFT TISSUES: No large hematoma. There is a well-defined fluid collection posterior to the left knee joint measuring approximately 2.6 x 1.5 cm (series 4 image 643) with a well-defined neck and scattered internal debris. There is diffuse dermal thickening and subcutaneous edema overlying the right hip and extending circumferentially around the right femur. There is a moderate suprapatellar joint effusion. Within the lateral aspect of the fusion there is heterogeneous attenuation which is partially obscured by metallic streak artifact.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: History of endometrial cancer. COMPARISON: 11/11/2020. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 180 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Oral contrast Omnipaque: 16.9 oz. Saline flush: 10 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: 72 sec. Scan field of view: 430 mm. DLP: 1236.10 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral lung base atelectasis. DISTAL ESOPHAGUS: Tiny hiatal hernia. HEART / VESSELS: Normal in size without pericardial effusion. Significant coronary artery atherosclerotic calcification. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is surgically absent. There is a new right ovarian cyst which measures up to 2.3 cm in diameter (series 2, image 285), likely physiologic in this pre-menopausal patient. The left ovary is normal. There is redemonstration of a small left Bartholin's cyst and prominent left nabothian cyst as well, similar to prior exam. BODY WALL: Tiny fat-containing periumbilical hernia. MUSCULOSKELETAL: No aggressive osseous lesions. CONCLUSION: 1. No evidence of recurrent malignancy or abdominopelvic metastatic disease. 2. Chronic and incidental findings as above.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral lung base atelectasis. DISTAL ESOPHAGUS: Tiny hiatal hernia. HEART / VESSELS: Normal in size without pericardial effusion. Significant coronary artery atherosclerotic calcification. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is surgically absent. There is a new right ovarian cyst which measures up to 2.3 cm in diameter (series 2, image 285), likely physiologic in this pre-menopausal patient. The left ovary is normal. There is redemonstration of a small left Bartholin's cyst and prominent left nabothian cyst as well, similar to prior exam. BODY WALL: Tiny fat-containing periumbilical hernia. MUSCULOSKELETAL: No aggressive osseous lesions.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Diffuse bilateral cysts involving both upper and lower lungs. Scattered areas of mild scarring. No significant air trapping on the expiratory images. No pleural effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Pectus excavatum with a Haller index of 3.0.
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CT Head wo contrast 1/5/2022 2:12 PM Clinical Information: slurred speech Spec Inst: onsent > 24 hours Comparison: None Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 210 mm. DLP: 1917 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. A small amount of thickening/fluid is seen in the right anterior ethmoid air cells. Otherwise, the visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: No CT evidence of acute intracranial abnormality. If it will make a difference in patient management to diagnose a stroke now, further evaluation with MRI should be performed, unless contraindicated in this patient for any reason.
Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. A small amount of thickening/fluid is seen in the right anterior ethmoid air cells. Otherwise, the visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
FINDINGS: BONES/JOINTS: No acute fracture or malalignment of the right femur. The femoral head remains well-seated within the acetabulum with mild degenerative changes. There are mild degenerative changes of the medial tibiofemoral joint space. The remaining joint spaces of the are well-maintained. There is chondrocalcinosis of the knee joint. No suprapatellar effusion. The proximal tibia and fibula are unremarkable. SOFT TISSUES: No large hematoma or fluid collection. Numerous metallic BBs overlie the right pelvis and proximal right femur.
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CT Head wo contrast 1/6/2022 3:58 AM Clinical Information: TBI Spec Inst: stealth Comparison: Head CT 1/4/2022 Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 241 mm. DLP: 1785 mGy cm. Findings: Multifocal parenchymal hemorrhages in bilateral frontal and temporal lobes are again noted with the largest hematoma in the right frontal lobe and left temporal lobes with surrounding edema, similar to the prior exam. Multifocal subdural hemorrhages along bilateral convexities and posterior falx are similar. There is mild increased expansion of bilateral frontal parietal convexity subdural spaces, likely associated subdural hygromas as well. Scattered basal and sulcal subarachnoid hemorrhage is unchanged. There is continued mass effect on the right frontal horn without significant midline shift. Ventricular size is similar with no hydrocephalus. Right orbital frontal calvarium fracture and additional maxillofacial fractures are again noted. There is patchy opacification of the paranasal sinuses, most prominent in the right maxillary sinus and sphenoid sinus. The right orbital hematoma along its superior aspect is similar measuring approximately 8 mm in the maximum craniocaudal dimension with mass effect on the extraocular muscles and mild hypoglobus. Impression: 1. No significant change in multifocal multicompartment hemorrhage, with largest parenchymal hemorrhages in the right frontal lobe and left inferior temporal lobe. 2. Mild expansion of bilateral frontoparietal convexity extra axial spaces, likely subdural hygromas. 3. Unchanged right orbital frontal calvarial fracture with underlying orbital hematoma and associated mass effect.
Findings: Multifocal parenchymal hemorrhages in bilateral frontal and temporal lobes are again noted with the largest hematoma in the right frontal lobe and left temporal lobes with surrounding edema, similar to the prior exam. Multifocal subdural hemorrhages along bilateral convexities and posterior falx are similar. There is mild increased expansion of bilateral frontal parietal convexity subdural spaces, likely associated subdural hygromas as well. Scattered basal and sulcal subarachnoid hemorrhage is unchanged. There is continued mass effect on the right frontal horn without significant midline shift. Ventricular size is similar with no hydrocephalus. Right orbital frontal calvarium fracture and additional maxillofacial fractures are again noted. There is patchy opacification of the paranasal sinuses, most prominent in the right maxillary sinus and sphenoid sinus. The right orbital hematoma along its superior aspect is similar measuring approximately 8 mm in the maximum craniocaudal dimension with mass effect on the extraocular muscles and mild hypoglobus.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Numerous bilateral pulmonary nodules, largest measuring 9 mm on series 2 image 141. Some of the larger pulmonary nodules have a spiculated appearance, including the 9 mm right lower lobe nodule described above as well as a 7 mm right upper lobe nodule as seen on on series 2 image 76. No focal consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: Heart size is normal. No pericardial effusion. Mild atherosclerotic disease of the thoracic aorta and coronary arteries. MEDIASTINUM / ESOPHAGUS: Prominent mediastinal lymph nodes, see below. LYMPH NODES: Enlarged bilateral hilar and mediastinal lymph nodes, largest measuring up to 1.2 cm in the right paratracheal distribution. Evaluation limited without intravenous contrast. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal within the limits of a noncontrast exam. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Lumbar Spine from Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 284 mm. DLP: 1401.50 mGy cm. (accession CT220002650), Scan field of view: 227 mm. DLP: 1077.30 mGy cm. (accession CT220002656), Patient weight: 142 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 224 mm. DLP: 816.30 mGy cm. (accession CT220002657), Patient weight: 142 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 415 mm. (accession CT220002652), Patient weight: 142 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 415 mm. DLP: 854 mGy cm. (accession CT220002651) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Moderate chronic white matter microangiopathic change and volume loss EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Moderate chronic white matter microangiopathic change and volume loss EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
Findings: Brain parenchyma: Diffuse age-appropriate brain parenchymal volume loss is again seen, resulting in mild exvacuo dilatation of the ventricular system. Scattered periventricular and subcortical white matter hypoattenuation is unchanged, suggestive of mild chronic microvascular ischemic disease. Remote lacunar infarcts are again seen in the bilateral basal ganglia. The white-gray matter differentiation is preserved. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Persistent atherosclerotic calcifications of the bilateral carotid siphons and vertebral arteries. Soft tissues: Unremarkable without discrete fluid collections. Orbits: Normal appearance. Calvarium and skull base: No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Well aerated.
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Lumbar Spine from Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 284 mm. DLP: 1401.50 mGy cm. (accession CT220002650), Scan field of view: 227 mm. DLP: 1077.30 mGy cm. (accession CT220002656), Patient weight: 142 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 224 mm. DLP: 816.30 mGy cm. (accession CT220002657), Patient weight: 142 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 415 mm. (accession CT220002652), Patient weight: 142 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 415 mm. DLP: 854 mGy cm. (accession CT220002651) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Moderate chronic white matter microangiopathic change and volume loss EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Moderate chronic white matter microangiopathic change and volume loss EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
FINDINGS: LOWER NECK: Heterogeneous thyroid with dominant right lobe nodule measuring 1.8 x 1.2 cm (series 501 image 64), not seen previously. CHEST: LUNGS / AIRWAYS / PLEURA: Unchanged noncalcified right lower lobe nodule measuring 5 mm (series 501 image 175). Subsegmental left basilar atelectasis. No pneumothorax or pleural effusion. The central airways are patent HEART / VESSELS: Right subclavian dual-chamber pacemaker. Mild calcified atherosclerosis, including coronary atherosclerosis. Nearly occlusive thrombus in the central left subclavian vein (image 82). Aortic and mitral valve calcifications. MEDIASTINUM / ESOPHAGUS: Large hiatal hernia. No mediastinal hematoma. DIAPHRAGM: Unremarkable. LYMPH NODES: None enlarged. CHEST WALL: Minimally displaced left posterior 10th through 12th rib fractures. ABDOMEN and PELVIS: LIVER: No suspicious lesion. BILIARY TRACT: Moderate intrahepatic and extrahepatic biliary dilation, likely related to cholecystectomy. GALLBLADDER: Absent. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Left adrenal nodule measuring 1.0 cm (image 256), unchanged since 6/24/2009. KIDNEYS: No hydronephrosis or laceration. Subcentimeter low-attenuation lesions bilaterally, too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large hiatal hernia. The loops of small bowel are normal in caliber COLON / APPENDIX: Colonic diverticulosis. There is distention of the rectum with stool with adjacent stranding. The appendix is not visualized. PERITONEUM / MESENTERY: Trace free fluid. No free air. RETROPERITONEUM: Normal. VESSELS: Mild scattered calcified atherosclerosis without aneurysm. URINARY BLADDER: Decompressed by Foley catheter. REPRODUCTIVE ORGANS: The uterus is present. BODY WALL: Subcutaneous stranding along the left flank. MUSCULOSKELETAL: Diffuse demineralization. THORACIC SPINE: VERTEBRA: Mild anterior wedging of T2. New 50% anterior wedging of T11, with associated retropulsion measuring 3 mm. DISC SPACES AND FACET JOINTS: No acute injury. Mild degenerative changes. ALIGNMENT: Dextrocurvature. LUMBAR SPINE: VERTEBRA: New 25% anterior wedging of L3, with retropulsion measuring 4 mm. Mild anterior wedging of L1 appears unchanged from radiograph 7/9/2012. DISC SPACES AND FACET JOINTS: No acute injury. Moderate degenerative changes. ALIGNMENT: Mild retrolisthesis of L1 on L2 and L5 on S1. Lower lumbar levocurvature.