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Generate impression based on findings. | 66 year old female with history of altered mental status and possible biliary obstruction. Evaluate for portal thrombosis in the setting of hyperkalemia. LIVER: The liver measures 17.3 cm, and has no biliary dilatation. Small amount of abdominal ascites. Portal vein is patent, with velocity measured at 14 cm/sec.BILIARY TRACT: Cholelithiasis, without evidence of cholecystitis. No biliary dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Hyperechoic renal parenchyma, which may be seen in medical renal disease. No hydronephrosis or hydroureter. Small right renal cyst, measuring approximately 2.4 cm.OTHER: Pleural effusions and abdominal ascites. | 1.Ascites and pleural effusions as above.2.Cholelithiasis, without findings of cholecystitis.3.No biliary dilatation or portal vein thrombosis. |
Generate impression based on findings. | History of renal stones. RIGHT KIDNEY: 10.2 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. Two subcentimeter renal stones are identified. No hydronephrosis.LEFT KIDNEY: 11.3 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. Two subcentimeter renal stones are identified. No hydronephrosis.BLADDER: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral subcentimeter non-obstructing renal stones. |
Generate impression based on findings. | 62-year-old male with creatinine elevation. Assess for obstruction/hydronephrosis. RIGHT KIDNEY: The right kidney is atrophic measuring 5 cm in length, and marked parenchymal atrophy is evident. No hydronephrosis.LEFT KIDNEY: The left kidney measures 13.5 cm in length. Normal echogenicity. No hydronephrosis.URINARY BLADDER: The urinary bladder is partially distended and shows no acute abnormality.OTHER: No significant abnormalities noted. | 1. No hydronephrosis.2. Atrophic right kidney with compensatory hypertrophy of the left kidney. Left kidney shows normal echogenicity of the renal parenchyma. |
Generate impression based on findings. | Elevated LFTs and sepsis LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 19.5 cm.GALLBLADDER, BILIARY TRACT: Cholelithiasis with mild diffuse wall thickening and mild pericholecystic fluid. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10 cm in lengthOTHER: Left kidney 10.2 cm in length. Spleen 9.8 cm in length. No ascites. | Mildly heterogeneous liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites.Cholelithiasis with gallbladder wall thickening and pericholecystic fluid raises the possibility of acute cholecystitis. A Murphy's sign could not be assessed due to the patient's inability to cooperate. |
Generate impression based on findings. | Elevated LFTs LIVER: Coarse echogenic liver echotexture without mass. Liver length 16.8 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.7 cm in lengthOTHER: Left kidney 11.7 cm in length. Spleen 6.2 cm in length. No ascites. | Coarse echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 66 year old female with a right lobe nodule. Previously biopsied and showed a follicular lesion of uncertain significance. RIGHT LOBE MEASUREMENTS: 2.3 x 2.7 x 4.9 cmLEFT LOBE MEASUREMENTS: 1.1 x 1.4 x 3.5 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: The right lobe is nearly completely replaced by a 3.5 x 2.3 x 2.7 cm isoechoic solid nodule with increased vascularity and well-defined margins. No associated calcifications.LEFT LOBE: The left thyroid lobe is normal in morphology, echogenicity, and size and contains a 5 x 4 x 2 mm superior pole hypoechoic nodule with no specific suspicious sonographic features.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 3.5-cm solid right thyroid lobe nodule. 5-mm left superior pole hypoechoic nodule with no specific suspicious sonographic features. |
Generate impression based on findings. | History of right lumpectomy and reconstruction. New palpable area of concern in the medial inferior right breast marked by the clinical service. A targeted right ultrasound was performed for the area marked by the clinical service. There is a mixed echogenicity lesion, predominantly cystic in appearance, with hyperechoic components as well. This measures 1.0 x 1.1 cm. The finding is likely related to fat necrosis/oil cyst formation. | Findings are most compatible with fat necrosis/oil cyst formation. The patient will be following up with Dr. Jaskowiak today for further management which will include palpably guided FNA.BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 66-year-old male with history of hemachromatosis. Evaluate liver. No current symptoms. LIVER: The liver measures 14.2 cm in diameter. Note is made of a diffusely heterogenous echotexture affecting the liver. No focal mass lesion identified. No intra- or extra-hepatic biliary ductal dilation. GALLBLADDER, BILIARY TRACT: No gallstones are identified. The common duct measures 5 mm in diameter. PANCREAS: The pancreas is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.6 cm in length.OTHER: The spleen measures 11.7 cm in diameter. | Diffusely heterogeneous echotexture of the liver is nonspecific but may be seen in setting of hepatic steatosis/parenchymal dysfunction. No evidence of focal masslesion. |
Generate impression based on findings. | 67-year-old male with acute kidney injury. Evaluate for hydronephrosis, obstruction. RIGHT KIDNEY: Measures 9.1 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. 0.9 cm right renal cyst without septation or nodular component.LEFT KIDNEY: Measures 11.0 cm in length. Increased echogenicity and mild hydronephrosis. 0.9 cm left renal cyst without septation or nodular component.URINARY BLADDER: Collapsed and incompletely visualized.OTHER: Moderate ascites. | 1. Mild left hydronephrosis.2. Increased renal echogenicity consistent with medical renal disease.3. Moderate ascites. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. 2 cm gallstone noted in the gallbladder fundus. Otherwise unremarkable appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 11.7 cm in length. The left kidney is poorly visualized. The renal parenchyma is echogenic bilaterally. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 10.9 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. | 1. Cholelithiasis without evidence of cholecystitis.2. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 70-year-old female with history of microscopic hematuria, negative CT in 2011. RIGHT KIDNEY: The right kidney measures 9.4 cm in length and is normal echogenicity with no focal lesions, nephrolithiasis or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.4 cm in length and is normal in density with no focal lesions, nephrolithiasis or hydronephrosis.OTHER: The bladder is nondistended limiting evaluation. No pelvic free fluid. | No focal renal lesions, hydronephrosis or nephrolithiasis. |
Generate impression based on findings. | 56 years old, Female, Reason: thyroid nodules History: thyroid nodules, pls assess for changes RIGHT LOBE MEASUREMENTS: 6.2 by 3.0 x 2.4 cmLEFT LOBE MEASUREMENTS: 2.9 x 2.3 by 5.9ISTHMUS MEASUREMENTS: 0.3RIGHT LOBE: There is a solid nodule within the right thyroid lobe which is slightly hypoechoic to background tissue measuring 1.7 x 1.4 x 1.4 cm.LEFT LOBE: There is a left predominantly solid nodule with mostly heterogeneously hypoechoic density in the periphery with a 6-mm hypoechoic central area. There is no vascular flow within this nodule. No definite calcifications within this nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a right level 2 lymph node measuring 2.4 x 1.7 x 0.7 cm with a fatty hilum which is not significantly changed from the prior exam.OTHER: No significant abnormality noted. | Bilateral lower pole nodules which are not significantly changed in size and appearance. |
Generate impression based on findings. | 68-year-old male with history of thyroid cancer and squamous cell cancer. Evaluate for recurrence, with special attention to node that had changed in echotexture previously. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Lymph nodes in the right neck level III station are without suspicious features. No new lymphadenopathy is identified. Specifically, the left neck level IV lymph node seen previously is not identified.OTHER: No significant abnormality noted. | No evidence of recurrent or metastatic disease. No lymphadenopathy. The previously discussed left level IV lymph node is not identified. |
Generate impression based on findings. | Neobladder with acute renal insufficiency RIGHT KIDNEY: Echogenic renal parenchyma without mass or stone. No significant hydronephrosis. Right kidney 13.6 cm in lengthLEFT KIDNEY: Echogenic renal parenchyma without mass or stone. No significant change in mild left hydronephrosis. Left kidney 12.7 cm in length.OTHER: Unremarkable neobladder. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass or stone. No significant change in mild left hydronephrosis. |
Generate impression based on findings. | 71 year-old female with weight loss, enlarged thyroid. RIGHT LOBE MEASUREMENTS: 6.3 cm x 2.1 cm x 1.8 cmLEFT LOBE MEASUREMENTS: 6.4 cm x 2.7 cm x 2.5 cmISTHMUS MEASUREMENTS: 5 mm in thickness.RIGHT LOBE: Predominately solid nodule with small cystic components at the lower pole measures 1.6 cm x 1.5 cm x 1.8 cm. No evidence of internal vascularity or definite microcalcifications.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left neck level 2 benign-appearing lymph node measures 1.1 cm x 0.7 cm x 0.4 cm.OTHER: No significant abnormality noted. | Predominantly solid nodule with small cystic components at the lower pole of the right thyroid lobe measuring 1.8 cm in longest dimension. Benign appearing left neck lymph node. |
Generate impression based on findings. | Female; 73 years old. Reason: RUQ ultrasound to evaluate for gallstones in pt with elevated lipase and epigastric pain History: epigastric pain LIVER: The liver measures 17.2 cm in length. The liver contour is smooth, the parenchyma demonstrates coarse echotexture. No worrisome masses identified.The portal vein is patent and demonstrates a normal direction of flow with a peak velocity of 0.33 m/sec.BILIARY TRACT: The gallbladder is normal in appearance without shadowing stones. There is no gallbladder wall thickening or pericholecystic fluid. There is mild intrahepatic biliary ductal dilatation. The common bile duct measures 3 mm, normal.PANCREAS: The pancreas is unremarkable. The body and tail are obscured by overlying bowel gas. There is no ultrasound evidence of pancreatitis.SPLEEN: The spleen measures 1.7 cm in length.RIGHT KIDNEY: The right kidney measures 10.4 cm in length. The renal cortex is echogenic. There is no renal stone or hydronephrosis. No worrisome renal mass is identified. Within the superior pole of the right kidney and a 1.1 x 1.1 x 1.1 centimeter simple renal cyst.OTHER: The left kidney measures 11.7 cm in length. The renal cortex is echogenic. There is no renal stone or hydronephrosis. No worrisome renal mass is identified. | 1.No ultrasound evidence of pancreatitis. 2.Mild intrahepatic biliary ductal dilatation. No cholelithiasis, evidence of acute cholecystitis, or extrahepatic biliary ductal dilatation.3.Echogenic kidneys consistent with medical renal disease. |
Generate impression based on findings. | 56-year-old female patient with right lower quadrant pain and a transplant kidney. Evaluate for vascular patency. RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No perinephric fluid collection is identified.KIDNEY: The right kidney measures 10.6 cm in length.COLLECTING SYSTEM/URETER: No evidence hydronephrosis.URINARY BLADDER: No significant abnormality noted.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels The transplant right renal artery is patent. Peak systolic velocity at the anastomosis measures approximately 1.1 m/s with RI of 0.81. Intrarenal resistive indices range from 0.65 to 0.76. The transplant right renal vein is patent.OTHER: No significant abnormality noted | 1. No evidence of hydronephrosis.2. Patent transplant renal vasculature. |
Generate impression based on findings. | 48-year-old male with right upper quadrant abdominal pain. LIVER: Normal in size and echotexture. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: The visualized biliary tract is normal in caliber.The gallbladder is collapsed with borderline wall thickening and a trace of fluid. No definite shadowing gallstones are identified.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Highly echogenic consistent with parenchymal disease. Correlate with history of renal disease or renal function testing. No hydronephrosis or shadowing calculus.OTHER: Left kidney poorly visualized. Limited views of the spleen demonstrate no abnormality. | Collapsed gallbladder with borderline wall thickening and trace of fluid. This appearance is not consistent with acute cholecystitis and no gallstones are identified.Significantly echogenic right kidney. Correlation with history of renal disease or renal function testing. |
Generate impression based on findings. | 61-year-old female patient with elevated AST and ALT. Evaluate for liver disease/lesions. LIVER: The liver measures 18.3 cm in length. 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. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The pancreas is normal in echogenicity.RIGHT KIDNEY: The right kidney measures 11 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.7 cm in length. No evidence of hydronephrosis.The spleen measures 10 cm in length. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: History of radiation as a child. Please assess for malignancy History: History of radiation as a child. Please assess for malignancy RIGHT LOBE MEASUREMENTS: 4.1 x 1.5 x 1.8 cm.LEFT LOBE MEASUREMENTS: 3.5 x 1.2 x 1.7 cm.ISTHMUS MEASUREMENTS: 0.2 cm.RIGHT LOBE: Normal echogenicity, morphology, and sinus without discrete nodules or masses.LEFT LOBE: Normal echogenicity, morphology, and sinus without discrete nodules or masses.ISTHMUS: Normal echogenicity, morphology, and sinus without discrete nodules or masses.PARATHYROID GLANDS: Not visualized.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal appearing thyroid without interval change. |
Generate impression based on findings. | 75 years old, Female, Reason: evaluate for thyroid nodules History: history of thyroid nodules RIGHT LOBE MEASUREMENTS: 5.5 x 1.7 x 4.5 cmLEFT LOBE MEASUREMENTS: 8.3 x 2.8 x 2.6 cm.ISTHMUS MEASUREMENTS: 0.23RIGHT LOBE: Subcentimeter right thyroid nodule with heterogeneous appearance measuring 0.8 x 0.5 x 0.4 cm.LEFT LOBE: Large left thyroid nodule is solid and cystic in appearance with questionable microcalcifications measuring 4.2 x 2.9 x 2.1 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Benign-appearing level 2 lymph node measuring 1.1 x 2.7 x 0.4 cm. | 1.Mixed solid/cystic left thyroid nodule measuring up to 4.2 cm, would be amenable to US-guided FNA/biopsy if not already performed.2.Bilateral subcentimeter thyroid nodules. |
Generate impression based on findings. | Acute renal insufficiency RIGHT KIDNEY: Mildly echogenic parenchyma without worrisome mass or hydronephrosis. Multiple subcentimeter nonobstructing right renal stones Stable renal sinus cysts. Right kidney 14 cm in length.LEFT KIDNEY: Mildly echogenic parenchyma without worrisome mass, stone, or hydronephrosis. 14.3 cm in length.OTHER: Bladder nondistended | Mildly echogenic parenchyma suggestive for medical renal disease/parenchymal dysfunction without worrisome mass or hydronephrosis. Multiple subcentimeter nonobstructing right renal stones. |
Generate impression based on findings. | 50 year-old female with epigastric/right upper quadrant pain. LIVER: Liver is normal in size and echotexture. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder wall is normal to upper normal without pericholecystic fluid. Dependent gallstones are present within the gallbladder. The gallbladder is not distended. The biliary tract is normal in caliber.PANCREAS: Poorly visualized due to bowel gas.RIGHT KIDNEY: Highly echogenic without hydronephrosis.OTHER: Highly echogenic left kidney without hydronephrosis. Small cyst. | Gallstones with gallbladder wall normal to upper normal. No gross evidence for acute cholecystitis.Highly echogenic kidneys as previously noted. |
Generate impression based on findings. | Hyperparathyroidism RIGHT LOBE MEASUREMENTS: 5.4 x 2 x 2.2 cmLEFT LOBE MEASUREMENTS: 5.7 x 2.1 x 1.9 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: 2.3 x 1.9 x 2.0 cm spongiform nodule.LEFT LOBE: No significant abnormality noted.ISTHMUS: 2 subcentimeter hypoechoic nodules. The largest measuring 0.8 x 0.7 x 0.5 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Lower pole right thyroid spongiform nodule. 2 subcentimeter isthmic hypoechoic nodules. No regional adenopathy. No convincing parathyroid adenoma candidate. |
Generate impression based on findings. | 93-year-old female with right upper quadrant pain and elevated transaminases. LIVER: There is normal in size and echotexture. No focal hepatic abnormality except for small cyst adjacent to the gallbladder fossa. Limited spectral and color Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Patient was unable to turn for this exam. The gallbladder appears unremarkable without cholelithiasis, wall thickening or pericholecystic fluid. The very tract is normal in caliber.PANCREAS: The head and body are adequately visualized. Small cystic area in the head as previously noted.. The tail was not well seen.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Moderate right pleural effusion. | Normal gallbladder and supine position.Right pleural effusion. |
Generate impression based on findings. | Ascites. Evaluate inferior vena cava. INFERIOR VENA CAVA: The extrahepatic inferior vena cava is patent.OTHER: The bladder is partially distended. Ascites is noted on the study bilaterally in the lower quadrants | Patent extra hepatic inferior vena cava. |
Generate impression based on findings. | HNF1B mutation associated with renal cysts RIGHT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. No renal cysts appreciated. 9.4 cm in lengthLEFT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. No renal cysts appreciated. 11.3 cm in length.OTHER: Bladder nondistended | Negative renal ultrasound. Normal parenchymal echogenicity without mass, stone, or hydronephrosis. No renal cysts. |
Generate impression based on findings. | 82-year-old female with left submandibular nodule. In the region of the palpable abnormality in the left submandibular region there is a normal-appearing lymph node measuring 0.6 x 1 1 x 1 cm. No other abnormalities are identified. | Normal-appearing lymph node corresponds to palpable abnormality. |
Generate impression based on findings. | Multiple thyroid nodules RIGHT LOBE MEASUREMENTS: 6 x 3.1 x 2.4 cmLEFT LOBE MEASUREMENTS: 4.5 x 2.3 x 3 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Multiple thyroid nodules. A 1.1 x 1.1 single hypoechoic focus with coarse internal echogenic foci is present and will be biopsied later today. A dominant predominantly solid nodule within the lower pole of the right thyroid gland measures approximately 4 x 2.3 x 2.1 cm; this thyroid nodule also be biopsied later today.LEFT LOBE: Multiple thyroid nodules. A number of these thyroid nodules are predominantly cystic and favor benign etiology. A dominant predominantly solid nodule within the lower pole measuring 1.2 x 0.8 x 1 cm is present and will be biopsied later today.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules. 3 of these nodules as described will be biopsied later today. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Mildly coarse liver echogenicity without mass. Liver length 16.4 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.9 cm in length.OTHER: Left kidney 12.3 cm in length. Spleen 8.8 cm in length. No ascites | Mildly coarse liver echogenicity raises the possibility of fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Hepatitis C and elevated lipase LIVER: Coarse echogenic liver echotexture without mass. Liver length 17 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.5 cm in lengthOTHER: Left kidney 10.6 cm in length. Spleen 11.3 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. Coarse echogenic liver echotexture consistent with fatty infiltration/parenchymal dysfunction without mass. No ascites. |
Generate impression based on findings. | 33-year-old male with borderline hypertension, CKD. Evaluate kidneys. ULTRASOUND KIDNEYSRIGHT KIDNEY: Measures 11.6 cm in length. There is diffuse parenchymal loss with secondary caliectasis likely due to volume loss. No hydronephrosis. No shadowing calculi.LEFT KIDNEY: Normal in echogenicity measuring 11.5 cm in length. No hydronephrosis or shadowing calculi.OTHER: No significant abnormalities noted. | 1. Diffuse right renal parenchymal loss with secondary caliectasis. No hydronephrosis bilaterally. 2. No evidence of renal artery stenosis. |
Generate impression based on findings. | Follow-up bilateral hydronephrosis BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 1 Left: 1 Length*** Right: 5 cm Left: 5 cm Mean for age: 4.2 cm Range for age: 3.8 - 5.8 cmADDITIONAL OBSERVATIONS: None | Bilateral grade 1 pelvicaliceal dilation.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | 48-year-old male with abdominal pain. LIVER: Liver is normal in size and echotexture. Small hepatic cysts identified.GALLBLADDER, BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Small cyst identified.OTHER: No significant abnormality | Normal gallbladder and biliary tract.Hepatic and renal cysts. |
Generate impression based on findings. | Male 69 years old Reason: eval for hepatomegaly and ascites History: swelling Small volume generalized ascites.Mild hepatomegaly noted liver 18.7 cm in length. | Small volume generalized ascites. |
Generate impression based on findings. | Short-term follow-up for probable fat necrosis in the left breast. A targeted left ultrasound was performed for the area of concern. At the 11:30 position, mixed hyperechoic and hypoechoic tissue with a several millimeter sized cyst is present measuring up to 1.4 cm, though significantly decreased in volume compared to the prior study. Incidental note is made of a superficially located 5 mm cyst near the nipple. There is no suspicious solid or cystic mass identified. | Findings compatible with resolving fat necrosis. As long as physical exam findings are not suspicious, routine mammography would be due in July 2016.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 55 years old Reason: to rule out hcc per protocol LIVER: Measures 15.3 in length. Increased hepatic echogenicity with coarse echotexture but no discrete focal lesion. Patent portal vein with antegrade flow with velocity of 24 cm/s. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilation. There are hyperechoic foci in the wall of the gallbladder with ringdown artifact likely representing cholesterolosis. In addition, there is a 3 x 2 x 3 mm gallbladder polyp.PANCREAS: The pancreas is incompletely imaged due to bowel gas. The imaged portions of the pancreas appear unremarkable. SPLEEN: Status post splenectomy.KIDNEY: The left kidney measures 10.7 cm in length. No hydronephrosis, nephrolithiasis, or solid mass. OTHER: No significant abnormalities noted. | Coarse, echogenic liver texture consistent with parenchymal dysfunction. No focal liver lesion. |
Generate impression based on findings. | Female; 57 years old. Reason: r/o fatty liver disease History: elevated GGT LIVER: The liver measures 22.1 cm in length. This diffuse coarse and echogenic with geographic areas of focal sparing. No suspicious lesions are identified.The main portal vein is patent and demonstrates normal direction of flow with a peak velocity of 20 cm/sec.BILIARY TRACT: The gallbladder is normal in appearance without cholelithiasis. The common bile duct measures 5 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas is unremarkable. The body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: The spleen measures 10.2 cm in length.RIGHT KIDNEY: The right kidney measures 11.1 cm in length. There is no hydronephrosis, shadowing renal stone, or suspicious lesion identified. OTHER: The left kidney measures 10.2 cm in length. There is no hydronephrosis, shadowing renal stone or suspicious lesion identified. | Hepatomegaly and diffuse hepatic steatosis. |
Generate impression based on findings. | History of ulcerative colitis and prior abnormal LFTs. LIVER: The liver is normal in morphology, echogenicity and size, measuring 15 cm in length. No focal lesion or intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 0.3 m/s. BILIARY TRACT: Normally distended gallbladder without gallbladder wall thickening, pericholecystic fluid, gallstones or focal tenderness. The common duct measures 3 mm, within normal limits.PANCREAS: No significant abnormalities noted of the pancreatic head and proximal body. Otherwise the pancreas is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.3 cm without a focal lesion.RIGHT KIDNEY: The right kidney measures 12.1 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney measures 11.9 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | Unremarkable right upper quadrant ultrasound. |
Generate impression based on findings. | Ms. Afagwu is a 25-year-old female with a personal history of biopsy-proven fibroadenoma of the right breast. She presents today for a new mass in the left breast for the past 2-3 months. Upon physical exam at the patient's area of concern, no discrete mass is appreciated.A targeted left breast ultrasound was performed for the palpable area of concern. In the left breast 7:00 location, approximately 3 cm from the nipple, no suspicious cystic or solid mass is identified. | No sonographic correlate identified for the patient's palpable area of concern. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 53-year-old woman with AKI. RIGHT KIDNEY: Measures 12.8 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 11.8 cm in length. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Bilateral ureteral jets were visualized. The bladder is well-distended and without abnormality. OTHER: Shadowing cholelithiasis, no gallbladder wall thickening. | 1.Increased renal echogenicity consistent with medical renal disease. No nephrolithiasis or hydronephrosis.2.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Rule out adenopathy or recurrence. Thyroid cancer with 2 year follow-up RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS:Status post thyroidectomy.ISTHMUS MEASUREMENTS:Status post thyroidectomy.RIGHT LOBE:Status post thyroidectomy.LEFT LOBE:In the left thyroidectomy bed there is a hypoechoic focus unchanged measuring 0.3 x 0.2 x 0.8 cm.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 2 lymph node measures 1.6 x 0.5 x 0.7 cm, unchangedOTHER: No significant abnormality noted. | Unchanged subcentimeter left thyroid bed nodule and right level 2 lymph node. |
Generate impression based on findings. | 58-year-old female patient with hyperparathyroidism. Please assess for thyroid nodules. RIGHT LOBE MEASUREMENTS: 3.9 x 1.1 x 1.3 cm.LEFT LOBE MEASUREMENTS: 3.0 x 0.9 x 0.8 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity. No dominant thyroid nodule is identified.LEFT LOBE: The left thyroid lobe is homogeneous in echogenicity. No dominant thyroid nodule is identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: There is a hypoechoic structure measuring 0.9 x 0.6 x 1.4 cm in the midline superior mediastinum/supraclavicular region which may correlate to findings on concomitant nuclear medicine scan.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Hypoechoic structure within the superior mediastinum/supraclavicular region may correlate to a focus of uptake on concomitant nuclear medicine scan and represent a parathyroid adenoma. |
Generate impression based on findings. | HCV cirrhosis LIVER: Cirrhotic morphology again noted without mass. Liver length 19.5 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.3 cm in lengthRIGHT KIDNEY: Right renal cyst. Right kidney 10 cm in length. OTHER: Nonobstructing subcentimeter left renal stone. Left renal cyst. Left kidney 10 cm in length. No ascites. | Stable cirrhotic morphology without mass or ductal dilatation. Cholelithiasis without acute inflammation. No ascites. Nonobstructing left renal stone. |
Generate impression based on findings. | 27 year old female with history of left breast pain, no palpable mass. A targeted left ultrasound was performed for the patient’s area of concern. No palpable mass was felt on physical exam. There is no discrete solid or cystic mass identified on ultrasound in the area of pain in the left upper outer quadrant. | No sonographic evidence for malignancy in the area of pain in the left upper outer quadrant.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | History of acute kidney injury on chronic kidney disease. Ultrasound guidance was provided for percutaneous biopsy of right kidney. Three passes were performed. | Ultrasound guidance for percutaneous biopsy of right kidney. |
Generate impression based on findings. | History of CHF and abnormal LFTs. LIVER:The liver measures 22 cm in length. It is mildly echogenic. The hepatic veins are dilated. Normal hepatopedal portal venous blood flow at 30 cm/s. No focal suspicious lesion. No intrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 4 mm. Status post cholecystectomy.PANCREAS: The visualized portions of pancreatic head and body are unremarkable. The remainder is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 17 cm in length without a focal lesion.KIDNEYS: The right kidney measures 10.8 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. Note is made of a 7 mm simple appearing cyst. Probable extrarenal pelvis. Color Doppler demonstrates hilar blood flow.The left kidney measures 11.9 cm in length without hydronephrosis, shadowing nephrolithiasis or suspicious lesion. Two simple appearing cysts are noted. Color Doppler demonstrates hilar blood flow.ABDOMINAL AORTA: The abdominal aorta is normal in caliber and tapers distally. It measures 2.1 cm proximally 1.9 cm at the mid-portion and 1.9 cm distally. INFERIOR VENA CAVA: The visualized portions of the inferior vena cava are unremarkable.OTHER: Partially distended bladder is otherwise unremarkable. | Hepatosplenomegaly. Dilated hepatic veins and mildly coarse liver parenchyma suggestive of hepatic congestion. Probable steatosis. No hydronephrosis. Bilateral simple appearing cysts. |
Generate impression based on findings. | Stage IV melanoma with brain metastasis with right thyroid focus seen on recent PET/CT RIGHT LOBE MEASUREMENTS: 4.4 x 1.4 x 2.1 cmLEFT LOBE MEASUREMENTS: 5.2 x 1.2 x 2 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: 0.4 x 0.3 x 0.3 hypoechoic subcentimeter nodule mid right thyroid glandLEFT 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. | Subcentimeter right mid pole thyroid nodule; a benign etiology is favored. No regional adenopathy. |
Generate impression based on findings. | 75 year old female who was recalled from screening mammogram for new left breast mass. No family history of breast cancer. MAMMOGRAM: An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. There is redemonstration of a 2.1-cm circumscribed, lobulated mass within the upper inner left breast, which persists on spot compression imaging.ULTRASOUND: A targeted left ultrasound was performed for the area of concern. At the 11 o'clock position of the left breast, 6 cm from the nipple there is a parallel, hypoechoic, lobulated mass with angular margins measuring 2.0 x 1.0 x 1.4 cm. There is minimal vascularity associated with this lesion. | 2.0-cm hypoechoic mass at the 11 o'clock position of the left breast, corresponding to the mammographic finding. Ultrasound guided biopsy of this mass is recommended. Results and recommendation were discussed with the patient, and all of her questions were answered.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Left knee swelling Sonographic evaluation was performed about the left knee in preparation for possible aspiration. The images demonstrate no significant fluid with a minimal amount of subcutaneous edema noted anteriorly. | No evidence of joint effusion or surrounding fluid. These findings were conveyed to the ordering clinician Dr. T. Balach at the time of the exam. |
Generate impression based on findings. | Reason: kidney stone, or other pathology History: left sided abdominal pain, left lumbar area RIGHT KIDNEY: The right kidney measures 10.3 cm in length. Normal renal echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.8 cm in length. Normal renal echogenicity. No shadowing stones or hydronephrosis.OTHER: Ureteral jets not visualized. Unremarkable bladder. | No acute renal abnormality. No renal calculi or hydronephrosis. |
Generate impression based on findings. | 52-year-old female patient with history of right breast cancer and benign mass seen on surveillance imaging. A targeted right breast ultrasound was performed. In the 10 o'clock position of the right breast 5 cm from the nipple there is a 0.6 x 0.3 x 1.0 cm parallel circumscribed oval hypoechoic mass is present, previously 0.8 x 0.8 x 0.3 cm. The previously seen lesion in the 11 o'clock position was not seen on the current examination. | Stable benign lesion in the 10 o'clock position of the right breast. Previously identified lesion in the 11 o'clock position was not visualized on today's examination. Recommend diagnostic bilateral mammogram in 6 months.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Acute kidney injury RIGHT KIDNEY: 8.9 cm in length. Increased renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 8.6 cm in length. Increased renal parenchymal echogenicity. 1.1 cm benign-appearing cyst noted in the midpole. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Collapsed with Foley catheter identified.OTHER: No significant abnormality noted. | Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on findings. | 40 year-old male presents with groin pain. RIGHT TESTIS: No significant abnormalities noted. Normal vascularity LEFT TESTIS: No significant abnormalities noted. Normal vascularityRIGHT EPIDIDYMIS: 3 mm cyst right epididymal headLEFT EPIDIDYMIS: 1.8 cm cyst left epididymal headOTHER: Borderline left scrotal varicocele. | Bilateral epididymal head cysts, larger on the left.Borderline left varicoceleI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Nausea vomiting right upper quadrant pain LIVER: 2.9 x 2.7 x 3 cm mixed echogenicity within segment 7 of the right lobe of the liver; this lesion is unchanged. Background liver again demonstrates heterogeneous echotexture. Liver length 15.5 cmGALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.7 cm in length OTHER: Left kidney 10.5 cm in length. Spleen 8.8 cm in length. No ascites. | Cholelithiasis without acute inflammation or ductal dilatation. Stable right hepatic lobe mass lesion consistent with FNH. Background liver parenchyma consistent with chronic liver disease. No ascites. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are a bilateral mammogram and ultrasound from 7/23/2015 and performed at the WomanCare P.C. Breast and Bone Density Center, Arlington IL . Two standard views of both breasts and ML and two spot compression views of left breast were obtained. The breast parenchyma is extremely dense. A BB marker in the left breast upper outer quadrant corresponds to a palpable abnormality/thickening. There is extensive bilateral scattered calcifications noted. Most of the calcifications layer on the ML view suggestive of milk of calcium. No obvious mass is noted on spot compression views.Ultrasound: In the right breast are multiple cysts most of which demonstrate calcifications, especially the cyst in the 9:00 position. Clustered cyst is noted in the right breast 12:00 position which measure 1.0 x 0.4 cm. In the left breast are multiple simple, septated cysts containing hyperechoic calcifications in the left upper outer quadrant and the largest septated cyst in the left breast 1:00 position measures 10 x 7 mm. | 1.The area of thickening/palpable in the left breast upper outer quadrant most likely corresponds to fibrocystic changes. 2.Bilateral scattered breast calcifications and multiple, septated and clustered cysts in both breasts. 3.Given the absence of prior mammograms for comparison, a six-month follow-up mammogram is recommended to demonstrate stability of the calcifications. 4.A right breast ultrasound is also recommended in the right breast to demonstrate stability of the clustered cyst.BIRADS: 3 - Probably benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 44-year-old male history of alcoholic cirrhosis. Recurrent ascites with recent abdominal drain now with erythema around the site. There is diffuse body wall edema with a focus of more confluent fluid in the palpable region of concern measuring 1.9 x 2.5 cm. The collection is not loculated. Another focus of more confluent fluid measures 2.3 x 1.5 x 2.9 cm with a channel communicating with the peritoneal ascites. There is no significant surrounding soft tissue hyperemia. | Diffuse body wall edema/anasarca with two regions of confluent non-loculated fluid collections, one of which communicates with the peritoneal ascites and likely reflects a small fluid containing hernia, which may be related to the recent drainage catheter tract. |
Generate impression based on findings. | Mild leukemia. History of stem cell transplant. Increasing liver function tests. LIVER: Non-cirrhotic liver morphology. 18 cm in length. Mildly increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Collapsed gallbladder, without specific evidence of cholecystitis. PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 11.4 cm in length. The left kidney is 11.8 cm in length, with an extrarenal pelvis incidentally noted. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 11.6 cm in length at the upper limits of normal, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites identified. | Mildly increased hepatic echogenicity, compatible with parenchymal dysfunction. |
Generate impression based on findings. | Status post cystectomy with ileal conduit with increased creatinine RIGHT KIDNEY: Normal parenchymal echogenicity with minimal hydronephrosis. No mass. Right kidney 7.9 cm in lengthLEFT KIDNEY: Normal parenchymal echogenicity with minimal hydronephrosis. Left kidney 9.8 cm in length. No massOTHER: Status post cystectomy. | Normal renal parenchymal echogenicity with bilateral minimal hydronephrosis. |
Generate impression based on findings. | Male 63 years old; Reason: R/O liver fibrosis History: long standing hx of HCV LIVER: The liver measures 14.0 cm in length. There is increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 20.9 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.1 mm. No stones are seen, there is very minimal sludge. No pericholecystic fluid. The common bile duct measures 2.8 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.2 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 13.6 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones are seen. There is a mildly complex cyst revisualized at the mid to upper pole measuring 3.6 cm x 3.9 cm x 3.6 cm. This previously measured 3.5 cm x 3.6 cm x 3.4 cm. Again demonstrated is thin septation within the cyst. A simple renal cyst is redemonstrated at the lower pole measuring 3.8 cm x 4.2 cm x 3.6 cm.LEFT KIDNEY: The left kidney measures 12.7 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | 1. The liver has increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses or intrahepatic ductal dilation are seen.2. Mildly complex renal cyst at the right mid to upper pole appears relatively stable in size from prior ultrasound. |
Generate impression based on findings. | Male 75 years old; Reason: of liver, screen for hcc History: same LIVER: The liver measures 18.9 cm in length. There is increased echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. A hepatic cyst is redemonstrated in the right lobe measuring 1.3 cm x 1.5 cm x 1.5 cm. The main portal vein is patent with normal hepatopetal flow measured at 10.9 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.6 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 4.7 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.2 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 12.8 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 12.3 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | Mild hepatomegaly. The liver has increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses seen. |
Generate impression based on findings. | Hepatitis B. Evaluate for hepatocellular carcinoma LIVER: Non-cirrhotic liver morphology. Mildly coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Prominent common bile duct is within normal limits given prior cholecystectomy.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.5 cm in length, and pelvic in location. The left kidney is 10.9 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 8.4 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites is identified in the upper abdomen. | Increased hepatic echogenicity, compatible with parenchymal dysfunction. No evidence of cirrhosis. No suspicious hepatic lesion identified. |
Generate impression based on findings. | Ms. Postma is a 45-year-old woman with biopsy-proven left breast cancer. She presents today for further evaluation of nonspecific lymph node seen on breast MRI and ultrasound at outside hospital and palpated by surgeon. A targeted left axillary ultrasound was performed for the palpable area of concern by Dr. Jaskowiak. -In the lower axilla, there is a 1.1 x 0.4 x 0.7 cm normal morphology lymph node noted with normal uniform cortical thickness and fatty hilum (annotated #1). -Another normal morphology lymph node measuring 1.6 x 1.2 cm with uniform cortical thickness and fatty hilum is seen in the mid axilla (annotated #2). These two lymph nodes correspond to those identified on outside hospital ultrasound examinations. No suspicious lymph nodes are identified. | Normal left axillary lymph nodes. Findings were communicated to the patient and Dr. Jaskowiak's office at the time of the exam.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Reason: Dopplers to assess portal flow History: pulmonary hypertension LIVER: The liver measures 16.7 cm in length. Normal hepatic parenchymal echogenicity and echotexture. The portal vein is patent with normal directional hepatopedal flow, peak velocity 18.9 cm/s. No focal masses.GALLBLADDER, BILIARY TRACT: Decompressed gallbladder without shadowing stones or sludge. The gallbladder wall measures 0.3 cm. The common bile duct measures 0.3 cm. No biliary ductal dilatation.PANCREAS: Limited evaluation due to overlying bowel gas. The pancreatic duct measures 0.2 cm.RIGHT KIDNEY: The right kidney measures 9.5 cm in length. Small midpole anechoic cyst measures 0.8 x 0.9 x 1.0 cm. Additional exophytic lower pole anechoic cyst measures 0.9 cm in the transverse plane. The renal parenchyma is unremarkable. No definite shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 7.9 cm in length. Multiple tiny hyperechoic foci with posterior acoustic shadowing likely represent tiny nonobstructive intrarenal calculi. No hydronephrosis.OTHER: The spleen measures 16.3 cm in length, enlarged. No ascites. | 1. No acute hepatobiliary abnormality. Specifically, normal portal venous directional flow, velocity, and waveforms.2. Multiple subcentimeter non-obstructive left renal stones.3. Splenomegaly. |
Generate impression based on findings. | Sickle cell disease in crisis Moderate splenomegaly with spleen length 18 cm. Homogeneous parenchyma without evidence for perisplenic fluid collection or infarction. Incidental note made of subcentimeter nonobstructing left renal stone. Liver length 18 cm in length. | Moderate splenomegaly without evidence for perisplenic fluid collection or infarction. Nonobstructing left renal stone. |
Generate impression based on findings. | 62 years old, Male, Reason: cirrhosis History: HCV LIVER: The liver measures 17.8 cm in length. Echogenicity of the liver parenchyma is within normal limits. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s. No nodularity to the liver capsule or widening of the fissures to suggest cirrhosis.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: The spleen is enlarged measuring 16.8 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.No definite evidence of cirrhosis. No nodularity or of the liver capsule or widening of the fissures to suggest cirrhosis.2.Splenomegaly is present.3.Liver size is at the upper limits of normal. |
Generate impression based on findings. | Reason: kidney stone History: stone RIGHT KIDNEY: The right kidney measures 11.0 cm in length. Multiple small stones measuring up to 0.6 cm in length. Anechoic cyst measures 2.3 x 1.8 x 1.8 cm. No hydronephrosis.LEFT KIDNEY: The left kidney measures 10.3 cm in length. Multiple small stones in the left inferior pole measure up to 0.8 cm in length. Anechoic cyst in the mid left kidney measures 2.2 x 2.3 x 2.4 cm. No hydronephrosis.OTHER: No significant abnormalities noted. | Multiple small bilateral renal calculi without hydronephrosis. |
Generate impression based on findings. | 60-year-old female with history of cirrhosis who presents for hepatocellular carcinoma screening. LIVER: Hepatic parenchyma is coarse in echogenicity with nodular contour; findings consistent with cirrhosis. No focal hepatic lesions to suggest hepatocellular carcinoma. The liver measures 18.5 cm in length.Main portal vein flow is hepatopetal with velocities measuring 22 cm/s.BILIARY TRACT: No biliary ductal dilatation. Gallbladder is absent.PANCREAS: No significant abnormalities noted.SPLEEN: Spleen measures 10.8 cm in length.RIGHT KIDNEY: The right kidney measures 11.0 cm and left kidney measures 10.2 cm in length without evidence of hydronephrosis. OTHER: Atherosclerotic calcifications affect the abdominal aorta. No ascites. | 1.Cirrhotic morphology without hepatic mass or ductal dilatation. 2.No ascites. |
Generate impression based on findings. | Palpable goiter RIGHT LOBE MEASUREMENTS: 6 x 1.9 x 2.8 cmLEFT LOBE MEASUREMENTS: 6.2 x 1.4 x 2.2 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Dominant predominantly solid lower pole nodule measuring 2.8 x 2.3 x 3.1 cm.LEFT LOBE: Dominant predominantly solid lower pole module measuring 2.5 x 1.5 x 2.7 cmISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Dominant bilateral lower pole thyroid nodules. These lesions are amenable to ultrasound guided percutaneous biopsy. |
Generate impression based on findings. | 67-year-old female presents with swelling of her right wrist. There is a clinical concern for fluid collection. There is edema of the soft tissue of the right wrist without a loculated fluid collection or mass. | 1. Edema of the soft tissue of the right wrist without discrete fluid collection or mass. |
Generate impression based on findings. | Left upper quadrant pain. LIVER: The liver is mildly echogenic. No focal lesion or biliary ductal dilatation. It is normal in size measuring 16.4 cm in craniocaudal dimension. Normal hepatopedal portal blood flow at 0.3 m/s. BILIARY TRACT: No extrahepatically biliary ductal dilatation with the common duct measuring 4 mm. Normally distended gallbladder without gallstones, wall thickening or pericholecystic fluid. No focal tenderness.PANCREAS: Limited evaluation of the pancreatic head shows no significant abnormality. The remainder the pancreas is not visualized.SPLEEN: The spleen is normal in size measuring 11.5 cm.RIGHT KIDNEY: The right kidney measures 12.8 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney measures 13.2 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | No specific findings to account for the patient's intermittent left upper quadrant pain. |
Generate impression based on findings. | Thyroid nodule. Assess interval change. RIGHT LOBE MEASUREMENTS: 5.1 X 1.7 x 1.5 cm, unchanged.LEFT LOBE MEASUREMENTS: 4.5 x 1.6 x 1.2 cm, unchanged.ISTHMUS MEASUREMENTS: 0.2 cm, unchangedRIGHT LOBE: Normal echotexture and size. A predominantly solid isoechoic nodule with a hypoechoic halo is again seen in the inferior pole and is unchanged in appearance and size, measuring 0.6 x 0.5 x 0.4 cm. LEFT LOBE: Normal echotexture and size. No significant abnormality noted.ISTHMUS: Normal echotexture and size. No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing lymph nodes are present bilaterally. Right level 4 lymph node measures 0.6 x 0.4 x 0.4 cm. OTHER: No significant abnormality noted. | 1.Normal thyroid size2.Right inferior pole isoechoic thyroid nodule measuring 0.6 cm, unchanged. |
Generate impression based on findings. | 41 y.o. male presents with RUQ. Evaluate hepatobiliary system. LIVER:The liver measures approximately 20.1 cm. There is coarse and increased echogenicity of the parenchyma. No mass, ascites, or intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder length measures approximately 13.9 cm. Echogenic dependent material within the gallbladder likely represents sludge. No stones. The gallbladder wall thickness is 0.2 cm. No pericholecystic fluid. The common bile duct measures 7.5 mm. Negative sonographic Murphy's sign.PANCREAS: Evaluation limited by overlying bowel gas.SPLEEN: The spleen measures 11.8 cm. No sonographic abnormalities.KIDNEYS: The right kidney measures 12.1 cm. The cortex has normal echogenicity. No shadowing calculi, hydronephrosis, or worrisome mass. The left kidney measures approximately 10.8 cm. The cortex has normal echogenicity. No shadowing calculi, hydronephrosis, or worrisome mass. OTHER: No significant abnormality noted. | 1. Coarse and increased echogenicity of the parenchyma in the liver consistent with chronic liver disease/parenchymal dysfunction. No mass or ascites.2. Hepatomegaly.3. Gallbladder sludge without signs of acute cholecystitis. |
Generate impression based on findings. | Ms. Kiawana Lagrone is a 23 year old female who presents for evaluation of intermittent left superior breast shooting pain for months. She denies associated skin change, nipple discharge or palpable lump. ULTRASOUND:On physical examination, no discrete mass is palpated.A targeted left ultrasound was performed for the patient’s area of pain in the superior left breast. There is no solid or cystic mass identified. | No sonographic evidence of malignancy in the left breast at site of pain. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually at age of 40 years. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 55 year old female with multiple right breast masses and right axillary adenopathy who was recalled from interpretation of outside examination for left breast asymmetry. History of ovarian cancer in sister diagnosed at age 45. LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: A ML view and 3 spot compression 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. There is redemonstration of a 1 cm mass in the the medial central left breast, which persists on compression imaging.LEFT BREAST ULTRASOUND: A targeted left ultrasound was performed for the mammographic area of concern. At the 9 o'clock position of the left breast, 3 cm from the nipple, there is a benign morphology intramammary lymph node measuring 0.7 cm, with normal color flow, corresponding to the finding on mammogram. At the 3 o'clock position of the left breast, 4 cm from the nipple, there is a 0.4 x 0.4 x 0.2 cm hypoechoic mass with ill-defined margins. | Ill-defined hypoechoic 0.4 cm mass at the 3 o'clock position of the left breast. While this may represent benign lesion, fine-needle aspiration with possible ultrasound guided core needle biopsy is recommended for definitive histologic diagnosis. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Male 22 years old; Reason: h/o rosai dorfman and thyroid nodules History: nodule comparison RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5.0 x 1.4 x 1.3 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 4.2 x 1.2 x 1.7 cm.ISTHMUS MEASUREMENT: The isthmus measures 0.3 cm.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: There is round circular hypoechoic lesion in the anterior isthmus measuring 0.5 cm in diameter; stable in size when compared to the prior study.LYMPH NODES: No lymphadenopathy noted.OTHER: No significant abnormality noted. | 1.Lesion at anterior isthmus of thyroid stable in size. |
Generate impression based on findings. | Male 65 years old Reason: Is there abscess or pocket of fluid in L elbow? History: L elbow cellulitis.Additional history from ultrasound technologist indicates patient has pain and swelling for one month. There are ill-defined hypoechoic areas within the muscle of the posterior elbow without a discrete loculated drainable fluid collection. This is along the posterior aspect of the elbow. This is consistent with induration or possible cellulitis without discrete drainable abscess. There are some comparison images to the right side. Subjectively I think the abnormal left side is slightly hyperemic. | No drainable abscess. Small ill-defined hypoechoic areas suggestive of cellulitis. |
Generate impression based on findings. | Female 44 years old Reason: Single subcentimeter left thyroid nodule with a calcification, follow-up ultrasound History: none RIGHT LOBE MEASUREMENTS: 5.3 x 1.5 x 1.2 cmLEFT LOBE MEASUREMENTS: 5 x 1.2 x 1.3 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Previously noted 5 x 5 mm hypoechoic nodule with central linear hyperechoic focus is unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small benign-appearing lymph nodes are unchanged.OTHER: No significant abnormality noted. | No significant change in the left lower lobe solitary subcentimeter nodule. |
Generate impression based on findings. | 57 year-old female with provided history of acute pancreatitis. Evaluate for gallstones. LIVER: The liver is normal in morphology without a discrete focal lesion or intra-hepatic biliary ductal dilatation. The parenchyma is slightly coarse in echotexture. There is normal hepatopetal portal venous blood flow. The velocity is slightly elevated at 54 cm/sec.GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 5 mm. Normally distended gallbladder with a 5 mm shadowing gallstone. There is no gallbladder wall thickening or pericholecystic fluid.PANCREAS: Partially visualized pancreatic parenchyma is enlarged and decreased in echogenicity compatible with edema and acute pancreatitis. No parapancreatic fluid collection is visualized.RIGHT KIDNEY: The right kidney is normal in size, measuring 10.2 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident.OTHER: The spleen is normal in size, measuring 11.5 cm. The left kidney is normal in size, measuring 7.8 cm without hydronephrosis or shadowing calculus. There is a 9-mm hypoechoic lesion within the superior aspect of the kidney, incompletely characterized. | 1. Cholelithiasis without evidence of acute cholecystitis.2. Coarsened hepatic echotexture may reflect parenchymal dysfunction.3. Edematous and enlarged partially visualized pancreas, compatible with acute pancreatitis.4. Incompletely characterized 9-mm left superior pole lesion. |
Generate impression based on findings. | Mass in back of neck. Suspected lipoma. Prominent fat lobules are noted in the palpable area of concern, which may represent a lipoma or prominent atypical subcutaneous fat. No suspicious vascularity or mass is identified. | Prominent subcutaneous fat versus lipoma, without suspicious features. |
Generate impression based on findings. | Enlarged thyroid seen on cervical MRI RIGHT LOBE MEASUREMENTS: 2.4 x 1.8 x 4.8 cmLEFT LOBE MEASUREMENTS: 2.6 x 1.5 x 5 cmISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: Subcentimeter benign-appearing colloid cyst.LEFT LOBE: 2 spongiform nodules. Lower pole nodule measures 1.8 x 1.3 x 2.3 cm. Mid pole nodule measures 0.8 x 0.5 x 0.8 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Two left thyroid spongiform nodules; favor benign etiology. No regional adenopathy. |
Generate impression based on findings. | 69-year-old male with hepatitis B, HIV positive. Evaluate for hepatocellular carcinoma. LIVER: Normal in size and coarsely echogenic. No focal hepatic abnormality. GALLBLADDER, BILIARY TRACT: Gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Inadequately visualized due to bowel gas.RIGHT KIDNEY: Small cystOTHER: Small left renal cyst. Spleen normal in size. | No interval change. No evidence for hepatic mass. |
Generate impression based on findings. | 27-year-old female with palpable lump in the left breast found by her doctor. A targeted left ultrasound was performed for the palpable area of concern in the upper outer quadrant of the left breast. There is no solid or cystic mass identified. There is dense fibroglandular tissue in this area. | No sonographic evidence for malignancy in the left breast. Palpable abnormality in the upper outer quadrant of the left breast likely corresponds to dense fibroglandular tissue. Further evaluation of a clinically suspicious abnormality should not delayed by negative imaging. Rather, negative imaging may serve to reinforce a negative clinical impression. Therefore, continued clinical management is recommended.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Transaminitis LIVER: Numerous bilobar confluent mass lesions consistent with metastatic disease. Limited Doppler interrogation the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 19.7 cmBILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 13.8 cm in lengthRIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 12.1 cm in length OTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis. Left kidney 13.6 cm in length. Mild ascites. | Numerous bilobar confluent hepatic mass lesions consistent with metastatic disease. Mild ascites.Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Reason: 44 y/o MDS, with increase ALK ,eval biliary tree, any cirrhosis? LIVER: The liver measures 18.5 cm in length, enlarged. Normal hepatic parenchymal echogenicity and echotexture. The portal vein is patent with normal directional hepatopedal flow, peak velocity 35.4 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The gallbladder wall measures 1.9 mm. The common bile duct measures 3.2 mm. No intrahepatic or extrahepatic biliary ductal dilatation.PANCREAS: No significant abnormalities noted.KIDNEYS: The right kidney measures 12.0 cm in length. The left kidney measures 11.6 cm in length. Unremarkable renal parenchyma. No shadowing stones or hydronephrosis.OTHER: The spleen measures 15.0 cm in length, enlarged. No ascites. | 1. Hepatosplenomegaly. No specific evidence of cirrhosis or biliary ductal dilatation. |
Generate impression based on findings. | Elevated LFTs LIVER: Mildly echogenic liver without worrisome mass. Benign-appearing hepatic cysts. Liver length 16.1 cm.BILIARY TRACT: Gallbladder absent. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10.7 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 12.1 cm in lengthOTHER: Left kidney 9.8cm in length. No ascites | Mildly echogenic liver suggestive for parenchymal dysfunction/chronic liver disease without worrisome mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Elevated LFTs with abdominal pain LIVER: Normal parenchymal echogenicity without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 16.1 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11.5 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 11.3 cm in lengthOTHER: Left kidney 10.4 cm in length. No ascites | Negative right upper quadrant abdominal ultrasound. No evidence for acute hepatobiliary abnormality. No ascites. |
Generate impression based on findings. | 61-year-old alcoholic cirrhosis of liver without ascites screen for HCC LIVER: Liver measures 17 cm, mild heterogenous echotexture with mild nodularity suggestive of cirrhotic morphology without any focal lesions. No intrahepatic delivery ductal dilatation.GALLBLADDER, BILIARY TRACT: Common bile duct measures up to 3 mm. The gallbladder is well distended without gallbladder wall thickening. No evidence of gallstones.PANCREAS: No significant abnormalities noted.KIDNEY: Right kidney measures 9 cm the left kidney measures 10 cm. No hydronephrosis or focal lesions. Previously described left renal stone is not seen on today's imagingOTHER: Spleen measures 11 cm without any focal lesions. | Cirrhotic morphology of the liver without any focal lesion. No ascites. |
Generate impression based on findings. | 72 year old female with acute kidney injury. RIGHT KIDNEY: The right kidney measures 10.6 cm in length without hydronephrosis or shadowing calculus. There is a 3.2 x 8.3 x 3.3 cm inferior pole septated cyst. There is mild cortical thinning. LEFT KIDNEY: The left kidney measures 10.1 cm in length without hydronephrosis or shadowing cavus. There is a 7 mm inferior pole simple appearing cyst. There is mild cortical thinning. URINARY BLADDER: The urinary bladder is nearly completely contracted. | No hydronephrosis. Simple and minimally complex cysts as above. |
Generate impression based on findings. | Right upper quadrant abdominal pain. LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Multiple 8-10 mm gallstones noted, with a small amount of biliary sludge. No evidence of cholecystitis. No sonographic Murphy's sign.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 9.9 cm in length. The left kidney is 9 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 9.2 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid is identified. | Cholelithiasis without cholecystitis. |
Generate impression based on findings. | Female; 51 years old. Reason: R/o mass v/s hernia History: Patient with gum ball size supraumbilical mass painful Superior to the umbilicus in the area of the patient's palpated abnormality is a fascial defect measuring approximately 0.9 x 0.7 cm transverse by AP. The hernia measures 3.4 x 1.0 x 2.1 cm and contains bowel and a small amount of free fluid. Peristalsis of the bowel is seen. There is no evidence of bowel wall thickening or dilation of the bowel loops. | Ventral wall hernia containing bowel without evidence of other complication. |
Generate impression based on findings. | 61 year old female with right upper quadrant pain. The patient was mildly tender to palpation during exam.LIVER: Findings of cholecystectomy. No biliary dilatation or other acute abnormality. Liver demonstrates subtle coarse echogenicity.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Findings of cholecystectomy, without acute abnormality. Mild epigastric tenderness during exam. |
Generate impression based on findings. | 59-year-old female with history of bridging fibrosis. Evaluate for HCC. LIVER: Coarse echotexture of the liver measuring 18.5 cm in length. No focal hepatic lesions. The main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 9.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.5 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 9.7 cm in length. | Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | Male 58 years old Reason: aki History: aki. RIGHT KIDNEY: The right kidney measures 11.7 cm. There is no hydronephrosis or shadowing renal stones. The renal cortex is mildly hyperechoic.LEFT KIDNEY: The left kidney measures 11.9 cm. There is no hydronephrosis or shadowing renal stones. The cortex is mildly hyperechoic.OTHER: Bladder is incompletely distended. Diffuse sludge is incidentally noted within the gallbladder. Dedicated gallbladder imaging was not performed. | The renal cortex is mildly hyperechoic bilaterally consistent with medical renal disease. No hydronephrosis or shadowing stones. |
Generate impression based on findings. | Jaundice with history of breast carcinoma LIVER: Extensive bilobar hepatic mass lesions consist with metastatic disease noted. A representative segment 8 lesion measures 3.2 x 3.4 cm. Liver length 16.8 cmGALLBLADDER, BILIARY TRACT: Minimal bilobar and hepatic ductal dilatation. Mildly prominent extrahepatic ductal dilatation with maximal CBD diameter of 0.7 cm. Gallbladder absent.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9 cm in lengthOTHER: Left kidney 11 cm in length. Spleen 10.4 cm in length. Trace ascites. | Extensive bilobar hepatic metastatic lesions. Minimal bilobar and extrahepatic ductal dilatation. Trace ascites. |
Generate impression based on findings. | Reason: evaluate cause of elevated LFTs History: elevated LFTs, acute myelogenous leukemia. LIVER: The liver measures 23.1 cm in length. The liver parenchymal echotexture is normal. There is a round, predominantly hyperechoic circumscribed lesion within the left lobe of the liver measuring 1.2 x 1.4 x 1.2 cm. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.26 m/s.BILIARY TRACT: The gallbladder appears contracted without evidence of cholelithiasis. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.9 cm in length. RIGHT KIDNEY: Kidney measures 12.9 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 12.8 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Bilateral pleural effusions. | 1.Hepatomegaly.2.1.4 cm hyperechoic lesion within the left hepatic lobe which is nonspecific, but favor benign etiology such as a hemangioma.3.Pleural effusions. |
Generate impression based on findings. | FDG avid right thyroid nodule RIGHT LOBE MEASUREMENTS: 4.5 x 2.2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Multiple right thyroid nodules. The dominant midpole nodule in is solid and measures 1.9 x 1.4 x 1.9 cm. Spongiform upper pole nodule measures 0.8 x 0.5 x 0.8 cm. A hypoechoic spongiform nodule within the lower pole measures 1.2 x 2.8 x 0.7 cm.LEFT LOBE: Multiple subcentimeter nodules. Representative upper pole nodule measures 0.5 x 0.4 by 0.4 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple thyroid nodules bilaterally. The dominant solid nodule within the right thyroid gland corresponds to the FDG avid lesion on PET/CT. This nodule will be biopsied today. |
Generate impression based on findings. | 64-year-old female patient with thyroid cancer status post surgery. RIGHT LOBE: Status post thyroidectomy without recurrent tissue identified.LEFT LOBE: A hypoechoic nodule in the region of the left thyroid bed measures approximately 0.6 x 0.6 x 0.8 cm, previously 0.6 x 0.5 x 0.8 cm.ISTHMUS: An anteriorly located well-circumscribed isoechoic nodule within the left aspect of the isthmus measures approximately 1.2 x 0.7 x 1.5 cm, previously 1.1 x 0.7 x 1.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is an enlarged right level four lymph node measuring 1.5 x 1.2 x 2.4 cm, which has a fatty hilum.OTHER: No significant abnormality noted. | 1. Status post thyroidectomy with stable postoperative changes.2. Stable isthmus nodule.3. Enlarged right level IV lymph node has a fatty hilum, however is new compared to the prior study; this is amenable to biopsy if clinically indicated. Findings communicated via e-mail to Dr Sarne. |
Generate impression based on findings. | Female; 36 years old. Reason: cholecystitis? History: RUQ pain, tenderness, vomiting LIVER: Liver measures 18.7 cm in length. The liver contour is smooth, the parenchyma is normal in echogenicity. No worrisome masses identified.The main portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: The gallbladder is normal in appearance. There is no cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The common duct measures 0.6 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are normal in appearance. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 9.4 cm in length.RIGHT KIDNEY: The right kidney measures 10.7 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. LEFT KIDNEY: The left kidney measures 10.7 cm in length. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. | Mild hepatomegaly but otherwise normal ultrasound right upper quadrant. Specifically there is no cholelithiasis, biliary ductal dilatation, or evidence of acute cholecystitis. |
Generate impression based on findings. | 47 years old, Male, Reason: r/o cause for renal failure History: renal failure RIGHT KIDNEY: Kidney measures 11.5 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis or shadowing calculus. Hypoechoic right lower pole renal cyst measures 1.7 x 1.7 x 1.5 cm. LEFT KIDNEY: The left kidney is very difficult to visualize due to patient's body habitus. Kidney measures 9.0 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No hydronephrosis, shadowing calculus or mass. Left lower pole renal cyst measures 3.8 x 3.1 x 4 cm.Bladder: The bladder is nondistended. | 1.Bilateral diffusely increased echogenicity of the kidneys consistent with medical renal disease.2.No evidence of hydronephrosis or shadowing calculus.3.Bilateral renal cysts. |