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Generate impression based on medical 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 medical findings. | 58-year-old male screening for hepatocellular carcinoma LIVER:The liver measures 16.1 cm in length. The liver is heterogeneous in echotexture similar to prior ultrasound. No new worrisome masses are seen within the liver. The portal vein is patent with hepatopetal flow measuring 37.3 cm/s. GALLBLADDER, BILIARY TRACT: The gallbladder is visualized without stones or significant sludge. Gallbladder wall measures 3.5 mm. Common bile duct measures 4.2 mm, which is normal in caliber.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 10.9 cm in length. There is significant abnormalities are noted.KIDNEYS: The right kidney measures 11.8 cm in length. The cortex is normal in echotexture. There is no new masses, hydronephrosis, or stone seen in the right kidney. The left kidney measures 10.5 cm in length. The cortex has normal echogenicity, there are no stones visualized, no hydronephrosis, and no masses seen. | 1. No new worrisome masses are seen within the liver. Again demonstrated, the liver is heterogeneous in echotexture similar to prior ultrasound and consistent with parenchymal dysfunction/chronic liver disease. |
Generate impression based on medical findings. | 73 year-old female with thyroid nodules. Evaluate for growth or lymphadenopathy. RIGHT LOBE MEASUREMENTS: 4.6 cm x 1.2 cm x 1.4 cm.LEFT LOBE MEASUREMENTS: 6.5 cm x 5.3 cm x 4.5 cmISTHMUS MEASUREMENTS: 5 mm in thicknessRIGHT LOBE: Solid nodule at the lower pole measures 1.2 cm x 0.9 cm x 0.7 cm, previously measured 0.9 cm x 0.6 cm x 0.7 cm.LEFT LOBE: Left lobe is replaced by two large solid nodules, one of which is located in upper pole measuring 4.9 cm x 3.4 cm x 4.7 cm, previously 4.8 cm x 4.7 cm x 4.2 cm. Second nodule in the lower pole measures 3.3 cm x 4.1 cm x 4.5 cm, previously measured 1.7 cm x 4.0 cm x 4.3 cm.ISTHMUS: Subcentimeter nodule measures 3 mm x 2 mm x 4 mm, previously measured 3 mm x 2 mm x 2 mm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral solid nodules slightly increased in size compared to prior study. Dominant nodules in the left lobe were previously biopsied with benign histology. |
Generate impression based on medical findings. | Female 82 years old Reason: concern for toxic multinodular goier History: hyperthyroidism on labs RIGHT LOBE MEASUREMENTS: 6 x 5.0 x 3.4 cm.LEFT LOBE MEASUREMENTS: 5.2 x 1.4 x 1.5 cm.ISTHMUS MEASUREMENTS: 4 mm.RIGHT LOBE: Right lobe of the thyroid is very heterogeneous. There is a dominant nodule measuring 4.7 x 4.5 cm. This nodule contains solid and cystic components and microcalcifications an amenable for biopsy.LEFT LOBE: There are subcentimeter nodules in the left lobe of the thyroid.ISTHMUS: There is a 1.2 x 1 cm nodule in the isthmus towards the right. The second complex nodule with possible solid and cystic components.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral nonenlarged lymph nodes. A level 2/3 noted on the right side measures 9 x 9 mm. Level 2 node on the left side measures 8 x 8 mm.OTHER: No significant abnormality noted. | Large dominant nodule in the right lobe of the thyroid. Multiple other nodules are also visualized as described above. Bilateral nonenlarged, lymph nodes. |
Generate impression based on medical findings. | Fever and sepsis RIGHT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. LEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 13 cm in length.OTHER: Bladder nondistended | Echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. No loculated collection or abscess. No evidence for acute parenchymal edema. |
Generate impression based on medical findings. | 83-year-old female prethyroidectomy for multinodular goiter with right parotid mass. Within the mid portion of the right parotid gland is a 0.7 x 1.0 x 1.2 cm mass. Although this appears mildly complex cystic on this exam, configuration is suggestive of lymph node. On the prior CT, the appearance was consistent with a lymph node. Incidentally noted is a 0.5 x 0.8 x 1 cm probable cyst in the right submandibular gland. | Right parotid mass which by ultrasound appears to be complex cystic although still could represent a lymph node.CLINICAL INFORMATION AND PRE-OPERATIVE DIAGNOSIS: Right parotid massPOST-OPERATIVE DIAGNOSIS : SameCOMPARISON: Outside CT neck from 11/27/2015 and outside ultrasound of the thyroid from 9/25/2015OPERATORS: Doctors: I, the attending physician, Dr. Paushter, performed the entire procedure.TECHNIQUE: Following a discussion of the procedure with the patient and her daughter, including its risks, benefits, alternatives and steps to prevent infection, an informed written consent was obtained and documented in the patient's chart. The time-out form was completed to confirm patient identity and side/type of procedure.Localizing US demonstrated 0.7 x 1.0 x 1.2 cm right parotid mass which may be complex cystic.. The skin over the target area was cleansed with chlorhexidine. Transducer was sterilely sheathed. Local anesthesia was obtained using 1% lidocaine, superficially and at depth. Using aseptic technique, and continuous ultrasound guidance, the lesion was sampled using 25 gauge needles. 3 fine needle aspirations were performed.Cytology was present to confirm specimen adequacy. Specimen was handed to cytology. The patient tolerated the procedure well without immediate complications. Routine post procedure instructions were communicated to the patient.COMPLICATIONS: NoneESTIMATED BLOOD LOSS: Less than 5 cc. An adhesive bandage was placed on the patient’s skin. |
Generate impression based on medical findings. | Evaluate for abscess near peritoneal dialysis catheter Portions of peritoneal dialysis catheter seen. No drainable fluid collection or abscess seen. Prominent vessels seen in subcutaneous tissues. Bilateral abdominal wall soft tissues symmetric in appearance otherwise. Incompletely imaged intra-abdominal ascites. | No evidence of abscess. |
Generate impression based on medical findings. | Female 64 years old Reason: r/o HCC History: cirrhosis, HCV LIMITED ABDOMENLIVER: The liver measures 20.1 cm in length. Echogenic parenchyma with nodular contour. No suspicious hepatic lesions. Left hepatic lobe lesion with mixed color flow compatible with intrahepatic portosystemic shunt. Liver cyst measures 1.1 cm The portal vein is patent with normal directional flow. BILIARY TRACT: No intrahepatic biliary ductal dilation. The common bile duct measures 5 mm in diameter. Status post cholecystectomy.PANCREAS: No significant abnormality noted.KIDNEYS: The right kidney measures 11.2 cm. The left kidney measures 12.2 cm. There is a 1.2 cm nonobstructive stone in the left kidney. No evidence of hydronephrosis or mass.SPLEEN: The spleen measures 11.8 cm in length. OTHER: No significant abnormalities noted. | 1.Cirrhosis without suspicious focal lesion to suggest HCC.2.Left hepatic lobe portosystemic shunt is unchanged.3.Nonobstructive left renal pelvis stone. |
Generate impression based on medical findings. | Reason: r/o obstruction History: none, but increased Cr RIGHT KIDNEY: Right kidney measures 10.1 cm. There is a simple appearing cyst in the right upper pole measuring 1.4 x 1.6 x 1.4 cm, previously 1.4 x 1.6 x 1.4 cm. No hydronephrosis or or shadowing stones. Normal parenchymal echogenicity.LEFT KIDNEY: Left kidney measures 9.5 cm. Hypoechoic lesion in the left lower pole measures 0.8 x 0.7 x 0.7 cm and likely represents a cyst. No hydronephrosis or shadowing stones. Normal parenchymal echogenicity.OTHER: No significant abnormalities noted. | No hydronephrosis. |
Generate impression based on medical 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. Multiple simple cysts are identified bilaterally. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 2 - Benign.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on medical findings. | 56-year-old male with abdominal pain, evaluate biliary dilation. LIVER: Measures 17.7 in length. Markedly increased hepatic echogenicity without discrete focal lesion. Patent portal vein with antegrade flow. BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or 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: No significant abnormalities noted. | 1. Markedly increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease, without discrete focal lesion. 2. No evidence of biliary dilation as clinically questioned. |
Generate impression based on medical findings. | Elevated creatinine RIGHT KIDNEY: Unremarkable echogenicity without mass, stone, or hydronephrosis. 12 cm in lengthLEFT KIDNEY: Unremarkable echogenicity without mass, stone, or hydronephrosis. 11.9 cm in lengthOTHER: Bladder nondistended | Negative renal ultrasound without evidence for mass, stone, or obstruction. |
Generate impression based on medical findings. | 44 year old woman with history of calcifications seen on screening mammogram 1/23/15. Also complains of a palpable mass in right superolateral axilla. An ML view and two spot magnification 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. Regional, round calcifications are seen in the left superolateral breast. These are highly likely benign based on distribution and morphology. ULTRASOUND | 1. Regional round calcifications in the left superolateral breast are highly likely benign. Followup with unilateral diagnostic mammogram is recommended in 6 months. Recommendation was discussed with and provided to the patient in writing.2. Sebaceous cyst of the right axilla.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on medical findings. | 46-year-old female with palpable left lump, 2 sites previously biopsied showing PASH, here for follow-up A targeted left breast ultrasound was performed at the 2:00 position at the site of previously biopsied masses. An irregular hypoechoic mass with no associated vascularity 10 cm from the nipple corresponding to patient's palpable abnormality is not significantly changed size measuring 2.9 x 1.4 cm, previously 3.5 x 1.6 cm. A smaller irregular hypoechoic mass 7 cm from the nipple is also unchanged measuring 0.6 x 0.6 cm, previously 0.9 x 0.4 cm. | Two left breast masses corresponding to PASH on biopsy are not significantly changed in size. Annual diagnostic mammogram is recommended. The next mammogram is due in January 2016. Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on medical findings. | Reason: 57M s/p OLT now with concern for large amount of ascites in the setting of fever. History: Large amount of ascites There is large volume ascites with the largest apparent pocket noted in the left lower quadrant. Partially visualized right pleural effusion. | Large volume ascites. |
Generate impression based on medical findings. | Goiter RIGHT LOBE MEASUREMENTS: 7.3 x 4.3 x 2.5 cmLEFT LOBE MEASUREMENTS: 7.1 x 5.7 x 4.9 cmISTHMUS MEASUREMENTS: 2 cmRIGHT LOBE: Diffusely enlarged heterogeneous gland. Multiple spongiform-appearing nodules. A representative lower pole nodule measures 3.5 x 3 x 2 cmLEFT LOBE: Diffusely enlarged heterogeneous gland without obvious discrete noduleISTHMUS: Diffusely enlarged heterogeneous gland without discrete nodulePARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely enlarged heterogeneous gland consistent with goiter. Multiple benign-appearing spongiform right lobe nodules. No regional adenopathy. |
Generate impression based on medical findings. | 84 year old female with outside ultrasound showing large nodules in the right lobe. RIGHT LOBE MEASUREMENTS: 9.7 x 5.0 x 4.2 cmLEFT LOBE MEASUREMENTS: 6.0 x 4.8 x 3.2 cmISTHMUS MEASUREMENTS: 2.1 cmRIGHT LOBE: Multinodular goiter. Dominant solid hyperechoic and hypoechoic nodule with small cystic spaces measures 6.0 x 3.2 x 4.8 cm. No obvious microcalcifications. LEFT LOBE: Heterogeneous left thyroid lobe with macrocalcifications. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous thyroid parenchyma with macrocalcifications and dominant right thyroid nodule as detailed above. |
Generate impression based on medical findings. | Female, 88 years old. Progressive renal failure. RIGHT KIDNEY: The right kidney measures 9.0 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.3 cm in length with increased cortical echogenicity. A lower pole simple cyst measures 3.0 x 2.6 x 2.9 cm. No shadowing stones or hydronephrosis.OTHER: The bladder is decompressed, limiting evaluation. | Increased renal cortical echogenicity compatible with medical renal disease. No hydronephrosis. |
Generate impression based on medical findings. | 61-year-old female with HCV cirrhosis. Evaluate for HCC. LIVER: Measures 18.7 cm in length with nodular contour and coarse echotexture.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common bile duct measures 8 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The distal tail of the pancreas is obscured by overlying bowel gas. The remaining pancreatic parenchyma is normal in echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Measures 10.0 cm in length and is normal in echogenicity with no evidence of hydronephrosis.OTHER: Left kidney measures 12.1 cm in length and is normal in echogenicity with no evidence of hydronephrosis. Spleen measures 14.7 cm in length and is normal in echogenicity. | Cirrhotic liver morphology with no focal hepatic lesions. Hepatosplenomegaly. |
Generate impression based on medical findings. | 1 year status post islet cell transplant; evaluate portal venous flow LIVER: Normal parenchymal echogenicity. Well-circumscribed subcentimeter echogenic foci within the right lobe of the liver; favor benign etiology. Liver length 15.3 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Main portal vein velocity 20 cm/s.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Subcentimeter nonobstructing right renal stone. Right kidney 10.5 cm in lengthOTHER: Left kidney 9.4 cm in length. Spleen 9.6 cm in length. No ascites. | Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Well-circumscribed subcentimeter echogenic foci within the right lobe of the liver; favor benign etiology. No ascites.Subcentimeter nonobstructing right renal stone. |
Generate impression based on medical findings. | Abdominal pain LIVER: No significant abnormalities noted. 14.7 cm in lengthBILIARY TRACT: No significant abnormalities noted. No evidence for acute inflammation or ductal dilatation. No evidence for gallstones.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Minimally complex left renal cyst. Nonobstructing lower pole left renal stone measuring 0.5 x 0.9 x 0.5 cm. Left kidney 10.8 cm in length. | No extrahepatic biliary abnormality. Specifically, no evidence for gallstones, acute inflammation, or ductal dilatation.Minimally complex left renal cyst. Nonobstructing left nephrolithiasis. |
Generate impression based on medical findings. | 43-year-old female with enlarged cervical lymph nodes and parathyroid glands on prior ultrasound. RIGHT LOBE MEASUREMENTS: 3.9 x 1.1 x 1.1 cmLEFT LOBE MEASUREMENTS: 3.8 x 0.9 x 0.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Small and diffusely heterogeneous without mass.LEFT LOBE: Small and diffusely heterogeneous without mass.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Again noted inferior to the right lobe of the thyroid are too hypoechoic nodules a smaller measures 0.2 x 0.3 x 0.4 cm and has an appearance suggestive of lymph node. The larger measures 0.5 x 1.1 x 0.5 cm, decreased when compared to prior exam. On the left, there is a 0.3 x 0.4 x 0.9 cm hypoechoic-isoechoic area at the inferior aspect of the left lobe which is stable. The hypoechoic nodule inferior to the left lobe described on the prior study is no longer seen. LYMPH NODES: No enlarged or morphologically abnormal lymph nodes.OTHER: No significant abnormality noted. | Small, heterogeneous thyroid.2 extrathyroidal nodules on the right are stable and one has an appearance of lymph node.A nodular focus which is inseparable from the inferior left lobe of the thyroid is stable. Previously described left hypoechoic mass inferior to the thyroid is not visualized.No abnormal lymph nodes in the neck. |
Generate impression based on medical findings. | Reason: check for progression in nodules History: none RIGHT LOBE MEASUREMENTS: 6.0 x 2.3 x 1.7 cmLEFT LOBE MEASUREMENTS: 5.7 x 2.5 x 1.6 cm.ISTHMUS MEASUREMENTS: 0.7 cm.RIGHT LOBE: Index nodule at the junction of the superior and inferior right thyroid measures 0.5 x 0.6 x 0.4 cm, previously 0.6 x 0.6 x 0.4 cm and is unchanged in appearance.Index inferolaterally positioned nodule which is hypovascular is more solid-appearing than the prior exam but unchanged in size measuring 0.6 x 0.4 x 0.4 cm, previously 0.8 x 0.8 cm.LEFT LOBE: Index isoechoic nodule in the left mid thyroid is unchanged measuring 1.2 x 1.0 x 0.5 cm, previously 1.0 x 1.0 x 0.6 cm.Index poorly circumscribed heterogeneous mixed isoechoic and hypoechoic nodule in the left lower thyroid measures 0.8 x 0.7 x 0.9 cm, previously 1.0 x 0.9 x 0.9 cm. This lesion has previously been biopsied and represents a colloid cyst.Hypoechoic nodule along the left inferior pole of the thyroid may represent an exophytic nodule and measures 0.5 x 0.6 x 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. | Index thyroid nodules are overall unchanged in size, although an inferolateral right index nodule is more solid-appearing than the prior exam. |
Generate impression based on medical findings. | Reason: 75 yo F with EtOH abuse presents with acute onset thrombocytopenia, evaluate for cirrhosis/liver pathology. Examination mildly limited by patient motion.LIVER: The liver measures 15.5 cm in length. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Gallbladder sludge and cholelithiasis without associated wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 6.7 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | 1.Increased hepatic echogenicity suggestive of parenchymal dysfunction/fatty infiltration.2.Cholelithiasis without evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on medical findings. | 43 year-old female with right-sided submandibular gland tenderness and swelling. Right submandibular gland appears normal and relatively symmetrical with the left. No shadowing calculus or ductal dilatation. The posterior auricular region on the right was also evaluated due to patient discomfort without mass or collection. | No submandibular gland stone or ductal dilatation. |
Generate impression based on medical findings. | HBV LIVER: Coarse liver echotexture again noted without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 13.8 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 8.3 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10 cm in lengthOTHER: Left kidney 10.2 cm in length no ascites | Mildly coarse liver echotexture again noted without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | 66 year old female who was recalled from screening mammogram for new focal asymmetry in the right upper outer breast with an adjacent partially circumscribed mass. Mammogram: Three standard views of the right breast and 2 spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty(BiRads Density Category A), unchanged in pattern and distribution. 6 mm round circumscribed benign morphology mass persist on spot compression views in the right breast upper-outer quadrant. No additional lesions/masses identified adjacent to it.Ultrasound: Targeted right upper-outer quadrant ultrasound was performed that demonstrated a simple cyst that measures 5 x 4 x 6 mm at 10:00 position. Adjacent to it is a small complex cyst that measures 2 x 2 mm. No suspicious cystic or solid mass noted. | Subcentimeter simple and complex cyst right breast 10:00 position on mammogram and ultrasound. No sonographic or mammographic evidence of malignancy. As long as patient's physical examination remains unchanged, annual screening mammogram is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on medical 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 medical findings. | Persistent primary hyperparathyroidism RIGHT LOBE MEASUREMENTS: 5 x 1.3 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.1 x 0.7 x 1.7 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Stable subcentimeter mixed cystic and solid nodules. Reference inferior nodule measures 0.6 x 0.4 x 0.7 cm.LEFT LOBE: Stable subcentimeter mixed cystic and solid nodules. Reference midpole nodule measures 0.4 x 0.4 x 0.5 cm.ISTHMUS: Stable isthmic hypoechoic solid nodule measuring 1.1 x 0.4 x 0.9 cm.PARATHYROID GLANDS: 0.5 x 0.4 x 0.4 hypoechoic possibly extrathyroidal nodule projecting posterior to the midportion of the left thyroid gland.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Hypoechoic subcentimeter focus projecting posterior to the midportion of the left thyroid gland. While this may represent a peripheral intrathyroidal nodule, it may alternatively represent an extrathyroidal focus and potential parathyroid adenoma candidate. Would recommend correlation with nuclear medicine study performed later this day.Stable subcentimeter bilateral thyroid nodules. No regional adenopathy. |
Generate impression based on medical findings. | 68-year-old female with enlarged thyroid gland. RIGHT LOBE MEASUREMENTS: 4.2 x 1.6 x 1.0 cmLEFT LOBE MEASUREMENTS: 5.2 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Solid mixed hyper and hypoechoic nodule posteriorly in the middle-inferior right thyroid lobe measures 1.8 x 1.1 x 1.0 cm.LEFT LOBE: Solid primarily hyperechoic nodule in the mid left thyroid lobe measures 1.5 x 0.9 x 2.3 cm. Adjacent posterior smaller nodule with spongiform features, most likely benign.ISTHMUS: Solid mixed hyper and hypoechoic nodule in the isthmus measures 1.9 x 1.0 x 1.9 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Scattered cervical lymph nodes with overall benign morphologic features.OTHER: No significant abnormality noted. | Multinodular thyroid as described above with solid dominant nodules which are amenable to biopsy. |
Generate impression based on medical findings. | History of multiple thyroid nodules. RIGHT LOBE MEASUREMENTS: 2.1 x 1.7 x 6 cmLEFT LOBE MEASUREMENTS: 1.6 x 1.6 x 6.4 cmISTHMUS MEASUREMENTS: 5 mmRIGHT LOBE: Two solid right thyroid lobe nodules. The larger nodule measures 1.6 x 1.3 x 2.3 cm in the inferior/mid pole. It is predominantly solid without specific suspicious sonographic features. Previously it measured approximately 1.9 x 1.5 x 1.8 cm.LEFT LOBE: Two solid left thyroid nodules are present. The larger nodule measures 1.2 x 1.0 x 1.5 cm in the superior pole. No specific suspicious sonographic features.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No pathologically enlarged or suspicious appearing cervical lymph nodes are identified.OTHER: No significant abnormality noted. | Bilateral thyroid lobe nodules with the largest being a 2.3 cm solid nodule in the inferior pole of the right thyroid lobe. This is minimally increased in size accounting for differences in measurement technique. |
Generate impression based on medical findings. | 73-year-old male patient with UTI, sepsis. Evaluate for hydronephrosis. RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No perinephric fluid collection is identified.KIDNEY: The transplant kidney measures 12.1 cm in length. Renal cortical echogenicity is within normal limits. A subcentimeter cyst is noted within the lower pole.COLLECTING SYSTEM/URETER: There is mild pelvicalyceal prominence, which decreases post-void. A catheter is noted within the renal pelvis.URINARY BLADDER: The bladder is distended with fluid with retention post-void. The distal end of a ureteral stent is visualized.OTHER: No significant abnormality noted | 1. Mild prominence of the collecting system which decreases post-void.2. Post-void urinary retention. |
Generate impression based on medical findings. | 38 year old male with rising LFTs and abdominal pain, evaluate for hepatic pathology/cholecystitis. LIVER: The liver is enlarged measuring 18.8 cm in length. The liver parenchyma is again markedly heterogenous. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.4 m/s.BILIARY TRACT: Gallbladder sludge, thickened gallbladder wall, nonspecific in setting of ascites. No additional signs of acute cholecystitis. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameterPANCREAS: Nonvisualization of pancreas secondary to overlying bowel gas.SPLEEN: The spleen is markedly heterogenous, new from the prior examination.RIGHT KIDNEY: Kidney measures 8.0 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Not visualized. OTHER: Incompletely imaged pleural effusions and complex ascites. Right iliac fossa transplant kidney with mild caliectasis appearing similar to to 5/22/2015 vascular ultrasound. | 1.New marked heterogeneity of the spleen which could be related to infarctions and/or hematoma. In the appropriate clinical setting, contrast-enhanced CT recommended for further evaluation.2.Hepatomegaly and marked heterogeneity of the liver which may be related to underlying steatosis/parenchymal dysfunction but underlying mass cannot be excluded. In the appropriate clinical setting, could be further evaluated with dedicated cross-sectional imaging.3.Mild caliectasis of the transplant kidney appearing grossly similar to recent vascular ultrasound.4.Gallbladder sludge. Gallbladder wall thickening which is nonspecific in the setting of ascites.5.Pleural effusions.Findings discussed with MARTIN, ELIZABETH at 4:24 p.m. on 6/12/2015. |
Generate impression based on medical findings. | Female 64 years old Reason: assess for liver lesions History: HCV with SVR; cirrhosis LIVER: Hyperechoic coarse appearance of the liver is again seen. Nodularities consistent with cirrhosis. No focal hepatic lesion is seen. Main portal vein is patent with normal directional flow and a peak velocity of 22.9 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 4 mm. Gallbladder is normal in appearance. No gallstones.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are scattered by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 7.2 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. In the right kidney there is a anechoic cyst measuring 2.3 x 1.4 x 2.2 cm. Within the left kidney there is a small cyst measuring 1.4 x 1.1 x 1.4 cm.OTHER: No significant abnormalities noted. | Cirrhotic morphology of the liver without focal hepatic lesion. |
Generate impression based on medical findings. | Female; 49 years old. Reason: Large Thyroid mass that extends from the right lobe to the left. History: Large Thyroid mass that extends from the right lobe to the left. RIGHT LOBE MEASUREMENTS: 7.5 x 2.2 x 2.5 cmLEFT LOBE MEASUREMENTS: 7.5 x 2.1 x 1.8 cm ISTHMUS MEASUREMENTS: 3.5 cmRIGHT LOBE: The right lobe is completely replaced by nodules. No dominant nodule is identified. LEFT LOBE: Left lobe is completely replaced by solid nodules with minimal flow on color Doppler. No dominant nodule is identified.ISTHMUS: The Isthmus is completely replaced by solid nodules with minimal flow on color Doppler. No dominant nodule is identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No worrisome lymphadenopathy.OTHER: No significant abnormality noted. | Multinodular goiter. |
Generate impression based on medical findings. | 65 years old, Male, Reason: Left thyroid mass on MRI and CT History: as above Technically difficult examRIGHT LOBE MEASUREMENTS: 6.6 x 2.2 x 2.5 cmLEFT LOBE MEASUREMENTS: 4.6 x 2.6 x 2.4 cmISTHMUS MEASUREMENTS: 0.7 cmRIGHT LOBE: Multiple subcentimeter hypoechoic nodules in the right thyroid lobe.LEFT LOBE: Left predominantly solid hypoechoic thyroid nodule measures 1.9 x 1.7 x 1.2 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Predominantly solid left thyroid nodule measuring up to 1.9 cm.2.Multiple subcentimeter hypoechoic nodules in the right thyroid lobe. |
Generate impression based on medical findings. | Right lower quadrant abdominal pain LIVER: Coarse echogenic liver echotexture without mass. Liver length 13.5 cmBILIARY TRACT: 0.3 x 0.3 x 0.2 cm subcentimeter gallbladder polyp. No ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11 cm in lengthRIGHT KIDNEY: Right renal cyst. Right kidney 10.5 cm in lengthOTHER: Left kidney 9.5 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for parenchymal dysfunction/fatty infiltration without mass or ductal dilatation. Subcentimeter gallbladder polyp. No ascites. |
Generate impression based on medical findings. | 31-year-old female with history of thyroid cancer status post thyroidectomy presents with palpable lymph nodes. Evaluate for lymphadenopathy. RIGHT LOBE, LEFT LOBE, ISTHMUS MEASUREMENTS: The thyroid has been surgically removed.RIGHT LOBE, LEFT LOBE, ISTHMUS: The thyroid has been surgically removed.LYMPH NODES: There are 2 suspicious cervical lymph nodes:There is a round, hypoechoic lesion with calcifications measuring approximately 0.8 x 0.5 x 1.0 cm in the right level II neck.There is a round, hypoechoic, 0.9 x 0.5 x 1.4 cm lesion with calcifications in the left level III neck.OTHER: No significant abnormality noted. | 1. Bilateral suspicious lymph nodes as described above. Recommend ultrasound-guided biopsy. |
Generate impression based on medical findings. | 61-year-old female patient with history of thyroid nodules on staging CT for colon cancer. Evaluate for quality. RIGHT LOBE MEASUREMENTS: 5.8 x 1.6 x 3.1 cm.LEFT LOBE MEASUREMENTS: 7.1 x 2.7 x 2.4 cm.ISTHMUS MEASUREMENTS: 1.2 cm in thickness.RIGHT LOBE: Multiple nodules are noted within the right thyroid gland, many which have imaging features of colloid nodules. The largest nodule with a spongiform appearance measures 1.7 x 1.4 x 1.4 cm in the right lower pole.LEFT LOBE: The left thyroid gland is heterogeneous containing multiple nodules many which have imaging features of colloid nodules. ISTHMUS: A nondescript, solid, heterogeneous nodule without significant internal vascularity within the isthmus measures 2.7 x 1.8 x 2.9 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Plaque is noted within the left carotid artery near the bifurcation. | Multinodular goiter as above. |
Generate impression based on medical findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 2.5 x 1.8 x 5.8 cmLEFT LOBE MEASUREMENTS: 2.8 x 12.1 x 7.2 cmISTHMUS MEASUREMENTS: 0.5 cmRIGHT LOBE: Multiple benign-appearing cystic and mixed cystic solid colloid nodules. A representative mid pole nodule measures 1 x 0.5 x 0.9 cm.LEFT LOBE: Solid lower pole nodule measuring 1.6 x 1 x 1.3 cm. Additional benign-appearing colloid nodules. A representative mid pole nodule measures 1.2 x 0.6 x 1.2 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple bilateral benign-appearing cystic and mixed cystic solid colloid nodules. Solid left lower pole nodule as described; the patient states that this nodule has been biopsied in the past; if prior documentation is not available, this nodule would be amenable to ultrasound-guided percutaneous biopsy. No regional adenopathy. |
Generate impression based on medical findings. | 39 year old female. Thyroid nodules check for change. Also examine high left level 2 nodes/scar for stability. RIGHT LOBE MEASUREMENTS: 4.1 x 1.2 x 1.3 cm.LEFT LOBE MEASUREMENTS: 4.3 x 1.8 x 2.4 cm.ISTHMUS MEASUREMENTS: 0.2 cm in AP dimension.RIGHT LOBE: Nodule 1: Mid pole, spongiform, 2.4 x 0.8 x 1 cm (previously 2.3 x 0.6 x 0.9 cm), not significantly changed and most suggestive of a colloid nodule.Nodule 2: Upper pole, mixed echogenicity, 1.3 x 0.5 x 0.4 cm, likely present on prior though not measured, hyperechogenic focus with suggestion of comet tail artifact, most likely a colloid nodule.LEFT LOBE: Nodule 1: Lower pole, 3.4 x 1.8 x 2.2 cm (previously 3.2 x 1.5 x 1.8 cm), solid, no calcifications. Indeterminate.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign appearing right cervical lymph nodes. No left cervical lymphadenopathy. OTHER: No significant abnormality noted. | Mild increased size of solid left thyroid nodule, which is indeterminate, amenable to biopsy if clinically warranted. |
Generate impression based on medical findings. | 54-year-old female with acute kidney injury. Evaluate for hydronephrosis. RIGHT KIDNEY: Measures 11.5 cm in length. Increased echogenicity without hydronephrosis, discrete mass, or nephrolithiasis.LEFT KIDNEY: Measures 14.3 cm in length. Increased echogenicity without hydronephrosis, discrete mass, or nephrolithiasis.BLADDER: Collapsed and not clearly visualized.OTHER: Cholelithiasis and echogenic biliary sludge in the gallbladder lumen. Shadowing from these gallstones limits evaluation of the posterior wall of the gallbladder. Mild perihepatic ascites. | 1.Increased renal echogenicity consistent with medical renal disease. No hydronephrosis.2.Limited images of the gallbladder demonstrate cholelithiasis and echogenic biliary sludge within the gallbladder lumen.3.Mild perihepatic ascites. |
Generate impression based on medical findings. | 29 year old female with right upper quadrant pain. LIVER: Normal echogenicity of the liver measuring 16.1 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow.BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal echogenicity.SPLEEN: Normal echogenicity of the spleen measuring 11.9 cm in length.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 12.1 cm in length. No hydronephrosis or shadowing calculi are noted. OTHER: Normal echogenicity of the left kidney measuring 11.6 cm in length. No hydronephrosis or shadowing calculi are noted. | Unremarkable examination. |
Generate impression based on medical findings. | 64-year-old female with right upper quadrant pain. History of Crohn's disease. 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: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. Visualized biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.SPLEEN: Poorly visualized due to high position.RIGHT KIDNEY: There is a shadowing, echogenic focus in the midportion of the right kidney likely representing a nonobstructing calyceal calculus.OTHER: Limited views of left kidney demonstrate no abnormality. | Normal gallbladder and biliary tract.Nonobstructing right renal stone. |
Generate impression based on medical findings. | Short-term follow-up for probably benign mass in the right breast. A targeted right ultrasound was performed . An oval hypoechoic lesion does not appear significantly changed in size, today measuring 5 x 4 mm. No vascularity is seen within the finding. This is favored to represent a complicated cyst or another benign etiology. A normal morphology lymph node is also seen posterior and superior to this mass. There is no suspicious solid or cystic mass identified. | No significant change in right breast mass. At this point, bilateral diagnostic mammogram with possible ultrasound is recommended in February 2016.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on medical findings. | Follow-up gallbladder polyp LIVER: Normal parenchymal echogenicity without mass. Liver length 16 cmBILIARY TRACT: Stable gallbladder polyp measuring 0.7 x 0.6 x 0.6 cm. Midportion of common bile duct obscured by gas. No evidence for intrahepatic ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 9.6 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10.1 cm in lengthOTHER: Left kidney 10 cm in length. No ascites. | Stable gallbladder polyp. |
Generate impression based on medical findings. | Ms. McCauley is a 52 year old female with known left breast cancer. Dr. Jaskowiak palpated a left axillary lymph node. She presents today for ultrasound evaluation of this area. Targeted left axillary ultrasound was performed. In the left axilla, there is an enlarged lymph node identified, measuring 1.7 x 0.8. In addition, there is abnormal non-hilar vascular flow seen in this lymph node. | Abnormal left axillary lymph node. An US-guided biopsy with clip placement should be performed for further evaluation. All results and recommendations were relayed to Dr. Jaskowiak and the patient. The patient will undergo an US-guided biopsy of this abnormal left axillary lymph node later today. She does not take any blood thinning medications.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical findings. | 20-year-old female patient with papillary thyroid cancer at age 16. Left posterior high cervical lymph node, soft palpated. RIGHT LOBE: Status post thyroidectomy without residual tissue identified.LEFT LOBE: Status post thyroidectomy without residual tissue identified.ISTHMUS: Status post thyroidectomy without residual tissue identified. A 0.3 x 0.4 cm benign morphology lymph node is noted within the thyroidectomy bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a right level 3 benign morphology lymph node. In the left posterior auricular region corresponding to the patient's palpable abnormality, there are two prominent benign morphology lymph nodes with fatty hila measuring up to 1.3 cm in the largest dimension. OTHER: No significant abnormality noted. | 1. No specific evidence of disease recurrence.2. Left posterior auricular prominent lymph nodes with benign morphology are likely reactive in etiology. |
Generate impression based on medical 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 medical findings. | 59-year-old female patient with history of papillary cancer. RIGHT LOBE: Status post thyroidectomy. There is a new hypoechoic focus within the right thyroid bed measuring 0.2 x 0.2 x 0.4 cm.LEFT LOBE: Status post thyroidectomy without recurrent or residual tissue identified.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a non-descript right level III lymph node measuring 0.8 x 0.4 x 1.5 cm. A benign morphology left level III lymph node measures 0.7 x 0.3 x 1.2 cm. OTHER: No significant abnormality noted. | 1. New hypoechoic focus within the right thyroid bed.2. Non-descript prominent right level III lymph node; this is amenable to biopsy if clinically indicated. |
Generate impression based on medical findings. | 50 year-old male with history of metastatic renal cell carcinoma, new onset left testicular swelling and pain. RIGHT TESTIS: Normal in echogenicity and vascularity.LEFT TESTIS: Normal in echogenicity and vascularity.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: Small left epididymal cyst and hydrocele, otherwise unremarkable.OTHER: No significant abnormalities noted. | No testicular mass, torsion, or acute inflammatory process. |
Generate impression based on medical findings. | Multiple lymph nodules. There is no evidence of significant cervical lymphadenopathy base on size criteria, including subcentimeter right level 5A lymph nodes. The major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | No discernible thyroid nodules or significant lymphadenopathy in the neck. |
Generate impression based on medical findings. | Female; 76 years old. Reason: evaluate nodularity, History: concern for parathyroid adenoma RIGHT LOBE MEASUREMENTS: 4.9 x 1.8 x 1.1 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.8 x 1.9 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: The thyroid gland is mildly heterogeneous. Along the posterior inferior aspect of the right lobe of the thyroid gland is an ovoid, heterogenous structure. This is hypervascular compared to the background thyroid. It measures approximately 1.1 by 0.8 cm transverse by AP however the margins are somewhat indistinct making precise measurement difficult.LEFT LOBE: Thyroid gland is mildly heterogeneous. In the midgland is a subcentimeter 0.8 x 0.7 x 0.5 cm (previously 0.7 x 0.7 x 0.5 cm) heterogeneous, hypoechoic at least partially solid nodule with internal vascularity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 0.7 x 0.7 x 0.5 cm right level 3 lymph node with fatty hilum.OTHER: Note is made of left internal jugular vein thrombosis. | 1. Stable left thyroid nodule.2. Heterogeneous structure alluded to above appears to be outside of the right thyroid lobe and has imaging features suggestive of a parathyroid adenoma. Correlation is recommended with patient's clinical history and laboratory results.3. Left internal jugular vein thrombosis.Findings discussed with Louann Shea APN at 5:13 pm on 2/20/2015. |
Generate impression based on medical findings. | 66-year-old male with laboratory findings of primary hypogonadism. Testicular tenderness on exam. RIGHT TESTIS: Normal in size, contour and echogenicity. Prominent rete testes which is normal variant.LEFT TESTIS: Normal in size, contour and echogenicity.RIGHT EPIDIDYMIS: Several small epididymal cysts, the largest in the head measuring 4 mm.LEFT EPIDIDYMIS: Left epididymal cyst in the head measuring 4 mmOTHER: Small tunica cyst on the left measuring 4 mm.Bilateral, complex small to moderate hydroceles with septation. | 1. Normal testes.2 bilateral epididymal cystic masses.3. Bilateral complex hydroceles.4. Small left tunica cyst. |
Generate impression based on medical findings. | Male 51 years old Reason: Post Liver Transplant. Please evaluate all vessels for patency History: Liver Transplant LIMITED ABDOMENLIVER: Transplanted liver measures 22 cm, enlarged. No focal liver lesions.BILIARY TRACT: No evidence of intra or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Mild splenomegaly. | Patent hepatic vasculature. Main portal vein is patent but not well visualized and a partial thrombus cannot be excluded. Increased velocity of the hepatic artery with decreased RI values. Clinical correlation and if necessary a follow-up Doppler study may be helpful for further evaluation. |
Generate impression based on medical findings. | Liver transplant LIMITED ABDOMENLIVER: Stable mildly coarse liver echotexture without mass. Liver length 16 cmBILIARY TRACT: Pneumobilia secondary to biliary drain placement.PANCREAS: No significant abnormalities noted.SPLEEN: Spleen 13.2 cm in length RIGHT KIDNEY: Mildly echogenic parenchyma again noted without worrisome mass, stone, or hydronephrosis. Right kidney 8.5 cm in length.OTHER: Mildly echogenic left renal parenchyma again noted. Left kidney 9.6 cm in length. No left hydronephrosis. No ascites | Stable coarse liver echotexture suggestive for chronic liver disease without mass or ductal dilatation. No ascites. Patent hepatic vessels with normal directional flow. |
Generate impression based on medical findings. | 55 year old female with fever, elevated GGT, elevated alkaline phosphatase. Evaluate for liver/gallbladder pathology. LIVER: Coarse echotexture of the liver measuring 12.6 cm in length. No focal hepatic lesions. Main portal vein is patent the directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Mild gallbladder wall thickening. No evidence of cholelithiasis or sludge. No pericholecystic fluid. 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: Increased echogenicity measuring 11.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Increased echogenicity of the left kidney measuring 7.8 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Mild gallbladder wall thickening with no evidence of cholelithiasis or cholecystitis.2. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on medical findings. | Male 70 years old; Reason: liver, common bile duct eval, given worsening jaundice, abd pain History: diffuse abd pain, jaundice, scleral icterus, HCV, cirrhosis LIVER: The liver measures 14.1 cm in length. There is coarse 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 28.8 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder surgically absent. The common bile duct measures 5.4 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 10.5 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.0 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen. | 1. The liver has coarse increased echogenicity compatible with fatty infiltration/hepatocellular dysfunction. No worrisome masses or intrahepatic ductal dilation are seen.2. Bilaterally the kidneys have increased echogenicity compatible with medical renal disease. |
Generate impression based on medical findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 6 x 1.5 x 1.2 cm LEFT LOBE MEASUREMENTS: 5.4 x 1.2 x 0.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Solid lower pole nodule with coarse internal calcifications. Nodule measures 2.1 x 1 x 1.2 cm.LEFT LOBE: Hypoechoic subcentimeter nodule measuring 0.4 x 0.2 x 0.47 m.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Dominant solid nodule with internal coarse calcifications lower pole right thyroid gland. This nodule is amenable to ultrasound guided percutaneous biopsy. No regional adenopathy. |
Generate impression based on medical findings. | Male 18 years old Reason: hypertension in young male History: hypertension RIGHT KIDNEY: The right kidney measures 10.5 cm. There is no hydronephrosis or shadowing renal stones.LEFT KIDNEY: The left kidney measures 10.6 cm. There is no hydronephrosis or shadowing renal stones.OTHER: The bladder was empty and was not imaged. The liver was noted to be diffusely echogenic suggestive of fatty infiltration. | 1. Unremarkable appearance of the kidneys.2. The liver was noted to be echogenic which is most likely due to fatty infiltration. |
Generate impression based on medical findings. | Ms. Molloy is a 26 year old female presenting for a short term 6 month follow-up for a probable intramammary lymph node in the left breast. Upon physical exam at the patient's area of concern, a soft mobile mass is appreciated.In the left breast 4:00 location, approximately 1 cm from the nipple, there is an oval hypoechoic lesion with central fatty hilum measuring 0.5 x 0.4 cm. This appears similar in size and appearance when compared to the prior ultrasound examination and is compatible with a benign intramammary lymph node. No suspicious cystic or solid mass is identified. | Benign intramammary lymph node in the left breast. No sonographic evidence of malignancy. No additional imaging workup is necessary this time.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | 48 year old male with a history of right lower quadrant pain and tenderness in the inguinal region. Reports congenital absence of left testis. RIGHT TESTIS: The right testis is normal in morphology, echogenicity, and size, measuring 2.6 x 4.9 x 2.3 cm. Spectral Doppler demonstrates arterial blood flow.LEFT TESTIS: NoneRIGHT EPIDIDYMIS: Normal morphology, echogenicity, and size without evidence of hyperemia.LEFT EPIDIDYMIS: NoneOTHER: Evaluation of the right inguinal region demonstrates no discrete abnormality. | Normal right testis. Absent left testis. |
Generate impression based on medical findings. | 43-year-old female patient with right breast cancer containing LCIS and DCIS. Evaluate for interval change status post chemotherapy. A targeted right breast ultrasound was performed. There is an ill-defined mass with multiple hyperechoic calcifications at 11 o'clock position, 4 cm from nipple, measuring 33 x 21 x 30 mm (previously 34 x 22 x 27 mm). Another portion of the tumor has become cystic, measuring 14 x 11 x 16 mm (previously 23 x 11 x 20 mm), with remaining solid component with calcifications. This is located at 10 o'clock position, 5 cm from nipple. | Status post chemotherapy for the right breast cancer. Slight reduction of the size of tumor. Part of the tumor has become cystic.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | Heart transplant evaluation LIVER:No significant abnormality noted. 13.4 cm in length GALLBLADDER, BILIARY TRACT: No significant abnormality noted.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. 9.3 cm in lengthKIDNEYS: No significant abnormality noted. Right kidney 9 cm in length. Left kidney 10 cm in length. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. No ascites | Negative abdominal ultrasound without evidence for acute, inflammatory, or neoplastic process. |
Generate impression based on medical findings. | Hyperparathyroidism RIGHT LOBE MEASUREMENTS: 1.5 x 1.7 x 5.1 cmLEFT LOBE MEASUREMENTS: 1.7 x 1.6 x 4.3 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: 2 mm benign colloid noduleLEFT LOBE: 2 mm benign colloid noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No parathyroid adenoma candidate could be identified within the neck. |
Generate impression based on medical findings. | Hepatitis C LIVER: Coarse echogenic liver without mass. Liver length 14.9 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation. Mild bilobar intrahepatic as well as mild extrahepatic biliary dilatation. Maximal CBD diameter 0.9 cm. The distal bile duct cannot be assessed due to overlying gas.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right renal cyst. 9.6 cm in length.OTHER: Echogenic focus within the spleen; favor benign etiology such as hemangioma. Spleen length 10.2 cm. Left kidney 10.6 cm in length. Left renal cyst. No ascites. | Echogenic liver parenchyma consistent with chronic liver disease without mass lesion. Gallbladder sludge without acute inflammation. Mild bilobar intrahepatic and mild extra hepatic biliary dilatation. The distal bile duct cannot be assessed due to overlying gas and a distal obstructing lesion cannot be excluded on this study. Would recommend correlation with CT or M.R.C.P. No ascites. |
Generate impression based on medical findings. | History of gallbladder polyp. LIVER: The liver is normal in morphology, contour and echogenicity. It measures 15 cm in craniocaudal dimension. No focal liver lesion or intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 32 cm/s.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm. Normally distended gallbladder. Demonstrated again is a sessile 5 mm nonmobile non-shadowing avascular probable gallbladder polyp currently measuring 5 mm compared to 3 mm previously. The gallbladder is otherwise normally distended without gallbladder wall thickening, pericholecystic fluid, shadowing gallstones or focal tenderness.PANCREAS: The visualized portions of the pancreatic body and head are normal. Normal caliber main pancreatic duct. The distal body and tail are obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 9.2 cm in length without a focal abnormality.RIGHT KIDNEY: The right kidney measures 10 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. OTHER: The left kidney measures 10.3 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. | Probable 5 mm gallbladder polyp, increased from 3 mm previously, continued follow up recommended. |
Generate impression based on medical findings. | 80 years old, Female, Reason: AKI History: As above RIGHT KIDNEY: Kidney measures 9.6 cm in length. Minimally hyperechoic. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.0 cm in length. Minimally hyperechoic kidney. Nohydronephrosis, shadowing calculus or mass.OTHER: A significant amount of ascites is present consistent with findings on recent CT scan. | 1.Generalized abdominal ascites.2.Kidneys are minimally hyperechoic consistent with medical renal disease. |
Generate impression based on medical findings. | 48-year-old male presents for HCC surveillance with history of HBV. LIVER: The liver morphology is normal and the capsule is smooth. The liver parenchyma is echogenic. It is normal in size, measuring 16 cm in craniocaudal dimension. There is no focal hepatic lesion or biliary ductal dilatation. Normal hepatopetal portal venous blood flow is present at 40 cm/sec.GALLBLADDER, BILIARY TRACT: Normally distended gallbladder without evidence of inflammation. The common duct is normal in caliber, measuring 5 mm.PANCREAS: The visualized portions of the pancreas are normal in appearance.RIGHT KIDNEY: The right kidney is normal in size, measuring 10.5 cm without hydronephrosis. The left kidney is normal in size, measuring 12.1 cm without hydronephrosis.OTHER: The spleen is normal in size, measuring 10.4 cm. | Echogenic hepatic parenchyma, compatible with diffuse fatty infiltration. No focal hepatic lesion or stigmata of cirrhosis. |
Generate impression based on medical findings. | History of thyroid nodules, assess for changes. RIGHT LOBE MEASUREMENTS: 4.5 x 1.4 x 1.7 cm.LEFT LOBE MEASUREMENTS: 3.5 x 1.3 x 1.4 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Normal background parenchymal echotexture. Lower pole partially cystic partially solid nodule without internal vascularity or calcifications measures 1.9 x 1.5 x 1.6 cm, previously 2.1 x 1.7 x 1.7 cm and is of low suspicion for malignancy.LEFT LOBE: Normal background parenchymal echotexture. Upper pole partially cystic nodule without internal vascularity measures 0.6 x 0.3 x 0.4 cm, previously 0.4 x 0.4 x 0.2 cm and remains very low suspicion for malignancy.ISTHMUS: Benign cyst in the isthmus measures 0.9 x 0.8 x 0.9 cm, previously 0.6 x 0.9 x 0.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A few benign morphology lymph nodes are noted.OTHER: No significant abnormality noted. | Right lower pole partially cystic partially solid nodule, low suspicion for malignancy based on ATA guidelines, slightly decreased in size. |
Generate impression based on medical findings. | Elevated creatinine Left iliac fossa renal transplant again demonstrates moderate hydronephrosis and proximal moderate hydroureter unchanged from the prior study. No ureteral stent could be identified within the left iliac fossa collecting system. No worrisome mass, stone, or perinephric collection appreciated. Neobladder collapsed. | No change in moderate left iliac fossa hydronephrosis and proximal moderate hydroureter. No ureteral stent could be identified. |
Generate impression based on medical findings. | Papillary thyroid carcinoma status post thyroidectomy RIGHT LOBE: Status post thyroidectomy. Stable 0.5 x 0.3 x 0.5 cm hypoechoic focus within the right thyroid bed. The second more inferior right thyroid bed focus is not identified on the current examinationLEFT LOBE: Status post thyroidectomy. No worrisome mass or noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post thyroidectomy. Stable hypoechoic focus within the right thyroid bed. No worrisome mass or regional adenopathy appreciated. |
Generate impression based on medical findings. | 61-year-old female with incidental thyroid nodule on CT. TSH normal RIGHT LOBE MEASUREMENTS: 5.3 x 1.5 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.6 x 1.3 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Ovoid, hyperechoic nodule in the mid pole of the right lobe measuring 0.9 x 1.2 x 1.4 cm. Small spongiform nodule and small cystic nodule also visualized in the right lobe.LEFT LOBE: In the medial, upper pole of the left lobe there is a mildly echogenic nodule with a hypoechoic rim measuring 0.3 x 0.4 x 0.5 cm. This could even represent an intrathyroidal lymph node.ISTHMUS: There is a 0.8 x 1.4 x 1.5 cm hyperechoic and minimally heterogeneous solid nodule to the left of midline.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Solid, echogenic Isthmus nodule.Hyperechoic right lobe nodule. Other small and benign-appearing nodules bilaterally. |
Generate impression based on medical findings. | 35-year-old male with transaminitis and HIV. Assess for cirrhosis and biliary obstruction. LIVER:Mild ascites. Normal echogenicity. No intrahepatic biliary dilation, focal mass.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with anechoic lumen. Echogenic material partially fills the lumen, consistent with cholelithiasis. Gallbladder wall measures 1.8 mm. Common hepatic duct measures 0.3 cm. No pericholecystic fluid. Negative sonographic Murphy's sign.PANCREAS: Evaluation the pancreas is limited due to overlying bowel gas.SPLEEN: Measures 12.0 cm without sonographic abnormalities.KIDNEYS: Left kidney measures 12.1 cm. Right kidney measures 11.3 cm. Normal echogenicity. No hydronephrosis, shadowing calculi, or focal mass. OTHER: No significant abnormality noted. | 1. Cholelithiasis and gallbladder wall thickening. Of note, in the context of ascites gallbladder wall thickening is nonspecific.2. Mild ascites. |
Generate impression based on medical findings. | Female, 68 years old. Rise in creatinine. Evaluate for renal obstruction/abnormality RIGHT KIDNEY: The right kidney measures 9.7 cm in length, with mildly increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney is poorly visualized but measures approximately 10.2 cm in length. No definite shadowing stones or hydronephrosis.OTHER: The bladder is distended without significant wall thickening. Increased hepatic echogenicity. | 1.Mildly increased renal cortical echogenicity suggests medical renal disease. No hydronephrosis.2.Increased hepatic echogenicity compatible with fatty infiltration parenchymal dysfunction. |
Generate impression based on medical findings. | Successful hypodense lesion seen on prior chest CT. Weight loss. Normal TSH. RIGHT LOBE MEASUREMENTS: 5.1 x 2.6 x 2.3 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.2 x 0.9 cmISTHMUS MEASUREMENTS: 0.2 cm in AP dimensionRIGHT LOBE: The heterogeneous predominantly-solid nodule in the midpole measures 3.2 x 1.8 x 2.8 cm, with some features suggestive of early spongiform changes. LEFT LOBE: Predominately cystic 0.4 x 0.3 x 0.4 cm nodule in the lower pole.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: 1.5 x 0.7 x 0.3 cm left level 3 lymph node, without suspicious features. | Thyroid nodules, with the dominant right lobe nodule demonstrating early spongiform changes. |
Generate impression based on medical findings. | 60-year-old male patient with HCV cirrhosis. Evaluate for HCC. LIVER: The liver is echogenic, nodular in contour, and measures 14.2 cm in length. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains sludge. There is no pericholecystic fluid. Minimal non-specific gallbladder wall thickening is noted. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 5 mm in diameter.PANCREAS: The head of the pancreas demonstrates normal echogenicity. The body and tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 13.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 13.2 cm in length. No evidence of hydronephrosis.The spleen measures 14.1 cm in length. | 1. Cirrhotic morphology of the liver without focal hepatic lesion.2. Biliary sludge. |
Generate impression based on medical findings. | History of right upper quadrant pain. No reported history of chronic liver disease. LIVER: The liver is normal in morphology, size and echogenicity, measuring 15 cm in length. The liver capsule is smooth. No intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 39 cm/s.Note is made of a 1.0 x 0.9 x 0.8 cm echogenic lesion without a surrounding halo, statistically likely a benign hemangioma in the absence of chronic liver disease.BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm.PANCREAS: The visualized pancreatic head and body is unremarkable. The remainder the pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 8.5 cm in length without a focal lesion.RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. The renal cortex is mildly echogenic. OTHER: The left kidney measures 10.8 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Note is made of prominent renal sinus fat and mild cortical echogenicity. Color Doppler demonstrates hilar blood flow. | No specific findings to account for the patient's right upper quadrant pain.1 cm right hepatic lobe echogenic lesion statistically likely represents a benign hemangioma in the absence of chronic liver disease.Findings suggestive of medical renal disease. |
Generate impression based on medical findings. | 63-year-old male with deceased donor renal transplant and decreased urine output, evaluate for flow and hematoma. RENAL TRANSPLANT:LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No peritransplant fluid collection is seen.KIDNEY: No evidence of nephrolithiasis. The renal cortex appears within normal limits.COLLECTING SYSTEM/URETER: No evidence of hydronephrosis.URINARY BLADDER: The bladder was not well visualized on today's examination.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels. Inflow and outflow vasculature appear intact with appropriate directional flow. The resistive index in a segmental artery ranges from 0.62-0.69. The resistive index in arcuate arteries range from 0.55-0.61.OTHER: No significant abnormality noted | No significant abnormality related to the right iliac fossa renal transplant. No evidence of nephrolithiasis or hydronephrosis. Inflow and outflow vasculature appear patent with appropriate directional flow. |
Generate impression based on medical findings. | Female, 77 years old. Microscopic Hematuria. RIGHT KIDNEY: The right kidney measures 8.8 cm in length, with normal echotexture. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.5 cm in length, with normal echotexture. No shadowing stones or hydronephrosis.OTHER: The bladder is nondistended. | No renal stones or hydronephrosis. |
Generate impression based on medical findings. | Abdominal pain and evidence of pancreatitis, please evaluate gallbladder and CBD LIVER: Liver measures 20.8 cm, mildly increased in size with mild increased echogenicity suggestive of hepatic steatosis. No evidence of liver lesions. Hepatic vessels appear patent. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Gallbladder is well distended with gallbladder wall thickness measuring up to 2 mm. Multiple stones noted within the gallbladder. Common hepatic duct and common bile duct measure 3 and 6 mm respectively, no evidence of any sludge or stones noted within it.PANCREAS: Not visualized due to overlying bowel gas.SPLEEN: Spleen measures 8.5 cm without any focal lesions.RIGHT KIDNEY: Right kidney measures 11.2 and left kidney measures 10.9 cm. No focal lesions noted. No hydronephrosis. OTHER: No ascites | 1. Mild hepatic steatosis.2. Cholelithiasis without evidence of acute cholecystitis. Common bile duct is not dilated without evidence of any sludge or stones within it. If clinically warranted, MRCP can be performed for thorough evaluation of the common bile duct. |
Generate impression based on medical findings. | Hepatitis C; Mantle cell lymphoma. LIVER: Coarse echogenic liver parenchyma without mass. Liver length 17.7 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.5 cm in lengthOTHER: Left kidney 12.1 cm in length. Spleen 12.7 cm in length. No ascites. | Coarse echogenic liver parenchyma consistent with chronic liver disease without mass or duct dilatation. No ascites. |
Generate impression based on medical findings. | 70-year-old female with acute kidney injury (AKI) and no clear etiology. RIGHT KIDNEY: The right kidney measures 10.5 cm in length. Hyperechoic parenchymal echogenicity. No hydronephrosis, shadowing calculi, or suspicious masses. There are scattered anechoic cortical cysts, which measure up to 2.1 x 2.1 x 2.3 cm. No significant interval change is noted.LEFT KIDNEY: The left kidney measures 10.9 cm in length. Hyperechoic renal parenchyma is again noted. There is a stable parapelvic cyst of the left lower renal pole measuring 2 x 2.3 x 1.8 cm. No hydronephrosis, shadowing calculi, or suspicious masses. No significant interval change is identified.URINARY BLADDER: The urinary bladder is collapsed and not visualized.OTHER: No significant abnormalities noted. | 1. Echogenic renal parenchyma compatible with medical renal disease.2. No hydronephrosis.3. Stable bilateral renal cysts. |
Generate impression based on medical findings. | 69-year-old female patient with history of bone marrow transplant and CHF, now with worsening edema and CKD. Evaluate size, shape, and echogenicity of her kidneys and blood flow. ULTRASOUND KIDNEYSRIGHT KIDNEY: The right kidney measures 9.7 cm in length and demonstrates mildly increased cortical echogenicity. No evidence of hydronephrosis.LEFT KIDNEY: The left kidney measures 10.3 cm in length and demonstrates mildly increased cortical echogenicity. No evidence of hydronephrosis. A 1 cm left midpole renal cyst is noted.OTHER:The bladder is decompressed. | 1. Mildly echogenic kidneys which can be seen with medical renal disease. No hydronephrosis.2. Suboptimal evaluation of the renal ostia, however, no specific secondary signs of renal artery stenosis distally. |
Generate impression based on medical findings. | Patient w/ acute renal failure, eval for hydronephrosis RIGHT KIDNEY: Mildly echogenic renal parenchyma, suggestive of medical renal disease. Right kidney measures 10.5 cm. No hydronephrosis or hydroureter.LEFT KIDNEY: Mildly echogenic renal parenchyma, suggestive of medical renal disease. Left kidney measures 10.7 cm. No hydronephrosis or hydroureter.OTHER: Well-distended urinary bladder. | Mildly echogenic renal parenchyma, suggestive of medical renal disease. No hydronephrosis or hydroureter. |
Generate impression based on medical findings. | Ms. Philbin is a 55 year old female with a personal history of right breast lumpectomy in 2011 with positive margins. She had an additional biopsy for new calcifications of the right breast in 2013 with results of DCIS. Since then patient has declined additional treatment/surgery. Family history of breast cancer in mother, maternal grandmother, and paternal grandmother. She presents today for a surgeon detected mass in the right medial breast. The skin has been marked by Dr. Chhablani. Targeted ultrasound was performed of the medial right breast at the site marked by the clinical service. In the right breast 3:00 location, there is no suspicious cystic or solid mass appreciated. | No suspicious finding at the site of palpable concern. The patient will follow up with Dr. Chhablani. The BiRads code below reflects the known DCIS in the right breast.BIRADS: 6 - Known cancer.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical findings. | Lesion over the lower manubrium/upper sternal junction MANUBRIUM/UPPER STERNAL JUNCTION: There is a 1.9 cm x 1.1 cm x 1.8 cm hypoechoic lesion within the soft tissue along the sternal notch corresponding to palpable lump. This lesion is nonvascular. There is a small area of increased hyperechogenicity which may reasonable the fatty hilum of a lymph node. | 1. Nonvascular hypoechoic lesion is visualized along the sternal notch. This is indeterminate on ultrasound however is amenable to ultrasound-guided biopsy if necessary. |
Generate impression based on medical findings. | Ms. Gill is a 31 year old female with a personal history of biopsy-proven fibroadenoma in the left breast diagnosed in February 05/20/2015. She presents today for short term ultrasound evaluation of this lesion. Upon physical exam at the patient's area of concern, there is a soft mobile superficial mass appreciated. Targeted ultrasound of the left breast demonstrates a 2.5 x 0.7 x 1.5 cm well-circumscribed mass, parallel to the skin, at 11:00 radian, 8 cm from nipple. There is minimal associated vascularity. This palpable mass is unchanged in morphology and size from the prior ultrasound study. | Stable size of biopsy-proven fibroadenoma of the left breast. Patient should continue to follow-up with her primary care team as clinically warranted. BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Chronic indwelling Foley with retention of urine RIGHT KIDNEY: Echogenic renal parenchyma. Multiple minimally complex cysts. No stone or hydronephrosis. 11.5 cm in lengthLEFT KIDNEY: Echogenic renal parenchyma without worrisome mass, stone, or hydronephrosis. 1.2 cm hypoechoic focus in the region of the mid; favor normal renal parenchyma.OTHER: Diffuse bladder wall thickening. Indwelling Foley catheter noted. Trace ascites. Large right pleural effusion. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. Diffuse bladder wall thickening suggestive for chronic inflammation; indwelling Foley catheter noted. Trace ascites. Large right pleural effusion. |
Generate impression based on medical findings. | 68-year-old male with abnormal sestamibi scan in the region of the lower pole of the left lobe of the thyroid. Patient has primary hyperparathyroidism with hypercalcemia. RIGHT LOBE MEASUREMENTS: The right lobe measures approximately 1.4 x 1.7 x 4.1 cmLEFT LOBE MEASUREMENTS: The left lobe measures approximately 1.5 x 1.5 x 4.8 cm.ISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: Homogeneous without mass.LEFT LOBE: Homogeneous without mass. However, the left lobe extends low in the neck.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Caudal to the left lobe of the thyroid is a complex cystic mass with internal vascularity measuring approximately 1 x 1.1 x 1.7 cm.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Complex cystic and vascular mass caudal to the left lobe of the thyroid consistent with atypical parathyroid adenoma and corresponding to the location of the abnormality on the sestamibi scan. |
Generate impression based on medical findings. | Female 58 years old; Reason: 57 yo woth HBV please screen for HCC History: none LIVER: The liver measures 20.2 cm in length. There is coarse 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 18.5 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 0.9 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 5.7 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.9 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.3 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 12.1 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. A simple renal cyst is seen measuring 1.1 cm x 1.1 cm x 0.8 cm.OTHER: No ascites is seen. | Hepatomegaly. A coarse echogenic liver is again seen, compatible with fatty infiltration/hepatocellular dysfunction. No new worrisome masses or ascites. |
Generate impression based on medical findings. | Female 47 years old Reason: eval pyelo History: AKI, shock Limited by body habitus.RIGHT KIDNEY: Echogenic consistent with medical renal disease. 12.1 cm in length. Right lower pole small simple cyst. No hydronephrosis or hydroureter.LEFT KIDNEY: 9.8 cm in length. Echogenic consistent with medical renal disease. No hydronephrosis or hydroureter.OTHER: Fluid collection right lower quadrant with some layering debris consistent with a large cystic structure. Correlate with gynecologic ultrasound for ovarian cyst or hydrosalpinx.Urinary bladder: Normal. | Echogenic kidneys consistent with medical renal disease. Small right renal cyst.Large cystic structure in the pelvis correlate with gynecologic exam and ultrasound.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | 20-year-old male patient with mononucleosis infection with hepatitis and thrombocytopenia. Evaluate for splenomegaly. The liver measures 18.3 cm in length. The spleen measures 20.6 cm in length. There is a 2.3 x 2.2 x 2.1 cm ill-defined hypoechoic. solid lesion within the lateral spleen. | 1. Splenomegaly.2. Single hypoechoic lesion within the spleen is likely benign in etiology, but non-specific; this may be re-imaged with ultrasound in 6 months to confirm stability. |
Generate impression based on medical findings. | History A thyroid carcinoma status post resection with PET-positive right supraclavicular lymph node. RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: At least 2 subcentimeter hypoechoic foci within the right supraclavicular region posterior and in between the right jugular and carotid, just superior to the right subclavian artery. These hypoechoic foci correspond to the PET-positive focus.OTHER: No significant abnormality noted. | At least 2 subcentimeter hypoechoic foci within the right supraclavicular region posterior and in between the right jugular carotid, just superior to the right subclavian artery. These hypoechoic foci correspond to the PET-positive focus and will be biopsied today. |
Generate impression based on medical findings. | Chronic kidney disease. Elevated creatinine. RIGHT KIDNEY: 8.8 cm in length. Mildly atrophic morphology. No hydronephrosis. No focal lesions. LEFT KIDNEY: 9.6 cm in length. Mildly atrophic morphology. No hydronephrosis. No focal lesions.BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Mildly atrophic kidneys without hydronephrosis, compatible with chronic renal disease. |
Generate impression based on medical findings. | Question of thrombus or abscess in the left groin after dialysis catheter removal. No specific abnormality is noted in the subcutaneous soft tissues. No fluid collection or mass effect is noted. | No sonographic findings in the left groin to account for the patient's symptoms. |
Generate impression based on medical findings. | 40-year-old female with history of incompletely characterized subcentimeter mass within the left central breast. Patient is asymptomatic. No family history of breast cancer. A left ML view in addition to a CC and 2 mL spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses(BiRads Density Category C), unchanged in pattern and distribution. 8 mm oval well-circumscribed mass is reidentified within the left central breast.Focal asymmetry within the left lower outer quadrant, disappears on spot compression views.ULTRASOUND:Targeted left breast ultrasound at 12:00 posterior to the nipple demonstrates a well circumscribed anechoic avascular mass with posterior enhancement measuring 7 x 5 x 6 mm, compatible with a simple cyst. This finding correlates with previously described well-circumscribed mass within the left central breast identified on mammography. | Simple cyst in central left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Female 78 years old Reason: 78yo F w/ acute on chronic renal failure, r/o obstruction History: as above RIGHT KIDNEY: The right kidney measures 8.1 cm. The renal cortex is hyperechoic. There is no hydronephrosis and no shadowing renal stone. There is a 2.9-cm simple cyst.LEFT KIDNEY: The left kidney measures 8.5 cm. The renal cortex is hyperechoic. There is no hydronephrosis and no shadowing renal stone.BLADDER: The bladder is decompressed by a Foley catheter and is not evaluated.OTHER: No significant abnormalities noted. | The renal cortex is hyperechoic bilaterally consistent with medical renal disease. No hydronephrosis. |
Generate impression based on medical findings. | Congestive heart failure. Elevated LFTs. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. 19 cm in length. No focal hepatic lesions. Normal direction of portal venous blood flow, with pulsatility and distended hepatic veins compatible with right heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. No cholelithiasis. The gallbladder wall is thickened, which may be seen in the setting of ascites. 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 8.0 cm in length. The renal parenchyma is echogenic. No suspicious renal lesions are evident. No hydronephrosis is present.The left kidney is 8.8 cm in length. The renal parenchyma is echogenic. There is a 5.3 cm solid and cystic mass at the inferior pole. No hydronephrosis is present.SPLEEN: 14.9 cm in length, without focal lesions evident.OTHER: Mild ascites is noted. Right pleural effusion, partially imaged. | 1. Hepatomegaly with increased hepatic echogenicity compatible with parenchymal dysfunction. Multiple additional findings compatible with of congestive heart failure.2. 5.3 cm solid and cystic mass at the inferior pole of the left kidney, suspicious for neoplasm. Dedicated renal protocol CT or MRI is recommended for further evaluation.3. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on medical findings. | 63-year-old male with new acute kidney injury, question of hydronephrosis. LIVER: Portions of the liver is visualized with coarse increased echogenicity comparable to prior ultrasound.RIGHT KIDNEY: The right kidney measures 12 cm in length. No significant abnormalities are noted.LEFT KIDNEY: The left kidney measures 11.7 cm in length. No significant abnormalities are noted. There is an anechoic cyst redemonstrated in the upper pole measuring 1.7 cm x 1.8 cm x 2.4 cm, relatively stable in size from prior ultrasound.OTHER: The bladder Foley catheter is not well-visualized. Trace amount of free fluid seen in the pelvis. | 1. Negative renal ultrasound. No hydronephrosis is seen.2. Redemonstrated increased echogenicity within the liver compatible with fatty liver/parenchymal dysfunction from prior ultrasound. Only portions of the liver are visualized but no worrisome masses are seen. |