exam_ID
int64 2k
16.7k
| raw_report
stringlengths 56
10.9k
| report_findings_positive
stringlengths 9
6.27k
| report_findings_negative
stringlengths 9
6.27k
|
|---|---|---|---|
16,400 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 75-year-old male with cholecystitis, hepatic mass. COMPARISON: CT dated 3/29/2019 TECHNIQUE: Outside CT images without IV contrast dated 1/10/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is heterogeneous hypodense mass measures 8.7 x 7.5 cm in the lateral segment of the left lobe image #26 series #2, new since 2019. An additional hypodense lesion measures 1.2 cm with CT attenuation measures 5 Hounsfield units lateral to the main mass in the left lobe, favors hepatic cyst and unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Mild thickening of the left renal gland measures 10 mm. Right adrenal gland is normal. KIDNEYS: Nonobstructing stone measures 6 mm in the interpolar calyx and additional 2 mm stone in the lower pole apex of the right kidney. Left kidney is normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes in the distal small bowel. Otherwise, stomach and small bowel are normal. COLON / APPENDIX: Uncomplicated colon diverticulosis. Otherwise, colon is normal. Appendix is not visualized. PERITONEUM / MESENTERY: 1 RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcification the abdominal aorta is branches without aneurysmal dilatation significant stenosis. URINARY BLADDER: Mild mural thickening without a stone or focal mass. REPRODUCTIVE ORGANS: Prostate is enlarged measures 6.1 cm in transverse diameter. BODY WALL: Postsurgical changes of midline laparotomy and multiple small midline incisional ventral hernias some of them contains fat and others small bowel loops without obstruction. MUSCULOSKELETAL: Diffuse osteopenia and scattered degenerative changes. No lytic or sclerotic bony lesion is identified. CONCLUSION: Limited evaluation due to lack of IV contrast. 1. Interval large heterogeneous soft tissue mass measures 8.7 x 7.5 cm in the lateral segment of the left lobe of the liver, concerning for neoplastic process. Recommend MRI/CT hepatic mass protocol for further evaluation. 2. Mildly thickened left adrenal gland, indeterminant. 3. Multiple small midline incisional ventral hernias containing fat and bowel loops or obstruction. 4. Right nonobstructing nephrolithiasis and other additional findings as above.
|
FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is heterogeneous hypodense mass measures 8.7 x 7.5 cm in the lateral segment of the left lobe image #26 series #2, new since 2019. An additional hypodense lesion measures 1.2 cm with CT attenuation measures 5 Hounsfield units lateral to the main mass in the left lobe, favors hepatic cyst and unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Mild thickening of the left renal gland measures 10 mm. Right adrenal gland is normal. KIDNEYS: Nonobstructing stone measures 6 mm in the interpolar calyx and additional 2 mm stone in the lower pole apex of the right kidney. Left kidney is normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes in the distal small bowel. Otherwise, stomach and small bowel are normal. COLON / APPENDIX: Uncomplicated colon diverticulosis. Otherwise, colon is normal. Appendix is not visualized. PERITONEUM / MESENTERY: 1 RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcification the abdominal aorta is branches without aneurysmal dilatation significant stenosis. URINARY BLADDER: Mild mural thickening without a stone or focal mass. REPRODUCTIVE ORGANS: Prostate is enlarged measures 6.1 cm in transverse diameter. BODY WALL: Postsurgical changes of midline laparotomy and multiple small midline incisional ventral hernias some of them contains fat and others small bowel loops without obstruction. MUSCULOSKELETAL: Diffuse osteopenia and scattered degenerative changes. No lytic or sclerotic bony lesion is identified.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Mild mucosal disease and aerated lesions within both maxillary ethmoid sinuses, left sphenoid sinus and nasal cavity. SOFT TISSUES:Unremarkable. OTHER: Endotracheal and feeding tubes are partially visualized.
|
16,401 |
EXAM: Interpretation of Outside Films CT Chest CLINICAL INFORMATION: History of metastatic breast cancer. COMPARISON: CT chest 12/16/2021 TECHNIQUE: Interpretation of Outside Films CT Chest. Outside CT images of the chest from 1/3/2022 were submitted for interpretation. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Small left pneumothorax with left-sided pigtail thoracostomy tube terminating in the posterolateral costodiaphragmatic recess. Prominent left lower lobe peribronchial thickening. Interval development of consolidative and groundglass opacities mainly involving the superior left lower lobe and lingula. Left lung interlobular septal thickening is also seen. Right greater than left small bilateral pleural effusions with adjacent atelectasis. Small peripheral groundglass opacities in the right lung apex. HEART / VESSELS: The heart is normal in size without pericardial effusion. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Postsurgical changes from left axillary lymph node dissection. CHEST WALL: Unchanged appearance of the left outer breast fluid collection and left breast skin thickening. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Osseous metastatic disease is again seen throughout the axial skeleton and bilateral ribs. Lytic and sclerotic destructive changes of the posterior left 10th - 12th ribs is again seen. Destructive osseous lesion in the anterolateral left second rib is also redemonstrated. Right scapula pathologic fractures involving the coracoid and acromion processes are again seen. Sternal metastatic lesions are also visualized. Moderate to severe T4 over T5 anterolisthesis is again seen. Several pathological compression deformities are again seen involving the C7, T4, T5, and L1. The C7 vertebral body has greater than 75% height loss. CONCLUSION: 1. Interval development of left hydropneumothorax with placement of left pigtail thoracostomy. 2. New consolidative and groundglass opacities in the left lung concerning for infection versus lymphangitic spread of the tumor (lymphangitis carcinomatosis). Likely malignant left pleural effusion. 3. Stable appearance of left outer breast fluid collection. 4. Diffuse osseous metastatic disease with redemonstration of pathological fractures as above. Moderate to severe T4 and T5 anterolisthesis is similar to prior. 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: The central airways are patent. Small left pneumothorax with left-sided pigtail thoracostomy tube terminating in the posterolateral costodiaphragmatic recess. Prominent left lower lobe peribronchial thickening. Interval development of consolidative and groundglass opacities mainly involving the superior left lower lobe and lingula. Left lung interlobular septal thickening is also seen. Right greater than left small bilateral pleural effusions with adjacent atelectasis. Small peripheral groundglass opacities in the right lung apex. HEART / VESSELS: The heart is normal in size without pericardial effusion. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Postsurgical changes from left axillary lymph node dissection. CHEST WALL: Unchanged appearance of the left outer breast fluid collection and left breast skin thickening. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Osseous metastatic disease is again seen throughout the axial skeleton and bilateral ribs. Lytic and sclerotic destructive changes of the posterior left 10th - 12th ribs is again seen. Destructive osseous lesion in the anterolateral left second rib is also redemonstrated. Right scapula pathologic fractures involving the coracoid and acromion processes are again seen. Sternal metastatic lesions are also visualized. Moderate to severe T4 over T5 anterolisthesis is again seen. Several pathological compression deformities are again seen involving the C7, T4, T5, and L1. The C7 vertebral body has greater than 75% height loss.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Mild mucosal disease and aerated lesions within both maxillary ethmoid sinuses, left sphenoid sinus and nasal cavity. SOFT TISSUES:Unremarkable. OTHER: Endotracheal and feeding tubes are partially visualized.
|
16,402 |
EXAM: Interpretation of Outside Films CT Neck CLINICAL INFORMATION: Female patient 33 years with thyroid nodule CT Neck 11022 SEHMC Rec 11222 Spec Inst: thyroid nodule CT Neck 11022 SEHMC Rec 11222 TECHNIQUE: 2 mm thick serial axial images were obtained through the neck without and after the intravenous administration of contrast. Sagittal and coronal reformatted views were also obtained. COMPARISON: None available. FINDINGS: Outside examination from SEHMC dated 1/10/2022 is submitted for interpretation on 1/12/2022. There is no mass within the nasopharynx, oropharynx or hypopharynx. Larynx is within normal limits. There is a large well-circumscribed heterogeneously enhancing lesion significantly expanding the right lobe of the thyroid gland. There are no associated calcifications. The lesion measures 7.5 x 5.4 cm in the axial plane. The lesion measures approximately 6.6 cm in maximal craniocaudal dimension. The lesion extends up to the level of the larynx and also extends into the superior most mediastinum on the right. There is significant mass effect upon the trachea which is displaced to the left. There is partial encasement of the right ICA but no significant narrowing. The right IJ is displaced laterally. The left lobe of the thyroid gland is unremarkable. The left carotid artery and left IJ are unremarkable. The submandibular glands and parotid glands appear unremarkable. There are shotty lymph nodes within the left and right upper internal jugular chain and submental region. There is no lymphadenopathy using CT size criteria. No destructive osseous lesion is identified. Paranasal sinuses and mastoid air cells are clear. There is no acute abnormality of the orbits. There is no abnormal enhancement within the visualized brain. Visualized lungs are clear. CONCLUSION: 01. Large heterogeneously enhancing lesion within the right lobe of the thyroid gland. There is focal mass effect upon the adjacent structures including the trachea which is displaced to the left and is only mildly narrowed.. There is lateral displacement of the right carotid artery and right internal jugular vein without evidence of invasion. Findings are nonspecific but suggest dominant thyroid nodule 02. No lymphadenopathy using CT size criteria
|
FINDINGS: Outside examination from SEHMC dated 1/10/2022 is submitted for interpretation on 1/12/2022. There is no mass within the nasopharynx, oropharynx or hypopharynx. Larynx is within normal limits. There is a large well-circumscribed heterogeneously enhancing lesion significantly expanding the right lobe of the thyroid gland. There are no associated calcifications. The lesion measures 7.5 x 5.4 cm in the axial plane. The lesion measures approximately 6.6 cm in maximal craniocaudal dimension. The lesion extends up to the level of the larynx and also extends into the superior most mediastinum on the right. There is significant mass effect upon the trachea which is displaced to the left. There is partial encasement of the right ICA but no significant narrowing. The right IJ is displaced laterally. The left lobe of the thyroid gland is unremarkable. The left carotid artery and left IJ are unremarkable. The submandibular glands and parotid glands appear unremarkable. There are shotty lymph nodes within the left and right upper internal jugular chain and submental region. There is no lymphadenopathy using CT size criteria. No destructive osseous lesion is identified. Paranasal sinuses and mastoid air cells are clear. There is no acute abnormality of the orbits. There is no abnormal enhancement within the visualized brain. Visualized lungs are clear.
|
FINDINGS: VASCULATURE: Descending thoracic aorta: No aneurysm, dissection, or stenosis. Abdominal aorta: No aneurysm, dissection, or stenosis. Celiac axis: Embolic coil within the left gastric artery. Otherwise no significant abnormality. Superior mesenteric artery: No aneurysm, dissection, or stenosis. Right renal: Single right renal artery. No aneurysm, dissection, or stenosis. Left renal: Multiple left renal arteries. No aneurysm, dissection, or stenosis. Inferior mesenteric artery: No aneurysm, dissection, or stenosis. Right Common Iliac artery: No aneurysm, dissection, or stenosis. Right External Iliac artery: No aneurysm, dissection, or stenosis. Right Internal Iliac artery: No aneurysm, dissection, or stenosis. Proximal Right Femoral arteries: No aneurysm, dissection, or stenosis. Left Common Iliac artery: No aneurysm, dissection, or stenosis. Left External Iliac artery: No aneurysm, dissection, or stenosis. Left Internal Iliac artery: No aneurysm, dissection, or stenosis. Proximal Left Femoral arteries: No aneurysm, dissection, or stenosis. ------------------------------------------------------------- LOWER CHEST: LUNG BASES: Normal. PLEURA: Normal. DISTAL ESOPHAGUS: Metallic clips at the GE junction. HEART: Normal. ABDOMEN and PELVIS: LIVER: Marked diffuse hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Similar appearance of minimal peripancreatic fat stranding. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Collapsed. REPRODUCTIVE ORGANS: Redemonstration of myomatous uterus which appears grossly unchanged with multiple calcifications. BODY WALL: Fat-containing ventral hernia. MUSCULOSKELETAL: Minimal multilevel discogenic degenerative changes within the thoracolumbar spine.
|
16,403 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Prostate cancer. Medical record indicates history of robotic-assisted laparoscopic radical prostatectomy with bilateral pelvic lymph node dissection on 6/11/2021. COMPARISON: CT 3/23/2021 TECHNIQUE: Outside CT images with IV contrast dated 1/7/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. 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: Scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: There are small bilateral pelvic sidewall fluid simple appearing fluid collections, new from the prior exam, the left measuring approximately 5.0 x 3.3 cm (series 3, image 75); the right measures 3.9 x 2.7 cm (series 3, image 79). RETROPERITONEUM: Normal. VESSELS: Moderate aortobiiliac atherosclerosis without aneurysm. URINARY BLADDER: Mild diffuse urinary bladder wall thickening. REPRODUCTIVE ORGANS: The prostate is surgically absent. No evidence of recurrent disease. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No suspicious osseous lesion is identified. Multilevel degenerative changes in the lumbar spine. CONCLUSION: 1. Status post radical prostatectomy. No evidence of recurrent or metastatic disease in the abdomen or pelvis. 2. Small new bilateral pelvic sidewall fluid collections, likely lymphoceles given surgical history. 3. Diffuse urinary bladder wall thickening, nonspecific. Further evaluation with urinalysis may be of benefit to exclude cystitis. 4. Chronic and incidental 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: IMAGE QUALITY: Satisfactory. 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: Scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: There are small bilateral pelvic sidewall fluid simple appearing fluid collections, new from the prior exam, the left measuring approximately 5.0 x 3.3 cm (series 3, image 75); the right measures 3.9 x 2.7 cm (series 3, image 79). RETROPERITONEUM: Normal. VESSELS: Moderate aortobiiliac atherosclerosis without aneurysm. URINARY BLADDER: Mild diffuse urinary bladder wall thickening. REPRODUCTIVE ORGANS: The prostate is surgically absent. No evidence of recurrent disease. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No suspicious osseous lesion is identified. Multilevel degenerative changes in the lumbar spine.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Calcific coronary atherosclerosis. ABDOMEN and PELVIS: LIVER: Hepatomegaly. BILIARY TRACT: Stable dilation of the common bile duct to approximately 1 cm within the pancreatic head with appropriate tapering. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colon is unremarkable. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Tiny fat-containing ventral hernia. MUSCULOSKELETAL: L4 on L5 grade 1 anterolisthesis.
|
16,404 |
Interpretation of Outside Films MR Head HISTORY: Evaluation for brain mass TECHNIQUE: Multiplanar, multisequence MRI of the brain was performed without and after intravenous contrast. COMPARISON: MRI of 11/18/2021 FINDINGS: INTRACRANIAL FINDINGS: There are multiple extra-axial avidly enhancing mass lesion in bilateral cerebral hemispheres most consistent with multiple meningiomas. For reference: The right frontal meningioma measures 12 x 29 mm on transverse diameter with prominent hyperostosis. An additional focus of right frontal meningioma measures 11 x 5 mm. A small right frontal meningioma in the right aspect of superior sagittal sinus measures 9 x 7 mm. The left frontal meningioma measures 23 x 6 mm with hyperostosis. There is a large lobulated meningioma along the posterior portion of the falx cerebri with involvement of the superior sagittal sinus which the superior component measures 25 x 24 mm and inferior component measures 28 x 38 mm with involvement of the superior sagittal sinus. A large meningioma in the left parietotemporal lesion measures 20 x 42 mm with hyperostosis. A meningioma in the superior portion of the right temporal region measures 10 x 16 mm. An on plaque meningioma of the right anterior clinoid process is noted with severe hyperostosis. A meningioma in anterior aspect of the left middle cranial fossa measures 17 x 27 mm vertebral arteries. A meningioma in the right occipital region measures 15 x 7 mm. A meningioma along the right tentorium measures 28 x 11 mm. There is mild parenchymal edema around the meningioma of the right parietal vertex. The rest of meningiomas are without significant associated edema. Scattered foci of small white matter FLAIR signal intensities is noted in the cerebral hemispheres most consistent with microvascular angiopathy. The brain parenchyma appears normal without evidence for acute ischemia, hemorrhage,. The ventricles are normal in size. There is no abnormal extra-axial collection. The flow voids at the skull base are normal. The cerebellar tonsils are normal in position. EXTRACRANIAL FINDINGS: The orbital contents are unremarkable. Mucosal thickening and enhancement is present in the left frontal, left ethmoidal and left maxillary sinus is most consistent with sinusitis. Effusion of right mastoidal sinus is seen. IMPRESSION: Multiple supratentorial meningiomas as described above with involvement of the superior sagittal sinus in the posterior vertex. The right anterior clinoid process meningioma is associated with osseous expansion and hyperostosis and with involvement of the right orbital apex. There is mass effect over the right optic nerve in the right orbital apex. Extension of the dural enhancement toward the left orbital apex is also noted along the meningioma located in the anterior portion of the left temporal lobe. Please note that evaluation for interval enlargement of the meningiomas is not possible because postcontrast images of the previous MRI are not complete.
|
FINDINGS: INTRACRANIAL FINDINGS: There are multiple extra-axial avidly enhancing mass lesion in bilateral cerebral hemispheres most consistent with multiple meningiomas. For reference: The right frontal meningioma measures 12 x 29 mm on transverse diameter with prominent hyperostosis. An additional focus of right frontal meningioma measures 11 x 5 mm. A small right frontal meningioma in the right aspect of superior sagittal sinus measures 9 x 7 mm. The left frontal meningioma measures 23 x 6 mm with hyperostosis. There is a large lobulated meningioma along the posterior portion of the falx cerebri with involvement of the superior sagittal sinus which the superior component measures 25 x 24 mm and inferior component measures 28 x 38 mm with involvement of the superior sagittal sinus. A large meningioma in the left parietotemporal lesion measures 20 x 42 mm with hyperostosis. A meningioma in the superior portion of the right temporal region measures 10 x 16 mm. An on plaque meningioma of the right anterior clinoid process is noted with severe hyperostosis. A meningioma in anterior aspect of the left middle cranial fossa measures 17 x 27 mm vertebral arteries. A meningioma in the right occipital region measures 15 x 7 mm. A meningioma along the right tentorium measures 28 x 11 mm. There is mild parenchymal edema around the meningioma of the right parietal vertex. The rest of meningiomas are without significant associated edema. Scattered foci of small white matter FLAIR signal intensities is noted in the cerebral hemispheres most consistent with microvascular angiopathy. The brain parenchyma appears normal without evidence for acute ischemia, hemorrhage,. The ventricles are normal in size. There is no abnormal extra-axial collection. The flow voids at the skull base are normal. The cerebellar tonsils are normal in position. EXTRACRANIAL FINDINGS: The orbital contents are unremarkable. Mucosal thickening and enhancement is present in the left frontal, left ethmoidal and left maxillary sinus is most consistent with sinusitis. Effusion of right mastoidal sinus is seen.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS AND FACE: Normal. SINUSES: Normal.
|
16,405 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 54-year-old male with adrenal nodule. COMPARISON: MRI 11/29/2021 TECHNIQUE: Outside CT images of the abdomen from Mobile Infirmary Health dated 1/3/2022 were submitted for interpretation. Coronal and sagittal reconstructions were also reviewed. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: 5 mm right lower lobe lung nodule without calcification or stranding (image 4 series 5). Otherwise normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Heterogeneous right adrenal mass measures 3.4 x 2.9 cm (image 28 series 5), previously 3.4 x 2.8 cm (image 17 series 10). This lesion measures 19 Hounsfield units precontrast, 49 Hounsfield units postcontrast, and 56 Hounsfield units on delayed phase. No calcifications or adjacent stranding are present. Normal left adrenal gland. KIDNEYS: Left renal cyst without enhancement measures 2.4 cm (image 35 series 5). LYMPH NODES: Small portacaval node is unchanged. None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: Small umbilical hernia contains fat. No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Right adrenal mass with slow progressive enhancement is not consistent with adrenal adenoma by CT or prior MRI. Differential diagnosis for this rare finding includes ganglioneuroma, myelolipoma with infarction, or adrenal angiomyolipoma. 2. Small noncalcified right pulmonary nodule. Follow-up is recommended. Findings were notified to Dr. Porterfield by Dr. Lockhart at 10:45 p.m. on 1/12/2022.
|
FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: 5 mm right lower lobe lung nodule without calcification or stranding (image 4 series 5). Otherwise normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Heterogeneous right adrenal mass measures 3.4 x 2.9 cm (image 28 series 5), previously 3.4 x 2.8 cm (image 17 series 10). This lesion measures 19 Hounsfield units precontrast, 49 Hounsfield units postcontrast, and 56 Hounsfield units on delayed phase. No calcifications or adjacent stranding are present. Normal left adrenal gland. KIDNEYS: Left renal cyst without enhancement measures 2.4 cm (image 35 series 5). LYMPH NODES: Small portacaval node is unchanged. None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: Small umbilical hernia contains fat. No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS AND FACE: Normal. SINUSES: Normal.
|
16,406 |
Interpretation of Outside Films CT Chest Clinical Information: 63-year-old female with provided history of new bladder cancer new bladder cancer CT Chest 11022 Radiology Clinic Rec 11222 Spec Inst: new bladder cancer CT Chest 11022 Radiology Clinic Rec 11222 Study reviewed: CT of chest with contrast performed at the radiology clinic on 1/10/2022, The images are available in PACS. Technique: 5 mm axial images are reviewed. 3 mm coronal and sagittal reformat. Findings: Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Mild upper lobe predominant centrilobular emphysema. The trachea and main bronchi are patent. A 4 mm right middle lobe nodule (image 39, series 2) is seen. Bilateral dependent atelectasis. No focal consolidation. No pleural effusion. 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. Mild to moderate 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: Please refer to MRI abdomen done the same day. Conclusion: Small 4 mm right middle lobe nodule, otherwise no convincing evidence of metastatic disease in the chest.
|
Findings: Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Mild upper lobe predominant centrilobular emphysema. The trachea and main bronchi are patent. A 4 mm right middle lobe nodule (image 39, series 2) is seen. Bilateral dependent atelectasis. No focal consolidation. No pleural effusion. 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. Mild to moderate 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: Please refer to MRI abdomen done the same day.
|
Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. EXTRA-AXIAL SPACES: Normal. Empty sella. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
|
16,407 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Muscular invasive squamous cell bladder cancer COMPARISON: None. TECHNIQUE: Outside MR images without and with IV contrast dated 1/10/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: STRUCTURED REPORT: MRI Pelvis LOWER ABDOMEN: BOWEL: Sigmoid diverticulosis. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Sessile enhancing mass centered at the right posterolateral bladder wall involving the uteropelvic junction measuring approximately 3.5 x 1.1 cm) series 10, image 12). This mass extends into the distal right ureter as seen on series 10, image 14. The mass extends beyond the muscularis propria, consistent with known muscular invasive pathology. There is mild T2 intermediate signal in the adjacent perivesicular fat (series 10, image 12). A right ureteral stent is seen coiling in the bladder. The visualized portion of the right ureter is diffusely thickened and enhancing throughout the visualized portions. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Postsurgical changes of the anterior abdominal wall. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Muscular invasive bladder cancer involving the right posterolateral bladder wall at the UVJ with suspected extravesicular extension. 2. While the bladder mass likely involves the distal right ureter, it is difficult to determine the superior extent of the tumor, given that the right ureter is diffusely thickened and enhancing, possibly reactive to the ureteral stent placement. 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: MRI Pelvis LOWER ABDOMEN: BOWEL: Sigmoid diverticulosis. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Sessile enhancing mass centered at the right posterolateral bladder wall involving the uteropelvic junction measuring approximately 3.5 x 1.1 cm) series 10, image 12). This mass extends into the distal right ureter as seen on series 10, image 14. The mass extends beyond the muscularis propria, consistent with known muscular invasive pathology. There is mild T2 intermediate signal in the adjacent perivesicular fat (series 10, image 12). A right ureteral stent is seen coiling in the bladder. The visualized portion of the right ureter is diffusely thickened and enhancing throughout the visualized portions. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Postsurgical changes of the anterior abdominal wall. MUSCULOSKELETAL: No significant abnormality.
|
Findings: CTA Neck: No significant stenosis at the origin of great vessels from the arch of aorta. Mild narrowing of the origin of both vertebral arteries. Atherosclerotic calcification at bilateral carotid bifurcation without flow limitation. Vertebral and carotid arteries otherwise show no flow-limiting stenosis. CTA Head: Atherosclerotic calcifications along bilateral intracranial ICAs without flow limitation. Bilateral MCAs, ACAs and the proximal branches appear normal. Intradural vertebral arteries, basilar artery and both PCAs. No flow-limiting stenosis. No aneurysm or AV malformation. There is no abnormal enhancement on the delayed postcontrast images.
|
16,408 |
EXAM: Interpretation of Outside Films MR MSK, MR Outside Images CLINICAL INFORMATION: 42-year-old male with family history of Lynch syndrome, right thigh mass. COMPARISON: No priors for comparison. TECHNIQUE: Outside MRIs of the right femur performed on 1/5/2022 and 1/6/2022 at St. Vincent's 119 were submitted for outside interpretation. Exams were performed per outside institution protocol. Outside imaging is not obtained in a standardized format accepted by UAB, which may limit interpretation. STRUCTURED REPORT: MRI HIP/BONE PELVIS v4/13/2019 FINDINGS: BONES: No fracture, marrow replacement or aggressive osseous lesion. MUSCLES/TENDON: There is a multilobulated mass with mixed heterogeneous T1 and T2 signal within the right posterior vastus medialis muscle. Following contrast there is heterogeneous nodular enhancement, with areas of central nonenhancement which may reflect necrosis. In largest cross-sectional dimension, the mass measures approximately 4.5 x 6.8 x 9.3 cm (axial T1 postcontrast series 4, image 26 sagittal T1 postcontrast series 5, image 19). The lesion extends into the most posterior aspect of vastus intermedius. The lesion abuts the posterior and medial cortex of the distal femur and also abuts and displaces the neurovascular bundle. There is a fairly significant amount of perilesional edema and a thin rim of faint perilesional enhancement within the surrounding musculature and periosteal enhancement along the medial distal femoral metadiaphysis. No frank associated cortical destruction. VESSELS \T\ NERVES: The mass anteriorly abuts and displaces the femoral and popliteal neurovascular bundle in the mid and distal thigh with poor delineation of the neurovascular margin along the inferior aspect of the mass. There is no significant vascular compression. No mass effect or contact of the sciatic nerve. CONCLUSION: Heterogeneously enhancing lobulated mass within vastus medialis, extending into posterior vastus intermedius and abutting the femoral cortex and neurovascular bundle. Main differential consideration is primary sarcoma, other etiologies not excluded. The lesion is amenable to percutaneous biopsy. 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: BONES: No fracture, marrow replacement or aggressive osseous lesion. MUSCLES/TENDON: There is a multilobulated mass with mixed heterogeneous T1 and T2 signal within the right posterior vastus medialis muscle. Following contrast there is heterogeneous nodular enhancement, with areas of central nonenhancement which may reflect necrosis. In largest cross-sectional dimension, the mass measures approximately 4.5 x 6.8 x 9.3 cm (axial T1 postcontrast series 4, image 26 sagittal T1 postcontrast series 5, image 19). The lesion extends into the most posterior aspect of vastus intermedius. The lesion abuts the posterior and medial cortex of the distal femur and also abuts and displaces the neurovascular bundle. There is a fairly significant amount of perilesional edema and a thin rim of faint perilesional enhancement within the surrounding musculature and periosteal enhancement along the medial distal femoral metadiaphysis. No frank associated cortical destruction. VESSELS \T\ NERVES: The mass anteriorly abuts and displaces the femoral and popliteal neurovascular bundle in the mid and distal thigh with poor delineation of the neurovascular margin along the inferior aspect of the mass. There is no significant vascular compression. No mass effect or contact of the sciatic nerve.
|
Findings: CTA Neck: No significant stenosis at the origin of great vessels from the arch of aorta. Mild narrowing of the origin of both vertebral arteries. Atherosclerotic calcification at bilateral carotid bifurcation without flow limitation. Vertebral and carotid arteries otherwise show no flow-limiting stenosis. CTA Head: Atherosclerotic calcifications along bilateral intracranial ICAs without flow limitation. Bilateral MCAs, ACAs and the proximal branches appear normal. Intradural vertebral arteries, basilar artery and both PCAs. No flow-limiting stenosis. No aneurysm or AV malformation. There is no abnormal enhancement on the delayed postcontrast images.
|
16,409 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Left femur lesion COMPARISON: None. TECHNIQUE: Outside MR images of the left femur without and with intravenous contrast dated 1/6/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: There is a aggressive marrow replacing lesion involving the mid femoral diaphysis extending inferiorly to involve the distal femoral epiphysis. The largest component of the tumor is fairly homogeneous on T1 signal, more heterogeneous signal at its most cranial and caudal margins. The lesion involves a length of the femur 25.5 cm in the craniocaudal dimension. There is destruction of the posterolateral aspect of the mid femoral diaphyseal cortex with extension through to the cortex with surrounding soft tissue component and enhancing periosteal reaction. The largest extraosseous soft tissue component measures approximately 3.4 x 5.4 x 8.3 cm (image 36, series 38; image 18, series 39). Central areas of nonenhancement and increased T2 signal suggest necrosis. The soft tissue mass abuts the neurovascular bundle of the distal thigh (image 35, series 38). Additionally, at the lower limits of study, there is increased T2 signal and postcontrast enhancement within the soft tissues surrounding the distal femoral epiphysis with cortical irregularity suggesting additional soft tissue component, which may extend to the joint space, incompletely evaluated. The soft tissue component of the mass extends into abuts adjacent musculature, to include vastus medialis, vastus lateralis, vastus intermedius, and the anterior biceps femoris. The remaining muscles and tendons are intact and unremarkable. CONCLUSION: 1. Aggressive distal left femur neoplasm with cortical destruction and large extraosseous soft tissue component extending into adjacent musculature and abutting the femoral vein. Differential considerations include, primary malignancy and metastatic disease. Biopsy recommended. 2. At the lower limits of study, the lesion extends to the distal femoral epiphysis with adjacent soft tissue component that may extend to the joint space, incompletely evaluated. 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: There is a aggressive marrow replacing lesion involving the mid femoral diaphysis extending inferiorly to involve the distal femoral epiphysis. The largest component of the tumor is fairly homogeneous on T1 signal, more heterogeneous signal at its most cranial and caudal margins. The lesion involves a length of the femur 25.5 cm in the craniocaudal dimension. There is destruction of the posterolateral aspect of the mid femoral diaphyseal cortex with extension through to the cortex with surrounding soft tissue component and enhancing periosteal reaction. The largest extraosseous soft tissue component measures approximately 3.4 x 5.4 x 8.3 cm (image 36, series 38; image 18, series 39). Central areas of nonenhancement and increased T2 signal suggest necrosis. The soft tissue mass abuts the neurovascular bundle of the distal thigh (image 35, series 38). Additionally, at the lower limits of study, there is increased T2 signal and postcontrast enhancement within the soft tissues surrounding the distal femoral epiphysis with cortical irregularity suggesting additional soft tissue component, which may extend to the joint space, incompletely evaluated. The soft tissue component of the mass extends into abuts adjacent musculature, to include vastus medialis, vastus lateralis, vastus intermedius, and the anterior biceps femoris. The remaining muscles and tendons are intact and unremarkable.
|
FINDINGS: RAPID images demonstrate CBF less than 30% volume: 0 mL and T. Max greater than 6seconds volume: 0 mL. Mismatch volume is 0 mL. There is no abnormal MTT, T max, CBV and CBF to suggest significant ischemia or infarction at the territory of the major intracranial arteries.
|
16,410 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Previously biopsied right thigh sarcoma. COMPARISON: 8/9/2021 TECHNIQUE: Outside MR images of the right femur without and with intravenous contrast dated 1/10/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: Large enhancing soft tissue mass encasing the mid/distal femur has increased in size since 8/9/2021, measuring approximately 8.2 x 11.0 x 14.5 cm (image 43, series 900; image 24, series 800), previously measuring approximately 5.6 x 8.8 x 11.6 cm. The mass demonstrates heterogeneous increased T2 signal with hypointense T1 signal as well as heterogeneous postcontrast enhancement. There are multiple large areas of cortical destruction. The mass abuts the superficial femoral artery and vein without encasement. Status post total knee arthroplasty. Fatty atrophic changes of the vastus medialis and vastus lateralis muscles. The remaining muscles and tendons are intact and unremarkable. CONCLUSION: 1. Interval increased size of the known high-grade sarcoma involving the mid/distal femur with large soft tissue component. The mass abuts the superficial femoral artery and vein. 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: Large enhancing soft tissue mass encasing the mid/distal femur has increased in size since 8/9/2021, measuring approximately 8.2 x 11.0 x 14.5 cm (image 43, series 900; image 24, series 800), previously measuring approximately 5.6 x 8.8 x 11.6 cm. The mass demonstrates heterogeneous increased T2 signal with hypointense T1 signal as well as heterogeneous postcontrast enhancement. There are multiple large areas of cortical destruction. The mass abuts the superficial femoral artery and vein without encasement. Status post total knee arthroplasty. Fatty atrophic changes of the vastus medialis and vastus lateralis muscles. The remaining muscles and tendons are intact and unremarkable.
|
FINDINGS: STRUCTURED REPORT: CT CAP CT Chest findings are reported separately. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: Probable small gallstone. No pericholecystic inflammation. PANCREAS: Subtle area of abnormally increased enhancement measures 2.4 x 1.6 cm on axial series 4, image 215. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Heterogeneously enhancing structure near the gastric fundus measures approximately 2.6 x 2.4 cm on axial series 4, image 164. No other suspicious lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Residual oral contrast is seen within the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered calcifications of the abdominal aorta, internal, and femoral arteries. URINARY BLADDER: Collapsed around Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Edema of the bilateral flanks. MUSCULOSKELETAL: Mild degenerative changes of the lumbar spine. No acute abnormality.
|
16,411 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Flank pain COMPARISON: CT 6/9/2021 TECHNIQUE: Outside CT images without IV contrast dated 1/7/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. 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: Normal. GALLBLADDER: Absent. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There is a moderate left hydronephrosis and hydroureter with a 4 mm obstructing calculus at the left vesicoureteric junction (series 2 image 81). No intrarenal calculi are identified. The right kidney is significantly atrophic compared to the left without hydronephrosis. There are postsurgical changes adjacent to the superior pole right kidney as well as areas of renal parenchymal scarring. 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: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Obstructing 4 mm calculus at the left vesicoureteric junction with resulting moderate obstructive features on the left. 2. Additional, nonacute findings as detailed in the report. 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: IMAGE QUALITY: Satisfactory. 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: Normal. GALLBLADDER: Absent. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There is a moderate left hydronephrosis and hydroureter with a 4 mm obstructing calculus at the left vesicoureteric junction (series 2 image 81). No intrarenal calculi are identified. The right kidney is significantly atrophic compared to the left without hydronephrosis. There are postsurgical changes adjacent to the superior pole right kidney as well as areas of renal parenchymal scarring. 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: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left basilar atelectasis. No suspicious pulmonary nodule. No focal consolidation, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. Right IJ approach venous catheter in place with tip in the distal SVC. MEDIASTINUM / ESOPHAGUS: Wall thickening of the distal esophagus with possible solid mass corresponding to the known biopsy-proven malignancy measuring approximately 1.9 x 1.4 cm (axial series 4, image 143). The mediastinum is otherwise unremarkable. LYMPH NODES: None enlarged. CHEST WALL: Trace nonspecific soft tissue emphysema in the left chest wall/axilla. No other significant abnormality. UPPER ABDOMEN: Please see separately dictated CT abdomen and pelvis report. MUSCULOSKELETAL: Partially visualized cervical fixation hardware. No aggressive osseous lesion.
|
16,412 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 36-year-old female with pelvic mass. COMPARISON: CTA abdomen pelvis 12/6/2021. TECHNIQUE: Outside CT images without IV contrast dated 1/10/2022 were submitted for interpretation. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar atelectasis left greater than right. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Prosthetic aortic valve. ABDOMEN and PELVIS: LIVER: Normal for technique BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique SPLEEN: Normal for technique. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is normal. PERITONEUM / MESENTERY: Interval development of heterogeneity of the omentum and small volume ascites. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Redemonstration of a large multicystic multiseptated lesion with coarse septal calcifications centered within the left adnexa measuring approximately 15.7 x 10.7 cm (series 2 image 65) previously 14.6 x 11.0 cm. There is a pedunculated uterus with bulky masses, likely representing fibroids. There is an additional cystic lesion located more posteriorly that measures 4.8 x 4.0 cm (series 2 image 71), previously 4.7 x 3.2 cm measured retrospectively. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most prominent at L5-S1. Bilateral pars defects with grade 1 anterolisthesis of L5 on S1. CONCLUSION: Interval development of small volume ascites and suspected peritoneal carcinomatosis. Similar size and appearance of the large left ovarian cystic lesion, suggestive of an mucinous ovarian neoplasm, and additional right adnexal cystic lesion. 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar atelectasis left greater than right. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Prosthetic aortic valve. ABDOMEN and PELVIS: LIVER: Normal for technique BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique SPLEEN: Normal for technique. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is normal. PERITONEUM / MESENTERY: Interval development of heterogeneity of the omentum and small volume ascites. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Redemonstration of a large multicystic multiseptated lesion with coarse septal calcifications centered within the left adnexa measuring approximately 15.7 x 10.7 cm (series 2 image 65) previously 14.6 x 11.0 cm. There is a pedunculated uterus with bulky masses, likely representing fibroids. There is an additional cystic lesion located more posteriorly that measures 4.8 x 4.0 cm (series 2 image 71), previously 4.7 x 3.2 cm measured retrospectively. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most prominent at L5-S1. Bilateral pars defects with grade 1 anterolisthesis of L5 on S1.
|
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Evaluation is slightly compromised by respiratory motion artifacts. Small to moderate bilateral pleural effusions with adjacent atelectatic changes are relatively stable. Right upper lobe and right middle lobe nondependent air space opacities are relatively unchanged. HEART / VESSELS: Redemonstration of mild cardiomegaly. Signs of anemia. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Unremarkable. LYMPH NODES: Prominent paracardiac lymph nodes appear unchanged and may be reactive. CHEST WALL: Asymmetric mild right gynecomastia. ABDOMEN and PELVIS: LIVER: Redemonstrated cirrhotic morphology of the liver. Small low-attenuation lesion in the right lobe of the liver is unchanged and is small to characterize. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Spleen is borderline enlarged at 13.6 cm. ADRENALS: Normal. KIDNEYS: Nonobstructing left renal lower pole calculus measuring 0.4 x 0.8 cm. LYMPH NODES: Prominent porta hepatis and retroperitoneal lymph nodes, likely related to the underlying liver disease. STOMACH / SMALL BOWEL: Feeding tube terminates in the distal duodenum. COLON / APPENDIX: A few scattered colonic diverticula without acute inflammatory changes. PERITONEUM / MESENTERY: Large volume ascites. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Bladder is decompressed by a Foley catheter. Gas within the bladder likely secondary to instrumentation. REPRODUCTIVE ORGANS: Dense prosthetic calcifications again seen. Fluid in the right inguinal region versus an undescended right testis. BODY WALL: Anasarca. MUSCULOSKELETAL: No significant abnormality.
|
16,413 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Sarcoma COMPARISON: None. TECHNIQUE: Outside CT images abdomen and pelvis dated 01/04/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small subcentimeter noncalcified nodules in the lingular segment and left lower lobe, are slightly enlarged compared to prior CT. A new subcentimeter nodule in the right middle lobe (on series 2/image 5). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Mild dilatation of intra and extrahepatic bile ducts. No obstructing radiopaque gallstone seen. GALLBLADDER: Absent. PANCREAS: Fatty atrophy of pancreas. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Several subcentimeter nonspecific retroperitoneal lymph nodes. There is a mildly enlarged right lateral pelvic sidewall lymph node measures 1.8 x 1.4 cm (series 2/image 158). STOMACH / SMALL BOWEL: Stomach and duodenum are partially distended. There is no abnormal dilatation of small bowel loops. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially distended REPRODUCTIVE ORGANS: Surgically absent uterus. No adnexal solid masses or pelvic fluid collection. BODY WALL: Moderate-sized fat-containing umbilical hernia. MUSCULOSKELETAL: Lumbar vertebrae demonstrate normal height and multilevel mild degenerative changes. CONCLUSION: 1.. Mildly enlarged nonspecific right lateral pelvic sidewall lymph node. Additional scattered subcentimeter retroperitoneal and inguinal lymph nodes are nonspecific. 2. No metastatic disease in the abdomen and pelvis. 3. Tiny noncalcified lung nodules, stable to mildly enlarged in size compared to prior chest CT 11/29/2021. A new tiny right lung base nodule. 4. Other incidental findings as described above.
|
FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small subcentimeter noncalcified nodules in the lingular segment and left lower lobe, are slightly enlarged compared to prior CT. A new subcentimeter nodule in the right middle lobe (on series 2/image 5). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Mild dilatation of intra and extrahepatic bile ducts. No obstructing radiopaque gallstone seen. GALLBLADDER: Absent. PANCREAS: Fatty atrophy of pancreas. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Several subcentimeter nonspecific retroperitoneal lymph nodes. There is a mildly enlarged right lateral pelvic sidewall lymph node measures 1.8 x 1.4 cm (series 2/image 158). STOMACH / SMALL BOWEL: Stomach and duodenum are partially distended. There is no abnormal dilatation of small bowel loops. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially distended REPRODUCTIVE ORGANS: Surgically absent uterus. No adnexal solid masses or pelvic fluid collection. BODY WALL: Moderate-sized fat-containing umbilical hernia. MUSCULOSKELETAL: Lumbar vertebrae demonstrate normal height and multilevel mild degenerative changes.
|
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Evaluation is slightly compromised by respiratory motion artifacts. Small to moderate bilateral pleural effusions with adjacent atelectatic changes are relatively stable. Right upper lobe and right middle lobe nondependent air space opacities are relatively unchanged. HEART / VESSELS: Redemonstration of mild cardiomegaly. Signs of anemia. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Unremarkable. LYMPH NODES: Prominent paracardiac lymph nodes appear unchanged and may be reactive. CHEST WALL: Asymmetric mild right gynecomastia. ABDOMEN and PELVIS: LIVER: Redemonstrated cirrhotic morphology of the liver. Small low-attenuation lesion in the right lobe of the liver is unchanged and is small to characterize. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Spleen is borderline enlarged at 13.6 cm. ADRENALS: Normal. KIDNEYS: Nonobstructing left renal lower pole calculus measuring 0.4 x 0.8 cm. LYMPH NODES: Prominent porta hepatis and retroperitoneal lymph nodes, likely related to the underlying liver disease. STOMACH / SMALL BOWEL: Feeding tube terminates in the distal duodenum. COLON / APPENDIX: A few scattered colonic diverticula without acute inflammatory changes. PERITONEUM / MESENTERY: Large volume ascites. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Bladder is decompressed by a Foley catheter. Gas within the bladder likely secondary to instrumentation. REPRODUCTIVE ORGANS: Dense prosthetic calcifications again seen. Fluid in the right inguinal region versus an undescended right testis. BODY WALL: Anasarca. MUSCULOSKELETAL: No significant abnormality.
|
16,414 |
Interpretation of Outside Films CT Chest Clinical Information: Spec Inst: OVARIAN CA CTA CHEST 1722 OUTSIDE REC 11222 Study reviewed: CTA of the chest with contrast 1/8/2022 performed at St. Vincent's East. The images are available in PACS. Please note the examination was performed outside of UAB protocol, monitoring and oversight. Thin slice images were performed, but only through the mediastinal structures. Complete chest images were performed using 5 mm images which can limit sensitivity for small abnormalities. Findings: Comparison, 9/22/2021. Lead less pacemaker is present. Small-moderate quantity of PTE in the lingula and left lower lobe. The main pulmonary artery measures 3.4 cm, motion artifact limiting fine detail. It measures approximately 3.0 cm on the previous. No convincing evidence of right heart strain. New large right pleural effusion is present with complete middle and right lower lobe atelectasis and dependent atelectasis in the right upper lobe. Heterogeneous density left upper lobe opacity is located peripherally. Pleural-based and somewhat wedge-shaped on the coronally reformatted images, this could represent a small focus of pneumonia or a small infarction from PTE too small and peripheral to visualize. No axillary adenopathy. A few small mediastinal lymph nodes have a similar appearance. No destructive osseous lesions. Right-sided port tip terminates in the SVC. Included portions of the upper abdomen show an enlarged subcapsular right hepatic lobe lesion around image 44 series 5 and a larger left hepatic lobe lesion around image 49. Conclusion: 1. Small-moderate quantity of PTE in the lingula and left lower lobe. A peripheral heterogeneous left apical opacity could represent a small region of infection or small pulmonary infarction. 2. New large right pleural effusion with complete middle and right lower lobe atelectasis. 3. Hepatic lesions are larger compared to the previous 9/22/2021.
|
Findings: Comparison, 9/22/2021. Lead less pacemaker is present. Small-moderate quantity of PTE in the lingula and left lower lobe. The main pulmonary artery measures 3.4 cm, motion artifact limiting fine detail. It measures approximately 3.0 cm on the previous. No convincing evidence of right heart strain. New large right pleural effusion is present with complete middle and right lower lobe atelectasis and dependent atelectasis in the right upper lobe. Heterogeneous density left upper lobe opacity is located peripherally. Pleural-based and somewhat wedge-shaped on the coronally reformatted images, this could represent a small focus of pneumonia or a small infarction from PTE too small and peripheral to visualize. No axillary adenopathy. A few small mediastinal lymph nodes have a similar appearance. No destructive osseous lesions. Right-sided port tip terminates in the SVC. Included portions of the upper abdomen show an enlarged subcapsular right hepatic lobe lesion around image 44 series 5 and a larger left hepatic lobe lesion around image 49.
|
Findings: Images are slightly degraded due to motion. There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Evaluation of posterior fossa is limited. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal.
|
16,415 |
Right femur CT: Indication: Interpretation outside study, femur fracture evaluation Images: Images are submitted from St. Vincent's Hospital ED. Images are dated 1/9/2022. Axial images are provided along with coronal and sagittal reformats. Findings: There is a comminuted fracture of the distal femoral metaphysis. The major distal fragments are displaced posteriorly and proximally impacted. There is a minimally displaced fracture line extending into the knee joint through the intercondylar notch. The articular surfaces of the medial and lateral femoral condyles are intact. There is no patellar fracture. The proximal tibia and fibula are unremarkable. There is moderate degenerative change of the medial tibiofemoral compartment. Impression: Comminuted, moderately displaced fracture of the distal femoral metaphysis with intra-articular extension through the femoral notch.
|
Findings: There is a comminuted fracture of the distal femoral metaphysis. The major distal fragments are displaced posteriorly and proximally impacted. There is a minimally displaced fracture line extending into the knee joint through the intercondylar notch. The articular surfaces of the medial and lateral femoral condyles are intact. There is no patellar fracture. The proximal tibia and fibula are unremarkable. There is moderate degenerative change of the medial tibiofemoral compartment.
|
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Postsurgical changes from bilateral lung transplant without significant narrowing at the tracheal anastomosis. Tracheobronchial tree is patent. No focal consolidation. Interval resolution of the previously seen nodular opacity in the lingula. Unchanged 5 mm pulmonary nodule in the periphery of the left lower lobe (series 2, image 59). No new suspicious pulmonary nodule or mass. No pleural effusions or pneumothorax. HEART / VESSELS: Postsurgical changes from heart transplant. Heart size is normal. No pericardial effusion. The main pulmonary artery and thoracic aorta are normal in caliber. MEDIASTINUM / ESOPHAGUS: Postsurgical changes to the anterior mediastinum. No significant abnormality in the thoracic esophagus. LYMPH NODES: None enlarged. CHEST WALL: Multiple surgical clips in the right axilla. UPPER ABDOMEN: Left renal atrophy. No other significant abnormality in the visualized soft tissue structures of the upper abdomen. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Postsurgical changes from median sternotomy with intact sternal wires.
|
16,416 |
EXAM: Interpretation of Outside Films CT CSPN HISTORY: 50 years-old Female with Spec Inst: CT C-SPINE 010822 REC 011222 MEDICALF WEST TECHNIQUE: Outside CT images of the cervical spine without contrast dated 1/8/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. COMPARISON: None FINDINGS: Craniocervical junction is normal. No acute cervical spine fractures. Grade 1 anterolisthesis of C3 on C4 and grade 1 retrolisthesis of C5 on C6, likely degenerative. No acute alignment abnormality. Cervical vertebral heights are within normal limits. Normal osseous mineralization. Atherosclerotic calcifications of the neck vasculature. Multiple thyroid hypoattenuating lesions, some of which demonstrate calcifications. Largest in the lower right lobe of thyroid measuring approximately 1.9 x 1.4 cm, may require further evaluation with thyroid ultrasound. Otherwise pre and paravertebral soft tissues in the neck are unremarkable. Multilevel degenerative changes in the cervical spine are described on a level by level basis below. C2-3: No significant abnormality. C3-4: Small posterior disc bulge. Otherwise, no significant abnormality. C4-5: No significant abnormality. C5-6: Disc space loss. Diffuse posterior disc bulge. Mild spinal canal stenosis. Bilateral uncovertebral hypertrophy. Mild bilateral neural foraminal stenosis. Mild bilateral facet arthropathy. C6-7: Small posterior disc bulge. Mild right uncovertebral hypertrophy and mild right neural foraminal stenosis. Mild bilateral facet arthropathy. C7-T1: No significant abnormality. Miscellaneous: Visualized upper chest is unremarkable. Visualized portions of the intracranial compartment are unremarkable. Visualized portions of bilateral orbits are unremarkable. Chronic right sphenoid sinusitis with central high attenuation, which are likely inspissated secretions versus fungal elements. IMPRESSION: 1. Mild multilevel degenerative changes of the cervical spine, most prominent at C5-C6 level as described above. No acute fracture or acute alignment abnormality of the cervical spine. 2. Multiple thyroid nodules. Further evaluation with thyroid ultrasound is suggested on an nonemergent outpatient basis. 3. Other chronic findings as described above.
|
FINDINGS: Craniocervical junction is normal. No acute cervical spine fractures. Grade 1 anterolisthesis of C3 on C4 and grade 1 retrolisthesis of C5 on C6, likely degenerative. No acute alignment abnormality. Cervical vertebral heights are within normal limits. Normal osseous mineralization. Atherosclerotic calcifications of the neck vasculature. Multiple thyroid hypoattenuating lesions, some of which demonstrate calcifications. Largest in the lower right lobe of thyroid measuring approximately 1.9 x 1.4 cm, may require further evaluation with thyroid ultrasound. Otherwise pre and paravertebral soft tissues in the neck are unremarkable. Multilevel degenerative changes in the cervical spine are described on a level by level basis below. C2-3: No significant abnormality. C3-4: Small posterior disc bulge. Otherwise, no significant abnormality. C4-5: No significant abnormality. C5-6: Disc space loss. Diffuse posterior disc bulge. Mild spinal canal stenosis. Bilateral uncovertebral hypertrophy. Mild bilateral neural foraminal stenosis. Mild bilateral facet arthropathy. C6-7: Small posterior disc bulge. Mild right uncovertebral hypertrophy and mild right neural foraminal stenosis. Mild bilateral facet arthropathy. C7-T1: No significant abnormality. Miscellaneous: Visualized upper chest is unremarkable. Visualized portions of the intracranial compartment are unremarkable. Visualized portions of bilateral orbits are unremarkable. Chronic right sphenoid sinusitis with central high attenuation, which are likely inspissated secretions versus fungal elements.
|
FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Trachea and central airways are patent. 2 masses are noted within the left upper and left lower lobes one of which is subpleural and measures 3.2 x 1.8 cm on axial series 401 image 73. Dependent bilateral atelectasis. No pleural effusion or pneumothorax. There is apical predominant paraseptal emphysema. HEART / OTHER VESSELS: Minimal coronary vascular calcifications. Moderate atherosclerosis in the aorta extending to the origins of the diverticulosis. Main pulmonary artery is dilated measuring 3.7 cm MEDIASTINUM / ESOPHAGUS: Moderately sized hiatal hernia. LYMPH NODES: Multiple enlarged mediastinal and hilar lymph nodes. The largest of these nodal complexes within the right hilum and measures 2.3 x 2.2 cm on axial series 401 image 55. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Within the pancreatic head. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing left inferior pole renal calculus measuring 5 mm. The kidneys are otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is normal. The colon is normal, aside from scattered diverticulosis, in its visualized portions of significant beam hardening artifact in the lower pelvis obscures the distal sigmoid and rectum. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: Scattered vascular calcifications. Replaced right hepatic artery arising from the SMA. URINARY BLADDER: Suspected anterior bladder diverticulum. REPRODUCTIVE ORGANS: The pelvis is obscured by significant beam hardening artifact. BODY WALL: Postsurgical changes of prior hernia repair with mild rectus diastases. MUSCULOSKELETAL: Bilateral hip arthroplasty hardware. Heterotopic ossification associated with the iliac crests. Advanced degenerative change throughout the thoracolumbar spine with lower lumbar spine facet arthropathy. Technically age indeterminate anterior wedging of the L1 vertebral body. Multilevel anterior bridging osteophytes with maintenance of the disc spaces suggestive of DISH. Lower thoracic spine Baastrup's disease. Left anterior chronic rib deformities.
|
16,417 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 51-year-old female with history of endometrial cancer; follow-up. COMPARISON: Multiple prior CTs of the abdomen pelvis, most recently 11/23/2021 TECHNIQUE: Outside CT images without and with IV contrast dated 1/5/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis versus scarring. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Interval development of a large hypoenhancing hepatic mass centered near the caudate/central liver and measuring approximately 7.8 x 6.5 cm on axial series 4, image 51. Multiple additional new subcentimeter hypoattenuating lesions throughout the liver, most numerous in the left hepatic lobe. BILIARY TRACT: Moderate segmental biliary ductal dilatation involving portions of the left hepatic lobe. Extrahepatic bile ducts are normal caliber. GALLBLADDER: Nondistended with wall thickening versus pericholecystic fluid. No radiopaque stones. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Interval development of multiple enlarged, morphologically abnormal retroperitoneal and periportal lymph nodes. Large precaval nodal conglomerate measures approximately 6.4 x 3.2 cm on axial series 4, image 82. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Interval development of extensive retroperitoneal and periportal lymphadenopathy with large, dominant hepatic lesion as described above at multiple additional subcentimeter hypoattenuating lesions scattered throughout the liver. Overall appearance is consistent with metastatic disease. 2. Segmental intrahepatic biliary ductal dilatation involving portions of the left hepatic lobe, secondary to obstruction from the central hepatic mass described above. 3. Gallbladder wall thickening versus pericholecystic fluid. Gallbladder is nondistended and no stones seen. Findings are nonspecific but may be related to passive congestion.
|
FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis versus scarring. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Interval development of a large hypoenhancing hepatic mass centered near the caudate/central liver and measuring approximately 7.8 x 6.5 cm on axial series 4, image 51. Multiple additional new subcentimeter hypoattenuating lesions throughout the liver, most numerous in the left hepatic lobe. BILIARY TRACT: Moderate segmental biliary ductal dilatation involving portions of the left hepatic lobe. Extrahepatic bile ducts are normal caliber. GALLBLADDER: Nondistended with wall thickening versus pericholecystic fluid. No radiopaque stones. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Interval development of multiple enlarged, morphologically abnormal retroperitoneal and periportal lymph nodes. Large precaval nodal conglomerate measures approximately 6.4 x 3.2 cm on axial series 4, image 82. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant 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 Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Innumerable centrilobular groundglass and more dense nodules bilaterally, predominantly in the lower lobes may represent atypical infection/bronchiolitis versus aspiration. More dense airspace opacity in the medial segment of the middle lobe and at the right lung base is likely also related. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Mildly nodular surface of the liver could represent chronic liver disease. MUSCULOSKELETAL: No significant abnormality.
|
16,418 |
Interpretation of Outside Films MR Head 1/13/2022 10:01 AM Clinical Information: TMJ arthritis Comparison: CT temporal bone dated 1/3/2022, MRI 10/20/2021, 3/20/2021 Technique: Multiplanar multisequence pre and postcontrast MRI images of the brain from East Alabama Healthcare examination dated 1/6/2022. Images include sagittal T1, axial T2 FLAIR, axial diffusion-weighted, axial T1, axial SWI, coronal T2, axial T2 space, postcontrast axial T1, sagittal T1 and coronal T1. Please note the examination was performed outside of UAB protocol, monitoring and oversight. There are associated diagnostic limitations which should be considered prior to implementation of clinical decisions. This study interpretation should be correlated with outside imaging interpretation as transfer of data via media other than direct line may cause compression and degradation of imaging data. Findings: Redemonstration of advanced degenerative change of the right temporomandibular joint with large surrounding effusion displaying peripheral enhancement. Area of bony dehiscence of the right middle cranial fossa extending into the temporal mandibular joint is redemonstrated however better visualized on CT. There is a focal extra-axial fluid collection anterior to this defect within the floor of the right middle cranial fossa best seen on series 13 image 8. This collection also displays peripheral enhancement, focal enhancement is noted within the skull base defect. There is no restricted diffusion in these collections. No intracranial mass, mass effect, edema, hemorrhage, hydrocephalus, or evidence of acute infarction. Age-appropriate cerebral volume. Trace microhemorrhage. Focal area of increased FLAIR signal within the right frontal periventricular white matter and basal ganglia is most suggestive of chronic microangiopathy. Major vascular flow voids are unremarkable. No abnormal enhancement. Minimal mucosal thickening of the ethmoid and frontal sinuses, moderate size bilateral mastoid effusions are present. Impression: Redemonstration of focal skull base defect within the right middle cranial fossa secondary to severe degenerative change of the right temporal mandibular joint. There is a large joint effusion with synovial inflammation which appears to extend cranially into the skull base defect into the overlying extra-axial space at the floor of the right middle cranial fossa. Findings appear relatively unchanged since MRI October 2021. 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: Redemonstration of advanced degenerative change of the right temporomandibular joint with large surrounding effusion displaying peripheral enhancement. Area of bony dehiscence of the right middle cranial fossa extending into the temporal mandibular joint is redemonstrated however better visualized on CT. There is a focal extra-axial fluid collection anterior to this defect within the floor of the right middle cranial fossa best seen on series 13 image 8. This collection also displays peripheral enhancement, focal enhancement is noted within the skull base defect. There is no restricted diffusion in these collections. No intracranial mass, mass effect, edema, hemorrhage, hydrocephalus, or evidence of acute infarction. Age-appropriate cerebral volume. Trace microhemorrhage. Focal area of increased FLAIR signal within the right frontal periventricular white matter and basal ganglia is most suggestive of chronic microangiopathy. Major vascular flow voids are unremarkable. No abnormal enhancement. Minimal mucosal thickening of the ethmoid and frontal sinuses, moderate size bilateral mastoid effusions are present.
|
Findings: Enlarged multi nodular thyroid with large nodular extension to the posterior mediastinum. 1.7 cm hypoattenuating nodule in the lower pole. The remainder of the neck soft tissues are normal. No acute fracture.
|
16,419 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Prostate lesion COMPARISON: None. TECHNIQUE: Outside MR images without and with IV contrast dated 1/3/2020 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: STRUCTURED REPORT: MRI Pelvis LOWER ABDOMEN: BOWEL: There is near circumferential wall thickening of the colon at the rectosigmoid junction measuring approximately 4.7 cm in length. This tumor likely straddles or is above the anterior peritoneal reflection, though local staging is difficult due to large field of view. Small rounded adjacent mesorectal lymph node (series 9, image five). PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Abnormal focal T2 hypointense signal in the left peripheral zone of the mid prostate measuring approximately 1.6 x 1.8 cm (series 5, image 9). Unable to a side a PI-RADs score due to lack of diffusion-weighted sequences. Mild prostatomegaly with bulging of the median lobe of the prostate into the posterior bladder wall. BODY WALL: Fat-containing left inguinal hernia. Fat-containing right lumbar hernia. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Suspicious appearing prostate lesion in the left mid peripheral zone, unable to be completely evaluated due to nondedicated protocol. Recommend correlation with PSA and consideration of dedicated prostate protocol MRI as clinically indicated. 2. High rectal versus sigmoid colonic mass, with difficulty assessing the relationship to anterior peritoneal reflection due to suboptimal imaging parameters/large field of view. 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: MRI Pelvis LOWER ABDOMEN: BOWEL: There is near circumferential wall thickening of the colon at the rectosigmoid junction measuring approximately 4.7 cm in length. This tumor likely straddles or is above the anterior peritoneal reflection, though local staging is difficult due to large field of view. Small rounded adjacent mesorectal lymph node (series 9, image five). PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Abnormal focal T2 hypointense signal in the left peripheral zone of the mid prostate measuring approximately 1.6 x 1.8 cm (series 5, image 9). Unable to a side a PI-RADs score due to lack of diffusion-weighted sequences. Mild prostatomegaly with bulging of the median lobe of the prostate into the posterior bladder wall. BODY WALL: Fat-containing left inguinal hernia. Fat-containing right lumbar hernia. MUSCULOSKELETAL: No significant abnormality.
|
Findings: There is evidence of dense supraclinoid ICA associated with a dense MCA with extension to distal MCA branches in favor of residual thrombosis. There is a large infarcted area involving the left frontoparietotemporal region in the territory of MCA cortical branches which has caused mass effect on the left lateral ventricle and about 2 mm left-to-right midline shift. No space-occupying hematoma is seen. The visualized paranasal sinuses and mastoid air cells are clear. Partial opacification of ethmoidal air cells is noted. No acute osseous or soft tissue abnormality seen.
|
16,420 |
EXAM: Interpretation of Outside Films CT Chest CLINICAL INFORMATION: Bladder cancer COMPARISON: None. TECHNIQUE: Outside CT images with IV contrast dated 1/7/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to clinical decision making. FINDINGS: LINES AND TUBES: Right-sided Mediport terminates in the right atrium. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Benign perifissural nodule along the major fissure on series 5 image #278 faint ground glass opacity in the right upper lobe and left upper lobe which are likely infectious or inflammatory in nature. Right lower lobe calcified granuloma. No pneumothorax or effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Calcified right hilar and subcarinal lymph nodes. None enlarged by CT criteria. CHEST WALL: No significant abnormality. UPPER ABDOMEN: See separate abdominal dictation. MUSCULOSKELETAL: No significant abnormality. No destructive osseous lesions. IMPRESSION: 1. No evidence of intrathoracic metastatic disease. 2. Minimal faint areas of groundglass opacity in the upper lobes anteriorly which is likely infectious or inflammatory in nature. 3. Old granulomatous disease. 4. See separate abdominal dictation.
|
FINDINGS: LINES AND TUBES: Right-sided Mediport terminates in the right atrium. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Benign perifissural nodule along the major fissure on series 5 image #278 faint ground glass opacity in the right upper lobe and left upper lobe which are likely infectious or inflammatory in nature. Right lower lobe calcified granuloma. No pneumothorax or effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Calcified right hilar and subcarinal lymph nodes. None enlarged by CT criteria. CHEST WALL: No significant abnormality. UPPER ABDOMEN: See separate abdominal dictation. MUSCULOSKELETAL: No significant abnormality. No destructive osseous lesions.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Advanced centrilobular emphysematous changes. Mild dependent atelectatic changes. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Heart size is normal. No pericardial effusion. Dense mitral annular calcifications. ABDOMEN and PELVIS: LIVER: Scattered tiny calcified granulomata. Unchanged subcentimeter hypoattenuating lesions in the inferior right hepatic lobe and perihilar left hepatic lobe, too small to characterize but likely cysts. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal in size. Scattered tiny calcified granulomata. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhanced. Bilateral renal cysts. Additional hypoattenuating lesion in the left kidney is too small to characterize, but is statistically likely a cyst. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No significant abnormality in the stomach or small bowel. No intraluminal contrast extravasation is identified. COLON / APPENDIX: No significant abnormality in the colon. The appendix is not definitely visualized. No intraluminal contrast extravasation is identified. The median (around a year is a peripherally taken care of the patient was cannulated about the no free intracranial fluid. No pneumoperitoneum. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: Advanced aortoiliac calcific atherosclerosis mild atheromatous narrowing of the SMA at its origin with maintained distal contrast opacification. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Coarsely calcified fibroid at the fundus. Redemonstration of circumscribed ovoid hypodensity at the fundus with interspersed internal areas of relative hyperattenuation, possibly within the endometrial cavity, measuring 4.5 x 4.0 cm) series 601, image 188) BODY WALL: No significant abnormality. MUSCULOSKELETAL: Osseous mineralization is diffusely decreased. Chronic anterior wedge compression deformity of the T12 vertebral body, unchanged. Similar appearance of linear band of sclerosis in the right femoral neck and proximal diaphysis. No new abnormality.
|
16,421 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 47-year-old male with bladder cancer. COMPARISON: None available. TECHNIQUE: Outside CT images with IV contrast dated 1/7/2022 were submitted for interpretation. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Subcentimeter hypodensity within the right hepatic lobe is too small to characterize; however, statistically represents a cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Prior granulomatous disease. ADRENALS: The right adrenal gland is unremarkable. Left adrenal nodule measuring 1.9 x 1.8 cm (series 6 image 59). KIDNEYS: No renal calculi or hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: There is a large, heterogeneously enhancing and lobulated lesion extending into the bladder lumen from the left lateral measuring approximately 5.2 x 5.0 cm (series 2 image 216). REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes. No aggressive osseous lesions. CONCLUSION: 1. Large, heterogeneously enhancing lesion arising from the left bladder wall and extending into the bladder lumen, consistent with the patient's known diagnosis of malignancy. No definite evidence of metastatic disease. 2. Indeterminate left adrenal nodule measuring up to 1.9 cm. This can be further evaluated with adrenal protocol 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Subcentimeter hypodensity within the right hepatic lobe is too small to characterize; however, statistically represents a cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Prior granulomatous disease. ADRENALS: The right adrenal gland is unremarkable. Left adrenal nodule measuring 1.9 x 1.8 cm (series 6 image 59). KIDNEYS: No renal calculi or hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: There is a large, heterogeneously enhancing and lobulated lesion extending into the bladder lumen from the left lateral measuring approximately 5.2 x 5.0 cm (series 2 image 216). REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes. No aggressive osseous lesions.
|
FINDINGS: There is no evidence of acute ischemia, intracranial hemorrhage, or intracranial mass. The ventricles and basal cisterns are unremarkable. The orbits are normal in appearance. The paranasal sinuses, including the mastoid air cells, are clear. The visualized extra-cranial soft tissues are unremarkable. No acute fracture or suspicious osseous lesion is identified.
|
16,422 |
Interpretation of Outside Films CT Chest Clinical Information: 63-year-old female with colon cancer. Comparison: Outside CT chest dated 9/7/2021. Technique: CT chest, abdomen and pelvis with contrast was obtained on 11/30/2021 at 1020 and since Birmingham, 2 mm axial, coronal and sagittal reformats, with 5 mm axial reformats are available at the time of interpretation. Findings: STRUCTURED REPORT: CT Chest LOWER NECK: Mildly heterogeneous thyroid gland. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Interval development of mixed attenuation groundglass opacities in the left upper lobe, with a new small volume left pleural effusion with adjacent atelectasis. Minimal atelectasis/scarring in the right lung base. No suspicious pulmonary nodule. HEART / VESSELS: The right IJ approach portacatheter terminates at the cavoatrial junction. Atria appear prominent. No central PE. MEDIASTINUM / ESOPHAGUS: Lower esophageal varices are again seen. LYMPH NODES: Subcentimeter right internal mammary lymph nodes again seen. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Will be reported separately with large ascites and interval decrease in the size of heterogeneous large right hepatic lobe metastasis. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No evidence of intrathoracic metastasis. 2. Interval development of mixed attenuation left upper lobe opacities represent pneumonia/inflammatory process. 3. New small volume left pleural effusion and other incidental findings as above. 'd, Jan 2022 'd, Jan 2022
|
Findings: STRUCTURED REPORT: CT Chest LOWER NECK: Mildly heterogeneous thyroid gland. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Interval development of mixed attenuation groundglass opacities in the left upper lobe, with a new small volume left pleural effusion with adjacent atelectasis. Minimal atelectasis/scarring in the right lung base. No suspicious pulmonary nodule. HEART / VESSELS: The right IJ approach portacatheter terminates at the cavoatrial junction. Atria appear prominent. No central PE. MEDIASTINUM / ESOPHAGUS: Lower esophageal varices are again seen. LYMPH NODES: Subcentimeter right internal mammary lymph nodes again seen. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Will be reported separately with large ascites and interval decrease in the size of heterogeneous large right hepatic lobe metastasis. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: BRAIN PARENCHYMA: There is no acute intracranial hemorrhage or acute infarct. No brain edema or mass effect. Similar findings of gunshot injury to the head with ballistic fragments scattered in the left parietal lobe and temporal parietal soft tissues. Left frontal temporoparietal craniotomy changes are stable. Stable areas of encephalomalacia in the left posterior frontal, parietal lobes and right frontal lobe. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Stable large defect in the anterior nasal septum.
|
16,423 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Colon cancer COMPARISON: CT abdomen pelvis dated 5/7/2021 TECHNIQUE: Outside CT images with IV contrast dated 11/30/2021 were submitted for interpretation. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Interval development of pseudocirrhosis. Large right hepatic metastasis has decreased in size since the prior exam and now measures approximately 10.0 x 8.3 cm, previously 10.6 x 14.2 cm. The more inferior metastasis is also decreased in size, and no demonstrates less enhancing internal components, suggestive of treatment response. The right portal vein is patent, but attenuated due to the large right hepatic metastasis. No new hepatic metastases are identified. BILIARY TRACT: Normal. GALLBLADDER: The gallbladder is partially collapsed with nonspecific pericholecystic fluid. PANCREAS: Normal. SPLEEN: Borderline enlarged. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small gastric hiatal hernia. Small esophageal varices. COLON / APPENDIX: There is diffuse wall thickening of the colon, possibly related to congestion from portal hypertension. PERITONEUM / MESENTERY: Interval development of large volume ascites. No discrete peritoneal nodularity. RETROPERITONEUM: Normal. VESSELS: Normal. URINARY BLADDER: Obscured by streak artifact from bilateral hip arthroplasties. REPRODUCTIVE ORGANS: Uterus is present. BODY WALL: Diffuse subcutaneous edema, more prominent inferiorly. MUSCULOSKELETAL: Total bilateral hip arthroplasties create streak artifact which obscures the pelvis. No destructive osseous lesion. CONCLUSION: Interval decrease in size of hepatic metastases. Interval development of pseudocirrhosis and portal hypertension with large volume ascites. No discrete peritoneal nodularity. 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. 'd, Jan 2022 'd, Jan 2022
|
FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Interval development of pseudocirrhosis. Large right hepatic metastasis has decreased in size since the prior exam and now measures approximately 10.0 x 8.3 cm, previously 10.6 x 14.2 cm. The more inferior metastasis is also decreased in size, and no demonstrates less enhancing internal components, suggestive of treatment response. The right portal vein is patent, but attenuated due to the large right hepatic metastasis. No new hepatic metastases are identified. BILIARY TRACT: Normal. GALLBLADDER: The gallbladder is partially collapsed with nonspecific pericholecystic fluid. PANCREAS: Normal. SPLEEN: Borderline enlarged. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small gastric hiatal hernia. Small esophageal varices. COLON / APPENDIX: There is diffuse wall thickening of the colon, possibly related to congestion from portal hypertension. PERITONEUM / MESENTERY: Interval development of large volume ascites. No discrete peritoneal nodularity. RETROPERITONEUM: Normal. VESSELS: Normal. URINARY BLADDER: Obscured by streak artifact from bilateral hip arthroplasties. REPRODUCTIVE ORGANS: Uterus is present. BODY WALL: Diffuse subcutaneous edema, more prominent inferiorly. MUSCULOSKELETAL: Total bilateral hip arthroplasties create streak artifact which obscures the pelvis. No destructive osseous lesion.
|
Findings: Interval postsurgical changes from right convexity craniectomy are again noted with a subdural drainage catheter extending along the right frontal convexity. There is decreasing pneumocephalus. Overlying scalp drainage catheter is also noted. There is a persistent large right parafalcine subdural hematoma extending along the right tentorial leaflet. The hemorrhage appears more homogeneous compared to the prior exam with an slightly decreased in maximum diameter measuring 2.3 cm compared to 2.7 cm previously. Small residual component along the right frontal convexity is similar. There is also a small left frontal convexity subdural hemorrhage, and minimal layering hemorrhage along the tentorium. There is generalized sulcal effacement, suggesting diffuse edema There is trace subarachnoid hemorrhage along the left parietal sulci, more pronounced compared to the prior exam. There is overall a 9 mm leftward midline shift, slightly increased from 7 mm previously. Maxillofacial fractures and associated paranasal sinus opacification is again noted.
|
16,424 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Liver metastases COMPARISON: PET/CT dated 11/23/2021 TECHNIQUE: Outside MR images without and with IV contrast dated 1/3/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: STRUCTURED REPORT: MRI Abdomen LOWER CHEST: LUNG BASES / PLEURA: No significant abnormality. DISTAL ESOPHAGUS: No significant abnormality. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Intermediate T2 signal mass in the hepatic dome (segment VIII) measures approximately 2.2 x 2.6 cm. Mild irregular peripheral postcontrast enhancement is seen. This lesion do not demonstrate diffusion restriction. Additionally there is a small T1 hypo intense lesion in the left lobe with diffusion restriction, on series 6/52 measuring 1.4 cm. Enhancement of this lesion was not assessed due to motion artifacts. Additionally there are small simple hepatic cysts. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Several simple bilateral renal cysts. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: Left lower quadrant colostomy noted. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Small hepatic lesions as described above are most concerning metastasis. 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: MRI Abdomen LOWER CHEST: LUNG BASES / PLEURA: No significant abnormality. DISTAL ESOPHAGUS: No significant abnormality. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Intermediate T2 signal mass in the hepatic dome (segment VIII) measures approximately 2.2 x 2.6 cm. Mild irregular peripheral postcontrast enhancement is seen. This lesion do not demonstrate diffusion restriction. Additionally there is a small T1 hypo intense lesion in the left lobe with diffusion restriction, on series 6/52 measuring 1.4 cm. Enhancement of this lesion was not assessed due to motion artifacts. Additionally there are small simple hepatic cysts. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Several simple bilateral renal cysts. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: Left lower quadrant colostomy noted. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis without cholecystitis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Nodular thickening of the left adrenal inferiorly measuring 1.0 x 1.3 x 1.5 cm (series 201 image 87), stable since 2017. KIDNEYS: Stable left upper pole simple renal cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach is unremarkable. Dilation of the small bowel to approximately 5 cm with a transition point within the distal ileum contained within a ventral hernia. The small bowel distal to this is decompressed however fluid and gas is visualized distal to the transition point. COLON / APPENDIX: Cecal resection postsurgical changes. Scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Right abdominal wall ventral hernia with incarcerated loop of ileum. Rectus diastases. MUSCULOSKELETAL: Mild multilevel discogenic degenerative changes in the thoracolumbar spine.
|
16,425 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Abdominal hernia COMPARISON: None. TECHNIQUE: Outside CT images with IV contrast dated 1/10/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Moderate right lower lobe atelectasis. Noncalcified lung nodule measuring approximately 6 x 5 mm at the base of the right upper lobe. Calcified left hilar lymph node and calcified granuloma involving the upper left lower lobe. DISTAL ESOPHAGUS: Small type I hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Mild intrahepatic and extrahepatic ductal dilation. These changes are likely related to postcholecystectomy state. GALLBLADDER: Surgically absent. Small calcified lesion within the gallbladder fossa, possibly representing dropped gallstone or postsurgical change. No surrounding inflammation. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mildly lobulated bilaterally. Mild bilateral pelviectasis. There are tiny punctate calcifications within the right lower pole, likely nonobstructing renal stones. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes related to Roux-en-Y gastric bypass. Jejunojejunal anastomosis is seen within the mid abdomen and is within normal limits. COLON / APPENDIX: No abnormality. The appendix appears to be surgically absent. PERITONEUM / MESENTERY: There are several scattered intraperitoneal surgical clips. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal masses. BODY WALL: There is rectus diastases (12 cm at maximum) and several small midline abdominal ventral hernias containing several loops of slightly protruded small bowel. Surgical clips in the right inguinal region. MUSCULOSKELETAL: No acute or aggressive osseous abnormality. Degenerative changes involving the thoracolumbar spine. Levocurvature of the lumbar spine with apex at L2 and dextrocurvature of the thoracic spine with apex at T6. CONCLUSION: 1. Rectus diastases with small ventral hernias. 2. Other incidental findings as outlined 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Moderate right lower lobe atelectasis. Noncalcified lung nodule measuring approximately 6 x 5 mm at the base of the right upper lobe. Calcified left hilar lymph node and calcified granuloma involving the upper left lower lobe. DISTAL ESOPHAGUS: Small type I hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Mild intrahepatic and extrahepatic ductal dilation. These changes are likely related to postcholecystectomy state. GALLBLADDER: Surgically absent. Small calcified lesion within the gallbladder fossa, possibly representing dropped gallstone or postsurgical change. No surrounding inflammation. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mildly lobulated bilaterally. Mild bilateral pelviectasis. There are tiny punctate calcifications within the right lower pole, likely nonobstructing renal stones. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes related to Roux-en-Y gastric bypass. Jejunojejunal anastomosis is seen within the mid abdomen and is within normal limits. COLON / APPENDIX: No abnormality. The appendix appears to be surgically absent. PERITONEUM / MESENTERY: There are several scattered intraperitoneal surgical clips. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal masses. BODY WALL: There is rectus diastases (12 cm at maximum) and several small midline abdominal ventral hernias containing several loops of slightly protruded small bowel. Surgical clips in the right inguinal region. MUSCULOSKELETAL: No acute or aggressive osseous abnormality. Degenerative changes involving the thoracolumbar spine. Levocurvature of the lumbar spine with apex at L2 and dextrocurvature of the thoracic spine with apex at T6.
|
Findings: The diagnostic quality/utility of this examination is degraded by patient motion. There is interval evolution of postsurgical changes from left P-comm aneurysm clipping. There is decreasing pneumocephalus with bilateral frontal convexity subdural collections with minimal hemorrhage. There is a hemorrhagic extra-axial collection underlying the craniotomy most pronounced along the frontal convexity that has increased compared to the prior exam, measuring up to 11 mm compared to 6 mm previously. There is partial effacement of the left lateral ventricle. There is a cavum septum pellucidum. There is a midline shift to the right of approximately 4 mm which is similar to the prior. There is more pronounced areas of hypoattenuation along the left frontal lobe, posterior limb of the left internal capsule and temporal lobe. There is decreasing subarachnoid hemorrhage with unchanged intraventricular hemorrhage. No other obvious new hemorrhage is noted. There is moderate mucosal thickening in the maxillary and sphenoid sinuses.
|
16,426 |
Interpretation of Outside Films MR Neck HISTORY: History of colorectal malignancy evaluation for neck mass COMPARISON: Ultrasound dated 11/24/2021 Technique: Axial images were obtained. Coronal and sagittal reconstruction were performed. FINDINGS: SOFT TISSUES: There is a 20 mm nodularity in superficial portion of the left-sided scalene muscle in the left supraclavicular region with mild enhancement after contrast injection (series 9 image 10). LYMPH NODES: No pathologic adenopathy by imaging size criteria. AERODIGESTIVE STRUCTURES: Normal. PAROTID GLANDS: Normal. SUBMANDIBULAR GLANDS: Normal. THYROID GLAND: There is a 12 mm T2 hyper signal nodule in the posterior portion of the right thyroid lobe. VASCULAR STRUCTURES: Normal. OSSEOUS STRUCTURES: No fracture, dislocation, or destructive lesion. Posterior disc osteophyte is noted at C5-C6 with mild spinal canal stenosis. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: Normal. IMPRESSION: A 20 mm soft tissue nodularity in superficial portion of the scalene muscles in the left supraclavicular region with mild enhancement concerning for a pathologic lymph node versus soft tissue metastasis. For the lesions involving the left shoulder please refer to the dedicated shoulder MRI.
|
FINDINGS: SOFT TISSUES: There is a 20 mm nodularity in superficial portion of the left-sided scalene muscle in the left supraclavicular region with mild enhancement after contrast injection (series 9 image 10). LYMPH NODES: No pathologic adenopathy by imaging size criteria. AERODIGESTIVE STRUCTURES: Normal. PAROTID GLANDS: Normal. SUBMANDIBULAR GLANDS: Normal. THYROID GLAND: There is a 12 mm T2 hyper signal nodule in the posterior portion of the right thyroid lobe. VASCULAR STRUCTURES: Normal. OSSEOUS STRUCTURES: No fracture, dislocation, or destructive lesion. Posterior disc osteophyte is noted at C5-C6 with mild spinal canal stenosis. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: 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: ET tube terminates in the midthoracic trachea. Circumferential soft tissue attenuation severely narrows the bronchus intermedius. Advanced upper lobe predominant centrilobular and paraseptal emphysematous changes with biapical and anterior paramediastinal bullae. Moderate right and small left pleural effusions with overlying relaxation atelectasis. Extensive septal thickening in the right upper lobe. Patchy groundglass and consolidative opacities throughout both lungs, with a confluent area of consolidation in the dependent left lower lobe. No pneumothorax. HEART / VESSELS: Moderate cardiomegaly. Hypoattenuation of the intracardiac blood pool relative to myocardium, suggestive of anemia. Dense calcific atherosclerosis in the coronary arteries. Coronary artery stent is noted. The thoracic aorta is normal in caliber. Right internal jugular approach vascular catheter terminates in the SVC. MEDIASTINUM / ESOPHAGUS: Esophagogastric catheter is in place. A few punctate foci of anterior pneumomediastinum (series 201, image 72) may be related to the Macklin effect. Bilateral perihilar soft tissue prominence. Edema in the mediastinal soft tissues. LYMPH NODES: Suboptimally evaluated secondary to diffuse chest wall and mediastinal edema. CHEST WALL: Diffuse chest wall edema. UPPER ABDOMEN: Small perihepatic ascites. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Multilevel degenerative changes in the thoracic spine.
|
16,427 |
EXAM: Interpretation of Outside Films MR MSK CLINICAL INFORMATION: 6-year-old female with history of metastatic colon cancer status post radiation and chemotherapy. COMPARISON: Left shoulder radiographs 12/17/2021, CT chest 12/10/2021 and left scapula MRI 5/12/2020 TECHNIQUE: Interpretation of Outside Films MR MSK STRUCTURED REPORT: MRI HIP/BONE PELVIS v4/13/2019 FINDINGS: Redemonstrated postsurgical changes of left shoulder disarticulation. The relatively well-defined lobulated T2 heterogeneous, T1 isointense, heterogeneously enhancing mixed osseous/soft tissue mass arising from and encasing the left scapula has not significantly changed in size compared to the most recent chest CT, within the limitations of differences in technique. However, it has significantly increased in size compared to the prior MRI. On today's exam the mass measures approximately 9.1 x 5.8 x 12.3 cm (axial T2 series 8 image 17 and sagittal T2 series 7, image 12). There is increased associated destruction of the scapula with new involvement of the distal clavicle compared to the prior MRI. The surrounding soft structures and musculature of the shoulder are poorly delineated from the mass. The mass closely approximates the posterior chest wall with preserved fat plane between the mass and the underlying ribs. There are numerous prominent left axillary lymph nodes, the largest of which has a cortex measuring up to 6 mm, with otherwise preserved nodal morphology. A few pulmonary nodules are seen in the imaged portion of the left lung, and are better appreciated on the chest CT from 12/10/2021. The axillary neurovascular bundle and abuts the anterior and medial margin of the mass without discrete intervening fat plane. CONCLUSION: 1. Heterogeneous soft tissue/osseous mass encasing the left scapula representing patient's known metastatic colorectal malignancy is similar in size to most recent chest CT, given differences in technique. The mass has significantly increased compared to the prior MRI. 2. Prominent left axillary lymph nodes and left lung pulmonary nodules, concerning for nodal and pulmonary metastases. Please see separately dictated CT chest dated 12/10/2021. 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: Redemonstrated postsurgical changes of left shoulder disarticulation. The relatively well-defined lobulated T2 heterogeneous, T1 isointense, heterogeneously enhancing mixed osseous/soft tissue mass arising from and encasing the left scapula has not significantly changed in size compared to the most recent chest CT, within the limitations of differences in technique. However, it has significantly increased in size compared to the prior MRI. On today's exam the mass measures approximately 9.1 x 5.8 x 12.3 cm (axial T2 series 8 image 17 and sagittal T2 series 7, image 12). There is increased associated destruction of the scapula with new involvement of the distal clavicle compared to the prior MRI. The surrounding soft structures and musculature of the shoulder are poorly delineated from the mass. The mass closely approximates the posterior chest wall with preserved fat plane between the mass and the underlying ribs. There are numerous prominent left axillary lymph nodes, the largest of which has a cortex measuring up to 6 mm, with otherwise preserved nodal morphology. A few pulmonary nodules are seen in the imaged portion of the left lung, and are better appreciated on the chest CT from 12/10/2021. The axillary neurovascular bundle and abuts the anterior and medial margin of the mass without discrete intervening fat plane.
|
Findings: There is slightly more pronounced hypoattenuation in the left frontal lobe extending to the operculum compatible with evolving infarct. There is no hemorrhage or significant mass effect. Findings are superimposed on cerebral volume loss with ventricular prominence. There are mild chronic microangiopathic changes. Chronic pontine lacunar infarcts are again noted. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
|
16,428 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Diverticulitis COMPARISON: CT 11/8/2021 TECHNIQUE: Outside CT images with IV contrast dated 1/4/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. 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: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticula. There is focal inflammation adjacent to a diverticula in the sigmoid colon compatible with acute diverticulitis. No evidence of macro perforation or associated diverticular abscess. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Retroaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny umbilical fat protrusion. MUSCULOSKELETAL: Degenerative disc disease at L5-S1 and other degenerative change. CONCLUSION: 1. Uncomplicated acute sigmoid diverticulitis. Recommend correlation with colonoscopy following resolution of inflammatory change to exclude underlying lesion. 2. Other incidental and noncontributory 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: IMAGE QUALITY: Satisfactory. 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: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticula. There is focal inflammation adjacent to a diverticula in the sigmoid colon compatible with acute diverticulitis. No evidence of macro perforation or associated diverticular abscess. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Retroaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny umbilical fat protrusion. MUSCULOSKELETAL: Degenerative disc disease at L5-S1 and other degenerative change.
|
FINDINGS: 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 (
|
16,429 |
Interpretation of Outside Films MR Head HISTORY: Evaluation and follow-up for brain lesions TECHNIQUE: Multiplanar, multisequence MRI of the brain was performed without and after intravenous contrast. COMPARISON: MRI of 7/8/2021 FINDINGS: INTRACRANIAL FINDINGS: Again noted is a right parietal approach intraventricular catheter which ends in the right lateral ventricle and unchanged in location. There is interval size decrease of the right lateral ventricle which appears decompressed at this time. Mild ventriculomegaly involving the left lateral ventricle is again noted. There is interval right-sided deviation of the septum pellucidum which is felt to be secondary to decompression of the right lateral ventricle. Since prior MRI there is interval size increase of the cystic structure along the catheter which now measures 39 x 30 mm on transverse diameter, previously 26 x 24 mm. The other smaller and deeply located cystic structure along the catheter shows interval size decrease now measuring 12 mm previously 17 mm. Evidence of pachygyria involving the left frontal cortex is again noted. There is persistent nodularity within the right-sided choroid plexus in the right lateral ventricle most consistent with intraventricular meningioma. There is a stable avidly enhancing extra-axial mass lesion in the left CP angle with extension to the left internal auditory canal measuring 27 x 33 mm on transverse diameter, previously 34 x 29 mm. There is persistent moderate mass effect over the left CP angle. Again noted is a lobulated avidly enhancing extra-axial mass lesion in the right CP angle with extension to the right foramen of Luschka and not obviously changed since prior study. A 13 mm presumed meningioma in the right CP angle with prominent dural tail toward the right internal auditory canal is again noted. Lobulated mass lesion in the left cavernous sinuses again noted most consistent with a stable meningioma. Prominent enhancement in the right cavernous sinuses also in favor of an additional stable meningioma. Small nodularity along the falx cerebri is again noted in favor of a small meningiomas. A 15 mm small meningioma in right aspect of superior sagittal sinus in the right frontal region is again noted. There is persistent minimal dural thickening and enhancement along the left sphenoidal bone with osseous expansion and in superior portion of the left orbit most consistent with intraosseous meningioma with extension to the left middle cranial fossa. There are numerous enhancing nodularity along the upper cervical cord not obviously changed since prior study concerning for a small foci of schwannoma versus meningioma. The brain parenchyma appears normal without evidence for acute ischemia, hemorrhage, or mass lesion There is no abnormal extra-axial collection. The flow voids at the skull base are normal. The cerebellar tonsils are normal in position. EXTRACRANIAL FINDINGS: The orbital contents are unremarkable. Effusion of left mastoidal sinus is seen. IMPRESSION: Interval size decrease of the right lateral ventricle is status post shunt placement. Stable mild dilation of the left lateral ventricle. Septum pellucidum is mildly deviated to right side which is likely due to volume loss of the right lateral ventricle. Interval mild enlargement of larger cystic structure along the shunt catheter that. The other smaller cystic structure along the catheter is smaller since prior study. Persistent pachygyria of left frontal lobe. No obvious interval change in the numerous lesions secondary to neurofibromatosis including an intraventricular meningioma of the right lateral ventricle, several meningiomas along the falx cerebri and in the supratentorium, a left sided vestibular schwannoma with moderate mass effect over the left middle cerebellar peduncle, meningiomas in the right CP angle, meningioma within the left and right cavernous sinuses as well as numerous meningiomas versus schwannomas in the upper cervical spinal canal. Persistent intraosseous meningioma of the left sphenoidal bone.
|
FINDINGS: INTRACRANIAL FINDINGS: Again noted is a right parietal approach intraventricular catheter which ends in the right lateral ventricle and unchanged in location. There is interval size decrease of the right lateral ventricle which appears decompressed at this time. Mild ventriculomegaly involving the left lateral ventricle is again noted. There is interval right-sided deviation of the septum pellucidum which is felt to be secondary to decompression of the right lateral ventricle. Since prior MRI there is interval size increase of the cystic structure along the catheter which now measures 39 x 30 mm on transverse diameter, previously 26 x 24 mm. The other smaller and deeply located cystic structure along the catheter shows interval size decrease now measuring 12 mm previously 17 mm. Evidence of pachygyria involving the left frontal cortex is again noted. There is persistent nodularity within the right-sided choroid plexus in the right lateral ventricle most consistent with intraventricular meningioma. There is a stable avidly enhancing extra-axial mass lesion in the left CP angle with extension to the left internal auditory canal measuring 27 x 33 mm on transverse diameter, previously 34 x 29 mm. There is persistent moderate mass effect over the left CP angle. Again noted is a lobulated avidly enhancing extra-axial mass lesion in the right CP angle with extension to the right foramen of Luschka and not obviously changed since prior study. A 13 mm presumed meningioma in the right CP angle with prominent dural tail toward the right internal auditory canal is again noted. Lobulated mass lesion in the left cavernous sinuses again noted most consistent with a stable meningioma. Prominent enhancement in the right cavernous sinuses also in favor of an additional stable meningioma. Small nodularity along the falx cerebri is again noted in favor of a small meningiomas. A 15 mm small meningioma in right aspect of superior sagittal sinus in the right frontal region is again noted. There is persistent minimal dural thickening and enhancement along the left sphenoidal bone with osseous expansion and in superior portion of the left orbit most consistent with intraosseous meningioma with extension to the left middle cranial fossa. There are numerous enhancing nodularity along the upper cervical cord not obviously changed since prior study concerning for a small foci of schwannoma versus meningioma. The brain parenchyma appears normal without evidence for acute ischemia, hemorrhage, or mass lesion There is no abnormal extra-axial collection. The flow voids at the skull base are normal. The cerebellar tonsils are normal in position. EXTRACRANIAL FINDINGS: The orbital contents are unremarkable. Effusion of left mastoidal sinus is seen.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Contusions involving the lateral aspect of the left lower lung. No pneumothorax or pleural effusion. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Extensive left chest wall emphysema. Linear foci of gas are noted within the intercostal musculature adjacent to these rib fractures and thought to be extrapleural (axial series 201 image 177 and axial series 201 image 168). ABDOMEN and PELVIS: LIVER: Multifocal ill-defined hypoattenuating foci within the liver are indeterminate. Hyperdense tubular focus along the posterior aspect of the liver is indeterminate. 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: The appendix is not visualized. Moderate fecal burden. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is present. Left ovarian cyst. BODY WALL: Fat-containing umbilical hernia. MUSCULOSKELETAL: Mildly displaced left lateral seventh and eighth rib fractures.
|
16,430 |
EXAM: Interpretation of Outside Films CT Body CLINICAL INFORMATION: Prostate cyst COMPARISON: None. TECHNIQUE: Outside CT abdomen and pelvis without and with IV contrast images dated 1/11/2022 were submitted for interpretation. STRUCTURED REPORT: CT Abdomen Pelvis Outside FINDINGS: LOWER CHEST: LUNG BASES: Atelectasis/scarring at the lung bases. PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART: Normal. ABDOMEN and PELVIS: LIVER: The liver has a normal morphology. Tiny hypoattenuating focus series 6 image 38 is too small to characterize. Other tiny foci are similar. BILIARY TRACT: Normal. GALLBLADDER: Gallstones are noted without evidence of acute cholecystitis. SPLEEN: Normal. PANCREAS: Mild fatty atrophy. ADRENALS: Normal. KIDNEYS: Kidneys enhance symmetrically with no hydronephrosis or obstructive calculus. Small hypoattenuating focus in the left kidney series 6 image 67 is too small to characterize. Delayed images demonstrate no significant filling defect in either ureter or proximal collecting system. LYMPH NODES: None pathologically enlarged. A few prominent retroperitoneal nodes are noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis without diverticulitis. Normal appendix. PERITONEUM / MESENTERY: Probable focus of fat necrosis in the right upper quadrant series 3 image 40. RETROPERITONEUM: Normal. VESSELS: Diffuse atherosclerosis. URINARY BLADDER: Diffuse bladder wall trabeculation with numerous diverticula noted. There is irregular thickening present. REPRODUCTIVE ORGANS: Prostatomegaly with median lobe hypertrophy. Coarse calcification within the prostate as well as a midline/paramidline cystic focus measuring up to 1.3 cm on series 9 image 124. BODY WALL: Small partial bowel containing hernia in the umbilicus. MUSCULOSKELETAL: No destructive osseous lesions. Degenerative changes in the spine. Decreased bone mineral density. Degenerative changes in both hips. CONCLUSION: 1. Prostatomegaly with cystic focus in the midline/paramidline prostate peripheral zone as described above. This favors a small cystic lesion such as a prostatic utricle cyst though should be correlated if there is concern for infection. Associated bladder wall thickening and numerous trabeculations/diverticula are present. Recommend cystoscopy if not previously performed. 2. Other incidental and noncontributory findings as described above.
|
FINDINGS: LOWER CHEST: LUNG BASES: Atelectasis/scarring at the lung bases. PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART: Normal. ABDOMEN and PELVIS: LIVER: The liver has a normal morphology. Tiny hypoattenuating focus series 6 image 38 is too small to characterize. Other tiny foci are similar. BILIARY TRACT: Normal. GALLBLADDER: Gallstones are noted without evidence of acute cholecystitis. SPLEEN: Normal. PANCREAS: Mild fatty atrophy. ADRENALS: Normal. KIDNEYS: Kidneys enhance symmetrically with no hydronephrosis or obstructive calculus. Small hypoattenuating focus in the left kidney series 6 image 67 is too small to characterize. Delayed images demonstrate no significant filling defect in either ureter or proximal collecting system. LYMPH NODES: None pathologically enlarged. A few prominent retroperitoneal nodes are noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis without diverticulitis. Normal appendix. PERITONEUM / MESENTERY: Probable focus of fat necrosis in the right upper quadrant series 3 image 40. RETROPERITONEUM: Normal. VESSELS: Diffuse atherosclerosis. URINARY BLADDER: Diffuse bladder wall trabeculation with numerous diverticula noted. There is irregular thickening present. REPRODUCTIVE ORGANS: Prostatomegaly with median lobe hypertrophy. Coarse calcification within the prostate as well as a midline/paramidline cystic focus measuring up to 1.3 cm on series 9 image 124. BODY WALL: Small partial bowel containing hernia in the umbilicus. MUSCULOSKELETAL: No destructive osseous lesions. Degenerative changes in the spine. Decreased bone mineral density. Degenerative changes in both hips.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Contusions involving the lateral aspect of the left lower lung. No pneumothorax or pleural effusion. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Extensive left chest wall emphysema. Linear foci of gas are noted within the intercostal musculature adjacent to these rib fractures and thought to be extrapleural (axial series 201 image 177 and axial series 201 image 168). ABDOMEN and PELVIS: LIVER: Multifocal ill-defined hypoattenuating foci within the liver are indeterminate. Hyperdense tubular focus along the posterior aspect of the liver is indeterminate. 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: The appendix is not visualized. Moderate fecal burden. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is present. Left ovarian cyst. BODY WALL: Fat-containing umbilical hernia. MUSCULOSKELETAL: Mildly displaced left lateral seventh and eighth rib fractures.
|
16,431 |
CT neck with contrast Indication: Spec Inst: PAROTID MASS CT NECK 1522 PRATTVILLE IMAG REC 11322. Comparison: No prior studies are available for comparison at this time. Technique: Outside facility CT neck with contrast was available for review. . Findings: A necrotic lesion is seen within/inferior to the right parotid gland measuring 18 x 13 x 22 mm in its maximum dimension additional subcentimeter nonspecific bilateral deep cervical nodes The nasopharynx appears normal. Airway is patent. The suprahyoid neck including the oropharynx, oral cavity, parapharyngeal spaces and retropharyngeal spaces are unremarkable. The epiglottis and aryepiglottic folds appear unremarkable. The infrahyoid neck including the larynx, hypopharynx and supraglottis appears normal. The thyroid gland and remaining salivary glands appear unremarkable. The visualized vascular structures appear unremarkable. The osseous structures appear unremarkable. Scattered paranasal sinus mucosal thickening The orbits and skull base appear unremarkable. The lung apices show no worrisome lung nodule/lesion. Mild paraseptal emphysema more prominent on the right side. Impression: Necrotic right parotid node. No additional worrisome nodule identified in the neck by CT criteria
|
Findings: A necrotic lesion is seen within/inferior to the right parotid gland measuring 18 x 13 x 22 mm in its maximum dimension additional subcentimeter nonspecific bilateral deep cervical nodes The nasopharynx appears normal. Airway is patent. The suprahyoid neck including the oropharynx, oral cavity, parapharyngeal spaces and retropharyngeal spaces are unremarkable. The epiglottis and aryepiglottic folds appear unremarkable. The infrahyoid neck including the larynx, hypopharynx and supraglottis appears normal. The thyroid gland and remaining salivary glands appear unremarkable. The visualized vascular structures appear unremarkable. The osseous structures appear unremarkable. Scattered paranasal sinus mucosal thickening The orbits and skull base appear unremarkable. The lung apices show no worrisome lung nodule/lesion. Mild paraseptal emphysema more prominent on the right side.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Normal. SOFT TISSUES:Unremarkable.
|
16,432 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Groin mass COMPARISON: Outside MRI dated 10/25/2021 TECHNIQUE: Outside MR images without and with IV contrast dated 1/12/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: STRUCTURED REPORT: MRI 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: No abnormality. BODY WALL: Postoperative appearance of the left groin. No suspicious nodular enhancing soft tissue is identified. Small fat-containing right inguinal hernia. Postoperative changes of the intra-abdominal wall with rectus diastases and eventration of the abdominal fat/small bowel. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Unchanged postsurgical appearance of the left groin without evidence of local recurrence or pelvic nodal metastases. 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: MRI 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: No abnormality. BODY WALL: Postoperative appearance of the left groin. No suspicious nodular enhancing soft tissue is identified. Small fat-containing right inguinal hernia. Postoperative changes of the intra-abdominal wall with rectus diastases and eventration of the abdominal fat/small bowel. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Please note that the concurrently obtained CT scan of the neck will be dictated separately. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis versus sequela of chronic aspiration. No acute abnormalities in the lungs and pleural spaces. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: Nonspecific borderline enlarged prevascular/para-aortic lymph node measuring up to 1.0 cm in short axis, may be reactive. CHEST WALL: 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: Scattered colonic diverticula without acute inflammatory changes. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed by a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing left inguinal hernia. Small fat-containing umbilical hernia. THORACIC VERTEBRA: VERTEBRA: T2 superior endplate acute fracture anteriorly. T5 superior endplate acute fracture. Possible mild superior endplate compression of the T3 and T4 vertebral bodies. No retropulsion of fracture fragments into the vertebral canal. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR VERTEBRA: Degenerative changes of the lower lumbar spine. VERTEBRA: L1 right transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. OTHER MUSCULOSKELETAL: Left sixth rib anterolateral subacute/chronic fracture.
|
16,433 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 56-year-old female with abdominal mass. COMPARISON: None available. TECHNIQUE: Outside CT images SEHMC dated 1/1/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Moderate sized right pleural effusion with adjacent compressive atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis. LYMPH NODES: There are several enlarged left iliac and bilateral inguinal lymph nodes. The largest right inguinal lymph node measures 2.4 x 1.6 cm (series 3 image 146). An enlarged para-aortic node is also present on image 69. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Mild mesenteric infiltration. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a complex, mixed cystic and solid lesion within the left adnexa with thick septations measuring approximately 5.9 x 5.2 cm (series 3 image 119) with mild surrounding fat stranding. The left gonadal vein appears slightly prominent. The uterus is unremarkable. BODY WALL: Diffuse anasarca. Small periumbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most pronounced at L5-S1. Grade 1 anterolisthesis of L5 on S1. Severe degenerative changes of the left hip. No aggressive osseous lesions. CONCLUSION: 1. Complex mixed density lesion within the left adnexa measuring up to 5.9 cm, concerning for ovarian neoplasm. 2. Multiple enlarged iliac and inguinal as well as retroperitoneal lymph nodes are concerning for metastatic disease. 3. Moderate right pleural effusion with adjacent compressive atelectasis. 4. 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Moderate sized right pleural effusion with adjacent compressive atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis. LYMPH NODES: There are several enlarged left iliac and bilateral inguinal lymph nodes. The largest right inguinal lymph node measures 2.4 x 1.6 cm (series 3 image 146). An enlarged para-aortic node is also present on image 69. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Mild mesenteric infiltration. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a complex, mixed cystic and solid lesion within the left adnexa with thick septations measuring approximately 5.9 x 5.2 cm (series 3 image 119) with mild surrounding fat stranding. The left gonadal vein appears slightly prominent. The uterus is unremarkable. BODY WALL: Diffuse anasarca. Small periumbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most pronounced at L5-S1. Grade 1 anterolisthesis of L5 on S1. Severe degenerative changes of the left hip. No aggressive osseous lesions.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Please note that the concurrently obtained CT scan of the neck will be dictated separately. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis versus sequela of chronic aspiration. No acute abnormalities in the lungs and pleural spaces. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: Nonspecific borderline enlarged prevascular/para-aortic lymph node measuring up to 1.0 cm in short axis, may be reactive. CHEST WALL: 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: Scattered colonic diverticula without acute inflammatory changes. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed by a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing left inguinal hernia. Small fat-containing umbilical hernia. THORACIC VERTEBRA: VERTEBRA: T2 superior endplate acute fracture anteriorly. T5 superior endplate acute fracture. Possible mild superior endplate compression of the T3 and T4 vertebral bodies. No retropulsion of fracture fragments into the vertebral canal. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR VERTEBRA: Degenerative changes of the lower lumbar spine. VERTEBRA: L1 right transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. OTHER MUSCULOSKELETAL: Left sixth rib anterolateral subacute/chronic fracture.
|
16,434 |
EXAM: Interpretation of Outside Films CT Body CLINICAL INFORMATION: Right flank pain. COMPARISON: 11/4/2019 TECHNIQUE: Outside CT abdomen and pelvis without IV contrast images dated 1/5/2022 were submitted for interpretation. STRUCTURED REPORT: CT Abdomen Pelvis Outside FINDINGS: LOWER CHEST: LUNG BASES: Minimal atelectasis at the bases. PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART: Normal. ABDOMEN and PELVIS: LIVER: Borderline steatosis. No focal hepatic lesions are seen within limits of a noncontrast examination. BILIARY TRACT: Normal. GALLBLADDER: The gallbladder is normal in appearance. SPLEEN: Normal. PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: There are multiple punctate bilateral nonobstructive calculi, the larger on the right measuring up to 6 mm. There is mild right hydroureteronephrosis and perinephric stranding secondary to a 5 mm calculus in the proximal right ureter. Left renal cyst. LYMPH NODES: None pathologically enlarged. Multiple prominent retroperitoneal lymph nodes are noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The colon is unremarkable. Surgical changes at the base of the cecum, possibly from prior appendectomy. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerosis without aneurysm. URINARY BLADDER: The bladder is unremarkable. REPRODUCTIVE ORGANS: No significant abnormality. BODY WALL: Fat-containing left inguinal hernia. Minute umbilical protrusion. MUSCULOSKELETAL: No destructive osseous lesions. Degenerative changes in the spine. CONCLUSION: 1. Nonobstructive bilateral renal calculi with obstructive proximal right ureteral calculus with mild hydroureteronephrosis. 2. Other incidental and noncontributory findings as described above.
|
FINDINGS: LOWER CHEST: LUNG BASES: Minimal atelectasis at the bases. PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART: Normal. ABDOMEN and PELVIS: LIVER: Borderline steatosis. No focal hepatic lesions are seen within limits of a noncontrast examination. BILIARY TRACT: Normal. GALLBLADDER: The gallbladder is normal in appearance. SPLEEN: Normal. PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: There are multiple punctate bilateral nonobstructive calculi, the larger on the right measuring up to 6 mm. There is mild right hydroureteronephrosis and perinephric stranding secondary to a 5 mm calculus in the proximal right ureter. Left renal cyst. LYMPH NODES: None pathologically enlarged. Multiple prominent retroperitoneal lymph nodes are noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The colon is unremarkable. Surgical changes at the base of the cecum, possibly from prior appendectomy. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerosis without aneurysm. URINARY BLADDER: The bladder is unremarkable. REPRODUCTIVE ORGANS: No significant abnormality. BODY WALL: Fat-containing left inguinal hernia. Minute umbilical protrusion. MUSCULOSKELETAL: No destructive osseous lesions. Degenerative changes in the spine.
|
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 (
|
16,435 |
Interpretation of Outside Films CT Chest Clinical Information: 79-year-old female, with ascites. Technique: CT chest, abdomen and pelvis with contrast was obtained on 1/17/2022 at flowers hospital. 2.5 mm axial, coronal and sagittal reformats are available at the time of interpretation. Comparison CT abdomen from the same day. Findings: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There is near complete atelectasis of the right middle lobe, with chronic volume loss and rightward mediastinal shift. Small volume right pleural effusion with adjacent atelectasis. Patchy atelectasis in the lingula. A few groundglass and mixed attenuation opacities in the right upper lobe. No suspicious pulmonary nodule. HEART / VESSELS: Mildly dilated pulmonary artery. No pericardial effusion. Severe mitral annular calcifications.. MEDIASTINUM / ESOPHAGUS: Fluid-filled esophagus, with a moderate sized hiatal hernia. Small volume fluid extends through the hiatus into the posterior mediastinum. LYMPH NODES: None enlarged. CHEST WALL: Soft tissue edema. UPPER ABDOMEN: Large volume ascites. Abdominal pain reported separately. MUSCULOSKELETAL: No destructive osseous lesion. Conclusion: 1. Volume loss in the right lung with near complete occlusion of the right middle lobe bronchus and complete atelectasis of the right middle lobe. A few mixed attenuation opacities in the right upper lobe likely infectious/inflammatory. Small volume right pleural effusion. 2. Moderate sized hiatal hernia with fluid-filled patulous esophagus, increased risk for aspiration. 3. Severe mitral annular calcifications and other incidental findings as above. 4. Large volume ascites and anasarca.
|
Findings: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There is near complete atelectasis of the right middle lobe, with chronic volume loss and rightward mediastinal shift. Small volume right pleural effusion with adjacent atelectasis. Patchy atelectasis in the lingula. A few groundglass and mixed attenuation opacities in the right upper lobe. No suspicious pulmonary nodule. HEART / VESSELS: Mildly dilated pulmonary artery. No pericardial effusion. Severe mitral annular calcifications.. MEDIASTINUM / ESOPHAGUS: Fluid-filled esophagus, with a moderate sized hiatal hernia. Small volume fluid extends through the hiatus into the posterior mediastinum. LYMPH NODES: None enlarged. CHEST WALL: Soft tissue edema. UPPER ABDOMEN: Large volume ascites. Abdominal pain reported separately. MUSCULOSKELETAL: No destructive osseous lesion.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Please note that the concurrently obtained CT scan of the neck will be dictated separately. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis versus sequela of chronic aspiration. No acute abnormalities in the lungs and pleural spaces. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: Nonspecific borderline enlarged prevascular/para-aortic lymph node measuring up to 1.0 cm in short axis, may be reactive. CHEST WALL: 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: Scattered colonic diverticula without acute inflammatory changes. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed by a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing left inguinal hernia. Small fat-containing umbilical hernia. THORACIC VERTEBRA: VERTEBRA: T2 superior endplate acute fracture anteriorly. T5 superior endplate acute fracture. Possible mild superior endplate compression of the T3 and T4 vertebral bodies. No retropulsion of fracture fragments into the vertebral canal. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR VERTEBRA: Degenerative changes of the lower lumbar spine. VERTEBRA: L1 right transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. OTHER MUSCULOSKELETAL: Left sixth rib anterolateral subacute/chronic fracture.
|
16,436 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 79-year-old female with abdominal pain. COMPARISON: None available. TECHNIQUE: Outside CT images Flowers Hospital dated 1/7/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated same-day CT chest. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Ill-defined subcentimeter hypodensity within the anterior spleen. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Moderate hiatal hernia. COLON / APPENDIX: No abnormality. The appendix is not well-visualized. PERITONEUM / MESENTERY: Massive amount of ascites. There are numerous soft tissue nodules throughout the peritoneum, most prominent along the anterior abdominal wall. For example, a lesion adjacent to the right pelvic wall measures 3.4 x 3.2 cm (series 301 image 149). An additional large lesion along the anterior abdominal wall measures 6.3 x 3.0 cm (series 301 image 88). Omental caking and diffuse peritoneal studding is noted. There appears to be herniation of the ascites downwards through the pelvic floor. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcifications of the abdominal aorta which is normal in caliber. URINARY BLADDER: Collapsed. REPRODUCTIVE ORGANS: The uterus is not visualized. BODY WALL: Small umbilical hernia containing ascites. Anasarca. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most pronounced in the lower lumbar spine with grade 1 anterolisthesis of L5 on S1. Small sclerotic focus in the pelvis on series 301 image 143. CONCLUSION: 1. Massive ascites with numerous peritoneal soft tissue nodules and omental caking, consistent with peritoneal carcinomatosis. A primary lesion is difficult to determine. 2. Severe pelvic floor laxity with incompletely imaged peritoneocele. 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated same-day CT chest. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Ill-defined subcentimeter hypodensity within the anterior spleen. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Moderate hiatal hernia. COLON / APPENDIX: No abnormality. The appendix is not well-visualized. PERITONEUM / MESENTERY: Massive amount of ascites. There are numerous soft tissue nodules throughout the peritoneum, most prominent along the anterior abdominal wall. For example, a lesion adjacent to the right pelvic wall measures 3.4 x 3.2 cm (series 301 image 149). An additional large lesion along the anterior abdominal wall measures 6.3 x 3.0 cm (series 301 image 88). Omental caking and diffuse peritoneal studding is noted. There appears to be herniation of the ascites downwards through the pelvic floor. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcifications of the abdominal aorta which is normal in caliber. URINARY BLADDER: Collapsed. REPRODUCTIVE ORGANS: The uterus is not visualized. BODY WALL: Small umbilical hernia containing ascites. Anasarca. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most pronounced in the lower lumbar spine with grade 1 anterolisthesis of L5 on S1. Small sclerotic focus in the pelvis on series 301 image 143.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Please note that the concurrently obtained CT scan of the neck will be dictated separately. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis versus sequela of chronic aspiration. No acute abnormalities in the lungs and pleural spaces. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: Nonspecific borderline enlarged prevascular/para-aortic lymph node measuring up to 1.0 cm in short axis, may be reactive. CHEST WALL: 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: Scattered colonic diverticula without acute inflammatory changes. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed by a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing left inguinal hernia. Small fat-containing umbilical hernia. THORACIC VERTEBRA: VERTEBRA: T2 superior endplate acute fracture anteriorly. T5 superior endplate acute fracture. Possible mild superior endplate compression of the T3 and T4 vertebral bodies. No retropulsion of fracture fragments into the vertebral canal. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR VERTEBRA: Degenerative changes of the lower lumbar spine. VERTEBRA: L1 right transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. OTHER MUSCULOSKELETAL: Left sixth rib anterolateral subacute/chronic fracture.
|
16,437 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: CT enterography from outside facility. Review the medical record indicates patient was transferred for suspected perforated Crohn's ileitis. COMPARISON: CT 1/8/2022 TECHNIQUE: Outside CT images with IV contrast dated 1/11/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small bilateral pleural effusions, unchanged DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postoperative changes from gastric bypass surgery. No intestinal obstruction. Multiple bowel loops demonstrate bowel wall thickening which may be on the basis of patient history of Crohn's disease or may be reactive given the adjacent peritoneal fluid collections described below. A discrete, perforated viscus is not visualized. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Multiple fluid collections are observed in the abdomen and pelvis. There is a somewhat dumbbell shaped, inflammatory fluid collection within the right mid abdomen measuring approximately 7.7 x 3.6 x 3.5 cm (series 2 image 43 and series 4 image 21) which appears increased in size compared to the prior exam. Multiple additional fluid collections and areas of nonorganized fluid are again observed. There is a tract where this appears to communicate with the inferior portion on image 48. Difficult to exclude bowel communication this area. Fluid collection in the left mid abdomen (series 2 image 48) appear slightly increased from the prior exam. Fluid collection in the right lower quadrant (series 2 image 58) appears slightly decreased from the prior exam. Fluid collection adjacent to the uterus is grossly stable. There is a indwelling left lower quadrant pigtail drainage catheter within a fluid collection in the left lower quadrant which contains only a small amount of fluid and residual air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Multiple abdominopelvic fluid collections as described with some demonstrating interval increase in size compared to the most recent prior CT examination. Bowel wall thickening may be related to patient history of inflammatory bowel disease or reactive to the adjacent mesenteric fluid collections. There is a tract which connects the fluid collections in the right lower quadrant. While definite bowel communication is not established, it is not excluded. 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small bilateral pleural effusions, unchanged DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postoperative changes from gastric bypass surgery. No intestinal obstruction. Multiple bowel loops demonstrate bowel wall thickening which may be on the basis of patient history of Crohn's disease or may be reactive given the adjacent peritoneal fluid collections described below. A discrete, perforated viscus is not visualized. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Multiple fluid collections are observed in the abdomen and pelvis. There is a somewhat dumbbell shaped, inflammatory fluid collection within the right mid abdomen measuring approximately 7.7 x 3.6 x 3.5 cm (series 2 image 43 and series 4 image 21) which appears increased in size compared to the prior exam. Multiple additional fluid collections and areas of nonorganized fluid are again observed. There is a tract where this appears to communicate with the inferior portion on image 48. Difficult to exclude bowel communication this area. Fluid collection in the left mid abdomen (series 2 image 48) appear slightly increased from the prior exam. Fluid collection in the right lower quadrant (series 2 image 58) appears slightly decreased from the prior exam. Fluid collection adjacent to the uterus is grossly stable. There is a indwelling left lower quadrant pigtail drainage catheter within a fluid collection in the left lower quadrant which contains only a small amount of fluid and residual air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Normal. SOFT TISSUES:Unremarkable.
|
16,438 |
EXAM: Interpretation of Outside Films MR MSK CLINICAL INFORMATION: 60-year-old female with left tibia lesion. COMPARISON: Left tibia and fibula radiographs 1/13/2022 TECHNIQUE: Interpretation of Outside Films MR MSK STRUCTURED REPORT: MRI HIP/BONE PELVIS v4/13/2019 FINDINGS: BONES: Extensive serpiginous and patchy discontinuous T1 hypointense, STIR/T2 heterogeneous signal with associated enhancement involving the proximal and mid left tibia with preserved areas of intramedullary fat. There is associated cortical thickening of the anterior lateral tibial cortex with extensive periosteal edema. No associated pathologic fracture. There is mild cortical edema and enhancement of the anterior and lateral cortex of the metadiaphysis. There is enhancement in the soft tissues of the surrounding foreleg. No discrete soft tissue component. No intramedullary fluid component. No marrow signal abnormality associated with the distal femur or right foreleg. MUSCLES/TENDON: Mild perilesional edema and enhancement within the surrounding muscles of the foreleg. VESSELS:No significant abnormality. NERVES: No significant abnormality. CONCLUSION: 1. Patchy discontinuous signal abnormality in the proximal and mid tibia with cortical thickening and periosteal edema. Given history of septic arthritis, sequela of osteomyelitis possibly with associated bone infarctions is favored. No drainable fluid collection. Malignant etiologies are less favored given preserved marrow fat, however, it is difficult to completely exclude. Biopsy is recommended. 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: BONES: Extensive serpiginous and patchy discontinuous T1 hypointense, STIR/T2 heterogeneous signal with associated enhancement involving the proximal and mid left tibia with preserved areas of intramedullary fat. There is associated cortical thickening of the anterior lateral tibial cortex with extensive periosteal edema. No associated pathologic fracture. There is mild cortical edema and enhancement of the anterior and lateral cortex of the metadiaphysis. There is enhancement in the soft tissues of the surrounding foreleg. No discrete soft tissue component. No intramedullary fluid component. No marrow signal abnormality associated with the distal femur or right foreleg. MUSCLES/TENDON: Mild perilesional edema and enhancement within the surrounding muscles of the foreleg. VESSELS:No significant abnormality. NERVES: No significant abnormality.
|
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 (
|
16,439 |
Interpretation of Outside Films MR Head HISTORY: Left-sided trigeminal neuralgia TECHNIQUE: Multiplanar, multisequence MRI of the brain was performed without and after intravenous contrast. COMPARISON: MRI of 11/8/2021 FINDINGS: INTRACRANIAL FINDINGS: There are tiny foci of FLAIR signal intensity in white matter of cerebral hemispheres in favor of minimal microvascular angiopathy. The brain parenchyma appears normal without evidence for acute ischemia, hemorrhage, or mass lesion. The ventricles are normal in size. There is no abnormal extra-axial collection. The flow voids at the skull base are normal. The cerebellar tonsils are normal in position. EXTRACRANIAL FINDINGS: The orbital contents are unremarkable. The visualized paranasal sinuses and mastoid air cells are well aerated. One of the branches of the left superior cerebellar artery is abutting the superior portion of the cisternal left trigeminal nerve without obvious mass effect or deviation which is likely an incidental finding. IMPRESSION: No acute intracranial lesion. One of the branches of the left superior cerebellar artery is abutting the superior portion of the cisternal left trigeminal nerve without obvious mass effect or deviation which is likely an incidental finding.
|
FINDINGS: INTRACRANIAL FINDINGS: There are tiny foci of FLAIR signal intensity in white matter of cerebral hemispheres in favor of minimal microvascular angiopathy. The brain parenchyma appears normal without evidence for acute ischemia, hemorrhage, or mass lesion. The ventricles are normal in size. There is no abnormal extra-axial collection. The flow voids at the skull base are normal. The cerebellar tonsils are normal in position. EXTRACRANIAL FINDINGS: The orbital contents are unremarkable. The visualized paranasal sinuses and mastoid air cells are well aerated. One of the branches of the left superior cerebellar artery is abutting the superior portion of the cisternal left trigeminal nerve without obvious mass effect or deviation which is likely an incidental finding.
|
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: Redemonstration of multinodular thyroid. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Slightly improved aeration of left lower lobe consolidation. Redemonstration of layering fluid within a left lower lobe bronchus (series 401 image 94). Interval improvement in the right lower lobe atelectasis with mild tree-in-bud type of nodularity, likely related to aspiration. HEART / OTHER VESSELS: Mild calcific coronary atherosclerotic disease. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Unchanged hepatic hypoattenuating lesions likely representing cysts. MUSCULOSKELETAL: Minimal multilevel discogenic degenerative changes within the thoracic spine.
|
16,440 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Abdominal mass COMPARISON: None. TECHNIQUE: Outside CT images with contrast and coronal and sagittal reformats dated 1/4/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Suboptimal. 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. The appendix is not well-visualized. PERITONEUM / MESENTERY: Trace intraperitoneal fluid, likely physiologic in nature. RETROPERITONEUM: There is a large retroperitoneal mass with predominantly cystic components probably arising from the anterior aspect of L4 vertebral body. This mass measures 10.6 x 8.7 cm (series 2 image 87). This mass results in mass effect upon adjacent structures. There is compression and invasion of right psoas muscle, caudally extending into the right iliacus. Coarse calcifications are seen arising within this mass, abutting the L5 vertebral body. Additionally multiple small calcific foci are seen predominantly in the peripheral portions of the cystic mass. There is compression and probable invasion of bilateral iliac veins as seen on series 3, image 184 and series 3, image 173. IVC however is patent, normally opacified. Further anteriorly the lesion extends to the anterior peritoneum and abuts the right rectus abdominis musculature without definite invasion. VESSELS: Aorta and iliac arteries are patent. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No destructive changes in the adjacent vertebral body. Lumbar vertebrae demonstrate normal height. No intraspinal extension of this mass. CONCLUSION: Large right-sided retroperitoneal predominantly cystic mass, likely arising from the anterior L5 vertebral body containing coarse calcifications with mass effect upon adjacent structures as described above. Findings are concerning for retroperitoneal neoplasm like soft tissue/myxoid chondrosarcoma Compression/invasion of the iliac veins bilaterally.. CT-guided percutaneous biopsy is recommended for confirmation. 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: IMAGE QUALITY: Suboptimal. 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. The appendix is not well-visualized. PERITONEUM / MESENTERY: Trace intraperitoneal fluid, likely physiologic in nature. RETROPERITONEUM: There is a large retroperitoneal mass with predominantly cystic components probably arising from the anterior aspect of L4 vertebral body. This mass measures 10.6 x 8.7 cm (series 2 image 87). This mass results in mass effect upon adjacent structures. There is compression and invasion of right psoas muscle, caudally extending into the right iliacus. Coarse calcifications are seen arising within this mass, abutting the L5 vertebral body. Additionally multiple small calcific foci are seen predominantly in the peripheral portions of the cystic mass. There is compression and probable invasion of bilateral iliac veins as seen on series 3, image 184 and series 3, image 173. IVC however is patent, normally opacified. Further anteriorly the lesion extends to the anterior peritoneum and abuts the right rectus abdominis musculature without definite invasion. VESSELS: Aorta and iliac arteries are patent. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No destructive changes in the adjacent vertebral body. Lumbar vertebrae demonstrate normal height. No intraspinal extension of this mass.
|
FINDINGS: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. RIGHT VERTEBRAL ARTERY: Short segment nonopacification of the right vertebral artery extending from the level of C6 with reconstitution at the level of C2/C3. 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. OSSEOUS STRUCTURES: Postsurgical changes of C4-C5 laminectomy, C3-C6 dorsal internal fixation and fusion, C5 corpectomy, and C4-C6 anterior fixation. Advanced multilevel discogenic degenerative change throughout the cervical spine. Multifocal mild mucosal thickening throughout the paranasal sinuses. SOFT TISSUES: Postsurgical changes extending within the right anterior neck soft tissues. A surgical drain is noted tracking from the superior aspect of the thyroid cartilage to the right lateral soft tissue/scan. OTHER: Right apical predominant extensive septal thickening as well as patchy consolidation and groundglass attenuation. Similar findings to a lesser extent are noted in the left apex. Endotracheal tube distal tip terminates at the level of the carina with predilection for the right mainstem bronchus.
|
16,441 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Pelvic mass, ovarian COMPARISON: None. TECHNIQUE: Outside CT images without contrast dated 1/12/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. 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: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes of the stomach, most consistent with sleeve gastrectomy. No gastric or small bowel obstruction. COLON / APPENDIX: No abnormality. Suspected appendix abuts the pelvic cystic mass. No periappendiceal or pericecal fat stranding. PERITONEUM / MESENTERY: No ascites. No peritoneal nodularity. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Large cystic pelvic mass measuring approximately 19 x 14 x 20 cm with internal septations. The right ovary is not seen separate from this mass. Suspected left ovary appears normal in size. The uterus is normal in size. BODY WALL: Fat-containing of alcohol hernia. MUSCULOSKELETAL: Posterior lumbar spinal fusion L4-L5 with bilateral rods and screws. No destructive osseous lesion. CONCLUSION: 1. Large pelvic cystic mass with internal septations is indeterminate, but suspicious for an epithelial neoplasm, possibly arising from the right ovary, which is not seen separate from this mass. Gynecological oncology consultation is recommended. 2. Additional incidental findings, as detailed.
|
FINDINGS: IMAGE QUALITY: Satisfactory. 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: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes of the stomach, most consistent with sleeve gastrectomy. No gastric or small bowel obstruction. COLON / APPENDIX: No abnormality. Suspected appendix abuts the pelvic cystic mass. No periappendiceal or pericecal fat stranding. PERITONEUM / MESENTERY: No ascites. No peritoneal nodularity. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Large cystic pelvic mass measuring approximately 19 x 14 x 20 cm with internal septations. The right ovary is not seen separate from this mass. Suspected left ovary appears normal in size. The uterus is normal in size. BODY WALL: Fat-containing of alcohol hernia. MUSCULOSKELETAL: Posterior lumbar spinal fusion L4-L5 with bilateral rods and screws. No destructive osseous lesion.
|
Findings: Evolving small volume hemorrhage along the left frontal approach ventricular stomach catheter with surrounding vasogenic edema. There is slight prominence of hemorrhage along the right frontal approach ventricular stomach catheter (image 178, series 3). There is new/increase in size of hemorrhage along the left occipital approach ventricular shunt catheter with surrounding edema. There is decrease in size of the right lateral ventricle. Stable opacification of the left lateral and third ventricles. Stable small hemorrhage in the occipital horn of left lateral ventricle.
|
16,442 |
Interpretation of Outside Films CT Chest Clinical Information: Concern for pulmonary metastases. Spec Inst: CT CHEST 010622 REC 011422 HUNTSVILLE HOSPITAL Study reviewed: CT of chest performed at Huntsville imaging Center on 1/6/2022. . The images are available in PACS. Please note the examination was performed outside of UAB protocol, monitoring and oversight. There are associated diagnostic limitations which should be considered prior to implementation of clinical decisions. Comparison:9/9/2021 Findings: Included images of the lower neck are unremarkable. Normal heart size. No pericardial effusions. A right chest port terminates near the cavoatrial junction. Mediastinal structures are within normal limits. No pathologically enlarged intrathoracic lymph nodes. The central airways are patent. No pleural effusions. Interval increase in size of the bilateral pulmonary nodules and masses, with lesions as follows: Left upper lobe nodule measuring 2.2 x 1.4 cm (series 2; image 26), previously measured about 1.1 x 1.6 cm. A right upper lobe/perihilar nodule measuring about 2.5 x 2.1 cm (series 2; image 38), previously measured about 1.6 x 1.5 cm. A superior segment right lower lobe mass which currently measures about 3.2 x 3.4 cm (series 2; image 51), previously measured about 3.0 x 2.1 cm. Please note that the concurrently obtained CT scan of the Abdomen will be dictated separately. Soft tissues of the chest wall are unremarkable. No aggressive osseous lesions. Conclusion: Worsening pulmonary metastatic disease.
|
Findings: Included images of the lower neck are unremarkable. Normal heart size. No pericardial effusions. A right chest port terminates near the cavoatrial junction. Mediastinal structures are within normal limits. No pathologically enlarged intrathoracic lymph nodes. The central airways are patent. No pleural effusions. Interval increase in size of the bilateral pulmonary nodules and masses, with lesions as follows: Left upper lobe nodule measuring 2.2 x 1.4 cm (series 2; image 26), previously measured about 1.1 x 1.6 cm. A right upper lobe/perihilar nodule measuring about 2.5 x 2.1 cm (series 2; image 38), previously measured about 1.6 x 1.5 cm. A superior segment right lower lobe mass which currently measures about 3.2 x 3.4 cm (series 2; image 51), previously measured about 3.0 x 2.1 cm. Please note that the concurrently obtained CT scan of the Abdomen will be dictated separately. Soft tissues of the chest wall are unremarkable. No aggressive osseous lesions.
|
FINDINGS: No intraparenchymal hemorrhage, mass effect or edema. The gray white matter differentiation is maintained. Redemonstrated is a lacunar infarct involving the bilateral caudate heads, left greater than right. Ill-defined region of hypoattenuation within the white matter of the right parietal lobe is unchanged. Hypoattenuation in bilateral occipital lobes also remain stable. 3Periventricular and subcortical white matter hypodensities are most consistent with chronic microangiopathic ischemic changes. There is mild diffuse cerebral atrophy with prominence of the cortical sulci, sylvian fissures and compensatory dilatation of the ventricles. No extra axial collections. No acute osseous abnormality. Trace right mastoid effusion. The paranasal sinuses and middle ears are clear. The orbits are unremarkable. The visualized soft tissues are unremarkable.
|
16,443 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 44-year-old female with a history of cervical cancer. COMPARISON: Outside CT abdomen pelvis without and with contrast 5/20/2021. TECHNIQUE: Outside CT images with IV contrast dated 1/6/2022 were submitted for interpretation. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Small stones are seen within the distal common bile duct without intra or extrahepatic biliary ductal dilatation. GALLBLADDER: Cholelithiasis without gallbladder wall thickening, pericholecystic fluid, or pericholecystic fat stranding. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Interval development of aortocaval adenopathy, now with a lymph node that measures 2.4 x 1.7 cm on axial image 139. Mildly prominent left external iliac lymph node measures 1.3 x 0.9 cm (series 4 image 45), previously measuring 2.6 x 1.8 cm (series 5 image 113). Prominent right external iliac lymph node now measures 1.7 x 1.3 cm (series 4 image 461), previously measuring 2.1 x 2.1 cm (series 5 image 110). STOMACH / SMALL BOWEL: The stomach and small bowel are distended with oral contrast. Otherwise COLON / APPENDIX: Oral contrast is seen within the proximal colon. No colonic wall thickening or pericolonic stranding. PERITONEUM / MESENTERY: No free intraperitoneal air or fluid. RETROPERITONEUM: Normal. VESSELS: Possible linear, nonocclusive filling defect within the left common femoral vein and SFV, best seen on coronal series (series 100 image 35). URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Bulky, heterogenous enhancing cervical mass measuring approximately 5.9 x 4.1 cm (series 4 image 496), previously measuring 7.7 x 6.3 cm. Mass continues to extend into the lower uterine segment and upper vagina, some to previous examination. Similar appearance of areas of this mass to the right adnexa. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Interval decrease in size of cervical malignancy and several pelvic lymph nodes. However, there is new retroperitoneal adenopathy. 2. Possible linear filling defect versus mixing within the left common femoral vein and SFV, not appreciably changed since May 2021. If there is concern for DVT, recommend ultrasound. 3. Stable chronic findings as above including choledocholithiasis and cholecystitis without cholecystitis. 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Small stones are seen within the distal common bile duct without intra or extrahepatic biliary ductal dilatation. GALLBLADDER: Cholelithiasis without gallbladder wall thickening, pericholecystic fluid, or pericholecystic fat stranding. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Interval development of aortocaval adenopathy, now with a lymph node that measures 2.4 x 1.7 cm on axial image 139. Mildly prominent left external iliac lymph node measures 1.3 x 0.9 cm (series 4 image 45), previously measuring 2.6 x 1.8 cm (series 5 image 113). Prominent right external iliac lymph node now measures 1.7 x 1.3 cm (series 4 image 461), previously measuring 2.1 x 2.1 cm (series 5 image 110). STOMACH / SMALL BOWEL: The stomach and small bowel are distended with oral contrast. Otherwise COLON / APPENDIX: Oral contrast is seen within the proximal colon. No colonic wall thickening or pericolonic stranding. PERITONEUM / MESENTERY: No free intraperitoneal air or fluid. RETROPERITONEUM: Normal. VESSELS: Possible linear, nonocclusive filling defect within the left common femoral vein and SFV, best seen on coronal series (series 100 image 35). URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Bulky, heterogenous enhancing cervical mass measuring approximately 5.9 x 4.1 cm (series 4 image 496), previously measuring 7.7 x 6.3 cm. Mass continues to extend into the lower uterine segment and upper vagina, some to previous examination. Similar appearance of areas of this mass to the right adnexa. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: 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 (
|
16,444 |
Interpretation of Outside Films CT Chest Clinical Information: 63-year-old female follow-up recurrent cervical cancer Spec Inst: CT CHEST 011122 REC 011422 RUSSELL MEDICAL CENTER Study reviewed: CT of chest without contrast performed at Russell Medical Center on January 11, 2022, The images are available in PACS. Findings: No prior CT for comparison Ill-defined patchy parenchymal opacities in the subpleural location of left upper lobe, to a lesser degree right upper lobe posterior segment near the fissure and right middle lobe near the diaphragm. No other discrete lung nodule or mass is noted. There are few small nodes in the mediastinum with the largest in the right lower paratracheal region measuring 16 x 11 mm in axial image 23, series 2. Small pericardial effusion is noted. There is no pleural effusion on either side. No focal lytic or sclerotic bone lesion is present. Conclusion: Indeterminate multifocal ill-defined airspace subpleural opacities in both lungs and borderline size paratracheal node. These findings are nonspecific, recommend comparison with any prior remote chest CT and follow-up
|
Findings: No prior CT for comparison Ill-defined patchy parenchymal opacities in the subpleural location of left upper lobe, to a lesser degree right upper lobe posterior segment near the fissure and right middle lobe near the diaphragm. No other discrete lung nodule or mass is noted. There are few small nodes in the mediastinum with the largest in the right lower paratracheal region measuring 16 x 11 mm in axial image 23, series 2. Small pericardial effusion is noted. There is no pleural effusion on either side. No focal lytic or sclerotic bone lesion is present.
|
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: Mild mucosal thickening in right maxillary sinus and right sphenoid sinus. CT maxillofacial: There is no acute maxillofacial or mandibular fracture. There is no evidence of orbital soft tissue injury. The middle ears, mastoid antra and mastoid air cells are clear. There is bilateral moderate to severe TMJ DJD.
|
16,445 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 63-year-old female with a history of cervical cancer. Patient has new vesicovaginal fistula. COMPARISON: None available. TECHNIQUE: Outside CT images without IV contrast dated 1/11/2022 were submitted for interpretation. FINDINGS: IMAGE QUALITY: Suboptimal given lack of IV contrast. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal for unenhanced technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for unenhanced technique. SPLEEN: Normal for unenhanced technique. ADRENALS: Normal for unenhanced technique. KIDNEYS: No hydroureteronephrosis or radiopaque urinary tract calculi bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal air or fluid. RETROPERITONEUM: Normal. VESSELS: Advanced atherosclerotic calcifications of the aortoiliac vasculature without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexa are unremarkable. BODY WALL: Small fat-containing periumbilical MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Limited evaluation for vesicovaginal fistula given lack of IV contrast. This could be further evaluated with CT cystogram or pelvic MRI as clinically indicated. 2. Within constraints of unenhanced technique, no evidence of metastatic disease within the abdomen or 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: IMAGE QUALITY: Suboptimal given lack of IV contrast. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal for unenhanced technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for unenhanced technique. SPLEEN: Normal for unenhanced technique. ADRENALS: Normal for unenhanced technique. KIDNEYS: No hydroureteronephrosis or radiopaque urinary tract calculi bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal air or fluid. RETROPERITONEUM: Normal. VESSELS: Advanced atherosclerotic calcifications of the aortoiliac vasculature without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexa are unremarkable. BODY WALL: Small fat-containing periumbilical MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple hypoattenuating nodules in the right thyroid lobe, the largest of which measures up to 8 mm. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Trace bilateral hemothoraces with overlying relaxation atelectasis. Subsegmental atelectatic changes in the right middle and bilateral lower lobes. No pneumothorax. HEART / VESSELS: Heart size is normal. No pericardial effusion. Advanced calcific atherosclerosis in the coronary arteries. The main pulmonary artery and thoracic aorta are normal in caliber. MEDIASTINUM / ESOPHAGUS: No acute injury DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: No acute injury BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis with borderline wall thickening and trace pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal size. A few scattered tiny calcified renal none. ADRENALS: Indeterminate right adrenal nodule measures 1.2 x 1.1 cm (series 502, image 294, 61 Hounsfield units). No significant abnormality in the left adrenal gland. KIDNEYS: Symmetric contrast enhancement. Nonobstructing punctate calculus in the interpolar right kidney. No hydroureteronephrosis. Excreted contrast is noted in the bilateral renal collecting systems and ureters. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Small diverticulum arising from the third portion the duodenum. COLON / APPENDIX: Diverticulosis. The appendix is not definitely visualized. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. Stranding about the gallbladder, as above. RETROPERITONEUM: Mild bilateral perinephric stranding. VESSELS: Mild calcific atherosclerosis in the abdominal aorta. Circumaortic left renal vein. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: Uterus is surgically absent. No significant adnexal abnormality. BODY WALL: Small fat-containing umbilical hernia. Injection site granulomata in the bilateral gluteal regions. MUSCULOSKELETAL: Segmental fractures of right ribs 6 and 7. There is also nondisplaced fracture of the right anterior third rib THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Adelia oh no erosions over at some windows leads but I haven't heard anything about the PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,446 |
CLINICAL HISTORY: Assess for cause of altered mental status COMPARISON: CT head performed same day TECHNIQUE: Noncontrast MRI head images performed at Anderson Regional Medical Center on 1/10/2022 were submitted for interpretation. Images include axial diffusion-weighted, sagittal T1, axial T2, axial T2 FLAIR, axial T1, axial GRE and coronal T2-weighted images. Please note the examination was performed outside of UAB protocol, monitoring and oversight. There are associated diagnostic limitations which should be considered prior to implementation of clinical decisions. This study interpretation should be correlated with outside imaging interpretation as transfer of data via media other than direct line may cause compression and degradation of imaging data. . FINDINGS: Images are degraded and of low quality. Within this limitation, there is no restricted diffusion to suggest an acute infarct. The apparent suggestion of increased DWI signal in the medial left temporal lobe is likely artifactual, since there is no significant abnormality on the T2 or FLAIR images in this region. There are numerous supra and infratentorial foci of low intensity on the GRE images. There are a fewer T2/FLAIR hyperintensities in the periventricular predominant fashion. The ventricles are normal in caliber and configuration. The mastoid air cells are relatively clear. The orbits are within normal limits. No suspicious calvarial lesion is noted. IMPRESSION: Images are degraded and of low quality. Within this limitation, no acute intracranial findings. MRI can be repeated if clinical concerns continues. Numerous supra and infratentorial foci of low intensity on the GRE images. Findings possibly represent microhemorrhages due to sequela of sickle cell disease.
|
FINDINGS: Images are degraded and of low quality. Within this limitation, there is no restricted diffusion to suggest an acute infarct. The apparent suggestion of increased DWI signal in the medial left temporal lobe is likely artifactual, since there is no significant abnormality on the T2 or FLAIR images in this region. There are numerous supra and infratentorial foci of low intensity on the GRE images. There are a fewer T2/FLAIR hyperintensities in the periventricular predominant fashion. The ventricles are normal in caliber and configuration. The mastoid air cells are relatively clear. The orbits are within normal limits. No suspicious calvarial lesion is noted.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple hypoattenuating nodules in the right thyroid lobe, the largest of which measures up to 8 mm. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Trace bilateral hemothoraces with overlying relaxation atelectasis. Subsegmental atelectatic changes in the right middle and bilateral lower lobes. No pneumothorax. HEART / VESSELS: Heart size is normal. No pericardial effusion. Advanced calcific atherosclerosis in the coronary arteries. The main pulmonary artery and thoracic aorta are normal in caliber. MEDIASTINUM / ESOPHAGUS: No acute injury DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: No acute injury BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis with borderline wall thickening and trace pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal size. A few scattered tiny calcified renal none. ADRENALS: Indeterminate right adrenal nodule measures 1.2 x 1.1 cm (series 502, image 294, 61 Hounsfield units). No significant abnormality in the left adrenal gland. KIDNEYS: Symmetric contrast enhancement. Nonobstructing punctate calculus in the interpolar right kidney. No hydroureteronephrosis. Excreted contrast is noted in the bilateral renal collecting systems and ureters. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Small diverticulum arising from the third portion the duodenum. COLON / APPENDIX: Diverticulosis. The appendix is not definitely visualized. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. Stranding about the gallbladder, as above. RETROPERITONEUM: Mild bilateral perinephric stranding. VESSELS: Mild calcific atherosclerosis in the abdominal aorta. Circumaortic left renal vein. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: Uterus is surgically absent. No significant adnexal abnormality. BODY WALL: Small fat-containing umbilical hernia. Injection site granulomata in the bilateral gluteal regions. MUSCULOSKELETAL: Segmental fractures of right ribs 6 and 7. There is also nondisplaced fracture of the right anterior third rib THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Adelia oh no erosions over at some windows leads but I haven't heard anything about the PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,447 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: History of sickle cell disease transferred with acute respiratory failure. COMPARISON: None available. TECHNIQUE: Outside CT images without and with IV contrast dated 1/9/2022 were submitted for interpretation. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Enlarged with lobular contour. ADRENALS: Normal. KIDNEYS: Heterogenous enhancing solid renal mass in the interpolar right kidney measuring approximately 3.5 x 4.2 x 4.0 cm (series 3, image 51 and series 5, image 51). Simple cyst in the right upper pole. A few additional smaller bilateral hypoattenuating renal lesions are too small to characterize, but statistically cysts. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed around a Foley catheter balloon. REPRODUCTIVE ORGANS: Unremarkable. BODY WALL: Nonspecific subcutaneous soft tissue nodularity in the right upper quadrant ventral abdominal wall, possibly an epidermal inclusion cyst. Small fat-containing umbilical hernia with the abdominal wall defect measuring up to 2.3 cm. MUSCULOSKELETAL: Patchy sclerosis throughout the lower lumbosacral spine and pelvis, compatible with patient's known sickle cell disease. Dense sclerotic focus in the right iliac bone, likely a bone island. CONCLUSION: 1. Solid right renal mass, consistent with renal cell carcinoma. 2. No evidence of metastatic disease within the abdomen or pelvis. 3. No acute abnormality is identified in the abdomen or 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Enlarged with lobular contour. ADRENALS: Normal. KIDNEYS: Heterogenous enhancing solid renal mass in the interpolar right kidney measuring approximately 3.5 x 4.2 x 4.0 cm (series 3, image 51 and series 5, image 51). Simple cyst in the right upper pole. A few additional smaller bilateral hypoattenuating renal lesions are too small to characterize, but statistically cysts. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed around a Foley catheter balloon. REPRODUCTIVE ORGANS: Unremarkable. BODY WALL: Nonspecific subcutaneous soft tissue nodularity in the right upper quadrant ventral abdominal wall, possibly an epidermal inclusion cyst. Small fat-containing umbilical hernia with the abdominal wall defect measuring up to 2.3 cm. MUSCULOSKELETAL: Patchy sclerosis throughout the lower lumbosacral spine and pelvis, compatible with patient's known sickle cell disease. Dense sclerotic focus in the right iliac bone, likely a bone island.
|
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 (
|
16,448 |
CLINICAL HISTORY: Assess for cause of AMS COMPARISON: None available TECHNIQUE: Outside noncontrast CT head images from Anderson Regional Medical Center were submitted for interpretation. FINDINGS: Artifact in the region of right temporal lobe. There is no intracranial hemorrhage or extra-axial collection. There is no intracranial mass effect or midline shift. The ventricular caliber and configuration are within normal limits. No calvarial fracture is appreciated. IMPRESSION: No intracranial hemorrhage.
|
FINDINGS: Artifact in the region of right temporal lobe. There is no intracranial hemorrhage or extra-axial collection. There is no intracranial mass effect or midline shift. The ventricular caliber and configuration are within normal limits. No calvarial fracture is appreciated.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple hypoattenuating nodules in the right thyroid lobe, the largest of which measures up to 8 mm. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Trace bilateral hemothoraces with overlying relaxation atelectasis. Subsegmental atelectatic changes in the right middle and bilateral lower lobes. No pneumothorax. HEART / VESSELS: Heart size is normal. No pericardial effusion. Advanced calcific atherosclerosis in the coronary arteries. The main pulmonary artery and thoracic aorta are normal in caliber. MEDIASTINUM / ESOPHAGUS: No acute injury DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: No acute injury BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis with borderline wall thickening and trace pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal size. A few scattered tiny calcified renal none. ADRENALS: Indeterminate right adrenal nodule measures 1.2 x 1.1 cm (series 502, image 294, 61 Hounsfield units). No significant abnormality in the left adrenal gland. KIDNEYS: Symmetric contrast enhancement. Nonobstructing punctate calculus in the interpolar right kidney. No hydroureteronephrosis. Excreted contrast is noted in the bilateral renal collecting systems and ureters. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Small diverticulum arising from the third portion the duodenum. COLON / APPENDIX: Diverticulosis. The appendix is not definitely visualized. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. Stranding about the gallbladder, as above. RETROPERITONEUM: Mild bilateral perinephric stranding. VESSELS: Mild calcific atherosclerosis in the abdominal aorta. Circumaortic left renal vein. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: Uterus is surgically absent. No significant adnexal abnormality. BODY WALL: Small fat-containing umbilical hernia. Injection site granulomata in the bilateral gluteal regions. MUSCULOSKELETAL: Segmental fractures of right ribs 6 and 7. There is also nondisplaced fracture of the right anterior third rib THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Adelia oh no erosions over at some windows leads but I haven't heard anything about the PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,449 |
Interpretation of Outside Films CT Chest Clinical Information: 58-year-old male with history of sickle cell disease hypertension and acute hypercapnic respiratory failure Spec Inst: Anderson Regional Medical Center DOS 1922 REC 11522 Study reviewed: CT of chest without contrast performed at Anderson Regional Medical Center on January 13, 2022, The images are available in PACS. Findings: No prior CT for comparison. There are bilateral patchy groundglass parenchymal opacities in the nondependent anterior lungs along with more denser confluent consolidation in the dependent lungs especially lower lobes right more than left. Few small size nodes are present in the mediastinum with dilated main pulmonary artery measuring 41 mm in axial image 54, series 6. There is no pleural or pericardial effusion. Mild increased sclerosis of the bones without any destructive lesion. Conclusion: 1. Bilateral multifocal groundglass and denser consolidative changes worrisome for infection? Covid. 2. Dilated main pulmonary artery reflective of secondary pulmonary artery hypertension in this patient with known sickle cell disease.
|
Findings: No prior CT for comparison. There are bilateral patchy groundglass parenchymal opacities in the nondependent anterior lungs along with more denser confluent consolidation in the dependent lungs especially lower lobes right more than left. Few small size nodes are present in the mediastinum with dilated main pulmonary artery measuring 41 mm in axial image 54, series 6. There is no pleural or pericardial effusion. Mild increased sclerosis of the bones without any destructive lesion.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple hypoattenuating nodules in the right thyroid lobe, the largest of which measures up to 8 mm. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Trace bilateral hemothoraces with overlying relaxation atelectasis. Subsegmental atelectatic changes in the right middle and bilateral lower lobes. No pneumothorax. HEART / VESSELS: Heart size is normal. No pericardial effusion. Advanced calcific atherosclerosis in the coronary arteries. The main pulmonary artery and thoracic aorta are normal in caliber. MEDIASTINUM / ESOPHAGUS: No acute injury DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: No acute injury BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis with borderline wall thickening and trace pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal size. A few scattered tiny calcified renal none. ADRENALS: Indeterminate right adrenal nodule measures 1.2 x 1.1 cm (series 502, image 294, 61 Hounsfield units). No significant abnormality in the left adrenal gland. KIDNEYS: Symmetric contrast enhancement. Nonobstructing punctate calculus in the interpolar right kidney. No hydroureteronephrosis. Excreted contrast is noted in the bilateral renal collecting systems and ureters. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Small diverticulum arising from the third portion the duodenum. COLON / APPENDIX: Diverticulosis. The appendix is not definitely visualized. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. Stranding about the gallbladder, as above. RETROPERITONEUM: Mild bilateral perinephric stranding. VESSELS: Mild calcific atherosclerosis in the abdominal aorta. Circumaortic left renal vein. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: Uterus is surgically absent. No significant adnexal abnormality. BODY WALL: Small fat-containing umbilical hernia. Injection site granulomata in the bilateral gluteal regions. MUSCULOSKELETAL: Segmental fractures of right ribs 6 and 7. There is also nondisplaced fracture of the right anterior third rib THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Adelia oh no erosions over at some windows leads but I haven't heard anything about the PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,450 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Evaluate for fracture COMPARISON: None. TECHNIQUE: Outside CT images from North Alabama Medical Center dated 1/14/22 were submitted for interpretation. CT images of the pelvis and left lower leg are provided for interpretation. FINDINGS: Pelvis: No acute fracture or dislocation. Specifically, no left femoral neck fracture. Right hip arthroplasty without complication. Moderate degenerative changes of the hip. Additional region of the SI joints and visualized lower lumbar spine. No suspicious osseous lesions. Chronic healed deformity of the right posterior ilium. Partially visualized posterior spinal decompression fusion at the lower lumbar spine. Small degenerative enthesophytes scattered about the pelvis. Diffuse decreased bone mineralization. No pelvic free fluid or lymphadenopathy. Prior hysterectomy. Moderate aortoiliac atherosclerotic disease without aneurysm. Noninflamed colonic diverticula. Remainder of the pelvic viscera are normal. Left tibia/fibula: Acute oblique periprosthetic fracture of the left proximal tibia at the tip of the tibial stem. No additional fractures identified. Chronic ununited medial malleolar fracture. The the condylar component and retrograde intramedullary nail with interlocking screws show no loosening or other complication. No additional acute fracture identified. Chronic malunited fracture deformity of left distal fibula. Degenerative changes of the ankle, hindfoot, midfoot. Degenerative calcaneal enthesophytes. CONCLUSION: 1. Acute oblique periprosthetic fracture at the tip of the knee arthroplasty tibial component. No additional acute osseous abnormality of the left lower leg or pelvis. 2. Chronic incidental findings as above.
|
FINDINGS: Pelvis: No acute fracture or dislocation. Specifically, no left femoral neck fracture. Right hip arthroplasty without complication. Moderate degenerative changes of the hip. Additional region of the SI joints and visualized lower lumbar spine. No suspicious osseous lesions. Chronic healed deformity of the right posterior ilium. Partially visualized posterior spinal decompression fusion at the lower lumbar spine. Small degenerative enthesophytes scattered about the pelvis. Diffuse decreased bone mineralization. No pelvic free fluid or lymphadenopathy. Prior hysterectomy. Moderate aortoiliac atherosclerotic disease without aneurysm. Noninflamed colonic diverticula. Remainder of the pelvic viscera are normal. Left tibia/fibula: Acute oblique periprosthetic fracture of the left proximal tibia at the tip of the tibial stem. No additional fractures identified. Chronic ununited medial malleolar fracture. The the condylar component and retrograde intramedullary nail with interlocking screws show no loosening or other complication. No additional acute fracture identified. Chronic malunited fracture deformity of left distal fibula. Degenerative changes of the ankle, hindfoot, midfoot. Degenerative calcaneal enthesophytes.
|
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: Mild mucosal thickening in right maxillary sinus and right sphenoid sinus. CT maxillofacial: There is no acute maxillofacial or mandibular fracture. There is no evidence of orbital soft tissue injury. The middle ears, mastoid antra and mastoid air cells are clear. There is bilateral moderate to severe TMJ DJD.
|
16,451 |
CLINICAL HISTORY: Refractory hypoxia, with MRSA pneumonia COMPARISON: None available at the time of interpretation TECHNIQUE: Noncontrast CT head images performed at North Alabama Medical Center on 1/13/2022 were submitted for interpretation. Images include the brain and bone windows. Please note the examination was performed outside of UAB protocol, monitoring and oversight. There are associated diagnostic limitations which should be considered prior to implementation of clinical decisions. This study interpretation should be correlated with outside imaging interpretation as transfer of data via media other than direct line may cause compression and degradation of imaging data. FINDINGS: 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. The ventricular caliber and configuration are within normal limits. Basal cisterns are patent. Imaged portions of the orbits are grossly unremarkable. Small amount of layering fluid in the maxillary sinuses. Severe opacification of bilateral mastoid air cells and middle ear clefts. No calvarial fracture is appreciated. IMPRESSION: No acute intracranial hemorrhage, or territorial infarct. Severe opacification of bilateral mastoid air cells and middle ear clefts. Small amount of layering fluid in the maxillary sinuses.
|
FINDINGS: 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. The ventricular caliber and configuration are within normal limits. Basal cisterns are patent. Imaged portions of the orbits are grossly unremarkable. Small amount of layering fluid in the maxillary sinuses. Severe opacification of bilateral mastoid air cells and middle ear clefts. No calvarial fracture is appreciated.
|
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 (
|
16,452 |
EXAM: Left knee MRI CLINICAL INFORMATION: COMPARISON: Left knee radiograph 1/3/2022 TECHNIQUE: Outside interpretation of a left knee MRI from Anniston radiology on 1/13/2022. STRUCTURED REPORT: MRI Knee 1/2/2020 FINDINGS: BONES:Oblique, minimally displaced fracture of the proximal fibula. There is a minimally depressed impaction fracture of the anterior medial femoral condyle (series 9 image 9 and series 3 and axial image 14 with diffuse bone marrow edema of the medial femoral condyle extending cranially into the distal femoral diaphysis. Bone marrow edema within the posterior medial tibial plateau. ARTICULATIONS: Effusion: Hemarthrosis. Patellofemoral compartment:No cartilage defect. Medial compartment:No cartilage defect. Lateral compartment:No cartilage defect. MENISCI: Medial meniscus:There is an oblique tear of the posterior body of the medial meniscus extending to the superior femoral articular surface (series 6 image 6). Lateral meniscus: Small vertically oriented tear of the posterior horn near the root. LIGAMENTS: Cruciate ligaments:There is a complete tear of the anterior cruciate ligament. There is a high-grade partial tear of the posterior cruciate ligament with several fibers remaining intact Medial collateral ligament:Intact with surrounding edema. Lateral collateral ligament: High grade or complete tear distally with surrounding edema. Posterolateral corner structures: Disruption of the capsule both laterally and medially. EXTENSOR MECHANISM:The distal quadriceps and patellar tendons are intact. There is a small Baker's cyst. MUSCLES: Moderate strain of the lateral gastrocnemius muscle near its origin. Mild strain of the biceps femoris. Mild strain of the semimembranosus muscle VESSELS: The popliteal artery is patent. There is no intermediate signal in vascular injury cannot be excluded. CONCLUSION: 1. Impaction fracture of the anterior aspect of the left medial femoral condyle. There is adjacent marrow edema and also within the posterior medial tibial plateau. 2. There is nondisplaced Fracture of the fibular head 3. Multi ligamentous injury including Complete rupture of the anterior cruciate ligament. 4. High-grade Partial thickness tear of posterior cruciate ligament . 5. High-grade or Complete rupture of the inferior lateral collateral ligament. 6. Small tears of the posterior horns of the medial and lateral menisci. 7. Grade 1 injury of the medial collateral ligament. 8. Large joint effusion containing hemorrhage 9. Multiple posterior compartment strains 10. Popliteal artery is patent. There is however irregular heterogeneous signal and atrophy. 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: BONES:Oblique, minimally displaced fracture of the proximal fibula. There is a minimally depressed impaction fracture of the anterior medial femoral condyle (series 9 image 9 and series 3 and axial image 14 with diffuse bone marrow edema of the medial femoral condyle extending cranially into the distal femoral diaphysis. Bone marrow edema within the posterior medial tibial plateau. ARTICULATIONS: Effusion: Hemarthrosis. Patellofemoral compartment:No cartilage defect. Medial compartment:No cartilage defect. Lateral compartment:No cartilage defect. MENISCI: Medial meniscus:There is an oblique tear of the posterior body of the medial meniscus extending to the superior femoral articular surface (series 6 image 6). Lateral meniscus: Small vertically oriented tear of the posterior horn near the root. LIGAMENTS: Cruciate ligaments:There is a complete tear of the anterior cruciate ligament. There is a high-grade partial tear of the posterior cruciate ligament with several fibers remaining intact Medial collateral ligament:Intact with surrounding edema. Lateral collateral ligament: High grade or complete tear distally with surrounding edema. Posterolateral corner structures: Disruption of the capsule both laterally and medially. EXTENSOR MECHANISM:The distal quadriceps and patellar tendons are intact. There is a small Baker's cyst. MUSCLES: Moderate strain of the lateral gastrocnemius muscle near its origin. Mild strain of the biceps femoris. Mild strain of the semimembranosus muscle VESSELS: The popliteal artery is patent. There is no intermediate signal in vascular injury cannot be excluded.
|
Findings: CTA neck: No significant stenosis at the origin of great vessels from the arch of aorta. The lateral carotid and vertebral arteries show no flow-limiting stenosis. CTA Head: Bilateral intracranial ICAs, MCAs, ACAs and their proximal branches appear normal. Intradural vertebral arteries, basilar artery and both PCAs show no flow-limiting stenosis. No evidence of aneurysm or AV malformation. There is fetal origin of both PCAs.
|
16,453 |
Interpretation of Outside Films MR Head 1/15/2022 3:03 PM Clinical Information: Spec Inst: MELANOMA MRI HEAD 1322 SEHMC REC 11522 Comparison: None available Technique: Axial diffusion, axial FLAIR, sagittal T1, axial T2, SWI, post contrast axial and coronal T1. Findings: There is a solid enhancing 7 mm lesion in the left inferior occipital lobe with surrounding vasogenic edema and local mass effect. Another tiny enhancing focus is seen in the right high frontal lobe measuring 5 mm. There is mild white matter microangiopathic changes. There are a few scattered microhemorrhages in the supratentorial and infratentorial brain on SWI. No acute infarction or intracranial hemorrhage Visualized paranasal sinuses and mastoid air cells are clear. Both orbits appear normal. Impression: Enhancing parenchymal lesions in the left occipital lobe and right high frontal lobe as above, consistent with metastasis. There is vasogenic edema surrounding the left occipital lobe lesion with local mass effect.
|
Findings: There is a solid enhancing 7 mm lesion in the left inferior occipital lobe with surrounding vasogenic edema and local mass effect. Another tiny enhancing focus is seen in the right high frontal lobe measuring 5 mm. There is mild white matter microangiopathic changes. There are a few scattered microhemorrhages in the supratentorial and infratentorial brain on SWI. No acute infarction or intracranial hemorrhage Visualized paranasal sinuses and mastoid air cells are clear. Both orbits appear normal.
|
Findings: CTA neck: No significant stenosis at the origin of great vessels from the arch of aorta. The lateral carotid and vertebral arteries show no flow-limiting stenosis. CTA Head: Bilateral intracranial ICAs, MCAs, ACAs and their proximal branches appear normal. Intradural vertebral arteries, basilar artery and both PCAs show no flow-limiting stenosis. No evidence of aneurysm or AV malformation. There is fetal origin of both PCAs.
|
16,454 |
Interpretation of Outside Films CT Chest Clinical Information: 47-year-old female with provided history of pulmonary sarcoidosis Spec Inst: PAIENT CARE CT CHEST 1522 MISS BAPTIST MED REC 11522 Study reviewed: CT of chest with contrast performed at Mississippi Baptist Medical Center on January 5, 2022, The images are available in PACS. Findings: No prior chest CT for comparison. Chest radiograph dated November 20, 2020 was reviewed. Bilateral asymmetric left more than right chronic interstitial lung disease involving predominantly the axial interstitium and to a lesser degree peripheral subpleural regions. Both lung volumes are relatively small for patient's age. There is no discrete lung nodule, mass or airspace consolidation. Only few small subcentimeter size nodes are seen in the mediastinum. The main pulmonary artery is approximately 24 mm in size in image 21, series 2. There is no pleural or pericardial effusion and visualized bones are unremarkable. Liver has heterogenous density. A small cyst is noted in the upper pole of left kidney along with accessory spleen in the left upper quadrant of the abdomen. Conclusion: Lung parenchymal chronic sarcoidosis changes left more than right without any superimposed acute bacterial or fungal infection or discrete nodule or mass.
|
Findings: No prior chest CT for comparison. Chest radiograph dated November 20, 2020 was reviewed. Bilateral asymmetric left more than right chronic interstitial lung disease involving predominantly the axial interstitium and to a lesser degree peripheral subpleural regions. Both lung volumes are relatively small for patient's age. There is no discrete lung nodule, mass or airspace consolidation. Only few small subcentimeter size nodes are seen in the mediastinum. The main pulmonary artery is approximately 24 mm in size in image 21, series 2. There is no pleural or pericardial effusion and visualized bones are unremarkable. Liver has heterogenous density. A small cyst is noted in the upper pole of left kidney along with accessory spleen in the left upper quadrant of the abdomen.
|
Findings: There is no intracranial hemorrhage or acute territorial infarction. There are advanced white matter microangiopathic changes, brain atrophy predominantly involving the left frontal lobe and exvacuo ventricular dilatation. Chronic lacunar infarcts in left thalamus and bilateral basal ganglia.
|
16,455 |
Interpretation of Outside Films CT Chest Clinical Information: 59-year-old male with history of COPD and interstitial lung disease Spec Inst: LUNG DISEASE CT CHEST 1722 BRIDGEWAY DIAG REC 11522 Study reviewed: CT of chest without contrast performed at Bridgeway diagnostic on January 7, 2022, The images are available in PACS. Findings: Compared with the another outside chest CT dated September 16, 2021. Bilateral asymmetric upper lobe subpleural cystic changes likely due to paraseptal emphysema along with slightly improved patchy groundglass parenchymal opacities involving all five lobes more dominant in the lower lobes, right middle lobe and lingula. There is associated bronchiectasis and bronchiolectasis. Subpleural cystic changes are also present in both lower lobes? Honeycombing versus emphysema. There is mosaic attenuation of the lung parenchyma. No discrete lung nodule or mass is noted. The main pulmonary artery measures 34 mm in diameter in axial image 51, series 6. There are multiple borderline size enlarged nodes in the mediastinum including prevascular, lateral aortic/AP window, upper and lower paratracheal and possibly hilar regions. Atherosclerotic calcification of coronary arteries is also present most pronounced in the LAD. There is small pericardial effusion which is new since prior study. No pleural effusion is noted on either side. There is no focal lytic or sclerotic bone lesion. Conclusion: Stable to slightly improved patchy groundglass parenchymal opacities in both lungs with persistent asymmetric upper lobe dominant paraseptal emphysema and possible minimal lower lobe honeycombing. Differential possibilities include chronic hypersensitivity pneumonitis and DIP with upper lobe dominant paraseptal emphysema.
|
Findings: Compared with the another outside chest CT dated September 16, 2021. Bilateral asymmetric upper lobe subpleural cystic changes likely due to paraseptal emphysema along with slightly improved patchy groundglass parenchymal opacities involving all five lobes more dominant in the lower lobes, right middle lobe and lingula. There is associated bronchiectasis and bronchiolectasis. Subpleural cystic changes are also present in both lower lobes? Honeycombing versus emphysema. There is mosaic attenuation of the lung parenchyma. No discrete lung nodule or mass is noted. The main pulmonary artery measures 34 mm in diameter in axial image 51, series 6. There are multiple borderline size enlarged nodes in the mediastinum including prevascular, lateral aortic/AP window, upper and lower paratracheal and possibly hilar regions. Atherosclerotic calcification of coronary arteries is also present most pronounced in the LAD. There is small pericardial effusion which is new since prior study. No pleural effusion is noted on either side. There is no focal lytic or sclerotic bone lesion.
|
Findings: No evidence of elongated transient time, and decreased CBV or CBF is noted to suggest significant ischemia or infarction at the territory of major intracranial arteries.
|
16,456 |
RADIOLOGIC EXAM: Interpretation of Outside Films CT CSPN CLINICAL INFORMATION: Trauma Spec Inst: CT Cervical Spine DOS 11522 COMPARISON: Same day subsequently obtained CT cervical spine. TECHNIQUE: Interpretation of Outside Films CT CSPN . Outside hospital CT images of the cervical spine without contrast were submitted for interpretation. Axial, coronal, and sagittal images were reviewed. STRUCTURED REPORT: CT Cervical Spine Trauma FINDINGS: 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: 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 head: 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 acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
|
16,457 |
Interpretation of Outside Films CT Head, Interpretation of Outside Films CT Face 1/15/2022 11:44 PM Clinical Information: Trauma. Spec Inst: CT Head DOS 11522 Comparison: Head and maxillofacial CT same date Technique: Interpretation of outside unenhanced head and maxillofacial CT performed on 1/15/2022 Findings: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Mild diffuse parenchymal volume loss. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. EXTRA-AXIAL SPACES: Acute small subdural hematoma along the right cerebral convexity measuring 6 mm, underlying the craniotomy flap. No significant mass effect or midline shift. VENTRICULAR SYSTEM: Ex vacuo dilatation. ORBITS: Left globe rupture. Small amount of retrobulbar hemorrhage and trace extraconal gas. Comminuted, displaced fractures of the left inferior and lateral orbital rim and subtle fractures of the anterior lamina papyracea. No extraocular muscle herniation or thickening. Small left periorbital hematoma. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. Post right hemicraniotomy changes. Maxillofacial CT: FACIAL BONES: Comminuted and displaced left nasal bone extending into the frontal process of the maxilla and involving the nasolacrimal duct. Comminuted, displaced anterior and posterior left maxillary sinus wall fractures. Pterygoid plates are intact. Multiple dental caries and periapical lucency. MANDIBLE: No fracture. No traumatic TMJ dislocation. SINONASAL CAVITIES: Moderate amount of intrasinus hemorrhage in the left maxillary and left ethmoid sinuses. Small amount of hemorrhage in the left frontal sinus. Mucosal thickening versus trace hemorrhage in the bilateral sphenoid sinuses. Impression: 1. Small subdural hematoma along the right cerebral convexity without significant mass effect or midline shift. 2. Left globe rupture with small retrobulbar hemorrhage. 3. Comminuted, displaced left orbital fractures as described. 4. Comminuted fractures of the anterior and posterior walls of the left maxillary sinus. 5. Left nasal bone and maxillary frontal process fractures extending through the nasolacrimal duct.
|
Findings: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Mild diffuse parenchymal volume loss. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. EXTRA-AXIAL SPACES: Acute small subdural hematoma along the right cerebral convexity measuring 6 mm, underlying the craniotomy flap. No significant mass effect or midline shift. VENTRICULAR SYSTEM: Ex vacuo dilatation. ORBITS: Left globe rupture. Small amount of retrobulbar hemorrhage and trace extraconal gas. Comminuted, displaced fractures of the left inferior and lateral orbital rim and subtle fractures of the anterior lamina papyracea. No extraocular muscle herniation or thickening. Small left periorbital hematoma. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. Post right hemicraniotomy changes. Maxillofacial CT: FACIAL BONES: Comminuted and displaced left nasal bone extending into the frontal process of the maxilla and involving the nasolacrimal duct. Comminuted, displaced anterior and posterior left maxillary sinus wall fractures. Pterygoid plates are intact. Multiple dental caries and periapical lucency. MANDIBLE: No fracture. No traumatic TMJ dislocation. SINONASAL CAVITIES: Moderate amount of intrasinus hemorrhage in the left maxillary and left ethmoid sinuses. Small amount of hemorrhage in the left frontal sinus. Mucosal thickening versus trace hemorrhage in the bilateral sphenoid sinuses.
|
Findings: CT head: 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 acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild mucosal thickening of the bilateral sphenoid sinuses. The remainder of the visualized paranasal sinuses and mastoid air cells are clear.
|
16,458 |
Interpretation of Outside Films CT Head, Interpretation of Outside Films CT Face 1/15/2022 11:44 PM Clinical Information: Trauma. Spec Inst: CT Head DOS 11522 Comparison: Head and maxillofacial CT same date Technique: Interpretation of outside unenhanced head and maxillofacial CT performed on 1/15/2022 Findings: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Mild diffuse parenchymal volume loss. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. EXTRA-AXIAL SPACES: Acute small subdural hematoma along the right cerebral convexity measuring 6 mm, underlying the craniotomy flap. No significant mass effect or midline shift. VENTRICULAR SYSTEM: Ex vacuo dilatation. ORBITS: Left globe rupture. Small amount of retrobulbar hemorrhage and trace extraconal gas. Comminuted, displaced fractures of the left inferior and lateral orbital rim and subtle fractures of the anterior lamina papyracea. No extraocular muscle herniation or thickening. Small left periorbital hematoma. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. Post right hemicraniotomy changes. Maxillofacial CT: FACIAL BONES: Comminuted and displaced left nasal bone extending into the frontal process of the maxilla and involving the nasolacrimal duct. Comminuted, displaced anterior and posterior left maxillary sinus wall fractures. Pterygoid plates are intact. Multiple dental caries and periapical lucency. MANDIBLE: No fracture. No traumatic TMJ dislocation. SINONASAL CAVITIES: Moderate amount of intrasinus hemorrhage in the left maxillary and left ethmoid sinuses. Small amount of hemorrhage in the left frontal sinus. Mucosal thickening versus trace hemorrhage in the bilateral sphenoid sinuses. Impression: 1. Small subdural hematoma along the right cerebral convexity without significant mass effect or midline shift. 2. Left globe rupture with small retrobulbar hemorrhage. 3. Comminuted, displaced left orbital fractures as described. 4. Comminuted fractures of the anterior and posterior walls of the left maxillary sinus. 5. Left nasal bone and maxillary frontal process fractures extending through the nasolacrimal duct.
|
Findings: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Mild diffuse parenchymal volume loss. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. EXTRA-AXIAL SPACES: Acute small subdural hematoma along the right cerebral convexity measuring 6 mm, underlying the craniotomy flap. No significant mass effect or midline shift. VENTRICULAR SYSTEM: Ex vacuo dilatation. ORBITS: Left globe rupture. Small amount of retrobulbar hemorrhage and trace extraconal gas. Comminuted, displaced fractures of the left inferior and lateral orbital rim and subtle fractures of the anterior lamina papyracea. No extraocular muscle herniation or thickening. Small left periorbital hematoma. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. Post right hemicraniotomy changes. Maxillofacial CT: FACIAL BONES: Comminuted and displaced left nasal bone extending into the frontal process of the maxilla and involving the nasolacrimal duct. Comminuted, displaced anterior and posterior left maxillary sinus wall fractures. Pterygoid plates are intact. Multiple dental caries and periapical lucency. MANDIBLE: No fracture. No traumatic TMJ dislocation. SINONASAL CAVITIES: Moderate amount of intrasinus hemorrhage in the left maxillary and left ethmoid sinuses. Small amount of hemorrhage in the left frontal sinus. Mucosal thickening versus trace hemorrhage in the bilateral sphenoid sinuses.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Tiny hiatal hernia. HEART / VESSELS: The heart is enlarged. ABDOMEN and PELVIS: LIVER: Scattered hepatic cysts. Subcentimeter hypoattenuating lesions are also noted which are indeterminate. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Indeterminate hypoattenuating lesion within the posterior aspect of the left kidney measures 1.4 x 1.3 cm on axial series 8 image 75. This lesion shows questionable mild enhancement; measuring 40 Hounsfield units on precontrast images and 60-70 Hounsfield units on postcontrast images. A smaller 11 mm indeterminate hypoattenuating lesion is noted more superiorly in the upper pole the left kidney. The kidneys are otherwise normal. LYMPH NODES: Nodule in the periaortic region adjacent to the second portion of the duodenum has the appearance of bowel wall and lumen although there is no definitive connection to the duodenum to suggest duodenal diverticulum. The other possibility is this is a centrally hypoattenuating lymph nodes although this is thought to be less likely. This is seen on axial series 8 image 83 and measures 1.3 x 1.0 cm. Other scattered mildly prominent para-aortic lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix and colon are normal. PERITONEUM / MESENTERY: Focal increased attenuation within the central mesentery with scattered nodules. RETROPERITONEUM: Normal. VESSELS: Scattered vascular calcifications. Two right renal arteries. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The prostate is moderately enlarged measuring 6.1 cm transverse. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Advanced degenerative change of the SI joints, hips, and pubic symphysis. There is partial anterior ankylosis of both SI joints. Advanced discogenic degenerative change of the lower lumbar spine facet arthropathy.
|
16,459 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Liver mass. Hepatocellular carcinoma. COMPARISON: CT dated 12/16/2021. TECHNIQUE: Outside MR images without and with IV contrast dated 1/13/2022 were submitted for interpretation. FINDINGS: STRUCTURED REPORT: MRI Abdomen LOWER CHEST: LUNG BASES / PLEURA: No significant abnormality. DISTAL ESOPHAGUS: No significant abnormality. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic with mild steatosis. Infiltrative arterially enhancing left hepatic lobe mass occupies essentially all of the left hepatic lobe and extends into the caudate. There is enhancing tumor thrombus within the left portal vein, extending into the main and right portal vein. Additional wedge-shaped area of T2 hyperintensity in the peripheral right hepatic lobe is noted with associated diffusion restriction and lack of retention of hepatobiliary phase contrast. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Mildly enlarged. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Otherwise unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Unchanged L1 compression fracture. Otherwise normal. CONCLUSION: 1. Unchanged appearance of infiltrative left hepatic lobe mass with associated tumor thrombus in the portal venous system, as above (LR-TIV). Given the avid arterial enhancement of the mass, this is favored to represent infiltrative hepatocellular carcinoma. No evidence of abdominal metastatic disease. 2. Additional wedge-shaped area of signal abnormality in the peripheral right hepatic lobe is indeterminate and could represent an intrahepatic metastasis versus focal fibrosis. Attention on follow-up is recommended.
|
FINDINGS: STRUCTURED REPORT: MRI Abdomen LOWER CHEST: LUNG BASES / PLEURA: No significant abnormality. DISTAL ESOPHAGUS: No significant abnormality. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic with mild steatosis. Infiltrative arterially enhancing left hepatic lobe mass occupies essentially all of the left hepatic lobe and extends into the caudate. There is enhancing tumor thrombus within the left portal vein, extending into the main and right portal vein. Additional wedge-shaped area of T2 hyperintensity in the peripheral right hepatic lobe is noted with associated diffusion restriction and lack of retention of hepatobiliary phase contrast. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Mildly enlarged. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Otherwise unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Unchanged L1 compression fracture. Otherwise normal.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Reticular opacity at the right base. Trace right pleural effusion. DISTAL ESOPHAGUS: Moderately sized hiatal hernia with distal esophageal wall thickening consistent with reflux esophagitis. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Lobulated cystic lesion within the posterior aspect of the right hepatic lobe on axial series 201 image 86. Mild periportal edema. Multiple ill-defined subtle hypoattenuating lesions within the left hepatic lobe the largest of which is noted on axial series 201 image 60. BILIARY TRACT: Normal. GALLBLADDER: Partially collapsed. PANCREAS: Hypoattenuating partially cystic ill-defined mass in the pancreatic tail measures 2.9 x 2.6 cm on axial series 201 image 107. There is mild upstream pancreatic ductal dilatation. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Multiple enlarged periaortic lymph nodes the largest of which measures 1.3 x 1.2 cm on axial series 201 image 119. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is identified. Diverticulosis. Focal section of colonic wall thickening involving the distal sigmoid colon (axial series 201 image 231. PERITONEUM / MESENTERY: Large volume ascites. Multifocal peritoneal and mesenteric nodules highly concerning for peritoneal carcinomatosis (for example axial series 201 images 84, 115, 128, and 131). RETROPERITONEUM: Normal. VESSELS: Mixing artifacts within the bilateral femoral veins. Scattered vascular calcifications. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The prostate is enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multilevel discogenic degenerative change no osseous metastatic lesions.
|
16,460 |
Interpretation of Outside Films CT Chest Clinical Information: 74-year-old male with dyspnea and chronic cough along with history of coronary artery disease, diabetes, hypertension and prior CVA. Spec Inst: CONTINUE CARE CT CHEST 1722 SPRINGHILL MED REC 11622 Study reviewed: CT of chest without contrast performed at Springhill medical Hospital on January 7, 2022, The images are available in PACS. Findings: No prior study for comparison. Bilateral subpleural coarse reticulations associated with traction bronchiectasis more pronounced in the lower lobes right more than left without definitive honeycombing. There is no associated consolidation or discrete lung nodule/mass. Several calcified nodes are present in the mediastinum along with few noncalcified nodes. Atherosclerotic coronary artery calcification is also noted the main pulmonary artery measures 30 mm in axial image 28, series 3. There is no pleural or pericardial effusion and visualized bones are unremarkable. Conclusion: Findings are suggestive of asymmetric chronic interstitial lung disease with probable UIP pattern.
|
Findings: No prior study for comparison. Bilateral subpleural coarse reticulations associated with traction bronchiectasis more pronounced in the lower lobes right more than left without definitive honeycombing. There is no associated consolidation or discrete lung nodule/mass. Several calcified nodes are present in the mediastinum along with few noncalcified nodes. Atherosclerotic coronary artery calcification is also noted the main pulmonary artery measures 30 mm in axial image 28, series 3. There is no pleural or pericardial effusion and visualized bones are unremarkable.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Focal fatty infiltration along the falciform ligament. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None pathologically enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Scattered noninflamed colonic diverticula. Normal appendix. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Myxomatous uterus. Bilateral adnexal cysts. BODY WALL: Omental fat-containing periumbilical hernia a small amount of adjacent fluid. MUSCULOSKELETAL: No significant abnormality.
|
16,461 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Bowel ischemia COMPARISON: CT abdomen performed subsequently on 01/17/2022 TECHNIQUE: Outside CT images abdomen and pelvis dated 01/15/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. Long segment thrombus within the proximal SMA with distal reconstitution by collaterals from the celiac trunk. Branches of the SMA demonstrates normal opacification particularly on delayed phase. Small bowel loops demonstrate normal wall thickness and enhancement. No bowel wall pneumatosis or portal venous gas. Origins of celiac trunk and a few mesenteric arteries are normal. Small caliber multiple bilateral renal arteries. Nonaneurysmal abdominal aorta. Small nonocclusive thrombi within the imaged lower thoracic aorta and abdominal aorta. Small bilateral pleural effusions. Splenic infarcts. Normal appearance of liver, gallbladder, pancreas and adrenal glands. Kidneys demonstrate symmetric enhancement without any infarcts. Small volume ascites. No pneumoperitoneum. No acute osseous findings. CONCLUSION: 1. Long segment acute thrombosis of SMA, which remains unchanged on subsequent CT obtained on 01/17/2022. Distal reconstitution of SMA and is branches from collaterals from the celiac trunk. 2. No obvious bowel wall thickening or hyperenhancement to suggest bowel ischemia. No bowel wall pneumatosis or portal venous gas. 3. Small splenic infarcts. Small thrombi within the lower thoracic and suprarenal abdominal aorta, which remains unchanged on subsequent CT. 4. Small volume ascites and small volume bilateral pleural effusions..
|
FINDINGS: IMAGE QUALITY: Satisfactory. Long segment thrombus within the proximal SMA with distal reconstitution by collaterals from the celiac trunk. Branches of the SMA demonstrates normal opacification particularly on delayed phase. Small bowel loops demonstrate normal wall thickness and enhancement. No bowel wall pneumatosis or portal venous gas. Origins of celiac trunk and a few mesenteric arteries are normal. Small caliber multiple bilateral renal arteries. Nonaneurysmal abdominal aorta. Small nonocclusive thrombi within the imaged lower thoracic aorta and abdominal aorta. Small bilateral pleural effusions. Splenic infarcts. Normal appearance of liver, gallbladder, pancreas and adrenal glands. Kidneys demonstrate symmetric enhancement without any infarcts. Small volume ascites. No pneumoperitoneum. No acute osseous findings.
|
FINDINGS: There is mild diffuse cerebral volume loss. White matter hypodensity suggestive for microvascular angiopathy. Evidence of intracranial atherosclerosis is seen. The brain parenchyma appears normal without evidence for acute territorial infarct, mass lesion, mass effect, or recent hemorrhage. The ventricles are normal in size. There is no abnormal extra axial collection. The calvarium is intact. Mucosal thickening of left sphenoidal sinus is suggestive for sinusitis.. The orbits are normal. Evidence of bilateral proptosis is noted.
|
16,462 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 65-year-old woman with cirrhosis undergoing evaluation for potential transplant COMPARISON: None. TECHNIQUE: Outside CT images of the abdomen and pelvis obtained without intravenous contrast at UAB West dated 1/1/2022 were submitted for interpretation on 1/17/2022. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: The examination is limited for detection of HCC given lack of intravenous contrast.2 STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Anterior right base pleural nodule measures 1 cm (image eight series 3). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: The contour is cirrhotic. There are multiple areas of lower attenuation involving multiple segments in both lobes, the largest on the left measuring 13.5 cm spanning segments II and IVA (image 19 series 3) and on the right measuring 8 cm in the inferior right lobe spanning segments V and VI (image 32 series 3). Patency of the hepatic and portal venous systems is not established without intravenous contrast. No large collaterals are seen. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: An 8 mm ovoid well-circumscribed low-attenuation the pancreatic tail may represent side branch-type IP MN. No other lesions given limitations of unenhanced technique. SPLEEN: None enlarged. No focal abnormalities given limitations of unenhanced technique. ADRENALS: Normal. KIDNEYS: Mild right perirenal stranding. No definite focal abnormalities for unenhanced technique. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality given limitations of unenhanced technique.. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: A moderately large amount of ascites is present. RETROPERITONEUM: Normal. VESSELS: Heavy calcific aeration is seen in the lower aspect of the normal caliber abdominal aorta, multiple iliac vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus appears surgically absent. The adnexa appear unremarkable. BODY WALL: Mild anasarca. MUSCULOSKELETAL: Degenerative changes are seen in the lumbar spine. No aggressive osseous lesions are noted. CONCLUSION: 1. Cirrhotic hepatic contour with multifocal areas of poorly defined low attenuation highly suspicious for potential HCC or, given the extensiveness infiltrative appearance is conceivable this represents heterogeneous steatosis. MRI of the abdomen without and with contrast is recommended for further assessment. 2. Periportal hypertension as evidenced by ascites. Patency of the portal mesenteric vasculature is not evaluable in the absence of intravenous contrast administration.
|
FINDINGS: IMAGE QUALITY: The examination is limited for detection of HCC given lack of intravenous contrast.2 STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Anterior right base pleural nodule measures 1 cm (image eight series 3). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: The contour is cirrhotic. There are multiple areas of lower attenuation involving multiple segments in both lobes, the largest on the left measuring 13.5 cm spanning segments II and IVA (image 19 series 3) and on the right measuring 8 cm in the inferior right lobe spanning segments V and VI (image 32 series 3). Patency of the hepatic and portal venous systems is not established without intravenous contrast. No large collaterals are seen. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: An 8 mm ovoid well-circumscribed low-attenuation the pancreatic tail may represent side branch-type IP MN. No other lesions given limitations of unenhanced technique. SPLEEN: None enlarged. No focal abnormalities given limitations of unenhanced technique. ADRENALS: Normal. KIDNEYS: Mild right perirenal stranding. No definite focal abnormalities for unenhanced technique. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality given limitations of unenhanced technique.. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: A moderately large amount of ascites is present. RETROPERITONEUM: Normal. VESSELS: Heavy calcific aeration is seen in the lower aspect of the normal caliber abdominal aorta, multiple iliac vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus appears surgically absent. The adnexa appear unremarkable. BODY WALL: Mild anasarca. MUSCULOSKELETAL: Degenerative changes are seen in the lumbar spine. No aggressive osseous lesions are noted.
|
FINDINGS: The gray-white matter differentiation is diffusely decreased in the brain. Also there is mild gyral swelling with effacement of the cerebral sulci for example the sulci between the superior and middle frontal gyri bilaterally. Evidence of intracranial atherosclerosis is seen. The brain parenchyma appears normal without evidence for acute territorial infarct, mass lesion, mass effect, or recent hemorrhage. The ventricles are normal in size. There is no abnormal extra axial collection. The calvarium is intact. Near complete opacification of left maxillary sinus and partial opacification of the right maxillary sinus and fluid in the ethmoidal and sphenoidal air cells is likely secondary to NG tube and ET tube placement.. Effusion of bilateral mastoidal sinuses is seen. Subcutaneous is stranding is seen in the vertex. Correlation with physical examination is recommended. The orbits are normal. There is diffuse vascular calcification. This finding can be sequela of renal failure.
|
16,463 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Covid. History of breast cancer. COMPARISON: 1/11/2022 UAB TECHNIQUE: Outside CT images from medical West FED dated 1/16/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Innumerable decreased attenuation lesions, with areas of focal sparing is grossly similar to prior. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypodensities statistically represent cysts but are formally indeterminate. Mild heterogeneity in enhancement bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Small ascites is increased from prior. Small mesenteric nodules are similar to prior. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Distended. REPRODUCTIVE ORGANS: Status post hysterectomy. Adnexa are unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Small sclerotic lesions in the bony pelvis and lumbar spine are unchanged from prior. CONCLUSION: 1. Extensive metastatic disease in the liver and small sclerotic lesions in the lumbar spine and pelvis are similar to prior. 2. Small ascites is increased from prior. 3. Patchy enhancement of the kidneys is more prominent than prior. Pyelonephritis cannot be excluded. Recommend clinical correlation with urinalysis. 4. Incidental findings as detailed above. 5. Chest findings to be reported separately.
|
FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Innumerable decreased attenuation lesions, with areas of focal sparing is grossly similar to prior. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypodensities statistically represent cysts but are formally indeterminate. Mild heterogeneity in enhancement bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Small ascites is increased from prior. Small mesenteric nodules are similar to prior. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Distended. REPRODUCTIVE ORGANS: Status post hysterectomy. Adnexa are unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Small sclerotic lesions in the bony pelvis and lumbar spine are unchanged from prior.
|
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: Diffuse bilateral multifocal groundglass opacities. Additionally, bilateral apical emphysematous changes are present. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Liver transplant postsurgical changes. MUSCULOSKELETAL: No significant abnormality.
|
16,464 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 53-year-old male with small bowel obstruction, concern for pneumatosis/ischemia. COMPARISON: CT 01/17/2022. TECHNIQUE: Outside CT images of the abdomen and pelvis dated 1/16/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered bilateral groundglass opacities with deep tendon atelectasis of the visualized lung. No pleural effusion. HEART /VESSELS: Central venous catheter tip terminates in the right atrium. Minimal coronary vascular calcifications. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube in place. There is fluid within the esophagus suggesting gastroesophageal reflux. LYMPH NODE: No enlarged lymph nodes visualized. CHEST: Normal. ABDOMEN and PELVIS: LIVER: Cirrhotic morphology of the liver. There is a 2.8 cm ill-defined hypoattenuating lesion in the posterior right hepatic lobe (on series 302, image 65. Additional questionable lesion in the left lobe measuring about 1.4 cm BILIARY TRACT: Normal. GALLBLADDER: Hyperdense contents within the gallbladder. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: A 2.2 cm right upper pole renal cortical cyst with dependent milk of calcium. No hydronephrosis. No perinephric fluid collection. LYMPH NODES: Scattered mildly prominent para-aortic and mesenteric lymph nodes. STOMACH / SMALL BOWEL: Esophagogastric tube tip terminates in the gastric body. Diffuse moderately dilated gas and fluid-filled small bowel without dilatation point. COLON / APPENDIX: Diffuse moderately dilated large bowel loops. There are gas foci along the dependent portions of the large bowel loops likely represent entrapped gas rather than pneumatosis. Small amount of gas is seen within the adjacent mesenteric vasculature for, for example series 601/image 66, which has resolved on subsequent CT done on 01/17/2022. PERITONEUM / MESENTERY: Large volume ascites. Mild dependent hyperdensity within the ascitic fluid RETROPERITONEUM: Mild retroperitoneal edema. VESSELS: Scattered atherosclerotic calcifications. Extensive enlarged portal venous system collaterals. URINARY BLADDER: Partially collapsed around a Foley balloon. REPRODUCTIVE ORGANS: Ascites tracking along the left inguinal canal. BODY WALL: Scattered partially wall edema. MUSCULOSKELETAL: Bilateral L5 pars defect. CONCLUSION: 1. Moderate diffuse distention of small or large bowel loops, which is unchanged on subsequent CT obtained on 01/17/2022 and likely related to adynamic ileus. Gas foci along the dependent portion of the colonic wall and circumferential along portions of distal small bowel loop may represent entrapped gas rather than bowel wall pneumatosis from ischemia. Trace gas within the adjacent mesenteric vasculature has resolved on subsequent CT performed on 01/17/2022 2. Cirrhotic morphology of the liver with sequelae of portal venous hypertension. A 2.7 cm hypoattenuating right hepatic lobe lesion, further evaluation with multiphasic CT is recommended. 3. Other incidental/chronic 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: IMAGE QUALITY: Satisfactory. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered bilateral groundglass opacities with deep tendon atelectasis of the visualized lung. No pleural effusion. HEART /VESSELS: Central venous catheter tip terminates in the right atrium. Minimal coronary vascular calcifications. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube in place. There is fluid within the esophagus suggesting gastroesophageal reflux. LYMPH NODE: No enlarged lymph nodes visualized. CHEST: Normal. ABDOMEN and PELVIS: LIVER: Cirrhotic morphology of the liver. There is a 2.8 cm ill-defined hypoattenuating lesion in the posterior right hepatic lobe (on series 302, image 65. Additional questionable lesion in the left lobe measuring about 1.4 cm BILIARY TRACT: Normal. GALLBLADDER: Hyperdense contents within the gallbladder. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: A 2.2 cm right upper pole renal cortical cyst with dependent milk of calcium. No hydronephrosis. No perinephric fluid collection. LYMPH NODES: Scattered mildly prominent para-aortic and mesenteric lymph nodes. STOMACH / SMALL BOWEL: Esophagogastric tube tip terminates in the gastric body. Diffuse moderately dilated gas and fluid-filled small bowel without dilatation point. COLON / APPENDIX: Diffuse moderately dilated large bowel loops. There are gas foci along the dependent portions of the large bowel loops likely represent entrapped gas rather than pneumatosis. Small amount of gas is seen within the adjacent mesenteric vasculature for, for example series 601/image 66, which has resolved on subsequent CT done on 01/17/2022. PERITONEUM / MESENTERY: Large volume ascites. Mild dependent hyperdensity within the ascitic fluid RETROPERITONEUM: Mild retroperitoneal edema. VESSELS: Scattered atherosclerotic calcifications. Extensive enlarged portal venous system collaterals. URINARY BLADDER: Partially collapsed around a Foley balloon. REPRODUCTIVE ORGANS: Ascites tracking along the left inguinal canal. BODY WALL: Scattered partially wall edema. MUSCULOSKELETAL: Bilateral L5 pars defect.
|
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries due to motion artifacts. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Endotracheal tube in the upper trachea in good position. Left lower lobe collapse is again seen. Worsening atelectatic changes at the right lung base. Interval diffuse worsening of the bilateral centrilobular tree-in-bud type of nodularity. HEART / OTHER VESSELS: Borderline heart size. Small pericardial effusion. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. Patulous esophagus with air-fluid level seen. A feeding tube courses through the esophagus, is coiled in the proximal stomach and terminates in the distal stomach. LYMPH NODES: None enlarged. CHEST WALL: Unchanged small fluid collection in the anterior chest wall to the left of midline, currently measuring about 2.5 x 2.1 cm (series 906; image 14). UPPER ABDOMEN: Heterogenous appearance of the liver which may represent congestive hepatopathy. MUSCULOSKELETAL: No significant abnormality.
|
16,465 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: History of duodenal neuroendocrine tumor with regional nodal metastasis status post Whipple on 12/10/2021, with course complicated by intra-abdominal abscesses status post percutaneous drain placement on 12/22/2021. The patient recently presented to an outside hospital with bilious emesis and anorexia. COMPARISON: CT abdomen and pelvis with contrast 1/4/2022, intraprocedural fluoroscopic images from drainage catheter check/exchange 1/5/2022. TECHNIQUE: Outside axial CT images of the abdomen and pelvis with contrast dated 1/17/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Mild distal esophageal thickening, probably related to gastroesophageal reflux. Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Postsurgical changes from hepaticojejunostomy with unchanged mild wall thickening and enhancement in the nondilated common bile duct. No intrahepatic biliary ductal dilatation. GALLBLADDER: Surgically absent. PANCREAS: Postsurgical changes from pancreaticoduodenectomy with right lower quadrant approach percutaneous stents terminating in the distal main pancreatic duct. No pancreatic ductal dilatation or parenchymal atrophy. No decrease in peripancreatic stranding and edema. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Unchanged bilateral renal hypodensities which are technically indeterminate but likely cysts. Additional hypoattenuating lesions in the left kidney are too small to characterize, but are statistically likely cysts. Nonobstructing bilateral nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Postsurgical changes from pancreaticoduodenectomy with left upper quadrant gastrojejunal anastomosis and hepaticojejunostomy. COLON / APPENDIX: Redemonstration of submucosal fat deposition in the ascending and transverse colon. The appendix is normal. PERITONEUM / MESENTERY: Percutaneous pigtail drainage catheter terminates within a markedly decompressed right upper quadrant fluid collection, now difficult to accurately measure. Ill-defined adjacent phlegmonous changes tracking into the retroperitoneum, with interval decrease in size of the peripherally enhancing collection in the root of the mesentery, deep to the cranial aspect of the SMA and SMV, measuring 2.2 x 1.1 cm (series 2, image 36). Interval decrease in size of the left paracolic gutter collection, measuring 1.7 x 1.1 m (series 2, image 31), previously measuring 2.6 x 1.4 cm (series 301, image 120) with decrease in adjacent stranding. No new intra-abdominal collection is identified. No pneumoperitoneum. RETROPERITONEUM: Mild peripancreatic stranding and edema, improved from prior examination, as above. VESSELS: Flattening of the IVC, suggestive of of intravascular volume depletion. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Expected postsurgical changes from recent epigastric midline laparotomy. No no organized or drainable fluid collection. Right upper quadrant percutaneous drainage catheter and right lower quadrant percutaneous pancreatic duct stent, as above. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. CONCLUSION: 1. Postsurgical changes from pancreaticoduodenectomy. Percutaneous drainage catheter terminates in the right hemiabdominal collection with marked decrease in size of this component and small residual component in the root of the mesentery. Findings are likely related to hepaticojejunostomy dehiscence as seen on recent catheter check/exchange. 2. Interval decrease in size of the collection in the left paracolic gutter. 3. Additional findings above. Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Mild distal esophageal thickening, probably related to gastroesophageal reflux. Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Postsurgical changes from hepaticojejunostomy with unchanged mild wall thickening and enhancement in the nondilated common bile duct. No intrahepatic biliary ductal dilatation. GALLBLADDER: Surgically absent. PANCREAS: Postsurgical changes from pancreaticoduodenectomy with right lower quadrant approach percutaneous stents terminating in the distal main pancreatic duct. No pancreatic ductal dilatation or parenchymal atrophy. No decrease in peripancreatic stranding and edema. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Unchanged bilateral renal hypodensities which are technically indeterminate but likely cysts. Additional hypoattenuating lesions in the left kidney are too small to characterize, but are statistically likely cysts. Nonobstructing bilateral nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Postsurgical changes from pancreaticoduodenectomy with left upper quadrant gastrojejunal anastomosis and hepaticojejunostomy. COLON / APPENDIX: Redemonstration of submucosal fat deposition in the ascending and transverse colon. The appendix is normal. PERITONEUM / MESENTERY: Percutaneous pigtail drainage catheter terminates within a markedly decompressed right upper quadrant fluid collection, now difficult to accurately measure. Ill-defined adjacent phlegmonous changes tracking into the retroperitoneum, with interval decrease in size of the peripherally enhancing collection in the root of the mesentery, deep to the cranial aspect of the SMA and SMV, measuring 2.2 x 1.1 cm (series 2, image 36). Interval decrease in size of the left paracolic gutter collection, measuring 1.7 x 1.1 m (series 2, image 31), previously measuring 2.6 x 1.4 cm (series 301, image 120) with decrease in adjacent stranding. No new intra-abdominal collection is identified. No pneumoperitoneum. RETROPERITONEUM: Mild peripancreatic stranding and edema, improved from prior examination, as above. VESSELS: Flattening of the IVC, suggestive of of intravascular volume depletion. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Expected postsurgical changes from recent epigastric midline laparotomy. No no organized or drainable fluid collection. Right upper quadrant percutaneous drainage catheter and right lower quadrant percutaneous pancreatic duct stent, as above. MUSCULOSKELETAL: No aggressive osseous abnormality is identified.
|
FINDINGS: CT of the head with and without contrast: There is no acute infarction, hemorrhage, mass, or cerebral edema. The gray-white matter differentiation is maintained. The cerebral cortical volume is appropriate for patient's age. Mild ex vacuo dilatation of the ventricles. No enhancing intracranial abnormality. Subcortical and periventricular hypodensities likely represent chronic microangiopathic changes. There is no acute osseous or orbital abnormality. Mild mucosal thickening of the right frontal sinus. The remainder of the visualized paranasal sinuses and mastoid air cells are clear. CT angiogram of the brain: RIGHT CAROTID: Calcifications of the carotid siphon. There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Calcifications of the carotid siphon. There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Mild atherosclerotic calcifications. Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Atherosclerotic calcification at carotid bifurcation and proximal ICA without flow limitation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Atherosclerotic calcification at carotid bifurcation and proximal ICA without flow limitation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: Anterior cervical fusion hardware at C6-7 shows no evidence of loosening or failure. No acute displaced fracture.
|
16,466 |
Interpretation of Outside Films CT Head Clinical Information: Trauma Spec Inst: CT Head DOS 11022 Comparison: None available Technique: Axial CT images of the head are provided for interpretation. The study was performed at outside hospital Spec Inst: CT Head DOS 11022 -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: There is no acute hemorrhage, evidence of acute infarction or hydrocephalus. There is no vasogenic edema or mass effect. Comminuted right mandibular ramus fracture is partially visualized please refer to separate maxillofacial CT report for further details. The visualized paranasal sinuses and mastoid air cells grossly appear clear. Impression: 1. No CT evidence of acute intracranial abnormality. 2. Comminuted right mandibular fracture. Please refer to separate maxillofacial CT report. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: There is no acute hemorrhage, evidence of acute infarction or hydrocephalus. There is no vasogenic edema or mass effect. Comminuted right mandibular ramus fracture is partially visualized please refer to separate maxillofacial CT report for further details. The visualized paranasal sinuses and mastoid air cells grossly appear clear.
|
FINDINGS: CT of the head with and without contrast: There is no acute infarction, hemorrhage, mass, or cerebral edema. The gray-white matter differentiation is maintained. The cerebral cortical volume is appropriate for patient's age. Mild ex vacuo dilatation of the ventricles. No enhancing intracranial abnormality. Subcortical and periventricular hypodensities likely represent chronic microangiopathic changes. There is no acute osseous or orbital abnormality. Mild mucosal thickening of the right frontal sinus. The remainder of the visualized paranasal sinuses and mastoid air cells are clear. CT angiogram of the brain: RIGHT CAROTID: Calcifications of the carotid siphon. There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Calcifications of the carotid siphon. There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Mild atherosclerotic calcifications. Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Atherosclerotic calcification at carotid bifurcation and proximal ICA without flow limitation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Atherosclerotic calcification at carotid bifurcation and proximal ICA without flow limitation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: Anterior cervical fusion hardware at C6-7 shows no evidence of loosening or failure. No acute displaced fracture.
|
16,467 |
Interpretation of Outside Films CT CSPN 1/18/2022 2:14 AM Clinical Information: Spec Inst: CT Cspine DOS 11022 Comparison: None available Technique: Axial CT images of the neck are provided for interpretation with sagittal and coronal reconstructions. -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: Cervical spine alignment is normal. There is a mildly displaced fracture of the left C7 transverse process with cortical offset and overriding. There is asymmetry of the lateral atlantodental intervals with the left more prominent than the right, however, otherwise no malalignment of the lateral masses is noted. This could be related to head positioning. There is mild chronic appearing central compression of the endplates of the cervical vertebral bodies. Conclusion: 1. Minimally displaced fracture of the left C7 transverse process with cortical offset and overriding. 2. Asymmetry of the lateral atlantodental intervals without lateral mass malalignment, could be due to head positioning. If there is concern for ligamentous injury, further evaluation with MRI could be considered, unless otherwise contraindicated. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: Cervical spine alignment is normal. There is a mildly displaced fracture of the left C7 transverse process with cortical offset and overriding. There is asymmetry of the lateral atlantodental intervals with the left more prominent than the right, however, otherwise no malalignment of the lateral masses is noted. This could be related to head positioning. There is mild chronic appearing central compression of the endplates of the cervical vertebral bodies.
|
Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Stable appearing small encephalomalacia in the right frontal lobe. Postsurgical changes from suboccipital craniectomy and right frontal burr hole. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal.
|
16,468 |
Interpretation of Outside Films CT LSPN 1/18/2022 2:14 AM Clinical Information: Spec Inst: CT LSpine DOS 11022 Comparison: None available Technique: Axial CT images of the lumbar spine were obtained with coronal and sagittal reconstructions. -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: The spinal alignment is maintained. Vertebral body heights are preserved. There is a mild disc bulge at L3-4, L4-5 and L5-S1. There are no significant degenerative changes with resultant spinal canal or foraminal narrowing. There is a mildly displaced fracture of the left L5 transverse process. There is a comminuted displaced fracture through the left sacral ala involving the S1-S2 neural foramen. There is a minimally displaced fracture through the anterior aspect of the right sacral ala as well, involving the margins of the S1-S2 neural foramen. There appears to be impingement on bilateral exiting S1 nerve roots by the fracture fragments. There is adjacent pelvic soft tissue swelling. Impression: 1. Displaced bilateral sacral alar fractures, left greater than right with involvement of the neural foramina and impingement on bilateral exiting S1 nerve roots. 2. Displaced mildly comminuted left L5 transverse process fracture. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: The spinal alignment is maintained. Vertebral body heights are preserved. There is a mild disc bulge at L3-4, L4-5 and L5-S1. There are no significant degenerative changes with resultant spinal canal or foraminal narrowing. There is a mildly displaced fracture of the left L5 transverse process. There is a comminuted displaced fracture through the left sacral ala involving the S1-S2 neural foramen. There is a minimally displaced fracture through the anterior aspect of the right sacral ala as well, involving the margins of the S1-S2 neural foramen. There appears to be impingement on bilateral exiting S1 nerve roots by the fracture fragments. There is adjacent pelvic soft tissue swelling.
|
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Mild dependent atelectatic changes in the left lower lobe. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal for technique. ADRENALS: Normal. KIDNEYS: Normal noncontrast appearance of both kidneys. Subcentimeter partially exophytic indeterminate attenuation lesion arising from the lower pole of the left kidney measures 0.7 x 0.7 cm (series 2, image 159). No radiopaque nephrolithiasis or hydroureteronephrosis. LYMPH NODES: Multiple enlarged periportal lymph nodes, with a representative node measuring 23 x 13 mm (series 2, image 106). Multiple additional prominent periportal and upper retroperitoneal lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild aortoiliac calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Rectus diastasis. Moderate size fat-containing umbilical hernia and fat-containing supraumbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormalities identified. Multilevel degenerative changes in the visualized thoracolumbar spine.
|
16,469 |
Interpretation of Outside Films CT TSPN 1/18/2022 2:14 AM Clinical Information: Spec Inst: CT Tspine DOS 11022 Comparison: None available Technique: Axial CT images of the thoracic spine are provided for interpretation with coronal and sagittal reconstructions. -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: There are scattered Schmorl's nodes. There are mild degenerative changes without significant spinal canal or foraminal narrowing. There are a few benign osseous hemangiomas. The spinal alignment is maintained. Vertebral body heights are preserved. There is no acute vertebral body fracture. The posterior elements are maintained. Chest findings are reported separately. Impression: 1. No CT evidence of acute thoracic spine osseous abnormality. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: There are scattered Schmorl's nodes. There are mild degenerative changes without significant spinal canal or foraminal narrowing. There are a few benign osseous hemangiomas. The spinal alignment is maintained. Vertebral body heights are preserved. There is no acute vertebral body fracture. The posterior elements are maintained. 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: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right ureteral stone impacted near the UVJ which measures approximately 4 mm. Associated mild hydronephrosis. Multiple punctate renal calculi bilaterally which appear nonobstructive. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colon is unremarkable. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality.
|
16,470 |
Interpretation of Outside Films CT Chest Clinical Information: 49-year-old male with provided history of trauma Spec Inst: CT Head DOS 11022 Study reviewed: CT of chest with contrast performed at DCH Regional Medical Center on January 10, 2022, The images are available in PACS. Findings: No prior CT for comparison. Oblique fracture of the proximal sternum just below the manubrial sternal junction with associated small retrosternal hematoma. Minimal subcutaneous inflammatory stranding is present in the anterior chest wall The thoracic vasculature is unremarkable including all three neck vessels. There is no focal lung consolidation or interstitial abnormality. No pleural or pericardial effusion or pneumothorax is noted. Conclusion: Findings are suggestive of seatbelt injury with proximal sternal minimally displaced fracture with retrosternal soft tissue hematoma.
|
Findings: No prior CT for comparison. Oblique fracture of the proximal sternum just below the manubrial sternal junction with associated small retrosternal hematoma. Minimal subcutaneous inflammatory stranding is present in the anterior chest wall The thoracic vasculature is unremarkable including all three neck vessels. There is no focal lung consolidation or interstitial abnormality. No pleural or pericardial effusion or pneumothorax is noted.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Mild dependent atelectatic changes. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Contracted. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Unchanged hypoattenuating lesion in the interpolar left kidney, too small to accurately characterize but likely a cyst. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No significant abnormality in the stomach. Postsurgical changes from right lower quadrant double barrel ileostomy. Multiple loops nonobstructed small bowel contained within a parastomal hernia. No significant upstream dilatation to suggest small bowel obstruction. The distal small bowel is decompressed. Interval postsurgical changes from J-pouch ileorectal anastomosis. COLON / APPENDIX: Postsurgical changes from total abdominal colectomy with patent J-pouch ileorectal anastomosis. PERITONEUM / MESENTERY: Small volume free fluid in the pelvis. No discrete rim-enhancing fluid collections. Mild mesenteric vascular congestion. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from recent infraumbilical midline laparotomy. Right lower quadrant double barrel ostomy with parastomal hernia containing a few loops of nonobstructed small bowel, as above. MUSCULOSKELETAL: No aggressive osseous abnormality is identified.
|
16,471 |
Interpretation of Outside Films CT Head Clinical Information: Spec Inst: CT HEAD -TRAUMA SAH REC: 11821 REQ: DR. GLEASON 68956 Comparison: Subsequently obtained head CT Technique: Unenhanced axial brain CT. Coronal and sagittal reformatted images were also obtained. Findings: Small-volume extra-axial hemorrhage along the anterior right cranial fossa extending to the right temporal convexity. There is also trace associated subarachnoid hemorrhage. There is small volume extra-axial hemorrhage is seen right cerebellum. There is no mass effect or midline shift. There is chronic encephalomalacia in the right frontal and temporal lobes with chronic bilateral basal ganglia infarcts. Chronic infarct is also seen in the left hemipons and right cerebellar hemisphere. There is no intracranial mass or hydrocephalus. Nondisplaced right occipital bone fracture better demonstrated on subsequent exam. Left parietal occipital scalp contusion. The visualized paranasal sinuses and mastoid air cells are clear. Conclusion: 1. Small-volume subdural hematoma along the anterior cranial fossa extending to the right temporal convexity. Trace associated subarachnoid hemorrhage. No significant mass effect or midline shift. 2. Small volume subarachnoid hemorrhage in the posterior fossa along the right cerebellum 3. Nondisplaced fracture of the right occipital bone
|
Findings: Small-volume extra-axial hemorrhage along the anterior right cranial fossa extending to the right temporal convexity. There is also trace associated subarachnoid hemorrhage. There is small volume extra-axial hemorrhage is seen right cerebellum. There is no mass effect or midline shift. There is chronic encephalomalacia in the right frontal and temporal lobes with chronic bilateral basal ganglia infarcts. Chronic infarct is also seen in the left hemipons and right cerebellar hemisphere. There is no intracranial mass or hydrocephalus. Nondisplaced right occipital bone fracture better demonstrated on subsequent exam. Left parietal occipital scalp contusion. The visualized paranasal sinuses and mastoid air cells are clear.
|
FINDINGS: CT of the head with and without contrast: Loss of gray-white matter differentiation and mild edema in the high right parietal lobe consistent with acute/subacute infarct. No mass effect or midline shift. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. No abnormal intracranial enhancement. No evidence of hemorrhagic conversion. No intracranial hemorrhage. No extra-axial collections. Basal cisterns are patent. Normal appearance of the orbits. Minimal mucosal thickening in bilateral maxillary sinuses. Mastoid air cells are clear. No acute fracture or aggressive osseous lesions. CT angiogram of the brain: RIGHT CAROTID: There is irregular moderate narrowing of the ophthalmic and supraclinoid ICAs without flow limitation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Severe near occlusive irregular narrowing of the left P1 segment which demonstrates minimal opacification (image 244, series #608). Mild diffuse irregular narrowing of the left P2 and P3 segments. No abnormality of the bilateral ACAs, MCAs, and right PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: Mild atherosclerosis of the proximal ICA without flow-limiting stenosis. No evidence of occlusion or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: Straightening of the cervical spine. Mild multilevel discogenic degenerative change, most prominent at C5-C6.
|
16,472 |
Interpretation of Outside Films CT Face 1/18/2022 7:12 AM Clinical Information: Spec Inst: Trauma - CT Face from DCH done 1-10-22 rec 1-18-22 Comparison: None available Technique: Axial CT images of the maxillofacial region are provided with coronal and sagittal reconstructions. -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: There is a comminuted, displaced, overriding fracture of the right mandibular ramus with TMJ subluxation. There is patchy opacification of the left ethmoid air cells. The remaining visualized paranasal sinuses and mastoid air cells are clear. There is a prominent right concha bullosa with nasal septal deviation to the left posteriorly and to the right anteriorly. Impression: 1. Comminuted, displaced overriding fracture of the right mandibular ramus with TMJ subluxation. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: There is a comminuted, displaced, overriding fracture of the right mandibular ramus with TMJ subluxation. There is patchy opacification of the left ethmoid air cells. The remaining visualized paranasal sinuses and mastoid air cells are clear. There is a prominent right concha bullosa with nasal septal deviation to the left posteriorly and to the right anteriorly.
|
FINDINGS: CT of the head with and without contrast: Loss of gray-white matter differentiation and mild edema in the high right parietal lobe consistent with acute/subacute infarct. No mass effect or midline shift. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. No abnormal intracranial enhancement. No evidence of hemorrhagic conversion. No intracranial hemorrhage. No extra-axial collections. Basal cisterns are patent. Normal appearance of the orbits. Minimal mucosal thickening in bilateral maxillary sinuses. Mastoid air cells are clear. No acute fracture or aggressive osseous lesions. CT angiogram of the brain: RIGHT CAROTID: There is irregular moderate narrowing of the ophthalmic and supraclinoid ICAs without flow limitation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Severe near occlusive irregular narrowing of the left P1 segment which demonstrates minimal opacification (image 244, series #608). Mild diffuse irregular narrowing of the left P2 and P3 segments. No abnormality of the bilateral ACAs, MCAs, and right PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: Mild atherosclerosis of the proximal ICA without flow-limiting stenosis. No evidence of occlusion or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: Straightening of the cervical spine. Mild multilevel discogenic degenerative change, most prominent at C5-C6.
|
16,473 |
MRI brain with and without Indication: Spec Inst: Brain METs - MRI Brain from RMC Anniston done 1-10-22 rec 1-18-22 Comparison: CT head from 1/9/2022 Technique: Outside images were provided for the interpretation. Findings: Multifocal heterogeneously enhancing lesions in the bilateral cerebellar hemispheres, predominantly on right side with significant vasogenic edema and, resulting in effacement of the fourth ventricle. There is moderate hydrocephalus involving the lateral and third ventricles with mild periventricular transependymal CSF flow. There is also additional enhancing nodule in the posterior medial aspect of the right temporal lobe. Remaining cerebral parenchyma is within normal limits. There is linear T2 hypointensities with increased susceptibility on GRE, seen in the periphery of the vermis lesion, hemorrhagic products. Impression: Multifocal heterogeneously enhancing lesions in the posterior fossa, right larger than the left cerebellar hemispheres with large perilesional edema and mass effect on fourth ventricle with effacement and resulting in proximal obstructive hydrocephalus as described above. Additional enhancing nodules in the medial aspect of the posterior right temporal lobe. Features of consistent with brain metastasis. Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution
|
Findings: Multifocal heterogeneously enhancing lesions in the bilateral cerebellar hemispheres, predominantly on right side with significant vasogenic edema and, resulting in effacement of the fourth ventricle. There is moderate hydrocephalus involving the lateral and third ventricles with mild periventricular transependymal CSF flow. There is also additional enhancing nodule in the posterior medial aspect of the right temporal lobe. Remaining cerebral parenchyma is within normal limits. There is linear T2 hypointensities with increased susceptibility on GRE, seen in the periphery of the vermis lesion, hemorrhagic products.
|
FINDINGS: SOFT TISSUES: Serpiginous ill-defined phlegmon/evolving abscess within the soft tissues adjacent to the left mandible approximately measuring 1.1 x 0.7 cm on axial series 2 image 156. It appears this collection may communicate with the overlying skin. Extensive adjacent stranding is noted without other definitive walled off fluid collection. The associated underlying osseous cortex is unremarkable. No infectious involvement of the masticator, parapharyngeal, sublingual, or submandibular spaces. The right neck soft tissues are unremarkable. LYMPH NODES: Prominent superior left cervical chain lymph nodes. AERODIGESTIVE STRUCTURES: Mild asymmetric soft tissue prominence on the left aspect of the oropharynx/palatine tonsil (axial series 2 image 181). PAROTID GLANDS/SUBMANDIBULAR GLANDS: Unremarkable. THYROID GLAND: Unremarkable. VASCULAR STRUCTURES: No evidence of dissection, occlusion, or aneurysm. OSSEOUS STRUCTURES: No fracture, dislocation, or destructive lesion. ORBITS: Unremarkable. PARANASAL SINUSES AND MASTOID AIR CELLS: Complex opacification of the left sphenoid sinus. Mucus retention cysts are noted within the maxillary sinuses. The remaining paranasal sinuses and mastoid air cells are clear. There is aeration of both petrous apices. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: Unremarkable. LUNG APICES: Unremarkable.
|
16,474 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Metastatic workup for right frontoparietal lesion. COMPARISON: None. TECHNIQUE: Outside CT images with IV contrast dated 1/17/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: No significant abnormality. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: Three-vessel calcific coronary atherosclerosis. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Indeterminate right adrenal nodule measuring approximately 1.8 x 1.1 x 1.7 cm (series 2 image 30). Indeterminate left adrenal nodule measuring approximately 1.6 x 1.2 x 2.0 cm (series 2 image 37). KIDNEYS: Left interpolar simple renal cyst with a maximum axial diameter of 4.5 cm (series 2 image 361). LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. Appendix is not visualized. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. VESSELS: Moderate calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. Large lipoma of the left lateral thigh musculature. MUSCULOSKELETAL: Discogenic thoracolumbar degenerative changes most prominent in the lower thoracic spine. CONCLUSION: 1. Bilateral indeterminate adrenal nodules. Recommend dedicated adrenal protocol CT or MRI to further characterize. 2. Diverticulosis without diverticulitis. 3. Small hiatal hernia. 4. Other incidental 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: No significant abnormality. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: Three-vessel calcific coronary atherosclerosis. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Indeterminate right adrenal nodule measuring approximately 1.8 x 1.1 x 1.7 cm (series 2 image 30). Indeterminate left adrenal nodule measuring approximately 1.6 x 1.2 x 2.0 cm (series 2 image 37). KIDNEYS: Left interpolar simple renal cyst with a maximum axial diameter of 4.5 cm (series 2 image 361). LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. Appendix is not visualized. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. VESSELS: Moderate calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. Large lipoma of the left lateral thigh musculature. MUSCULOSKELETAL: Discogenic thoracolumbar degenerative changes most prominent in the lower thoracic spine.
|
FINDINGS: RAPID images demonstrate CBF less than 30% volume: 0 mL and T. Max greater than 6seconds volume: 22 mL. Mismatch volume is 22 mL. There is elevated Tmax in the right parietal lobe with associated small area of increased cerebral blood volume. No large ischemic penumbra.
|
16,475 |
Interpretation of CT head 1/18/2022 8:15 AM Clinical Information: Spec Inst: Brain lesion, ro METs - CT Head from Russell Medical Center done 1-17-22 rec 1-18-22 Comparison: CT dated 11/14/2021 Technique: Axial unenhanced images were acquired of the brain with coronal and sagittal reformats generated from this data. Findings: There is stable appearance of the right frontoparietal craniotomy defect. There is a round ill-defined hypodense masslike lesion in the right posterior frontal lobe extending into the right frontoparietal lobe, likely vasogenic edema, slightly progressive compared to prior CT scan on 11/14/2021. There is mass effect mass effect with compression of the lateral ventricle and 9 mm right to left midline shift. Calcified atherosclerosis of right vertebral artery is seen. Faint calcifications in bilateral basal ganglia are noted. There is evidence of bilateral lens replacements. No intracranial hemorrhage, or hydrocephalus is seen. No acute infarction seen. The visualized paranasal sinuses and mastoid air cells are clear. No acute osseous or soft tissue abnormality seen. --------------- Conclusion: 1. A 2.6 x 3.9 cm hypodense mass in the right frontoparietal convexity near the vertex. Interval progression of vasogenic edema, mass effect and right-to-left midline shift. 2. Bilateral lens replacement 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: There is stable appearance of the right frontoparietal craniotomy defect. There is a round ill-defined hypodense masslike lesion in the right posterior frontal lobe extending into the right frontoparietal lobe, likely vasogenic edema, slightly progressive compared to prior CT scan on 11/14/2021. There is mass effect mass effect with compression of the lateral ventricle and 9 mm right to left midline shift. Calcified atherosclerosis of right vertebral artery is seen. Faint calcifications in bilateral basal ganglia are noted. There is evidence of bilateral lens replacements. No intracranial hemorrhage, or hydrocephalus is seen. No acute infarction seen. The visualized paranasal sinuses and mastoid air cells are clear. No acute osseous or soft tissue abnormality seen. ---------------
|
FINDINGS: FACIAL BONES: Peripherally enhancing fluid collection adjacent to the left maxilla measuring 2.9 x 1.8 x 2.3 cm (image 74, series #301 and image 66, series #604). There is associated cortical disruption of adjacent alveolar process of the left first molar. Multiple dental caries and periapical lucency. No fracture. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. REMAINING VISUALIZED BONES: Normal. SINONASAL CAVITIES: Moderate mucosal thickening of the bilateral maxillary sinuses with adjacent periapical lucency in the maxillary teeth, likely odontogenic in origin. Disruption of the anteroinferior left maxillary sinus wall adjacent to the fluid collection (image 316, series #2 and image 72, series #601). VISUALIZED INTRACRANIAL STRUCTURES: Normal. ORBITAL CONTENTS: Normal.
|
16,476 |
Lumbar MRI before and after contrast: Outside images were provided for the interpretation - Clinical indication: Spec Inst: Sacral fx, radiculopathy - MRI LS Spine from AHI done 1-13-22 rec 1-18-22. - Technique: Outside images were provided for the interpretation - Comparison: No previous similar studies are presented for comparison.. - Findings: This study is significantly limited by susceptibility artifacts from the extensive posterior fusion hardware. Superior lumbar canal cannot be evaluated due to the significant streaky artifacts. The spinal canal at L3-S1 is within normal limits. There is a laminectomy at L3-4, L4-5 and L5-S1 with associated small fluid collection in the posterior lumbar soft tissues with possible minimal peripheral enhancement, likely seroma. There is no definite mass effect on thecal sac posteriorly. No definite postcontrast enhancement is identified in the spinal canal, given the limitation of significant artifacts. There is a possible fracture involving the sacrum at S4-5 level. There is minimal presacral edema extending from S2 to S4. There is again nondisplaced bilateral sacral fractures, significantly unchanged from the prior CT lumbar spine. - Impression: 1. Bilateral sacral fractures with presacral edema, unchanged from the prior CT lumbar spine. 2. Significant susceptibility artifacts from the posterior fusion hardware, limits the evaluation of the lumbar spine spinal canal. Small fluid collection in the posterior lumbar soft tissues at L3-L5 without significant mass effect, likely seroma. Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution
|
Findings: This study is significantly limited by susceptibility artifacts from the extensive posterior fusion hardware. Superior lumbar canal cannot be evaluated due to the significant streaky artifacts. The spinal canal at L3-S1 is within normal limits. There is a laminectomy at L3-4, L4-5 and L5-S1 with associated small fluid collection in the posterior lumbar soft tissues with possible minimal peripheral enhancement, likely seroma. There is no definite mass effect on thecal sac posteriorly. No definite postcontrast enhancement is identified in the spinal canal, given the limitation of significant artifacts. There is a possible fracture involving the sacrum at S4-5 level. There is minimal presacral edema extending from S2 to S4. There is again nondisplaced bilateral sacral fractures, significantly unchanged from the prior CT lumbar spine. -
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Small calcific focus in the left parietal lobe in the region of previously seen hemorrhage. Post LITT procedure of the left mesial temporal lobe. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
|
16,477 |
Lumbar MRI before and after contrast: Outside images were provided for the interpretation - Clinical indication: Spec Inst: Sacral fx, radiculopathy - MRI LS Spine from AHI done 1-13-22 rec 1-18-22. - Technique: Outside images were provided for the interpretation - Comparison: No previous similar studies are presented for comparison.. - Findings: This study is significantly limited by susceptibility artifacts from the extensive posterior fusion hardware. Superior lumbar canal cannot be evaluated due to the significant streaky artifacts. The spinal canal at L3-S1 is within normal limits. There is a laminectomy at L3-4, L4-5 and L5-S1 with associated small fluid collection in the posterior lumbar soft tissues with possible minimal peripheral enhancement, likely seroma. There is no definite mass effect on thecal sac posteriorly. No definite postcontrast enhancement is identified in the spinal canal, given the limitation of significant artifacts. There is a possible fracture involving the sacrum at S4-5 level. There is minimal presacral edema extending from S2 to S4. There is again nondisplaced bilateral sacral fractures, significantly unchanged from the prior CT lumbar spine. - Impression: 1. Bilateral sacral fractures with presacral edema, unchanged from the prior CT lumbar spine. 2. Significant susceptibility artifacts from the posterior fusion hardware, limits the evaluation of the lumbar spine spinal canal. Small fluid collection in the posterior lumbar soft tissues at L3-L5 without significant mass effect, likely seroma. Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution
|
Findings: This study is significantly limited by susceptibility artifacts from the extensive posterior fusion hardware. Superior lumbar canal cannot be evaluated due to the significant streaky artifacts. The spinal canal at L3-S1 is within normal limits. There is a laminectomy at L3-4, L4-5 and L5-S1 with associated small fluid collection in the posterior lumbar soft tissues with possible minimal peripheral enhancement, likely seroma. There is no definite mass effect on thecal sac posteriorly. No definite postcontrast enhancement is identified in the spinal canal, given the limitation of significant artifacts. There is a possible fracture involving the sacrum at S4-5 level. There is minimal presacral edema extending from S2 to S4. There is again nondisplaced bilateral sacral fractures, significantly unchanged from the prior CT lumbar spine. -
|
Findings: No acute infarction, hemorrhage, or cerebral edema. Gray-white matter differentiation is maintained. Confluent periventricular areas of white matter hypoattenuation, compatible with chronic microangiopathic changes, unchanged. Chronic lacunar infarct in the left pons. There is no intracranial mass or hydrocephalus. No acute osseous abnormality. Chronic fracture deformity of the right lamina papyracea. The visualized paranasal sinuses and mastoid air cells are clear. Bilateral globes and optic nerves are intact. The retrobulbar soft tissues have normal appearance.
|
16,478 |
Interpretation of outside CT C-spine. Outside scans for interpretation only. Findings: No C-spine fracture or subluxation is seen. There is marked dilatation of the left C4 and C5 vertebral foramina and also of the right C5-6 and C6-7 vertebral canals, apparent prominent tortuosity of the vertebral arteries. Bone texture is normal with no lytic or blastic lesion. The paraspinal soft tissues are unremarkable. --------------- Conclusion: No C-spine fracture or subluxation.
|
Findings: No C-spine fracture or subluxation is seen. There is marked dilatation of the left C4 and C5 vertebral foramina and also of the right C5-6 and C6-7 vertebral canals, apparent prominent tortuosity of the vertebral arteries. Bone texture is normal with no lytic or blastic lesion. The paraspinal soft tissues are unremarkable. ---------------
|
Findings: CT Head: Unenhanced images of the brain are unremarkable. The postcontrast images demonstrate no abnormal enhancement. The orbits appear normal. There is no acute osseous abnormality or focal aggressive osseous lesion. The paranasal sinuses and mastoid air cells are clear. CTA Neck: There is a three branch vessel aortic arch. No flow-limiting stenosis in the aorta or origins of the mediastinal great vessels. There is noncalcified atherosclerosis in the bilateral common carotid arteries without flow-limiting stenosis. There is atherosclerotic disease of the bilateral carotid bifurcations, left greater than right with less than 50% luminal narrowing. The bilateral vertebral arteries are patent without flow-limiting stenosis. There is no evidence of dissection or occlusion of the cervical vasculature. The internal jugular veins appear normal. CTA Head: There is no occlusion, flow-limiting stenosis, aneurysm, or vascular malformation identified within the intracranial vasculature. The posterior circulation is hypoplastic. There is an incidental developmental venous anomaly in the left frontal centrum semiovale. Other nonvascular findings: Enlarged multinodular thyroid gland with prominent right posterior thyroid nodule with substernal extension. The neck soft tissues are otherwise within normal limits. The visualized upper lungs are clear. There is no acute osseous abnormality or focal aggressive osseous lesion.
|
16,479 |
Interpretation of Outside Films CT TSPN, Interpretation of Outside Films CT LSPN 1/18/2022 9:10 AM Clinical Information: Spec Inst: Trauma - CT Complete spine from BMCS done 1-18-22 rec 1-18-22 Comparison: None available Technique: Axial CT images of the thoracic and lumbar spine are provided for interpretation with coronal and sagittal reconstructions. -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: Thoracic spine alignment is normal. The vertebral body heights are preserved. No acute fracture is seen. There are a few scattered Schmorl's nodes. No significant degenerative changes are noted resulting in osseous spinal canal or foraminal narrowing. Lumbar spine alignment is normal. Vertebral body heights are preserved. No acute fracture is seen. No significant degenerative changes resulting in spinal canal or foraminal narrowing are noted. Conclusion: No CT evidence of acute thoracic or lumbar spine osseous injury. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: Thoracic spine alignment is normal. The vertebral body heights are preserved. No acute fracture is seen. There are a few scattered Schmorl's nodes. No significant degenerative changes are noted resulting in osseous spinal canal or foraminal narrowing. Lumbar spine alignment is normal. Vertebral body heights are preserved. No acute fracture is seen. No significant degenerative changes resulting in spinal canal or foraminal narrowing are noted.
|
Findings: CT Head: Unenhanced images of the brain are unremarkable. The postcontrast images demonstrate no abnormal enhancement. The orbits appear normal. There is no acute osseous abnormality or focal aggressive osseous lesion. The paranasal sinuses and mastoid air cells are clear. CTA Neck: There is a three branch vessel aortic arch. No flow-limiting stenosis in the aorta or origins of the mediastinal great vessels. There is noncalcified atherosclerosis in the bilateral common carotid arteries without flow-limiting stenosis. There is atherosclerotic disease of the bilateral carotid bifurcations, left greater than right with less than 50% luminal narrowing. The bilateral vertebral arteries are patent without flow-limiting stenosis. There is no evidence of dissection or occlusion of the cervical vasculature. The internal jugular veins appear normal. CTA Head: There is no occlusion, flow-limiting stenosis, aneurysm, or vascular malformation identified within the intracranial vasculature. The posterior circulation is hypoplastic. There is an incidental developmental venous anomaly in the left frontal centrum semiovale. Other nonvascular findings: Enlarged multinodular thyroid gland with prominent right posterior thyroid nodule with substernal extension. The neck soft tissues are otherwise within normal limits. The visualized upper lungs are clear. There is no acute osseous abnormality or focal aggressive osseous lesion.
|
16,480 |
Interpretation of Outside Films CT TSPN, Interpretation of Outside Films CT LSPN 1/18/2022 9:10 AM Clinical Information: Spec Inst: Trauma - CT Complete spine from BMCS done 1-18-22 rec 1-18-22 Comparison: None available Technique: Axial CT images of the thoracic and lumbar spine are provided for interpretation with coronal and sagittal reconstructions. -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: Thoracic spine alignment is normal. The vertebral body heights are preserved. No acute fracture is seen. There are a few scattered Schmorl's nodes. No significant degenerative changes are noted resulting in osseous spinal canal or foraminal narrowing. Lumbar spine alignment is normal. Vertebral body heights are preserved. No acute fracture is seen. No significant degenerative changes resulting in spinal canal or foraminal narrowing are noted. Conclusion: No CT evidence of acute thoracic or lumbar spine osseous injury. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: Thoracic spine alignment is normal. The vertebral body heights are preserved. No acute fracture is seen. There are a few scattered Schmorl's nodes. No significant degenerative changes are noted resulting in osseous spinal canal or foraminal narrowing. Lumbar spine alignment is normal. Vertebral body heights are preserved. No acute fracture is seen. No significant degenerative changes resulting in spinal canal or foraminal narrowing are noted.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Tiny hypoattenuating lesion in the right hepatic lobe is too small to characterize, but is statistically likely a cyst. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Hypoattenuating lesion in the interpolar region of the left kidney is too small to characterize, but is statistically likely a cyst. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality in the colon. The appendix is not definitely visualized; however, no significant stranding in the right lower quadrant to suggest acute appendicitis. PERITONEUM / MESENTERY: Trace pelvic ascites. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Corpus luteal cyst in the left ovary. Otherwise, no significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified.
|
16,481 |
Interpretation of Outside Films CT Face 1/18/2022 9:10 AM Clinical Information: Spec Inst: Trauma - CT Face from BMCS done 1-18-22 rec 1-18-22 Comparison: None available Technique: Maxillofacial axial CT scan images with reformats, bone and soft tissue windows reviewed. -Please note: Outside imaging is not obtained in a standardized format accepted by UAB. This may limit sensitivity and specificity of interpretation. If clinical suspicion for pathology remains, would recommend repeat imaging at this institution. Findings: There are mildly displaced fractures involving the anterior and posterior lateral walls of the left maxillary sinus as well as the orbital floor. There is a mildly displaced fracture of the left lateral wall of the orbit and minimally displaced fractures through the left zygomatic arch. There are slightly comminuted fractures of bilateral nasal bones. There is buckling and overriding comminuted fractures of the nasal septum. There is patchy opacification of bilateral ethmoid air cells with aerated secretions in the sphenoid sinuses. There is moderate mucosal thickening in the left maxillary sinus. The globes are intact. There is no post septal retrobulbar hematoma. There is extensive soft tissue swelling around the nose and opacification of the nasal cavities. Impression: Multiple facial fractures involving left zygomaticomaxillary complex with bilateral nasal bones and nasal septum fractures. Comment: This interpretation is not intended to supersede the original interpretation and should not be relied upon exclusively for clinical decision making.
|
Findings: There are mildly displaced fractures involving the anterior and posterior lateral walls of the left maxillary sinus as well as the orbital floor. There is a mildly displaced fracture of the left lateral wall of the orbit and minimally displaced fractures through the left zygomatic arch. There are slightly comminuted fractures of bilateral nasal bones. There is buckling and overriding comminuted fractures of the nasal septum. There is patchy opacification of bilateral ethmoid air cells with aerated secretions in the sphenoid sinuses. There is moderate mucosal thickening in the left maxillary sinus. The globes are intact. There is no post septal retrobulbar hematoma. There is extensive soft tissue swelling around the nose and opacification of the nasal cavities.
|
FINDINGS: BRAIN PARENCHYMA: Severe edema and loss of gray-white matter differentiation in the right frontoparietal and temporal lobes consistent with recent MCA infarct with associated subfalcine herniation and approximately 7 mm of right-to-left midline shift. Effacement of the right basal cisterns with mild right uncal herniation. There is a small area of hemorrhagic conversion in the anterior aspect of the right temporal lobe (image 24, series #80518). Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. EXTRA-AXIAL SPACES: Effacement of the right basal cisterns as below. No extra-axial collections. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. VENTRICULAR SYSTEM: Near complete effacement of the right lateral ventricle and third ventricle. No significant enlargement of the left lateral ventricle. ORBITS: Normal. SINUSES: Paranasal sinuses are clear. VESSELS: No significant abnormality.
|
16,482 |
Interpretation of Outside Films CT Chest Clinical Information: 53-year-old male status post MVC Spec Inst: Trauma - CT CAP from BMCS done 1-18-22 rec 1-18-22 Study reviewed: CT of chest with contrast performed at Baptist medical Center south on January 18, 2022, The images are available in PACS. Findings: No prior CT for comparison. Part of the left lower lateral chest wall was excluded from field-of-view There is no mediastinal soft tissue hematoma. The thoracic aorta is normal in its contour and caliber. Only small subcentimeter size nodes are present in the mediastinum. Advanced upper lobe dominant centrilobular emphysema with minimal dependent basilar atelectasis and apical parenchymal scarring. There is no discrete lung nodule/mass or airspace consolidation. Trace pericardial effusion is present without pleural effusion on either side. No traumatic injury to the visualized bones of thoracic cage. Conclusion: 1. No intrathoracic traumatic injury. 2. COPD
|
Findings: No prior CT for comparison. Part of the left lower lateral chest wall was excluded from field-of-view There is no mediastinal soft tissue hematoma. The thoracic aorta is normal in its contour and caliber. Only small subcentimeter size nodes are present in the mediastinum. Advanced upper lobe dominant centrilobular emphysema with minimal dependent basilar atelectasis and apical parenchymal scarring. There is no discrete lung nodule/mass or airspace consolidation. Trace pericardial effusion is present without pleural effusion on either side. No traumatic injury to the visualized bones of thoracic cage.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Trace right pleural effusion. Trace subsegmental bibasilar dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Interval enlargement of hypoenhancing central perihilar lesion near the caudate measuring 11.6 x 8.9 cm (previously 7.8 x 6.5 cm). Innumerable additional hypoattenuating lesions throughout the liver are new and/or enlarged since the prior study. BILIARY TRACT: Worsening intrahepatic ductal dilatation with abrupt transition near the level of the central perihilar hepatic mass. GALLBLADDER: Stable gallbladder wall thickening versus pericolic fluid collection. No radiopaque stones. PANCREAS: Closely abutted by the large periportal nodal conglomerate but otherwise grossly normal in appearance. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Redemonstration of multiple enlarged, morphologically abnormal periportal, periaortic, and retroperitoneal lymph nodes and precaval nodal conglomerate. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Subtle omental nodularity and stranding, most conspicuous in the left upper quadrant. Interval development of small volume simple pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: Main portal vein as it courses through the periportal nodal conglomerate appears irregular and not well evaluated. Focal filling defect seen within a portion of the SMV on axial series 201, image 110. Mild-to-moderate compressive effects on the IVC secondary to enlargement of the central perihilar hepatic lesion. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Interval removal of intrauterine device. Stable size of uterus measuring 4.5 x 3.8 cm (series 204, image 69), previously 4.6 x 3.8 cm. Interval increase in size of left adnexal mass which now measures 1.9 x 3.4 cm (series 201, image 256), previously 1.3 x 2.7. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
16,483 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: Outside CT images of chest, abdomen and pelvis dated 1/18/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. CHEST: LUNG / AIRWAY / PLEURA: Endotracheal tube in appropriate position, approximately 4 cm above the carina. Diffuse bilateral emphysematous changes, worse at the apices. Bibasilar dependent atelectasis. HEART / PERICARDIUM: Cardiac chambers are normal in size. No pericardial fluid or thickening. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube in place. LYMPH NODES: None enlarged. CHEST WALL: Normal. ABDOMEN and PELVIS: LIVER: Normal. GALLBLADDER: Normal. KIDNEYS: Two subcentimeter simple cysts in the right kidney. Otherwise unremarkable. ADRENALS: Normal. SPLEEN: Normal. PANCREAS: Normal. STOMACH / SMALL BOWEL: Esophagogastric tube tip terminates in the gastric fundus. Small bowel is unremarkable. COLON / APPENDIX: Nondistended air and fluid-filled large bowel. Normal appearance of appendix. MESENTERY / PERITONEUM: Normal. LYMPH NODES: None enlarged. VESSELS: Scattered atherosclerotic vascular calcifications. REPRODUCTIVE ORGANS: Not well-visualized. URINARY BLADDER: Partially collapsed around Foley balloon. MUSCULOSKELETAL: No acute osseous abnormality. No destructive lesion. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen and pelvis. 2. Other incidental/chronic findings as described above. Advanced emphysematous changes in the lungs. 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: IMAGE QUALITY: Satisfactory. CHEST: LUNG / AIRWAY / PLEURA: Endotracheal tube in appropriate position, approximately 4 cm above the carina. Diffuse bilateral emphysematous changes, worse at the apices. Bibasilar dependent atelectasis. HEART / PERICARDIUM: Cardiac chambers are normal in size. No pericardial fluid or thickening. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube in place. LYMPH NODES: None enlarged. CHEST WALL: Normal. ABDOMEN and PELVIS: LIVER: Normal. GALLBLADDER: Normal. KIDNEYS: Two subcentimeter simple cysts in the right kidney. Otherwise unremarkable. ADRENALS: Normal. SPLEEN: Normal. PANCREAS: Normal. STOMACH / SMALL BOWEL: Esophagogastric tube tip terminates in the gastric fundus. Small bowel is unremarkable. COLON / APPENDIX: Nondistended air and fluid-filled large bowel. Normal appearance of appendix. MESENTERY / PERITONEUM: Normal. LYMPH NODES: None enlarged. VESSELS: Scattered atherosclerotic vascular calcifications. REPRODUCTIVE ORGANS: Not well-visualized. URINARY BLADDER: Partially collapsed around Foley balloon. MUSCULOSKELETAL: No acute osseous abnormality. No destructive lesion.
|
Findings: There is a hyperdense right MCA with a large area of hypoattenuation in the right frontal, temporal and parietal lobes with associated mass effect resulting in mild effacement of the right lateral ventricle. No space-occupying lobar hemorrhage.
|
16,484 |
CT scan of the petrous temporal bones. Outside scan dated 1/10/2022 for interpretation only Clinical: Otomastoiditis. Findings: There is a wall up left mastoidectomy defect in the mastoidectomy bowl is opacified. There is also opacification of the left middle ear cavity, apparent left otomastoiditis. There is opacification of right mastoid air cells. The right middle ear is essentially negative. There is slight soft tissue thickening in the right epitympanum. The bilateral IACs, inner ear structures which are visible and EACs are unremarkable. There are degenerative changes in the upper cervical spine. --------------- Conclusion: Left otomastoiditis.
|
Findings: There is a wall up left mastoidectomy defect in the mastoidectomy bowl is opacified. There is also opacification of the left middle ear cavity, apparent left otomastoiditis. There is opacification of right mastoid air cells. The right middle ear is essentially negative. There is slight soft tissue thickening in the right epitympanum. The bilateral IACs, inner ear structures which are visible and EACs are unremarkable. There are degenerative changes in the upper cervical spine. ---------------
|
FINDINGS: RAPID images demonstrate CBF less than 30% volume: 126 mL and T. Max greater than 6seconds volume: 155 mL. Mismatch volume is 29 mL. There is a large area of reduced cerebral blood flow in the right MCA vascular territory with a slightly larger area of elevated Tmax. There is associated reduced cerebral blood volume in this area.
|
16,485 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Prostate cancer. Review of the medical record indicates prior TRUS prostate biopsy showing adenocarcinoma, GS 4+4=8 in 5/12 cores, GS 3+4=7 in 2/12 cores, and GS 3+3=6 in 1/12 cores. COMPARISON: None. TECHNIQUE: Outside MR images without IV contrast dated 1/6/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: STRUCTURED REPORT: MRI Prostate Prostate: Measurement: 6.9 x 3.7 x 4.6 cm cm; estimated volume: 61 cc; Focal lesion(s): Lesion # 1 (index lesion): - Key image: series 4; image 51; - Size: 30 x 15 mm; - Location: bilateral; mid and apex; posterior peripheral zone and posterior transition zone; - T2WI: 5; DWI: 5; DCE (early and focal enhancement): ; - PI-RADS v2.1 score: 5 - Very high (clinically significant cancer is highly likely to be present); - Likelihood of extraprostatic extension: 5 - Highly likely; - Likelihood of seminal vesicle invasion: 2 - Unlikely; Diffuse abnormalities: Diffusely striated appearance of the peripheral zone on T2WI may reflect prostatitis; Bladder: Trabeculated appearance. Adenopathy: No pathologically enlarged lymph nodes. Bones: No aggressive bony lesions. Other: No significant pelvic free fluid. Note: For more details about the Prostate Imaging-Reporting and Data System (PI-RADS) version 2.1, please visit: http://www.acr.org/Quality-Safety/Resources/PIRADS CONCLUSION: Large, high risk lesion for clinically significant prostate cancer (PI-RADS 5) in the bilateral posterior peripheral zone and involving the posterior transitional zone. There is evidence of extraprostatic extension. No adenopathy or metastatic disease identified 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: STRUCTURED REPORT: MRI Prostate Prostate: Measurement: 6.9 x 3.7 x 4.6 cm cm; estimated volume: 61 cc; Focal lesion(s): Lesion # 1 (index lesion): - Key image: series 4; image 51; - Size: 30 x 15 mm; - Location: bilateral; mid and apex; posterior peripheral zone and posterior transition zone; - T2WI: 5; DWI: 5; DCE (early and focal enhancement): ; - PI-RADS v2.1 score: 5 - Very high (clinically significant cancer is highly likely to be present); - Likelihood of extraprostatic extension: 5 - Highly likely; - Likelihood of seminal vesicle invasion: 2 - Unlikely; Diffuse abnormalities: Diffusely striated appearance of the peripheral zone on T2WI may reflect prostatitis; Bladder: Trabeculated appearance. Adenopathy: No pathologically enlarged lymph nodes. Bones: No aggressive bony lesions. Other: No significant pelvic free fluid. Note: For more details about the Prostate Imaging-Reporting and Data System (PI-RADS) version 2.1, please visit: http://www.acr.org/Quality-Safety/Resources/PIRADS
|
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Reticular opacities at the bilateral bases are likely atelectasis within scarring. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild coronary and thoracic aortic calcifications. ABDOMEN and PELVIS: LIVER: Postsurgical changes of left hepatectomy. Small exophytic nodule at the inferior aspect of the right hepatic lobe measures 6 mm on axial series 201 image 95. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Absent ADRENALS: Bilateral adrenal nodules containing macroscopic fat consistent with myelolipomas. KIDNEYS: Multiple scattered simple renal cysts. The right inferior pole nonobstructing renal calculus measuring 2 mm. LYMPH NODES: Prominent perisigmoid/perirectal lymph nodes measuring up to 1 cm in short axis. STOMACH / SMALL BOWEL: Gastric diverticulum. The small bowel is normal. COLON / APPENDIX: The appendix and colon are normal. PERITONEUM / MESENTERY: Ill-defined patchy regions of increased attenuation throughout the mesentery with associated nodularity. Extensive stranding adjacent and urinary bladder. RETROPERITONEUM: Normal. VESSELS: Scattered vascular calcifications. URINARY BLADDER: Diffuse bladder wall thickening and perivesicular stranding. REPRODUCTIVE ORGANS: The prostate is significantly enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Indeterminate tiny sclerotic focus in the inferior aspect of the L3 vertebral body (coronal series 203 image 86). Multilevel discogenic degenerative change most pronounced in the lower lumbar spine with associated spine facet arthropathy.
|
16,486 |
EXAM: Interpretation of Outside Films CT Chest CLINICAL INFORMATION: 58-year-old female with history of malignant neoplasm of the peritoneum. Interpretation of outside CT chest abdomen and pelvis with contrast performed at flowers Hospital on 1/14/2022. COMPARISON: None. TECHNIQUE: Interpretation of Outside Films CT Chest. FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT Chest LOWER NECK: Unremarkable. CHEST: LUNGS / AIRWAYS / PLEURA: The trachea and central bronchi are patent and clear. There is mild diffuse bronchial wall thickening, which could be seen with bronchitis. There are multiple pleural-based pulmonary nodules on the right lung base with the two largest measuring 9 x 14 mm (on series 4 image 79) and 10 x 16 mm cm (on series 4 image 81, with corresponding sagittal series 201 images 44 and 48). No focal consolidation, pleural effusion or pneumothorax. Linear opacity of subsegmental scarring/atelectasis is also noted within the lingula. HEART / VESSELS: Heart size is normal. No pericardial effusion. Mild atherosclerotic disease of the aortic arch. Mediastinal great arteries are normal in caliber. No evidence of large central pulmonary thromboembolic disease. MEDIASTINUM / ESOPHAGUS: Unremarkable. LYMPH NODES: No pathologically enlarged intrathoracic lymph nodes. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please see same day CT abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. Mild degenerative bony changes. CONCLUSION: 1. Few pulmonary nodules within the right lung base, along the right diaphragmatic pleura, are concerning for metastatic disease, recommend attention on follow-up scans. 2. Other incidental findings as described, without otherwise convincing CT evidence of intrathoracic metastatic disease. 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: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT Chest LOWER NECK: Unremarkable. CHEST: LUNGS / AIRWAYS / PLEURA: The trachea and central bronchi are patent and clear. There is mild diffuse bronchial wall thickening, which could be seen with bronchitis. There are multiple pleural-based pulmonary nodules on the right lung base with the two largest measuring 9 x 14 mm (on series 4 image 79) and 10 x 16 mm cm (on series 4 image 81, with corresponding sagittal series 201 images 44 and 48). No focal consolidation, pleural effusion or pneumothorax. Linear opacity of subsegmental scarring/atelectasis is also noted within the lingula. HEART / VESSELS: Heart size is normal. No pericardial effusion. Mild atherosclerotic disease of the aortic arch. Mediastinal great arteries are normal in caliber. No evidence of large central pulmonary thromboembolic disease. MEDIASTINUM / ESOPHAGUS: Unremarkable. LYMPH NODES: No pathologically enlarged intrathoracic lymph nodes. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please see same day CT abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. Mild degenerative bony changes.
|
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Cystic region of consolidation at the periphery of the right base, unchanged. The lungs are hyperexpanded. 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: Stomach is normal. There are multiple loops of fluid-filled distended distal small bowel in the lower pelvis with associated wall thickening. No transition point. COLON / APPENDIX: Diffuse colonic wall thickening and mucosal hyperenhancement is unchanged from prior. The appendix is not identified. PERITONEUM / MESENTERY: Diffuse mesenteric congestion. Moderate amount of peripherally enhancing free fluid along the right abdominal cavity measuring 2.5 x 1.1 cm on axial image 153. The previously seen lower pelvic collection shows interval insertion of a pigtail drain with interval decompression/near complete resolution. Left upper quadrant pigtail drain is in similar position. RETROPERITONEUM: Normal. VESSELS: Heterogeneous decreased attenuation within the bilateral femoral and iliac vein likely related to venous mixing. URINARY BLADDER: Fluid distended. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Hyperdense foreign body adjacent to the spinous process of the T10 vertebral body, unchanged.
|
16,487 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 15-year-old female with malignant neoplasm of peritoneum. COMPARISON: Outside CT abdomen and pelvis 2/17/2021. TECHNIQUE: Outside CT images of the chest, abdomen, and pelvis dated 1/14/2022. were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Liver cirrhosis.. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Two small simple renal cyst in the right kidney. Otherwise unremarkable. LYMPH NODES: Several stable subcentimeter periportal/gastrohepatic lymph nodes. Stable small subcentimeter lateral pelvic sidewall lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormal dilatation of large bowel loops. Rectum is compressed and displaced to the left pelvic peritoneum as described below. PERITONEUM / MESENTERY: New posterior perihepatic peritoneal metastasis measuring 1.3 and 1.6 cm on series 5/16 and image 14. Additional small mesenteric nodule in the mid abdomen measuring 1.1 cm on series 5/image 90 RETROPERITONEUM: Redemonstration of well-circumscribed, heterogenous perirectal mass measuring 8.2 x 5.5 x 12.0 cm, previously 6.7 x 5.4 x 11.5 cm. VESSELS: Scattered atherosclerotic calcifications. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Partially distended. BODY WALL: Midline post surgical stranding from recent laparoscopy. No ventral hernia or discrete abdominal wall fluid collection. MUSCULOSKELETAL: Severe degenerative disease with bilateral SI joints with air vacuum phenomenon. CONCLUSION: 1. Interval enlargement of large heterogenous right perirectal mass, now measuring 8.2 x 5.5 x 12.0 cm again likely metastasis. Additional small volume subcapsular posterior perihepatic and peritoneal metastasis as described above. 2. Compression and displacement of the rectum to the left with questionable wall invasion. Expected postsurgical changes of recent laparotomy in the anterior pelvic wall. Stable abdominal findings as detailed 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Liver cirrhosis.. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Two small simple renal cyst in the right kidney. Otherwise unremarkable. LYMPH NODES: Several stable subcentimeter periportal/gastrohepatic lymph nodes. Stable small subcentimeter lateral pelvic sidewall lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormal dilatation of large bowel loops. Rectum is compressed and displaced to the left pelvic peritoneum as described below. PERITONEUM / MESENTERY: New posterior perihepatic peritoneal metastasis measuring 1.3 and 1.6 cm on series 5/16 and image 14. Additional small mesenteric nodule in the mid abdomen measuring 1.1 cm on series 5/image 90 RETROPERITONEUM: Redemonstration of well-circumscribed, heterogenous perirectal mass measuring 8.2 x 5.5 x 12.0 cm, previously 6.7 x 5.4 x 11.5 cm. VESSELS: Scattered atherosclerotic calcifications. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Partially distended. BODY WALL: Midline post surgical stranding from recent laparoscopy. No ventral hernia or discrete abdominal wall fluid collection. MUSCULOSKELETAL: Severe degenerative disease with bilateral SI joints with air vacuum phenomenon.
|
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus. Main pulmonary artery is normal in diameter. LUNGS / AIRWAYS / PLEURA: Moderate centrilobular and paraseptal emphysematous changes of the lungs. Peripheral predominant groundglass and nodular airspace opacities most notably in the bilateral lower lobes and right middle lobe. No pleural effusion or pneumothorax. Trachea and proximal bronchi are patent. HEART / OTHER VESSELS: Heart is normal in size. Trace pericardial effusion. Scattered mild coronary atherosclerotic calcification. Thoracic aorta is normal in course and caliber. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Several prominent mediastinal nodes which contains small calcifications, likely related to prior granulomatous disease. No pathologic-appearing adenopathy in the chest. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Surgical clips in the gallbladder fossa post cholecystectomy. Visualized upper abdomen is otherwise unremarkable. MUSCULOSKELETAL: Mild degenerative changes of thoracic spine. No destructive osseous lesion seen.
|
16,488 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Destructive lesion proximal right humeral metaphysis COMPARISON: PET/CT 1/4/2020, radiographs 10/6/2021 TECHNIQUE: Outside MR images right shoulder without and with contrast dated 1/11/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: There is an avidly enhancing mass measuring approximately 3.3 x 4.4 x 4.7 cm within the right proximal humeral diametaphysis which extends to the anterior cortex along the the bicipital groove. There is marked thinning of the anterior cortex but no definite extraosseous soft tissue component is identified. There is some nonenhancement centrally within the mass suggesting minimal areas of necrosis. The lesion demonstrates markedly increased signal on fluid sensitive sequences and isointense to muscle on T1-weighted images. The lesion does not appear to extend across the physis. There is moderate perilesional edema extending inferiorly into the proximal humeral diaphysis. No significant periosteal edema or enhancement is identified. No evidence of pathologic fracture. There is questionable edema within the mid right humeral shaft. The post contrast images suggest faint enhancement in this region. There is a lytic lesion within the right mid humeral shaft on radiographs dated 10/6/2021 and 4/7/2020 No high-grade rotator cuff tear or bursitis is seen. No para labral cysts or displaced labral tear identified given the limitations of this nonarthrographic exam. Mild AC joint and glenohumeral joint degenerative changes. The long head biceps tendon is unremarkable. No significant muscular atrophy is seen. CONCLUSION: 01. Avidly enhancing right proximal humerus lesion as described above consistent with biopsy-proven plasmacytoma. Marked thinning of the anterior cortex predisposes for pathologic fracture. No pathologic fracture or extraosseous soft tissue component is identified on the current exam. 02. Partial visualization of additional mid right humeral shaft lesion. 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: There is an avidly enhancing mass measuring approximately 3.3 x 4.4 x 4.7 cm within the right proximal humeral diametaphysis which extends to the anterior cortex along the the bicipital groove. There is marked thinning of the anterior cortex but no definite extraosseous soft tissue component is identified. There is some nonenhancement centrally within the mass suggesting minimal areas of necrosis. The lesion demonstrates markedly increased signal on fluid sensitive sequences and isointense to muscle on T1-weighted images. The lesion does not appear to extend across the physis. There is moderate perilesional edema extending inferiorly into the proximal humeral diaphysis. No significant periosteal edema or enhancement is identified. No evidence of pathologic fracture. There is questionable edema within the mid right humeral shaft. The post contrast images suggest faint enhancement in this region. There is a lytic lesion within the right mid humeral shaft on radiographs dated 10/6/2021 and 4/7/2020 No high-grade rotator cuff tear or bursitis is seen. No para labral cysts or displaced labral tear identified given the limitations of this nonarthrographic exam. Mild AC joint and glenohumeral joint degenerative changes. The long head biceps tendon is unremarkable. No significant muscular atrophy is seen.
|
FINDINGS/CONCLUSION: Comminuted fracture of the distal radius extending into the radiocarpal and distal radioulnar joints. There is mild impaction of the fracture fragments. No other acute osseous abnormality is seen. Cystic degenerative changes of the carpal bones are noted. Advanced degenerative changes of the thumb CMC joint. Soft tissue swelling of the wrist. There is a radiopaque density within the volar subcutaneous soft tissues of the hand at the level of the thumb MCP joint (image 137, series 204)
|
16,489 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: 73-year-old male with nephrolithiasis. COMPARISON: CT abdomen pelvis 5/30/2020 2018. TECHNIQUE: Outside CT images of the abdomen and pelvis without contrast dated 1/6/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. 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: Small calcified splenic granulomas.3. ADRENALS: Normal. KIDNEYS: Stable bilateral simple renal cysts. Multiple small bilateral nonobstructing calculi. Stable tiny 2 to 3 mm calculus in the right renal interpolar calyx. Stable focal cortical calcification in the right renal lower pole. Previous punctate calculus in the left interpolar calyx is been passed. Band of left lower pole renal calculus measuring about 4.2 mm. No ureteric or vesical calculi seen. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic calcifications of the aorta, iliac, femoral arteries. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild enlargement of the prostate. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Multiple small bilateral nonobstructive renal calculi as described above. No hydronephrosis. 2. Redemonstration of right simple renal cyst and new left simple renal cyst. 3. Stable mild prostatomegaly. Other stable 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: IMAGE QUALITY: Satisfactory. 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: Small calcified splenic granulomas.3. ADRENALS: Normal. KIDNEYS: Stable bilateral simple renal cysts. Multiple small bilateral nonobstructing calculi. Stable tiny 2 to 3 mm calculus in the right renal interpolar calyx. Stable focal cortical calcification in the right renal lower pole. Previous punctate calculus in the left interpolar calyx is been passed. Band of left lower pole renal calculus measuring about 4.2 mm. No ureteric or vesical calculi seen. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic calcifications of the aorta, iliac, femoral arteries. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild enlargement of the prostate. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. Cerebellar tonsils are minimally low lying. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Globes are intact. No fracture. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: No fracture. Pterygoid plates are intact. MANDIBLE: Bilateral temporomandibular joints are intact. No fracture. SINONASAL CAVITIES: Paranasal sinuses are clear.
|
16,490 |
EXAM: Outside MR Image Interpretation CLINICAL INFORMATION: Thigh mass Additional history from chart: Reported hamstring injury on 9/17/2021, with progressive left thigh swelling and pain. Patient had aspiration of the presumed hematoma of the posterior thigh on 12/3/2021 at outside facility yielding 650 mL of bloody sanguinous fluid. COMPARISON: Outside CTA left femur 12/28/2021 TECHNIQUE: Outside MR images of the left thigh without and with contrast dated 1/11/2022 were submitted for interpretation. The MRI acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: There is a large heterogeneous mass in the left posterior proximal thigh centered within the left semitendinosus muscle which measures approximately 12.6 x 14.7 cm in axial dimensions and approximately 29.4 cm in craniocaudal length. The mass demonstrates markedly increased, heterogeneous signal on fluid sensitive sequences and predominantly increased T1 signal with some areas demonstrating low to intermediate signal, isointense to muscle. Evaluation for postcontrast enhancement is difficult due to significant intrinsic T1 signal throughout the mass but there are small areas of enhancement such as on coronal image 24 measuring approximately 2.7 x 2.9 cm. There is no perilesional edema or enhancement and no abnormal marrow signal or enhancement. No left inguinal femoral lymphadenopathy. No fracture. Right hip arthroplasty hardware is noted. CONCLUSION: Large heterogeneous cystic and solid mass in the posterior proximal thigh centered in the left semitendinosis muscle as described above. There are several nodular like areas within the lesion. Significant T1 shortening within the lesion presumably represents a large amount of methemoglobin secondary to a large intramuscular hematoma. However it would be difficult to exclude an underlying mass lesion particularly given small solid areas of enhancement 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: There is a large heterogeneous mass in the left posterior proximal thigh centered within the left semitendinosus muscle which measures approximately 12.6 x 14.7 cm in axial dimensions and approximately 29.4 cm in craniocaudal length. The mass demonstrates markedly increased, heterogeneous signal on fluid sensitive sequences and predominantly increased T1 signal with some areas demonstrating low to intermediate signal, isointense to muscle. Evaluation for postcontrast enhancement is difficult due to significant intrinsic T1 signal throughout the mass but there are small areas of enhancement such as on coronal image 24 measuring approximately 2.7 x 2.9 cm. There is no perilesional edema or enhancement and no abnormal marrow signal or enhancement. No left inguinal femoral lymphadenopathy. No fracture. Right hip arthroplasty hardware is noted.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is noted. No significant abnormality in the thoracic esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hypoattenuating lesion in the right hepatic lobe is too small to characterize, but is statistically likely a cyst. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: Phrygian cap. Multiple tiny radiopaque gallstones versus sludge layering in the fundus. Nondistended. No wall thickening. No pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality in the colon. The appendix is not definitely visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,491 |
EXAM: Outside CT Image Interpretation CT abdomen/pelvis with contrast dated 1/10/2022 time 13:16 CLINICAL INFORMATION: 57-year-old male with history of esophageal adenocarcinoma January 2022. Transfer to UAB from outside hospital for further evaluation and management. COMPARISON: Limited comparison to CT chest dated 1/10/2022 TECHNIQUE: Outside CT images with IV contrast dated 1/10/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Mild mucosal thickening of the distal esophagus. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: There is a 1 cm stone in the cystic duct with mild distention of the gallbladder. There is no pericholecystic fluid or gallbladder wall thickening. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There is a paraesophageal nodule with suspected central necrosis at the level of the GE junction which measures 2.6 x 2.2 cm (series 3, image 12). STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticulosis without evidence of diverticulitis. Hyperdense oral contrast is seen throughout the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed by Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Scattered subcutaneous foci of gas within the anterior abdominal wall, likely sequela of prior injections. There is mild diffuse anasarca. The entire abdominal wall is included within the study. MUSCULOSKELETAL: No significant abnormality. No aggressive osseous lesions. CONCLUSION: 1. Uniform thickening of the distal esophagus. Nodule at the level of the GE junction concerning for metastatic lymph node in this patient with a history of esophageal cancer. 2. Cholelithiasis without cholecystitis and additional incidental 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Mild mucosal thickening of the distal esophagus. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: There is a 1 cm stone in the cystic duct with mild distention of the gallbladder. There is no pericholecystic fluid or gallbladder wall thickening. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There is a paraesophageal nodule with suspected central necrosis at the level of the GE junction which measures 2.6 x 2.2 cm (series 3, image 12). STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticulosis without evidence of diverticulitis. Hyperdense oral contrast is seen throughout the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed by Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Scattered subcutaneous foci of gas within the anterior abdominal wall, likely sequela of prior injections. There is mild diffuse anasarca. The entire abdominal wall is included within the study. MUSCULOSKELETAL: No significant abnormality. No aggressive osseous lesions.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is noted. No significant abnormality in the thoracic esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hypoattenuating lesion in the right hepatic lobe is too small to characterize, but is statistically likely a cyst. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: Phrygian cap. Multiple tiny radiopaque gallstones versus sludge layering in the fundus. Nondistended. No wall thickening. No pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality in the colon. The appendix is not definitely visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,492 |
Interpretation of Outside Films CT Chest CLINICAL INFORMATION: 57-year-old male, Spec Inst: CT CHEST 11022 MARSHALL MED REC 11822 TECHNIQUE: Please note the examination was performed outside of UAB protocol, monitoring and oversight. There are associated diagnostic limitations which should be considered prior to implementation of clinical decisions. Scout images, as well as contrast enhanced Axial and Coronal reformatted images through the chest were provided and reviewed. COMPARISON: No prior chest CT available for comparison. FINDINGS: Scouts: No additional findings within the chest. Lower neck and Mediastinum: The thyroid gland is unremarkable. There is mild thickening within the distal esophagus, which collectively measures up to 21 x 33 mm in maximum axial dimension (series 2, image 45). Lymph nodes: No pathologically enlarged supraclavicular, axillary, mediastinal or hilar lymph nodes. Heart and great arteries: The cardiac chambers appear normal in size. No pericardial effusion. There is mild fusiform aneurysmal dilatation of the ascending thoracic aorta, measuring up to 4 cm. The main pulmonary artery is prominent and measures up to 3.2 cm. No evidence of large central pulmonary thromboembolic disease. Moderate to severe atherosclerotic calcification of the coronary arteries, with possible associated coronary arterial stents. Airways: The trachea and central bronchi are patent and clear. Lungs : Lungs are clear bilaterally without evidence of focal pulmonary opacities or suspicious pulmonary nodules or masses. Pleura: No pleural effusion or pneumothorax. Upper abdomen: The CT of the abdomen and pelvis will be reported separately. Bones and soft tissues: The visualized chest wall soft tissues are unremarkable. No evidence of aggressive or destructive intrathoracic osseous lesions. CONCLUSION: 1. Thickening of the distal esophagus is nonspecific, could represent esophagitis versus esophageal malignancy, recommend further evaluation with upper GI endoscopy. 2. Mild aneurysmal dilatation of the ascending thoracic aorta, measuring up to 4 cm. 3. Prominent main pulmonary artery measuring up to 3.2 cm. 4. Moderate to severe atherosclerotic calcification of the coronary arteries, with possible coronary arterial stents. 5. No otherwise significant intrathoracic abnormalities. 6. Please see separately reported CT of the abdomen and pelvis.
|
FINDINGS: Scouts: No additional findings within the chest. Lower neck and Mediastinum: The thyroid gland is unremarkable. There is mild thickening within the distal esophagus, which collectively measures up to 21 x 33 mm in maximum axial dimension (series 2, image 45). Lymph nodes: No pathologically enlarged supraclavicular, axillary, mediastinal or hilar lymph nodes. Heart and great arteries: The cardiac chambers appear normal in size. No pericardial effusion. There is mild fusiform aneurysmal dilatation of the ascending thoracic aorta, measuring up to 4 cm. The main pulmonary artery is prominent and measures up to 3.2 cm. No evidence of large central pulmonary thromboembolic disease. Moderate to severe atherosclerotic calcification of the coronary arteries, with possible associated coronary arterial stents. Airways: The trachea and central bronchi are patent and clear. Lungs : Lungs are clear bilaterally without evidence of focal pulmonary opacities or suspicious pulmonary nodules or masses. Pleura: No pleural effusion or pneumothorax. Upper abdomen: The CT of the abdomen and pelvis will be reported separately. Bones and soft tissues: The visualized chest wall soft tissues are unremarkable. No evidence of aggressive or destructive intrathoracic 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 (
|
16,493 |
EXAM: Interpretation of Outside Films CT Chest CLINICAL INFORMATION: Interpretation of outside CT chest without contrast performed at Huntsville imaging Center on 1/6/2022. History of sarcoidosis. COMPARISON: Outside CT chest without contrast 9/7/2021 TECHNIQUE: Interpretation of Outside Films CT Chest. Please note the examination was performed outside of UAB protocol, monitoring, and oversight. There are associated diagnostic limitations which should be considered prior to implementation of clinical decisions. CT chest without contrast was obtained on 1/6/2022 at Huntsville imaging Center. 1.25 mm axial, 2.5 mm axial, 2 mm coronal and sagittal reformats are available at the time of interpretation. FINDINGS: CONTRAST DISCLAIMER: Lack of intravenous contrast limits evaluation. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There is new focal nodularity in the right lung apex with new pulmonary nodule measuring 0.8 x 1.3 cm on series 3 image 20/image 66 series 4. Similar appearance of the partially calcified right upper lobe pulmonary nodule measuring up to 1.5 cm in diameter, previously 1.5 cm in diameter as measured by this radiologist. Bilateral upper lobe predominant scarring with volume loss and traction bronchiectasis is overall stable appearance. Mildly more pronounced perilymphatic nodularity particularly along the fissures. No pleural effusion or pneumothorax. Central airways are patent. HEART / VESSELS: Heart size is normal. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Numerous calcified mediastinal and hilar lymph nodes, overall unchanged. LYMPH NODES: Numerous calcified lymph nodes throughout the mediastinum and bilateral hila, similar to prior examination. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Scattered calcified granuloma involving the visualized liver, spleen, and periportal lymph nodes. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. New 1.3 cm pulmonary nodule in the apical right upper lobe, likely infectious/inflammatory in etiology related to known history of sarcoidosis. Recommend CT chest in three months to assess for resolution/stability. 2. Mild increase in perihepatic distribution pulmonary nodularity may suggest worsening disease, sarcoid flare. 3. Overall stable appearance of bilateral apical predominant pulmonary scarring, calcified hilar, mediastinal, and periportal lymph nodes, and liver/spleen granulomata, sequela of sarcoidosis. 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: CONTRAST DISCLAIMER: Lack of intravenous contrast limits evaluation. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There is new focal nodularity in the right lung apex with new pulmonary nodule measuring 0.8 x 1.3 cm on series 3 image 20/image 66 series 4. Similar appearance of the partially calcified right upper lobe pulmonary nodule measuring up to 1.5 cm in diameter, previously 1.5 cm in diameter as measured by this radiologist. Bilateral upper lobe predominant scarring with volume loss and traction bronchiectasis is overall stable appearance. Mildly more pronounced perilymphatic nodularity particularly along the fissures. No pleural effusion or pneumothorax. Central airways are patent. HEART / VESSELS: Heart size is normal. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Numerous calcified mediastinal and hilar lymph nodes, overall unchanged. LYMPH NODES: Numerous calcified lymph nodes throughout the mediastinum and bilateral hila, similar to prior examination. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Scattered calcified granuloma involving the visualized liver, spleen, and periportal lymph nodes. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is noted. No significant abnormality in the thoracic esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hypoattenuating lesion in the right hepatic lobe is too small to characterize, but is statistically likely a cyst. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: Phrygian cap. Multiple tiny radiopaque gallstones versus sludge layering in the fundus. Nondistended. No wall thickening. No pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality in the colon. The appendix is not definitely visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,494 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Right-sided abdominal pain. COMPARISON: None. TECHNIQUE: Outside CT images without IV contrast dated 1/10/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. 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 GALLBLADDER: Contracted. PANCREAS: No peripancreatic fat stranding. SPLEEN: Mildly enlarged. ADRENALS: Normal. KIDNEYS: There is minimal dilatation of the right renal collecting system. The right ureter is distended with an abrupt transition point to nondilated in the pelvis at the level of the right adnexa (series 2, image 69). No definite etiology for obstruction is identified. No radiopaque stone is seen. No perinephric fat stranding. Mild left prominence without gross hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Accessory right renal artery. Scattered atherosclerosis. Cardiac enlargement URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Mild dilatation of the right renal collecting system and ureter with a transition to nondilated ureter in the pelvis, of uncertain etiology. Consider further evaluation with CT urogram as clinically indicated. 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: IMAGE QUALITY: Satisfactory. 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 GALLBLADDER: Contracted. PANCREAS: No peripancreatic fat stranding. SPLEEN: Mildly enlarged. ADRENALS: Normal. KIDNEYS: There is minimal dilatation of the right renal collecting system. The right ureter is distended with an abrupt transition point to nondilated in the pelvis at the level of the right adnexa (series 2, image 69). No definite etiology for obstruction is identified. No radiopaque stone is seen. No perinephric fat stranding. Mild left prominence without gross hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Accessory right renal artery. Scattered atherosclerosis. Cardiac enlargement URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is noted. No significant abnormality in the thoracic esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hypoattenuating lesion in the right hepatic lobe is too small to characterize, but is statistically likely a cyst. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: Phrygian cap. Multiple tiny radiopaque gallstones versus sludge layering in the fundus. Nondistended. No wall thickening. No pericholecystic stranding. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality in the colon. The appendix is not definitely visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
|
16,495 |
EXAM: Outside CT Image Interpretation CLINICAL INFORMATION: Dissection. COMPARISON: None. TECHNIQUE: Outside CT images with IV contrast dated 1/18/2022 were submitted for interpretation. The CT acquisition was performed outside of UAB protocol, monitoring and oversight. Interpretation may have reduced accuracy, which should be considered prior to implementation of clinical decisions. FINDINGS: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: ABDOMINAL AORTA: Stanford type A aortic dissection with extension distally into the bilateral common iliac arteries. CELIAC AXIS: Arises from the true lumen. The anterior aspect of the intimal flap extends partially into the ostium. SMA: Arises from the true lumen. There is extension of the intimal flap into the ostium. There is thickening of the arterial wall concerning for intramural hematoma. RIGHT RENAL: Arises from the true lumen. Patent. LEFT RENAL: Arises from the false lumen. IMA: Arises from the false lumen. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: As above. Patent. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: As above. Patent. ------------------------------------------------------------- ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Relative hypoenhancement of the left kidney compared to the right secondary to dissection. Indeterminant exophytic lesion arising from the upper pole the right kidney (series 2, image 152). Left simple renal cyst. No hydronephrosis bilaterally. LYMPH NODES: None pathologically enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Few noninflamed colonic diverticula. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: As above. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. Bilateral fat-containing inguinal hernias. MUSCULOSKELETAL: Mild multilevel discogenic degenerative changes. No aggressive osseous lesions. CONCLUSION: 1. Stanford type A aortic dissection with involvement of the bilateral common iliac arteries. The intimal flap extends anteriorly into the ostia of the celiac axis and SMA with thickening of the walls of the proximal SMA concerning for intramural hematoma and impending propagation of the dissection. The left renal artery arises from the false lumen with relative hypoperfusion of the left kidney. 2. Indeterminant right renal lesion. Further characterization with multiphase renal protocol CT is recommended. 3. For concomitant chest CT findings, see separately dictated report. 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: IMAGE QUALITY: Satisfactory. STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: ABDOMINAL AORTA: Stanford type A aortic dissection with extension distally into the bilateral common iliac arteries. CELIAC AXIS: Arises from the true lumen. The anterior aspect of the intimal flap extends partially into the ostium. SMA: Arises from the true lumen. There is extension of the intimal flap into the ostium. There is thickening of the arterial wall concerning for intramural hematoma. RIGHT RENAL: Arises from the true lumen. Patent. LEFT RENAL: Arises from the false lumen. IMA: Arises from the false lumen. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: As above. Patent. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: As above. Patent. ------------------------------------------------------------- ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Relative hypoenhancement of the left kidney compared to the right secondary to dissection. Indeterminant exophytic lesion arising from the upper pole the right kidney (series 2, image 152). Left simple renal cyst. No hydronephrosis bilaterally. LYMPH NODES: None pathologically enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Few noninflamed colonic diverticula. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: As above. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. Bilateral fat-containing inguinal hernias. MUSCULOSKELETAL: Mild multilevel discogenic degenerative changes. No aggressive osseous lesions.
|
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. Cerebellar tonsils are minimally low lying. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Globes are intact. No fracture. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: No fracture. Pterygoid plates are intact. MANDIBLE: Bilateral temporomandibular joints are intact. No fracture. SINONASAL CAVITIES: Paranasal sinuses are clear.
|
16,496 |
EXAM: Interpretation of Outside Films CT Chest CLINICAL INFORMATION: 58-year-old male, outside hospital transfer for aortic dissection. Aortic dissection. Interpretation of outside CTA chest performed at Vaughan regional Medical Center on 1/18/2022 COMPARISON: Portable chest radiograph dated on/19/2020.. TECHNIQUE: Interpretation of Outside Films CT Chest. Please note the examination was performed outside of UAB protocol, monitoring, and oversight. There are associated diagnostic limitations which should be considered prior to implementation of clinical decisions. FINDINGS: Precontrast images are not available. VASCULATURE: CORONARY ARTERIES: There are no significant atherosclerotic calcifications of the native coronary arteries. There is no extension of the dissection into coronary arteries. Right and left coronary arteries arise from the respective coronary sinuses. The dissection appears to start just above the origin of coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: Dilatation of the ascending aorta measuring up to 5.1 cm in diameter at the aortic root on series 602 image 65. Aortic dissection is present extending above the aortic valve extending distally through the aortic arch and thoracic aorta to the abdominal aorta. The pseudolumen is opacified with contrast. AORTIC ARCH: Extension of the aortic dissection into the aortic arch. Opacification of the pseudolumen with contrast. ARCH VESSELS: The arch measures up to 3.9 cm on axial image 239; series 2. Extension of the aortic dissection through the origins of brachiocephalic artery, the right common carotid and right subclavian artery, proximal aspect of the left common carotid and left subclavian arteries. Distal aspects of the imaged right vessels are opacified. DESCENDING THORACIC AORTA: Extension of the aortic dissection and the descending thoracic aorta. There is opacification of the pseudolumen. The descending thoracic aortic dissection at the level of left main pulmonary artery measures up to 3.3 cm on axial image 227; series 2. UPPER ABDOMINAL AORTA: Please see same day CT abdomen for abdomen findings. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Examination is in expiration. Bilateral dependent atelectasis. No focal consolidation, pleural effusion, or pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Heart size is normal. Small volume hemopericardium, with pericardial fluid with density measuring 42 Hounsfield units on series 2 image 193. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please see same day CT abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. CONCLUSION: 1. Aneurysm of the ascending aorta with associated aortic dissection extending just above the aortic root through the aortic arch, thoracic aorta, and into the abdominal aorta (type A dissection) disease. Dissection flap extends into the brachiocephalic, left common carotid, and left subclavian artery proximally. Contrast opacification in the true and false lumen is identified. 2. Small-volume hemopericardium. Coronary arteries appear to be spared. 3. Please see same day CTA abdomen for abdomen findings. 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: Precontrast images are not available. VASCULATURE: CORONARY ARTERIES: There are no significant atherosclerotic calcifications of the native coronary arteries. There is no extension of the dissection into coronary arteries. Right and left coronary arteries arise from the respective coronary sinuses. The dissection appears to start just above the origin of coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: Dilatation of the ascending aorta measuring up to 5.1 cm in diameter at the aortic root on series 602 image 65. Aortic dissection is present extending above the aortic valve extending distally through the aortic arch and thoracic aorta to the abdominal aorta. The pseudolumen is opacified with contrast. AORTIC ARCH: Extension of the aortic dissection into the aortic arch. Opacification of the pseudolumen with contrast. ARCH VESSELS: The arch measures up to 3.9 cm on axial image 239; series 2. Extension of the aortic dissection through the origins of brachiocephalic artery, the right common carotid and right subclavian artery, proximal aspect of the left common carotid and left subclavian arteries. Distal aspects of the imaged right vessels are opacified. DESCENDING THORACIC AORTA: Extension of the aortic dissection and the descending thoracic aorta. There is opacification of the pseudolumen. The descending thoracic aortic dissection at the level of left main pulmonary artery measures up to 3.3 cm on axial image 227; series 2. UPPER ABDOMINAL AORTA: Please see same day CT abdomen for abdomen findings. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Examination is in expiration. Bilateral dependent atelectasis. No focal consolidation, pleural effusion, or pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Heart size is normal. Small volume hemopericardium, with pericardial fluid with density measuring 42 Hounsfield units on series 2 image 193. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Please see same day CT abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
|
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 (
|
16,497 |
RADIOLOGIC EXAM: Interpretation of Outside Films CT Face, Interpretation of Outside Films CT Head CLINICAL INFORMATION: Spec Inst: WBMC 11822--trauma---recd 11922 DR Reiff 61435 COMPARISON: CT head obtained 1/19/2022. TECHNIQUE: Interpretation of Outside Films CT Face, Interpretation of Outside Films CT Head STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: Tiny intraparenchymal hemorrhage in the left frontal lobe and left thalamus with mild surrounding edema. These are unchanged on subsequently obtained CT head. No mass effect or midline shift. Gray-white matter differentiation is maintained. No evidence of acute infarction. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Ex vacuo dilatation. Tiny nodule in the posterior left ventricle body which is likely secondary to volume averaging given that it is not visualized on the subsequently obtained thinner slice CT head. Hyperattenuation in the dependent lateral ventricles is better visualized on subsequent CT head. ORBITS: Bilateral pseudophakia. No fracture. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Questionable nondisplaced fracture left posterior wall of the maxillary sinus adjacent to the infraorbital foramen. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Small amount hemorrhage within the dependent left maxillary sinus. Opacification of a mid frontal sinus. Mild mucosal thickening of the left frontal, ethmoid, and maxillary sinuses. Fluid within the left nasal cavity. CONCLUSION: 1. Tiny intraparenchymal hemorrhages in the left frontal lobe and left thalamus. No significant mass effect or midline shift. 2. Hyperattenuation in the dependent ventricles is better visualized on subsequent CT head. 3. Questionable nondisplaced fracture left posterior maxillary sinus. 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: Tiny intraparenchymal hemorrhage in the left frontal lobe and left thalamus with mild surrounding edema. These are unchanged on subsequently obtained CT head. No mass effect or midline shift. Gray-white matter differentiation is maintained. No evidence of acute infarction. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Ex vacuo dilatation. Tiny nodule in the posterior left ventricle body which is likely secondary to volume averaging given that it is not visualized on the subsequently obtained thinner slice CT head. Hyperattenuation in the dependent lateral ventricles is better visualized on subsequent CT head. ORBITS: Bilateral pseudophakia. No fracture. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Questionable nondisplaced fracture left posterior wall of the maxillary sinus adjacent to the infraorbital foramen. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Small amount hemorrhage within the dependent left maxillary sinus. Opacification of a mid frontal sinus. Mild mucosal thickening of the left frontal, ethmoid, and maxillary sinuses. Fluid within the left nasal cavity.
|
Findings: The diagnostic quality/utility of this examination is degraded by patient motion. There is similar appearance of extensive right MCA territory infarction involving the right frontoparietal and temporal lobes and basal ganglia, causing mass effect on the right lateral ventricle and about 8 mm left-to-right midline shift, unchanged since prior study. There is mild prominence of the left lateral ventricle. There is mass effect the right cerebral peduncle with early uncal herniation. A focus of hyperattenuation is seen in the anterior aspect of the right temporal lobe suggestive for hemorrhagic conversion. The visualized paranasal sinuses and mastoid air cells are clear. No acute osseous or soft tissue abnormality seen.
|
16,498 |
RADIOLOGIC EXAM: Interpretation of Outside Films CT Face, Interpretation of Outside Films CT Head CLINICAL INFORMATION: Spec Inst: WBMC 11822--trauma---recd 11922 DR Reiff 61435 COMPARISON: CT head obtained 1/19/2022. TECHNIQUE: Interpretation of Outside Films CT Face, Interpretation of Outside Films CT Head STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: Tiny intraparenchymal hemorrhage in the left frontal lobe and left thalamus with mild surrounding edema. These are unchanged on subsequently obtained CT head. No mass effect or midline shift. Gray-white matter differentiation is maintained. No evidence of acute infarction. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Ex vacuo dilatation. Tiny nodule in the posterior left ventricle body which is likely secondary to volume averaging given that it is not visualized on the subsequently obtained thinner slice CT head. Hyperattenuation in the dependent lateral ventricles is better visualized on subsequent CT head. ORBITS: Bilateral pseudophakia. No fracture. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Questionable nondisplaced fracture left posterior wall of the maxillary sinus adjacent to the infraorbital foramen. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Small amount hemorrhage within the dependent left maxillary sinus. Opacification of a mid frontal sinus. Mild mucosal thickening of the left frontal, ethmoid, and maxillary sinuses. Fluid within the left nasal cavity. CONCLUSION: 1. Tiny intraparenchymal hemorrhages in the left frontal lobe and left thalamus. No significant mass effect or midline shift. 2. Hyperattenuation in the dependent ventricles is better visualized on subsequent CT head. 3. Questionable nondisplaced fracture left posterior maxillary sinus. 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: Tiny intraparenchymal hemorrhage in the left frontal lobe and left thalamus with mild surrounding edema. These are unchanged on subsequently obtained CT head. No mass effect or midline shift. Gray-white matter differentiation is maintained. No evidence of acute infarction. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Ex vacuo dilatation. Tiny nodule in the posterior left ventricle body which is likely secondary to volume averaging given that it is not visualized on the subsequently obtained thinner slice CT head. Hyperattenuation in the dependent lateral ventricles is better visualized on subsequent CT head. ORBITS: Bilateral pseudophakia. No fracture. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Questionable nondisplaced fracture left posterior wall of the maxillary sinus adjacent to the infraorbital foramen. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Small amount hemorrhage within the dependent left maxillary sinus. Opacification of a mid frontal sinus. Mild mucosal thickening of the left frontal, ethmoid, and maxillary sinuses. Fluid within the left nasal cavity.
|
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: Mild thickening of the gastric antral wall. The small bowel is normal. COLON / APPENDIX: The appendix is normal. Scattered diverticulosis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Mildly distended. REPRODUCTIVE ORGANS: The uterus is present. There is a small amount of fluid within the endometrial cavity. Left corpus luteal cyst. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
|
16,499 |
RADIOLOGIC EXAM: Interpretation of Outside Films CT CSPN CLINICAL INFORMATION: Trauma Spec Inst: WBMC 11822--trauma---recd 11922 Dr. Reiff 61435 COMPARISON: None. TECHNIQUE: Interpretation of Outside Films CT CSPN . Outside hospital CT images of the cervical spine were submitted for interpretation. Axial, coronal, and sagittal images were reviewed. STRUCTURED REPORT: CT Cervical Spine Trauma FINDINGS: 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: 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 of the head with and without contrast: There is no acute infarction, hemorrhage, or cerebral edema. The gray-white matter differentiation is maintained. Moderate age-appropriate diffuse parenchymal volume loss with ex vacuo dilatation of the ventricles. Confluent periventricular white matter hypoattenuation consistent with advanced microangiopathic change. Small chronic infarcts in the left caudate head. Cerebellar and corpus callosal atrophy. There is no space occupying intracranial lesion or enhancing intracranial abnormality. No extra-axial collections. Basal cisterns are patent. There is no acute osseous or orbital abnormality. The paranasal sinuses are clear. Trace left mastoid air cell effusion. CT angiogram of the brain: RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Mild scattered atherosclerosis of the aortic arch and proximal branch vessels without flow-limiting stenosis. RIGHT CAROTID: Advanced calcified atherosclerosis of the proximal ICA with approximately 50% luminal narrowing. No flow-limiting stenosis. Mild irregularity of the distal ICA likely secondary to atherosclerosis. No evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Advanced calcified atherosclerosis of the proximal ICA with approximately 50% narrowing. No evidence of occlusion or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: Mild diffuse irregularity, likely secondary to atherosclerosis. There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: Loss of tissue fat planes in the right neck with atrophy of the right submandibular gland. There is soft tissue fullness in the left submandibular space and left lingual tonsil within ill-defined mass measuring approximately 4.7 x 3.4 cm on image 145 series 504. There is a large ulceration of the posterior oral tongue and base of tongue. . Noncalcified 5 mm nodule in the right upper lobe (image 135, series #502). Multiple additional subcentimeter pulmonary nodules for example tiny 2 mm nodule in the right upper lobe. Biapical centrilobular emphysematous change. CERVICAL SPINE: Advanced multilevel discogenic degenerative change of the cervical spine. Reversal of cervical lordosis at C3-C4. Severe bilateral C3-C4 and right C4-C5 neural foraminal narrowing. Moderate spinal canal narrowing at C3-C4 and C4-C5 due to posterior disc osteophyte complexes. Indeterminately lucent lesion in the the left T3 vertebral body measuring up to 8 mm (image 94, series #502). Partially visualized sclerotic lesions within the T4 and T5 vertebral bodies.
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.