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Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Family history of breast cancer in mother, diagnosed at the age of 63. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no suspicious solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Female 57 years old; Reason: R/O liver lesions History: Hx of HCV LIVER: The liver measures 20.5 cm cm in length. There is increased, coarse, and heterogenous echogenicity of the liver parenchyma. . There is a round well-defined hyperechoic lesion noted in the portal hepatis that appears similar to the prior ultrasound dated March 2016 favored to be an area of focal fat. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 23 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall appears normal but was unable to be measured. Gallstones are seen. Negative Murphy's. No pericholecystic fluid. The common bile duct measures 6.5 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.0 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.9 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 11.4 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted. | 1. Coarse echogenic liver consistent with chronic liver disease/parenchymal dysfunction with no suspicious focal lesions. No ascites.2. Hyperechoic focus at the porta hepatis favored to be an area of focal fat.3. Gallstones without evidence of acute cholecystitis. |
Generate impression based on findings. | Right breast ultrasound performed, patient scheduled first stereotactic biopsy of right breast calcifications in the upper inner quadrant. A targeted right ultrasound was performed for the mammographic area of concern, in the central and upper inner breast. Multiple simple and clustered cyst identified in the right breast 12:00 position, clustered cyst measuring 1.2 x 0.5 cm and a small complex cyst measuring 4 x 3 mm.No suspicious solid mass or a correlate to the cluster of calcifications in the upper inner quadrant identified. | No definite ultrasound correlate identified to the cluster of calcifications in the right breast. Simple and clustered cyst identified in the right breast 12:00 position. BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 41 years old, Female, Reason: 41 yo with HCV History: none LIVER: The liver measures 14.8 cm in length. The liver parenchymal echotexture is heterogeneous. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.1 m/s. No evidence of ascites.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.5 cm in length. RIGHT KIDNEY: Kidney measures 11.2 cm in length. No hydronephrosis. LEFT KIDNEY: Kidney measures 11.5 cm in length. No evidence of hydronephrosis. | 1.No focal hepatic lesion identified. |
Generate impression based on findings. | Reason: Rule out HCC History: HCV, cirrhosis LIVER: Coarse, echogenic hepatic echotexture. The liver measures 14.3 cm in length. The portal vein is patent with normal directional hepatopedal portal venous blood flow, peak velocity of 18.0 cm/s. No focal masses.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The gallbladder wall measures 0.2 cm. The proximal common bile duct measures 0.4 cm and the distal duct measures 0.6 cm. No biliary ductal dilatation or shadowing stones.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 12.5 cm in length. No hydronephrosis, masses, or shadowing calculi.LEFT KIDNEY: The left kidney measures 12.3 cm in length. Non-obstructing 1.0 cm stone in the lower pole of the left kidney. No hydronephrosis or masses.SPLEEN: The spleen measures 14.5 cm in length.OTHER: No ascites. | 1. Findings consistent with chronic liver disease, hepatic parenchymal dysfunction, or hepatic steatosis without significant interval change. No focal masses.2. 1.0 cm non-obstructing left lower pole renal calculus. |
Generate impression based on findings. | History of nonalcoholic steatohepatitis. History of kidney cancer status post partial nephrectomy. Gallbladder polyp. LIVER: The liver is heterogeneous coarse and echogenic, limiting evaluation for a discrete lesion. Note is made of a 1.5 cm septated cyst, unchanged. No focal suspicious lesion. No intrahepatic biliary ductal dilatation. It measures 18.5 cm in length. Normal hepatopedal portal venous blood flow at 22 cm/s.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm.Normally distended gallbladder. There are 2 non-shadowing avascular nonmobile sessile foci one of them measuring 8 mm and the other measuring 5 mm.No shadowing gallstones, wall thickening, pericholecystic fluid or focal tenderness.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable. The distal body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 8.5 cm without a focal lesion.RIGHT KIDNEY: The right kidney measures 9.5 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. The cortex is echogenic. Contour changes from partial nephrectomy.OTHER: The left kidney measures 10.5 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. The cortex is echogenic. | 1. Heterogeneous coarsened echogenic liver parenchyma may reflect fatty infiltration and/or parenchymal dysfunction. No focal suspicious lesion.2. Two subcentimeter non-shadowing avascular nonmobile sessile gallbladder foci. Differential considerations include multiple polyps, non-shadowing adherent gallstones and/or sludge. Continued follow-up is suggested.3. Findings suggestive of medical renal disease. |
Generate impression based on findings. | Renal cysts RIGHT KIDNEY: 9.8 cm in length. No hydronephrosis. No suspicious lesion identified.LEFT KIDNEY: 8.9 cm. No hydronephrosis. The anechoic left midpole cyst measures 1.2 x 1.4 x 1.2 cm, unchanged in size and appearance. The hypoechoic left inferior pole cystic nodule measures 1.9 x 1.7 x 1.6 cm, unchanged in size and appearance.OTHER: No significant abnormalities noted. | Unchanged renal cysts. The lower pole cyst appears simile. The midpole cyst is less sharply defined, but unchanged. |
Generate impression based on findings. | Cystectomy with neobladder. Elevated creatinine. RIGHT KIDNEY: 12.5 cm in length. Mildly echogenic renal parenchyma. No suspicious lesions identified. No hydronephrosis. LEFT KIDNEY: 13.5 cm in length. Mildly echogenic renal parenchyma. 3.7 cm simple appearing collecting system cyst in the inferior pole, as seen on the prior CT. No suspicious lesions identified. No hydronephrosis.BLADDER: Neobladder not well visualized. OTHER: No significant abnormalities noted. | Mildly echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 76-year-old male post thyroidectomy for papillary carcinoma. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for recurrent disease. |
Generate impression based on findings. | Asymptomatic female presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. No suspicious cystic or solid mass is identified.This exam was interpreted by two radiologists. | No sonographic evidence for malignancy.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then comparisons will be made for future exams. BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 54-year-old female with chills and sensation. RIGHT LOBE MEASUREMENTS: 5.4 x 2 x 1.8 cmLEFT LOBE MEASUREMENTS: 3.8 x 1.5 x 1.1 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal-appearing thyroid without thyromegaly or mass. |
Generate impression based on findings. | NASH staging per intercept, 303 protocol LIVER: Liver measures 17.2 cm with increased echogenicity and coarseness consistent with fatty infiltration not significant changed from prior examination. Limited Doppler interrogation of the main portal vein demonstrates normal flow directionality and patency, 21.4 cm/s.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallbladder appears unremarkable. No evidence of gallstones. Common hepatic duct measures up to 3 mm.PANCREAS: Head of pancreas as visualized appears slightly hyperechoic probably fatty infiltration. Body and tail of pancreas is not visualized due to overlying bowel gas.SPLEEN: Spleen measures 10.3 cm without any abnormality.RIGHT KIDNEY: Right kidney measures 11.2 cm left kidney measures 11 cm. No hydronephrosis OTHER: No ascites | Moderate fatty infiltration of the liver unchanged from prior examination. No ascites |
Generate impression based on findings. | 73-year-old female patient with abdominal pain with lipase elevation. Evaluate for bleed, inflammation. LIVER: The liver measures 16.8 cm in length and demonstrates increased parenchymal echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is filled with stones. No significant pericholecystic fluid or gallbladder wall thickening is identified. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 2 mm in diameter.PANCREAS: A majority of the pancreas is not visualized secondary to overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.0 cm in length. No evidence of hydronephrosis. There is a 1.5 x 1.6 cm right upper pole renal cyst.OTHER: The left kidney measures 11.1 cm in length. No evidence of hydronephrosis.The spleen is not visualized on this examination. | 1. Increased hepatic parenchymal echogenicity, which is likely related to hepatic steatosis.2. Poorly visualized pancreas; contrast enhanced CT is better means of evaluation for pancreatitis.3. Cholelithiasis without sonographic evidence of acute cholecystitis.4. Right renal cyst. |
Generate impression based on findings. | 45-year-old male with hypothyroidism and thyroid nodules for follow-up. RIGHT LOBE MEASUREMENTS: 5.5 x 1.8 x 1.6 cmLEFT LOBE MEASUREMENTS: 5.0 x 1.6 x 1.5 cmISTHMUS MEASUREMENTS: 0.2 cm RIGHT LOBE: vague, solid and heterogeneous nodule in the posterior midportion of the right lobe measures 0.8 x 1 x 0.8 cm without change.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable right thyroid nodule. |
Generate impression based on findings. | Ms. Lopez is a 39-year-old female presenting for short term ultrasound follow-up for known right chest wall lipoma. Family history of breast cancer in both maternal and paternal great aunts. Personal history of lupus. Upon physical exam at the patient's area of concern, a superficial soft mobile mass is appreciated.A targeted right breast ultrasound was performed for the patient’s area of concern. In the right breast 9:00 location, approximately 9 cm from the nipple, there is revisualization of an oval isoechoic mass measuring 2.4 x 0.5 x 1.3 cm, previously measuring 2.4 x 0.5 x 1.2 cm. Sonographic findings are compatible with a benign lipoma.In the right breast 10:00 location, approximately 5 cm from the nipple, there is a round anechoic lesion identified, measuring 0.5 x 0.3 x 0.6 cm. Sonographic findings are compatible with a simple cyst. In the right axillary region, at least four enlarged right axillary lymph nodes are again identified, appearing stable when compared to the prior ultrasound examination from July 2015. | (1) Benign lipoma of the right lateral chest.(2) Simple cyst of the right upper outer breast.(3) Enlarged but stable right axillary lymph nodes, likely related to patient's personal history of lupus.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 77-year-old male with elevated LFTs and renal failure. LIVER: The liver measures 18.2 cm in the craniocaudal dimension. There appears to be periportal cuffing. The liver contour is relatively smooth. The parenchyma is mildly coarsened. No focal hepatic lesion or intrahepatic biliary ductal dilatation. Normally oriented portal venous blood flow at 50 cm/sec is slightly pulsatile, which may be seen in the setting of right-sided heart failure. GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring up to 4 mm. No gallstones are evident, however, the gallbladder is distended with moderate diffuse gallbladder wall thickening and pericholecystic fluid, findings that are nonspecific in the setting of ascites. PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen is moderately enlarged, measuring 15.6 cm in length without a discrete abnormality.KIDNEYS: The right kidney measures 12.8 cm in length without hydronephrosis. Note is made of a 2.3 x 2.1 x 2 x 1 cm multiseptated cystic lesion with calcification suspected in the septi. The left kidney is suboptimally visualized, measures 12.8 cm in length without hydronephrosis. There is a 1.5 cm interpolar simple appearing cyst. The renal cortices are mildly hyperechogenic.ABDOMINAL AORTA: The proximal aorta measures 2.2 cm in AP dimension. The mid-distal aorta is not visualized due to overlying bowel gas shadowing.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: The urinary bladder almost entirely contracted around a Foley catheter.Pleural effusions and small volume ascites is present. | 1. Hydropic gallbladder with nonspecific gallbladder wall thickening in the setting of ascites. If there is continued clinical concern for acute cholecystitis, a HIDA scan may be considered. 2. Heterogeneous liver parenchyma may represent diffuse fatty infiltration/parenchymal dysfunction.3. Echogenic renal cortices, compatible with medical renal disease.4. Ascites and pleural effusions. 5. Bilateral simple and minimally complex renal cysts. |
Generate impression based on findings. | Male 61 years old Reason: acute cholecystitis and assess CBD stent for occlusion History: RUQ abd pain, jaundice, elevated LFTs LIVER: Normal echogenicity of the liver. Liver measures 13.4 cm.GALLBLADDER, BILIARY TRACT: Gallbladder wall is thickened with small amount of pericholecystic fluid. These findings are suspicious for acute cholecystitis. There is pneumobilia. Small amount of sludge is noted within the gallbladder. Mild intrahepatic biliary dilatation is present. Common bile duct measures 8 mm.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Increased echogenicity of the right kidney without evidence of hydronephrosis.OTHER: No significant abnormalities noted. | Gallbladder wall thickening and pericholecystic fluid with small amount of sludge and possible stone in the gallbladder. These findings are suspicious for acute cholecystitis.Mild intra and extra hepatic biliary dilatation with minimal pneumobilia. |
Generate impression based on findings. | 27-year-old male with elevated liver function tests. LIVER: Measures 14.5 in length. Increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: Collapsed gallbladder with known cholelithiasis, but not clearly demonstrated on this study. No biliary ductal dilation. PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Unremarkable in size and echogenicity. KIDNEY: No hydronephrosis, nephrolithiasis, or solid mass. OTHER: Mild-to-moderate pericardial effusion. | 1.Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease.2.Mild to moderate pericardial effusion. |
Generate impression based on findings. | Recurrent pyelonephritis with CVA tenderness; pregnant RIGHT KIDNEY: Slight interval increase in degree of moderate hydronephrosis. No worrisome mass or stone. No perinephric collection. Right kidney 13.2 cm in length.LEFT KIDNEY: No significant abnormalities noted. 12.7 cm in lengthOTHER: Intrauterine pregnancy. Bladder nondistended. | Slight interval increase in degree of right moderate hydronephrosis. No worrisome mass, stone, or abscess. |
Generate impression based on findings. | 36-year-old with palpable right breast mass for the last several weeks. A targeted right ultrasound was performed for the palpable area of concern. There is a mixed echogenicity but predominately hypoechoic mass at the right breast 10:00 position measuring 0.9 x 0.9 cm. Peripheral vascularity is noted. | 9 mm right breast mass. At this point, bilateral diagnostic mammography and referral to a breast surgeon for consideration of palpably guided sampling are recommended. The patient declined mammography today despite extensive discussions regarding its potential benefits for her. The patient voiced understanding that mammography may detect breast cancer that is not seen on ultrasound in this setting.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Mildly echogenic renal parenchyma without mass, stone, or hydronephrosis. 15.1 cm in length.LEFT KIDNEY: AbsentOTHER: Bladder nondistended | Mildly echogenic right renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Evaluate for a left axillary lymph nodes. Known left breast cancer. A targeted left ultrasound was performed for the axillary region. Multiple lymph nodes with uniformly thickened cortices, retained hila and retained hilar blood flow are seen. There is no suspicious morphology lymph node or solid or cystic mass identified. | No suspicious morphology axillary lymph node. The patient will be seeing Dr. Chhablani again today.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 28-year-old female with conjugated hyperbilirubinemia who presents with evaluation for hepatobiliary pathology LIVER: The liver is normal in echogenicity and measures 21 cm in length.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. The common bile duct measures 0.3 cm in diameter. There is a septated complex fluid collection inferior to the liver, adjacent to the gallbladder. Pericholecystic fluid and gallbladder wall thickening measuring 5 mm is most likely secondary to the adjacent fluid collection. No evidence of cholelithiasis.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen is normal in echogenicity and measures 10.6 cm in length.KIDNEYS: The right kidney measures 12.3 cm in length and the left kidney measures 13.9 cm in length without evidence of hydronephrosis. OTHER: Partially visualized right pleural effusion. | 1.Complex pericholecystic fluid collection adjacent to the gallbladder. 2.Edematous gallbladder wall is likely secondary to the adjacent complex fluid collection as above.3.Partially visualized right pleural effusion.4.Hepatomegaly. |
Generate impression based on findings. | 21-year-old with history of bilateral breast fibroadenomas. Interval follow up exam to assess for stability. History of breast cancer in the patient's mother diagnosed at age 51 and the patient's maternal grandmother. A whole breast ultrasound was performed for the palpable areas of concern. In the 11 o'clock position in the right breast 1 cm from the nipple is a 1.2 x 1.3 x 1.2 centimeters (previously 1.2 x 1.1 x 1.2 cm) round nearly isoechoic mass with circumscribed margins and through transmission. At the 9 o'clock position in the right breast 3 cm from the nipple a 1.1 x 0.6 x 1.6 cm (previously 1.2 x 0.6 x 1.7 cm) oval, parallel hypoechoic mass is present.At the 3 o'clock position of the left breast 1 cm from the nipple a 0.7 x 0.4 x 0.6 cm (previously 0.7 x 0.9 x 0.4 cm) parallel hypoechoic mass is present.No significant internal vascularity is noted in any lesion. | Stable bilateral masses most likely are presenting fibroadenomata. Continued follow-up with repeat bilateral breast ultrasound in one year is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female; 55 years old. Reason: evaluate for abdominal wall abscess History: abdominal wall erythema In the subcutaneous tissues superior to the liver along the midline of the abdomen is a complex, loculated fluid collection. This collection measures 3.4 x 1.1 x 2.3 cm and demonstrates no vascularity on color Doppler. | 3.4 x 1.1 x 2.3 cm loculated subcutaneous fluid collection . A benign etiology such as a seroma or resolving hematoma is favored. Abscess is considered less likely. |
Generate impression based on findings. | Urosepsis RIGHT KIDNEY: 11.0 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 10.6 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Not distended.OTHER: No significant abnormality noted. | No hydronephrosis. |
Generate impression based on findings. | Recurrent UTIs. RIGHT KIDNEY: 9.7 cm in length. Echogenic renal parenchyma. No focal lesions, renal stones, or hydronephrosis.LEFT KIDNEY: 9.2 cm in length. Echogenic renal parenchyma. No focal lesions, renal stones, or hydronephrosis.BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Echogenic renal parenchyma without stones or hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | Male, 63 years old. Hyponatremia and AKI RIGHT KIDNEY: The right kidney measures 10.9 cm in length, with normal echotexture. An exophytic lower pole cystic structure measures 1.5 x 1.4 x 1.7 cm. Mild hydronephrosis. No shadowing stones.LEFT KIDNEY: The left kidney measures 11.7 cm in length, with normal echotexture. Mild hydronephrosis. No shadowing stones.OTHER: The bladder is distended, without significant wall thickening. | Mild bilateral hydronephrosis. |
Generate impression based on findings. | Painless jaundice with a large liver LIVER: No obvious discrete liver mass. Liver length 18.5 cm.GALLBLADDER, BILIARY TRACT: Severe bilobar intrahepatic ductal dilatation associated with severe extrahepatic ductal dilatation. Debris versus tumor within the extrahepatic duct noted. Associated with large porta hepatis mass measuring approximately 4.6 x 3 x 3 cm.PANCREAS: Atrophy of pancreatic body. The pancreas head is not well visualized due to overlying gas.RIGHT KIDNEY: Echogenic parenchyma with multiple cysts. No stone, worrisome mass, stone, or hydronephrosis. Right kidney 9.6 cm in length.OTHER: No ascites. Spleen 7.7 cm in length. | Severe bilobar intrahepatic as well as extrapelvic biliary dilatation secondary to obstruction by large porta hepatis mass. Differential diagnosis includes malignancy either of pancreatic or biliary origin. Would recommend correlation with dedicated cross-sectional imaging.Echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction.Dr. Woodruff notified of findings 2/13/2015; 11:30 am. |
Generate impression based on findings. | Known bilateral breast masses presents for follow-up. A targeted bilateral ultrasound was performed for the known masses. The left breast mass at 1:00 currently measures 2.8 x 1.1 x 2.2 cm, previously 2.1 x 0.9 x 2.2. Left breast mass at 6:00 currently measures 2.4 x 1.0 x 1.7 cm, previously 1.7 x 0.7 x 1.4 cm. Right breast mass at 10:00 currently measures 1.2 x 0.7 x 1.4 cm, previously 1.5 x 0.6 x 1.9 cm. | Slight interval enlargement in the known left breast masses. No significant change in the right breast mass. These continue to most likely represent fibroadenomata. The patient will follow-up with Donna Christian in surgery clinic today for further evaluation.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 33-year-old female with history of right upper quadrant pain. Evaluate for gallstones. LIVER: No significant abnormalities noted. The liver measures 16 cm in length.BILIARY TRACT: No significant abnormalities noted. No gallstones, gallbladder wall thickening or pericholecystic fluid.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. The spleen measures 10.5 cm in length.RIGHT KIDNEY: No significant abnormalities noted. The right kidney measures 11.9 cm.OTHER: No significant abnormalities noted. The left kidney measures 13.1 cm. | No cholelithiasis, or findings of cholecystitis. |
Generate impression based on findings. | 51-year-old male with right upper quadrant pain. LIVER: Liver is normal in size and mildly echogenic. Although nonspecific this could be due to steatosis. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal veinGALLBLADDER, BILIARY TRACT: Gallbladder is well-visualized and is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Head and body appear normal. The tail was not well seen.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Small left renal cyst. Spleen appears unremarkable. | Mildly echogenic liver. No evidence for gallbladder abnormality. |
Generate impression based on findings. | 73-year-old female with dyspnea on exertion. Rule out nodules. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 6.3 x 2.1 x 1.9 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 6.4 x 1.8 x 1.9 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.6 cm in thickness.RIGHT LOBE: The right thyroid lobe has a heterogenous multinodular echotexture. The largest nodule is in the lower pole measuring 2.5 x 2.2 x 1.8 cm and has a spongiform appearance.LEFT LOBE: The left thyroid lobe has a heterogenous multinodular echotexture. The largest nodule is in the left lower pole measuring 2.9 x 2 x 2.6 cm and has a spongiform appearance.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No suspicious cervical lymphadenopathy.OTHER: No significant abnormality noted. | Multinodular goiter. |
Generate impression based on findings. | 52 year old female with history of thyroid gland malignancy and metastases. Evaluate amount of abdominal ascites, possible paracentesis. LIVER: Limited evaluation of the liver reveals a nodular contour and heterogeneous appearance, similar to prior.OTHER: Minimal abdominal free fluid, likely not amenable to future paracentesis given the small amount. | Heterogeneous/nodular liver, similar to prior, and minimal ascites. |
Generate impression based on findings. | Abnormal coagulation profile LIVER: Coarse echogenic liver echotexture without mass. Liver length 25 cm. Limited interrogation of main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 13 cm in lengthOTHER: Left kidney 12.8 cm in length. Spleen 18.8 cm in length. | Hepatosplenomegaly with coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Family history of breast cancer in mother, diagnosed at the age of 30. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Bilateral saline implants are identified. No suspicious solid or cystic mass is seen. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Ms. Stevens is a 66 year old female with known multicentric right breast cancer with metastatic axillary lymphadenopathy. She presents today for imaging evaluation to assess treatment response. Targeted right breast ultrasound was performed for the known areas of malignancy.In the right breast 9:00 location, approximately 7 cm from the nipple, there is revisualization of the biopsy-proven malignancy with associated biopsy marker clip now measuring approximately 2.2 x 1.7 x 1.8 cm, previously measuring 2.8 x 2.1 x 2.9 cm.In the right breast 9:00 location, approximately 5 cm from the nipple, there is revisualization of the second biopsy-proven malignancy with associated biopsy marker clip now measuring approximately 0.9 x 0.3 x 0.9 cm, previously measuring 1.0 x 1.2 x 1.0 cm.Of note, the two sites of malignancy at the 9:00 location are confluent on today's examination.In the right breast 8:00 location, approximately 7 cm from the nipple, there is revisualization of the third biopsy-proven malignancy now measuring approximately 0.9 x 0.7 x 0.7 cm, previously measuring 0.9 x 0.6 x 0.8 cm. | Stable to slight interval improvement in known multifocal right breast malignancy, measurements as above. Patient should continue to follow up with her breast surgeon/medical oncologist for further evaluation. All results recommendations were discussed with the patient and Dr. Nanda.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | LIVER: The liver measures 7.2 cm in length, and grossly normal in appearance.The main portal vein is patent, with flow velocity of 23 cm/s.BILIARY TRACT: Mobile sludge is seen within the gallbladder. No biliary dilatation or gallbladder wall thickening.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen is normal in appearance, and measures 5 cm.RIGHT KIDNEY: The right kidney measures 6.2 cm, and demonstrates grade 4 pelvocaliectasis.OTHER: The left kidney measures 5.5 cm, and is grossly normal in appearance. | 1. Gallbladder sludge, without additional significant abnormality of the liver or biliary system.2. Right kidney Grade 4 pelvicaliectasis. |
Generate impression based on findings. | Male, 61 years old. Hypodense lesions in both kidneys on CT scan. Pre kidney transplant evaluation RIGHT KIDNEY: The right kidney measures 10.6 cm in length, with increased cortical echogenicity. Multiple small hypoechoic structures are noted. A lower pole hypoechoic structure measures 1.7 x 1.4 x 2.3 cm, predominantly cystic in appearance, nonvascular. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.7 centimeters in length, with increased cortical echogenicity. Multiple small hypoechoic structures are noted. A lower pole cystic appearing lesion measures 1.3 x 1.4 x 2.5 cm, nonvascular. The hypodense lesion seen on CT in the upper pole are not well visualized. No shadowing stones or hydronephrosis.OTHER: The bladder is decompressed. | Multiple cystic-appearing lesions in the bilateral kidneys. Left upper pole hypodense lesions are not well visualized on ultrasound. |
Generate impression based on findings. | 40-year-old female with right upper quadrant pain and elevated bilirubin. LIVER: Liver is mildly enlarged and homogeneous in echogenicity. No focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: Visualized portions of the biliary tract are normal in caliber. On decubitus imaging there is a gallstone in the neck of the gallbladder which does not appear freely mobile. The gallbladder is not greatly distended, there is no wall thickening or pericholecystic fluid. The patient was highly tender over the gallbladder.PANCREAS: Body and tail appear normal. The head is not well seen.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Limited views left kidney demonstrate no abnormality. Spleen is normal in size. | Gallstone, likely impacted in the gallbladder neck |
Generate impression based on findings. | Reason: HCC screening, GFR too low for cross sectional imaging History: Cryptogenic cirrhosis LIVER: The liver measures 15.1 cm in length and is nodular in morphology. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.15 m/s.BILIARY TRACT: Gallbladder surgically absent. The common bile duct is mildly prominent measuring up to 10 mm in diameter, not unexpected status post cholecystectomy and similar to prior cross-sectional imaging.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11.3 cm in length. RIGHT KIDNEY: Kidney measures 9.5 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 8.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Mild upper abdominal ascites. | Cirrhotic liver without suspicious focal hepatic lesions identified. Ascites. |
Generate impression based on findings. | Female 62 years old; Reason: thyroid nodules History: thyroid nodules RIGHT LOBE MEASUREMENTS: 5.5 x 1.8 x 1.8 cm.LEFT LOBE MEASUREMENTS: 5.3 x 1.4 x 1.5 cm.ISTHMUS MEASUREMENT: 0.4 cm.RIGHT LOBE: There are two nodules on the right.Nodule #1: an ovoid, hyperechoic nodule in the midpole of the right lobe measuring approximately 1.1 x 0.8 x 1.2 cm. This appears similar in appearance to the prior study.Nodule #2: There is a small, spongiform nodule measuring approximately 0.8 x 0.7 x 0.9cm that appears similar to the prior study. LEFT LOBE: There is one nodule on the left.Nodule #1: Measures approximately 0.4 x 0.4 x 0.3 cm. It is mildly echogenic with a hypoechoic rim. This may represent an intrathyroidal lymph node.ISTHMUS: There is an approximately 1.6 x 1.0 x 1.9 cm heterogenous slightly hypoechoic ovoid nodule at the left aspect of the isthmus. This is similar in appearance to the prior study. LYMPH NODES: No suspicious adenopathy noted. OTHER: No significant abnormality noted. | 1.Multinodular thyroid as above grossly stable since the prior study. |
Generate impression based on findings. | 53-year-old male with congestive heart failure, precardiac transplant. Evaluate for malignancy. Exam is very limited by body habitus and patient inability to cooperate.LIVER:Limited without gross, focal abnormality. Liver appears somewhat echogenic which is nonspecific but could be due to fatty liver. Liver is enlarged, measuring 21 cm in length. Limited evaluation of the portal vein demonstrates appropriate flow direction and pulsatile waveform consistent with heart failure.GALLBLADDER, BILIARY TRACT: Small non--- dependent, nonmobile echogenic focus in the gallbladder consistent with a 4 mm polyp. Biliary tract is normal in caliber.PANCREAS: LimitedSPLEEN: Enlarged without gross, focal abnormality. Focus of accessory splenic tissue noted.KIDNEYS: Right kidney measures 11.1 cm in length without gross abnormality. Left kidney measures 11.6 cm in length without gross abnormality. ABDOMINAL AORTA: LimitedINFERIOR VENA CAVA: Limited with ECMO catheter notedOTHER: Right pleural effusion. | Very limited exam with hepatosplenomegaly and gallbladder polyp. Right pleural effusion. |
Generate impression based on findings. | Ms. Blue is a 17-year-old female presenting with a palpable left breast mass for the past 3 months. Patient is two months postpartum. Upon physical exam at the patient's area of concern, a superficial soft mobile mass is appreciated.A targeted left breast ultrasound was performed for the patient’s area of concern. In the left breast 8:00 location, approximately 10 cm from the nipple, there is a superficial hypoechoic lesion identified measuring 0.7 x 0.4 x 0.7 cm. Sonographic findings are compatible with an epidermal inclusion cyst. There are no suspicious solid or cystic findings identified. | Benign epidermal inclusion cyst of the left breast. No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 61-year-old male patient with nausea, weight loss, right upper quadrant pain. Question of cholecystitis, liver disease. LIVER: The liver measures 15.8 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder wall is mildly thickened measuring up to 4 mm with comet tail artifact indicative of adenomyomatosis. No gallstones or pericholecystic fluid is identified. Sonographic Murphy's sign is negative. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 7.9 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. A 1 cm cyst is noted within the right upper pole.OTHER: The left kidney measures 9.8 cm in length and demonstrates increased cortical echogenicity. No evidence of hydronephrosis. A subcentimeter left lower pole renal cyst is noted.The spleen measures 9 cm in length. | 1. Increased renal cortical echogenicity consistent with medical renal disease/parenchymal dysfunction.2. Bilateral renal cysts.3. Gallbladder adenomyomatosis. |
Generate impression based on findings. | 77-year-old male with shortness of breath. Evaluate for ascites, liver congestion. LIVER: Normal echogenicity of the liver measuring 16.4 cm in length. There is a subcentimeter calcified granuloma. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.BILIARY TRACT: Thickened gallbladder wall measuring 6 mm in thickness. There is a shadowing stone measuring up to 1.4 cm. No pericholecystic fluid. Sonographic Murphy sign is negative. Mild intrahepatic biliary ductal dilatation is noted. Common bile duct measures 3 mm in caliber.PANCREAS: Normal echogenicity of the visualized pancreas.SPLEEN: Normal echogenicity of the spleen measuring 13.7 cm. Accessory splenule is noted measuring 1.4 cm x 1.5 cm x 1.3 cm.RIGHT KIDNEY: Enlarged measuring 18.4 cm in length. Renal parenchyma is replaced by innumerable cysts, some of which are complex appearing with internal debris.OTHER: Left kidney is also enlarged measuring 16.5 cm in length. Renal parenchyma is also replaced by innumerable cysts, some of which are complex appearing with internal debris.Left pleural effusion. | 1. Gallbladder wall thickening cholelithiasis with no pericholecystic fluid. This may be related to heart disease or renal failure.2. Mild intrahepatic biliary ductal dilatation, with normal caliber of the common bile duct however.3. Left pleural effusion. 4. Bilateral innumerable renal cysts, some of which are complex and contain internal debris. |
Generate impression based on findings. | Male 47 years old Reason: r/o hydronephrosis, pyelonephriits History: AKI, leukocytosis LIVER:Echogenic liver, compatible with fatty infiltration. Liver is enlarged measuring 18 cm. No focal liver lesions.GALLBLADDER, BILIARY TRACT: No significant abnormality noted. No evidence of intra or extrahepatic biliary dilatation. Gallbladder is contracted, therefore, cannot be optimally evaluated.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Spleen measures 7 cm.KIDNEYS: Bilateral slightly echogenic kidneys. Right kidney measures 11.1 cm. Left kidney measures 10.4 cm. No evidence of hydronephrosis or focal lesions. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Small right-sided pleural effusion.Doppler findings:Hepatic veins and IVC are patent. Main portal vein and its branches are patent with normal flow direction. Hepatic artery is patent. | Mild hepatomegaly and echogenic liver. Bilateral echogenic kidneys.Normal Doppler findings. |
Generate impression based on findings. | 61-year-old male with acute lymphoblastic leukemia and stem cell transplant, now with abnormal liver function. LIVER: Liver is moderately to markedly echogenic which is non--- specific. There is no focal hepatic abnormality identified. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: No gallstones, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: There is a 3 cm complex cyst arising from lower pole of the right kidney with multiple relatively fine septations. This was identified on prior CT scan.OTHER: No significant abnormalities noted. | Echogenic liver without focal abnormality. Patent main portal vein.Complex cyst right kidney. |
Generate impression based on findings. | Ms Mason is a 66-year-old woman who returns for further imaging evaluation of 2 round masses in the left breast. Full field ML and compression CC and ML views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. In the left lower inner quadrant there are 2 circumscribed round masses of typically benign morphology. Scattered benign calcifications are noted bilaterally. ULTRASOUND | Typically benign mammographic masses correspond to 2 probable complicated cysts in the left breast 7:00 position 3 cm from the nipple. Unilateral left diagnostic mammogram in 6 months is recommended to ensure stability. Findings and recommendation were discussed with Ms. Mason, who agrees with the plan. Notably, Ms. Mason today states that she is currently experiencing her first menstrual period since completing menopause 14 years ago. She was strongly encouraged to see her gynecologist or primary care physician promptly for evaluation of this and she stated that she would make arrangements to be seen today.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Reason: cirrhosis, HCC screen LIVER: The liver measures 13 cm in length and is nodular in contour. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.24 m/s.BILIARY TRACT: Status post cholecystectomy. No intrahepatic biliary ductal dilatation is present. The common bile duct measures 8 mm in diameter, unchanged.PANCREAS: Pancreas not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 11.4 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.5 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Cirrhotic liver morphology without focal lesions identified. Mild splenomegaly. No ascites. |
Generate impression based on findings. | Evaluate left renal cyst RIGHT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Right kidney 11.3 cm in lengthLEFT KIDNEY: Stable minimally complex left renal cyst measuring 6.9 x 6 x 5.4 cm. Normal parenchymal echogenicity without worrisome mass, stone, or hydronephrosis. Left kidney 13.1 cm in length.OTHER: No significant abnormalities noted. | Stable minimally complex left renal cyst. |
Generate impression based on findings. | Female 49 years old; Reason: RUQ pain, cholecysitis vs. gallstone History: ruq pain The gallbladder wall measures 3.1 mm. An echogenic shadowing foci seen within the gallbladder fundus. This was also visualized on prior CT within the distal fundal fold. No pericholecystic fluid is seen. The common bile duct measures 3.0 mm in diameter. The portal vein is patent with hepatopetal flow. The liver is only partially visualized however no worrisome masses or intrahepatic ductal dilation are seen. | Small echogenic foci within the gallbladder fundus either represents a small gallstone or milk of calcium. This was seen on prior CT. No sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | 42 year old male with right cervical lymphadenopathy. Evaluate lymph nodes, soft tissue In the right lateral neck at the area of palpation noted by the patient there is a lymph node measuring 1.2 cm x 0.6 cm x 1.1 cm with suggestion of a prominent fatty hilum and central vascularity favoring a reactive etiology. There are multiple additional smaller lymph nodes in the right lateral neck which are benign in appearance. In the left neck there is a prominent lymph node measuring 0.8 cm x 0.4 cm x 2.0 cm which is elongated in contour with prominent fatty hilum and nonspecific heterogeneity of the cortex. Additional smaller benign appearing lymph nodes are also present. | Bilateral lymph nodes as described above felt to be most likely reactive in etiology. |
Generate impression based on findings. | Male; 63 years old. Reason: ascites History: distention Cirrhotic liver morphology. Mild ascites, redistributed but overall stable to slightly decreased from prior. | Mild ascites, stable to slightly decreased from prior. |
Generate impression based on findings. | 38 years old, Female, Reason: evaluate GB History: RUQ pain Exam is limited due to patient's body habitus.LIVER: The liver measures 18.5 cm in length. Increased echogenicity of the liver suggestive of fatty infiltration. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.6 cm in length. RIGHT KIDNEY: Kidney measures 11.3 cm in length. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.6 cm in length, kidney not well visualized. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or acute cholecystitis.2.Increased echogenicity of the liver is consistent with fatty infiltration. |
Generate impression based on findings. | Female 69 years old; Reason: 69 y.o. F with a history of HPT \T\ thyroid nodules. Please evaluate History: HPT RIGHT LOBE MEASUREMENTS: The thyroid is surgically absent.LEFT LOBE MEASUREMENTS: The thyroid is surgically absent.ISTHMUS MEASUREMENT: The thyroid is surgically absent.RIGHT LOBE, LEFT LOBE, ISTHMUS: The thyroid is surgically absent.LYMPH NODES: No adenopathy noted. OTHER: No significant abnormality noted, specifically no masses. | 1.Surgical changes of a thyroidectomy without masses or adenopathy. |
Generate impression based on findings. | 67-year-old male patient with history of HCV. HCC screening. LIVER: The liver measures 11.8 cm in length and demonstrates coarsened hepatic echotexture. There is a new 1.9 x 1.3 x 2.1 cm area of hypoechogenicity within the left hepatic lobe which appears to be bulging the liver contour; this is not seen on prior CT. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 2 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 9.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.3 cm in length. No evidence of hydronephrosis.The spleen measures 9.0 cm in length. | 1. Hypoechoic lesion within left hepatic lobe concerning for HCC; dedicated contrast enhanced CT/MRI of the liver is recommended further evaluation.2. Coarsened hepatic echotexture consistent with chronic liver disease. |
Generate impression based on findings. | 33-year-old female patient with right upper quadrant abdominal pain, worse after meals, in patient with obesity and prediabetes. Evaluate for cholelithiasis, cholecystitis, liver pathology. LIVER: The liver measures 21.1 cm in length. Hepatic parenchyma echogenicity is increased. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. The patient is mildly tender with palpation near the neck of the gallbladder. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 2 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.4 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.8 cm in length. No evidence of hydronephrosis.The spleen measures 8.5 cm in length. | 1. No cholelithiasis or sonographic evidence of acute cholecystitis. However, the patient is mildly tender with sonographic palpation of the gallbladder neck; HIDA scan can be considered for further evaluation if clinically indicated.2. Hepatic steatosis. |
Generate impression based on findings. | Status post open cholecystectomy with left lateral segmentectomy elevated LFTs LIMITED ABDOMENLIVER: Status post left lateral segmentectomy. Diffusely coarse and echogenic liver echotexture without mass.BILIARY TRACT: No significant abnormalities noted.OTHER: No ascites | Abnormal coarse and echogenic liver echotexture consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Patent hepatic vessels with normal directional flow. No ascites. |
Generate impression based on findings. | Female 45 years old Reason: Thyroid nodule History: hx of thyroid nodule RIGHT LOBE MEASUREMENTS: 6.3 x 2.3 x 2.0 cmLEFT LOBE MEASUREMENTS: 6.3 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Diffusely heterogeneous thyroid echotexture. Within the superior/midpole of the right thyroid lobe there is a 1.1 x 1.1 x 1.2 cm predominantly solid hypoechoic nodule.LEFT LOBE: Diffusely heterogeneous thyroid echotexture. No discrete measurable thyroid nodule.ISTHMUS: Diffusely heterogeneous echotexture.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous echotexture throughout a mildly enlarged thyroid gland with a predominantly solid 1.2-cm hypoechoic nodule within the superior/mid pole of the right thyroid lobe. The appearance is suggestive a dominant nodule within a diffuse multinodular goiter. Correlation with previous outside hospital imaging would be helpful to ensure stability. No significant lymphadenopathy. |
Generate impression based on findings. | 32 year-old female with right upper and lower quadrant pain, early satiety, anorexia. Evaluate for appendicitis. The appendix is visualized and appears normal in caliber and echogenicity and is compressible. No free fluid or lymphadenopathy.The visualized liver appears normal in echogenicity. There as stones in the gallbladder with no evidence of cholecystitis. No gallbladder wall thickening. No pericholecystic fluid. No intra-or extrahepatic biliary ductal dilatation. | 1. Cholelithiasis with no evidence of cholecystitis.2. No evidence of appendicitis. |
Generate impression based on findings. | 35-year-old female with history of renal stones. RIGHT KIDNEY: Right kidney measures 12 cm, and has mild pelvic caliectasis. No significant cortical thinning. There is an approximately 1 cm renal calculus in the pelvis.LEFT KIDNEY: The left kidney measures approximately 12.4 cm, and there is no hydronephrosis on the left. No left renal calculus are seen.OTHER: Bladder is within normal limits, and both ureteral jets are seen. The uterus presses against the wall of the bladder, causing some mass effect. Likely uterine fibroid. | Mild right pelvic caliectasis and renal pelvic calculus as above. |
Generate impression based on findings. | 35-year-old female complains of abdominal pain. She has an elevated gtt. Evaluate for biliary pathology. LIVER:The liver measures 16.8 cm. There is coarse, increased, and heterogeneous echotexture of the liver. No masses or ascites. No intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended. No evidence of stones or sludge. The gallbladder wall measures approximately 2.9 mm. No pericholecystic fluid. The common bile duct measures approximately 2.7 mm.PANCREAS: Evaluation of the pancreas limited by overlying bowel gas.SPLEEN: The spleen measures 7.9 cm. No radiographic abnormalities are noted.KIDNEYS: The right kidney measures 11.1 cm. The cortex has normal echogenicity. No shadowing calculi or hydronephrosis. The left kidney measures 11.4 cm. The cortex has normal echogenicity. No shadowing calculi or hydronephrosis. OTHER: No significant abnormality noted. | 1. Coarse, increased, and heterogeneous echotexture of the liver consistent with chronic liver disease/parenchymal dysfunction. No masses or ascites.2. No biliary pathology such as cholelithiasis noted. |
Generate impression based on findings. | Ms. McGhee is a 27-year-old female presenting with palpable lump in the right breast, and complaining of transient bilateral breast pain over the last few months. Family history is positive for breast cancer in paternal cousin diagnosed at 40 years of age. Mobile smooth lump is present within the right upper outer quadrant on the physical exam.A targeted ultrasound was performed for the patient’s area of concern in the right breast at the 11:00 position, approximately 5 cm from the nipple, which revealed no focal sonographic correlate. No suspicious cystic or solid mass is identified.Targeted ultrasound was also performed of bilateral breasts in the 3:00, 6:00, 9:00, 12:00 and retroareolar positions. There is no solid or cystic mass identified. | Normal sonographic evaluation of bilateral breasts. Palpable area of concern is associated with dense fibroglandular tissue within the right axillary tail. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. All results and recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 68-year-old female with thrombocytopenia, evaluate spleen. The spleen appears normal in size measuring 10.4 cm in length, without discrete focal lesion. No perisplenic fluid or collection is identified. | No splenomegaly or discrete lesion. |
Generate impression based on findings. | History of islet cell transplant one year prior. Evaluate portal venous flow. LIVER: The liver is mildly echogenic, unchanged. No perihepatic fluid. Echogenic ring structures are unchanged. No focal suspicious lesion. The main portal vein demonstrates a normal spectral waveform, normal hepatopedal blood flow with peak systolic velocity of 0.4 m/s. The right and left portal veins are patent. The hepatic veins are patent and demonstrate normal orientation blood flow.BILIARY TRACT: No biliary ductal dilatation with the common duct measuring 4 mm. Normally distended gallbladder without wall thickening, gallstones, pericholecystic fluid or focal tenderness.PANCREAS: The visualized portions of the pancreas are unremarkable.SPLEEN: The spleen measures 9.9 cm without a focal lesion.RIGHT KIDNEY: The right kidney measures 9.5 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney measures 10.2 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | Normal hepatopedal portal venous blood flow. |
Generate impression based on findings. | Hepatitis C LIVER: Stable cirrhotic morphology without worrisome mass. Liver length 15.3 cmGALLBLADDER, BILIARY TRACT: No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Stable angiomyolipomas. No worrisome mass, stone, or hydronephrosis. Right kidney 10.8 cm in lengthOTHER: Left kidney 10.4 cm in length. Stable left angiomyolipomas. Spleen 12.1 cm in length. No ascites. | Stable cirrhotic morphology without mass or ductal dilatation. No ascites. Stable bilateral renal angiomyolipomas. |
Generate impression based on findings. | Male 26 years old; Reason: Look for evidence of tumor has positive paraneoplastic antibody History: Multiple neurological symptoms. RIGHT TESTIS: The right testicle measures 1.9 cm x 2.7 cm x 4.9 cm. The right testicle is homogenous with arterial and venus doppler flow present and symmetric throughout. No mass is seen. No significant abnormalities noted.LEFT TESTIS: The left testicle measures 2.0 cm x 2.9 cm x 4.9 cm. The left testicle is homogenous with arterial and venus doppler flow present and symmetric throughout. No masses seen. No significant abnormalities noted.RIGHT EPIDIDYMIS: Right epididymis measures 0.9 cm x 1.1 cm x 4.1 cm. There is a round anechoic lesion at the medial end of the epididymis measuring 1.1 cm x 1.0 cm x 0.9 cm.LEFT EPIDIDYMIS: The epididymis measures 0.8 cm x 1.5 cm x 4.4 cm. No significant abnormalities noted. | 1. Negative testicular ultrasound. No masses were seen bilaterally.2. Hypoechoic lesion seen in the right epididymis represents an epididymal cyst or a spermatocele. |
Generate impression based on findings. | Fever pain and elevated creatinine; renal transplant Right iliac fossa renal transplant demonstrates unremarkable parenchymal echogenicity without perinephric collection. No worrisome mass, stone, or hydronephrosis. 13.3 cm in length.Bladder nondistended | Unremarkable right iliac fossa renal transplant without perinephric collection, mass, stone, or hydronephrosis. |
Generate impression based on findings. | Left testicular pain. Evaluate for torsion. RIGHT TESTIS: 5.6 x 2.3 x 3.8 cm. Normal vascularity. No focal lesions.LEFT TESTIS: 5.6 x 3.6 x 2.7 cm. Normal vascularity. No focal lesions.RIGHT EPIDIDYMIS: 9 x 10 x 12 mm. Normal vascularity.LEFT EPIDIDYMIS: 8 x 8 x 13 mm. Normal vascularity.OTHER: No significant abnormalities noted. No hydrocele or varicocele. | No evidence of torsion or specific abnormality otherwise to account for the patient's symptoms. |
Generate impression based on findings. | Male 64 years old Reason: increasing creatinine History: elevated creatinine Ultrasound guidance and technical assistance was provided for a renal allograft in the left iliac fossa. 4 passes were made by Dr. Cunningham using an 18-gauge Bard needle. The procedure was successfully completed. | Successful ultrasound guided biopsy of the allograft in the left iliac fossa. |
Generate impression based on findings. | History renal stones RIGHT KIDNEY: Normal parenchymal echogenicity without mass, stones, or hydronephrosis. Right kidney 10.4 cm in lengthLEFT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Left kidney 11.2 cm in length.OTHER: Bladder nondistended | Negative renal ultrasound. No evidence for mass, stone, or obstruction. |
Generate impression based on findings. | 74-year-old male with history of right adrenal mass and bilateral renal cysts. RIGHT KIDNEY: The right kidney measures approximately 10.4 cm, and demonstrates no hydronephrosis or shadowing stones. Several small cysts are seen. No internal vascularity, and no significant interval change.LEFT KIDNEY: Left kidney measures approximately 11.8 cm, without renal calculus or hydronephrosis. Several small cysts are again noted. No internal vascularity, and no significant interval change.OTHER: Urinary bladder is within normal limits, unchanged.Right adrenal nodule measures approximately 3.8 x 3 x 2.6 centimeters, nonspecific but likely myelolipoma and is unchanged. | Multiple bilateral renal cysts and right adrenal myolipoma, unchanged. |
Generate impression based on findings. | 45-year-old male with transaminitis. Evaluate for steatosis, gallbladder sludge. LIVER: The liver measures 19.6 cm in length. Diffusely increased echogenicity consistent with hepatic steatosis. No superimposed discrete focal lesion. Patent main portal vein.GALLBLADDER, BILIARY TRACT: There is layering sludge within the gallbladder. There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No sonographic Murphy sign could be elicited during the examination due to patient condition.PANCREAS: The pancreas is not well-visualized due to patient body habitus and bowel gas.KIDNEYS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1.Limited examination demonstrating hepatic steatosis and gallbladder sludge.2.No evidence of acute cholecystitis or biliary obstruction. |
Generate impression based on findings. | 32-year-old female with history of microscopic thyroid cancer status post lobectomy. Evaluate for adenopathy/recurrence. RIGHT LOBE MEASUREMENTS: 3.4 x 1.2 x 0.9 cmLEFT LOBE MEASUREMENTS: Status post left thyroidectomyISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: Two subcentimeter hypoechoic nodules in the right thyroid measuring 0.6 x 0.5 x 0.3, and 0.2 x 0.2 x 0.1 cm are without significant interval change since the prior study. The larger of the two nodules has somewhat ill-defined margins. LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A heterogeneous hypoechoic lymph node measuring 0.6 x 0.6 x 0.7 cm in the right level II station not seen on the prior study has a suspicious rounded morphology and echotexture. Other scattered cervical lymph nodes on the right and left have overall benign morphologic features.OTHER: No significant abnormality noted. | 1. A morphologically abnormal right level II lymph node not seen on prior studies raises suspicious for nodal metastasis. 2. Right thyroid nodules without significant interval change. |
Generate impression based on findings. | 63 years old, Male, Reason: right testicular mass RIGHT TESTIS: There is a dominant solid lesion in the right testis which is heterogeneous and mostly isoechoic to background testicular tissue. This lesion has vascular flow and is highly suspicious for malignancy. There is normal vascularity and Doppler flow within the visualized normal tissue of the right testicle.LEFT TESTIS: Patient status post left orchiectomy with prosthesis.RIGHT EPIDIDYMIS: Right epididymal cyst measuring 1.0 x 0.7 cm.LEFT EPIDIDYMIS: No significant abnormalities noted. | Dominant solid right testicular lesion with vascularity, highly suspicious for malignancy. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Mildly heterogeneous liver without mass. Liver length 15.7 cm.BILIARY TRACT: Cholelithiasis with mild diffuse wall thickening. No pericholecystic fluid. No positive Murphy's sign. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.1 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Left kidney 10.6 cm in length. No ascites. | Mildly heterogeneous liver raises the possibility of fatty infiltration/parenchymal dysfunction without mass. Cholelithiasis with mild diffuse wall thickening without pericholecystic fluid or Murphy's sign. While there is no evidence for acute cholecystitis, chronic inflammation cannot be excluded. No ductal dilatation. No ascites. |
Generate impression based on findings. | 77-year-old female with history of palpable breast mass and new right breast abnormality on screening mammogram. Patient has a history of right chest wall injections for pain as recently as 7/2/2015. Physical exam demonstrated a palpable mobile mass in the right breast at the 12 o'clock position approximately 10 cm from the nipple. The patient reported a palpable mass in the right breast 12 o'clock position approximately 6 cm from the nipple. A targeted right ultrasound was performed in the aforementioned locations.At the 12 o'clock position approximately 10 cm from the nipple, an oval, cystic lesion with internal echogenic foci and linear septations was present measuring 1.8 x 0.8 x 1.7 cm. There was no internal vascularity.At the 12 o'clock position approximately 6 cm from the nipple in the area of the patient's reported palpable mass, normal breast tissue is appreciated. No suspicious masses identified. | 1. Cystic lesion with internal echogenic foci and septations likely representing an injection granuloma from recent pain injection. Follow-up ultrasound in 3 months and surgical consult is recommended.2. In the area of the patient's pain at the 12:00 position of the right breast 6 cm from the nipple, no suspicious masses or abnormalities were noted.Results and plan were discussed with the patient at length.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 33-year-old female status post ICD implant with onset of pain in the left axilla No evidence for a fluid collection or edema are seen in the area of the patient's concern. Over the area where the patient feels discomfort a shadowing density seen in the soft tissue. | In the area where the patient feels discomfort, a shadowing density is seen likely representing the ICD wire. No discrete evidence for edema or fluid collection are seen. |
Generate impression based on findings. | Female 65 years old Reason: 65 yo with cirrhosis please screen for HCC LIVER: Nodular contour of the liver compatible with known cirrhosis. No focal hepatic mass. Liver measures 13.9 cm. Main portal vein is patent with normal directional flow and a peak velocity of 32 cm/s.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. The common bile duct measures 3 mm. No significant gallbladder wall thickening. There is a shadowing gallstone present within the gallbladder. No evidence of acute inflammation of the gallbladder.PANCREAS: Pancreas is normal in appearance. The distal tail the pancreas is secured by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 8.5 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10.1 cm. Left kidney measures 10.5 cm. OTHER: No significant abnormalities noted. | 1.Nodular contour of the liver compatible with cirrhosis without evidence of a focal mass.2.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | 28-year-old male with hepatitis B. Evaluate for cirrhosis and HCC. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16.5 cm in length. The liver capsule is smooth. No focal lesion or intrahepatic biliary ductal dilatation is evident. Normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm. A normally distended gallbladder is present without wall thickening, gallstones, pericholecystic fluid or focal tenderness.PANCREAS: The poorly visualized pancreatic body and head are unremarkable.SPLEEN: The spleen measures 10.8 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 10.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | No focal hepatic lesion or specific stigmata of cirrhosis. |
Generate impression based on findings. | Ms. Metcalf submitted outside study for review. Submitted for review is:-Right breast ultrasound: 1/11/2016 This examination was performed at Ingalls Memorial Hospital. Static ultrasound images are submitted for interpretation. In the right retroareolar region, approximately 1 cm from the nipple, there is a lobulated hypoechoic mass identified measuring 2.9 x 1.2 cm. There is minimal associated vascularity. | Sonographic findings most suggestive of a fibroadenoma. Given patient's age and palpability, a surgical consultation is recommended at this time for further evaluation and for consideration of palpably-guided FNA. Alternatively, the patient may return for a short term 6 month ultrasound follow-up examination to confirm stability as long as the mass is unchanged. BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 63-year-old male with elevated bilirubin. Evaluate for gallstones common ascites. LIVER: Increased echogenicity of the liver measuring 18.0 cm in length. No hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder is contracted containing stones. Gallbladder wall is mildly thickened measuring 4 mm in thickness. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common bile duct is normal in caliber measuring 4 mm. No intra-extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal in echogenicity.RIGHT KIDNEY: Increased echogenicity of the right kidney measuring 11.5 cm in length. Focal echogenic focus in the lower pole is noted.OTHER: Normal echogenicity of the spleen measuring 13.9 cm in length. Increased echogenicity of the left kidney measuring 12.2 cm in length. Non obstructing 5-mm calculus is noted in the mid to upper pole.Abdominal ascites.Bilateral pleural effusions. | 1. Increased echogenicity of the liver compatible with fatty infiltration.2. Contracted gallbladder with cholelithiasis. Mild thickening of the gallbladder wall is nonspecific in the setting of ascites. No pericholecystic fluid. Sonographic Murphy's sign is negative.3. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. Nonspecific echogenic focus in the lower pole of the right kidney may be a small AML or non shadowing stone. Nonobstructing calculus in the left kidney.4. Abdominal ascites and bilateral pleural effusions. |
Generate impression based on findings. | 81-year-old male with history of cholecystectomy, continued right upper quadrant and right lower quadrant pain. LIVER: Normal echogenicity of the liver measuring 19.7 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Mild intra-and extrahepatic biliary ductal dilatation is again seen. PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: The right kidney is atrophic and increased in echogenicity measuring 11.8 cm in length with moderate to severe hydronephrosis and debris worse when compared to prior CT dated 1/20/2015. No shadowing calculi are noted.OTHER: Left kidney is increased in echogenicity measuring 13.5 cm in length. Cyst in the midpole measures 2.5 cm x 3.6 cm x 2.6 cm. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 13.6 cm in length. | 1. Increased renal echogenicity bilaterally suggestive of parenchymal dysfunction. The right kidney is atrophic with moderate to severe hydronephrosis and debris worse when compared to prior CT. No hydronephrosis in the left kidney. No evidence of nephrolithiasis bilaterally. 2. Mild intra and extrahepatic biliary ductal dilatation is again seen and appears stable. |
Generate impression based on findings. | 24-year-old with 2 palpable areas of concern in the left breast which are marked by the clinical service for ultrasound. A targeted left ultrasound was performed for the 2 palpable areas of concern marked by the clinical service. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. Clinical follow-up as needed is recommended.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 84-year-old female with HCV, cirrhosis. Evaluate for HCC LIVER: Cirrhotic liver morphology. Liver measures 14.8 cm in length. Focal echogenic focus along the anterior aspect of the right hepatic lobe measures 5 mm x 4 mm x 5 mm. Additional hepatic cyst measures 6 mm x 6 mm x 6 mm. Portal vein is patent with appropriate directional flow.BILIARY TRACT: Contracted gallbladder containing multiple shadowing stones. No pericholecystic fluid. No gallbladder wall thickening. The common bile duct measures 9 mm in caliber, pancreatic duct measures 4 mm in caliber. PANCREAS: Visualized portions of pancreas are normal in caliber.SPLEEN: Normal echogenicity of the spleen measuring 7.1 cm in length.RIGHT KIDNEY: Status post right nephrectomy.OTHER: No significant abnormality noted. | 1. Cirrhotic liver morphology. Stable hyperechoic focus in the right hepatic lobe not significantly changed and may represent a hemangioma or fat within a fissure. Continued follow up recommended. Additional subcentimeter hepatic cyst is noted. 2. Stable prominence of the common bile duct. 3. Contract gallbladder containing stones with no evidence of cholecystitis. |
Generate impression based on findings. | Female, 87 years old. Decreased UOP. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 10.4 cm in length, with mildly increased cortical echogenicity. A midpole simple cyst measures 4.5 x 5.4 x 4.6 cm. A lower pole lesion measures 3.3 x 3.9 x 3.0 cm, heterogeneous and hypoechoic with internal vascularity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.6 cm, with mildly increased cortical echogenicity. An upper pole simple cyst measures 2.3 x 2.6 x 2.7 cm. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. | 1. A 3 to 4 cm hypoechoic right lower pole renal lesion corresponds with an enhancing mass seen on recent CT imaging, and likely reflects renal cell carcinoma. Additional bilateral renal cysts.2.No hydronephrosis. |
Generate impression based on findings. | 57-year-old female with lump in the posterior knee. Grayscale and color ultrasound examination of the left posterior popliteal region demonstrates a circumscribed solid lesion measuring 3.5 x 2.0 x 3.5 cm with internal linear regions of increased echogenicity and no significant vascularity. | Sonographic findings as described above are most suggestive of a lipoma. Cross-sectional imaging may be performed for further evaluation if warranted clinically. |
Generate impression based on findings. | Acute kidney injury. History of TIPS. RIGHT KIDNEY: 12.3 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 11.2 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Collapsed post voidOTHER: Cirrhotic liver morphology, partially imaged. Moderate to large amount of ascites identified. | 1. No hydronephrosis.2. Cirrhosis with ascites. |
Generate impression based on findings. | 74-year-old male with hematuria. RIGHT KIDNEY: The right kidney measures 13.8 cm in length. No hydronephrosis. Numerous cysts are again seen some with minimal internal complexity. No definite solid lesion is identified. No shadowing calculi.LEFT KIDNEY: The left kidney measures 13.1 cm in length. No hydronephrosis. Multiple cysts are again seen, some with minimal internal complexity. No definite solid lesion is identified. No shadowing calculi.URINARY BLADDER: No acute abnormality of the urinary bladder.OTHER: No significant abnormalities noted. | Multiple bilateral renal cysts. No dominant mass is identified. Consider further evaluation with CT or MRI as the multiplicity of nodules makes any single nodule difficult to evaluate. |
Generate impression based on findings. | Male 33 years old; Reason: 33 y.o. M with metastatic papillary thyroid cancer in a left level III lymph node History: PTC 3 left neck lymph nodes were localized under sonographic guidance. 0.1 cc of methylene blue was injected.The lesions where left level 3 superior, left level 3 mid and left level 3 inferior/level 4.Surface markings were performed by the service. | 1.Intraoperative methylene blue localization of left lymph nodes. |
Generate impression based on findings. | Oliguria. Rising creatinine. Status post sigmoid colectomy. Please note that the examination is limited by poor acoustic penetrationRIGHT KIDNEY: 7.6 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 8.5 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Not well visualized due to abdominal wounds and bandages.OTHER: No significant abnormality noted. | Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 21-year-old female with postprandial pain and nausea/vomiting, evaluate for gallstone disease. LIVER: Normal echogenicity of the liver measuring 14.2 cm in length. No focal hepatic lesion. Main portal vein is patent with appropriate directional flow, however with elevated velocity up to 60 cm/s which is nonspecific on this nondedicated exam.GALLBLADDER, BILIARY TRACT: Gallbladder is normal in echogenicity with no evidence of gallstones. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 11.6 cm in length. No hydronephrosis.OTHER: Normal echogenicity of the left kidney measuring 11.2 cm in length. No hydronephrosis. Normal echogenicity of the spleen measuring 10.2 cm in length. | 1. Elevated main portal vein velocity which is nonspecific on this nondedicated exam. 2. No evidence of cholelithiasis. |
Generate impression based on findings. | 72-year-old female with history of thyroid cancer status post resection. Evaluate for adenopathy, recurrence. RIGHT LOBE MEASUREMENTS: Surgically absentLEFT LOBE MEASUREMENTS: Surgically absentISTHMUS MEASUREMENTS: Surgically absentRIGHT LOBE: No suspicious lesions in the right thyroid bed. No significant interval change in hyperechoic tiny foci seen on the prior study.LEFT LOBE: No suspicious lesions in the left thyroid bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Scattered cervical lymph nodes with benign morphologic features. No new lymphadenopathy.OTHER: No significant abnormality noted. | No sonographic evidence of recurrent disease or lymphadenopathy. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast benign biopsy. Family history of breast cancer in mother diagnosed in her 60's and maternal grandmother diagnosed in her 50's. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD. The breast parenchyma is heterogeneously dense, which may obscure small masses (BiRads Density Category C), unchanged in pattern and distribution. New asymmetry is present in the superior posterior right breast best seen on MLO view. Stable scattered bilateral benign calcifications. Previously described ill-defined mass previously confirmed to be a cyst on ultrasound in the left lower outer breast is not visualized on the current exam compatible with a waxing and waning cyst. No suspicious masses, microcalcifications are present. | New asymmetry in the superior posterior right breast best seen on MLO view which further evaluation with spot compression views and possibly ultrasound is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | The patient submitted outside mammogram dated 3/21/2014, from Mount Sinai. Submitted outside study was compared to the current mammogram and ultrasound dated 7/1/2015. There is no significant change between these two studies. | Unchanged left retroareolar intraductal papilloma. Please see the addendum to the diagnostic mammogram and ultrasound for details. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 33 year old female with right upper quadrant pain. LIVER: Measures 17.9 cm in length, upper limits of normal, and is normal in echogenicity.BILIARY TRACT: Status post cholecystectomy. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal echogenicity with no evidence of pancreatic ductal dilatation.SPLEEN: Normal echogenicity of the spleen measuring 10.3 cm in length RIGHT KIDNEY: Measures 11.27 m in length and is normal in echogenicity with no evidence of hydronephrosis.OTHER: Left kidney measures 10.7 cm in length and is normal in echogenicity with no evidence of hydronephrosis. | No significant abnormality noted to account for the patient's symptoms. |
Generate impression based on findings. | 76 years old, Female, Reason: 76 yo F, New onset kidney failure History: elevated Cr, lactic acid RIGHT KIDNEY: Kidney measures 10.3 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. There is trace perinephric fluid on the right. Right superior simple-appearing cyst measures 4.5 x 3.0 x 3.6 cm appearing similar to the recent CT study. Right renal stone measures up to 1.3 cm. No evidence of hydronephrosis.LEFT KIDNEY: Kidney measures 8.8 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. Left renal cyst measures 2.6 x 2.9 x 3.4 cm. Nonobstructing left renal stone measures up to 0.7 cm. No evidence of hydronephrosis.OTHER: Trace ascites. | 1.Increased echogenicity of the kidneys bilaterally is consistent with medical renal disease.2.Nonobstructing nephrolithiasis bilaterally.3.Bilateral renal cysts. |
Generate impression based on findings. | Ms. Calle is a 60 year old female with a personal history of right breast mastectomy for ILC in 2009 followed by radiation and tamoxifen therapy. She presents today for a physician palpated superficial lump in her right axilla. On physical examination, a superficial mass is palpated in the right axilla.A targeted right axillary ultrasound was performed for the palpable area of concern. There is a superficially located, round anechoic lesion with layering echogenic material measuring 6 x 4 x 8 mm. There is no internal vascular flow. Sonographic findings are consistent with a benign oil cyst with calcifications. | Benign oil cyst of the right axilla corresponding to the palpable area of concern. No sonographic evidence for malignancy in the right axilla. As long as the patient's physical examination remains normal, left breast unilateral diagnostic mammogram is recommended annually, due next in June 2017. Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on findings. | Male 68 years old Reason: transplant kidney eval, cholecsytitis, free fluid, infrarenal aneurysm as best as able History: ruq abdominal pain, h/o renal transplant and 3 cm infrarenal aortic aneurysm and cholelithiasis LIVER: Liver measures 18.2 cm, enlarged. No focal liver lesions.BILIARY TRACT: Significant gallbladder wall thickening with small amount of pericholecystic fluid. There are multiple gallstones. These findings are compatible with acute cholecystitis. No evidence of intra or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Spleen measures 10.8 cm.RIGHT KIDNEY: No evidence of hydronephrosis bilaterally. Right iliac fossa transplant kidney measures 11.6 cm, unremarkable. Bilateral native kidneys are not well seen due to their increased echogenicity. 1.5 cm simple cyst within the echogenic left kidney. AORTA:No evidence of aortic aneurysm. IVC:Unremarkable.OTHER: No significant abnormalities noted. | Cholelithiasis with acute cholecystitis. |