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Generate impression based on medical findings. | Female 69 years old; Reason: Primary HPT. Assess Sternal Notch location as this may be where the Parathyroid adenoma is located History: Primary HPT. Assess Sternal Notch location as this may be where the Parathyroid adenoma is located RIGHT LOBE MEASUREMENTS: Status post surgical removal.LEFT LOBE MEASUREMENTS: Status post surgical removalISTHMUS MEASUREMENT: Status post surgical removal.ISTHMUS: No significant abnormality noted.LYMPH NODES: A right level I lymph node measures 1.0 x 0.6 x 2.7 cm. An additional left level II lymph node measures 0.9 x 0.5 x 2.4 cm.OTHER: No evidence of a parathyroid adenoma, including adjacent to the sternal notch | 1.No evidence of a parathyroid adenoma, including adjacent to the sternal notch. |
Generate impression based on medical findings. | Ms. Larson is a 61-year-old woman with metastatic breast cancer. She presents today with clinician- and self-palpated left cervical nodes. The clinical team requests biopsy of one of these nodes for ER/PR/HER-2 receptor status to guide treatment planning. On physical exam, there are two palpable nodes in the left cervical region, superficial to the sternocleidomastoid muscle. No abnormality is palpated in the supraclavicular region.Targeted left cervical ultrasound was performed for the palpable and clinical areas of concern. There is no lymphadenopathy visualized by ultrasound in the supraclavicular region.The first and superior most palpable left cervical node corresponds to a 12 x 5 x 10 mm isoechoic node without increased vascular. The second and inferior most palpable cervical node corresponds to a 8 x 6 x 10 mm hypoechoic node without increased vascularity. | Left cervical lymphadenopathy. Ultrasound-guided core biopsy of the superior most node was performed during today's visit and will be reported under a separate accession.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on medical 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 medical findings. | Melanoma with diarrhea fevers and elevated LFTs LIVER: No significant abnormalities noted. 17.1 cm in lengthGALLBLADDER, BILIARY TRACT: Probable interval increase in size of large mass arising from the gallbladder now measuring approximately 11.9 x 9.9 x 11.3 cm. No ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.4 cm in lengthOTHER: Left kidney 12.1 cm in length. Spleen 11.2 cm in length. No ascites | Probable interval increase in size of large gallbladder/gallbladder fossa mass suggestive for melanoma metastasis. Unremarkable liver echotexture without intrahepatic mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Primary hyperparathyroidism; assess for nephrolithiasis RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 12.4 cm in length.LEFT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 12.2 cm in length.OTHER: Bladder nondistended. Incidental note made of echogenic liver parenchyma. | Negative renal ultrasound without evidence for mass, stone, or hydronephrosis. Incidental note made of echogenic liver parenchyma suggestive for hepatic fatty infiltration/parenchymal dysfunction. |
Generate impression based on medical findings. | 3o year old female with acute liver failure. Evaluate for portal vein thrombosis. LIVER: Liver is enlarged measuring 20.8 cm in length and is normal in echogenicity. The portal vein is patent with appropriate flow and no evidence of thrombus. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common bile duct measures 3 mm in caliber. No intra or extrahepatic biliary ductal dilatation. PANCREAS: Normal echogenicity with no pancreatic ductal dilatation. KIDNEYS: Increased echogenicity of the renal parenchyma, right greater than left. There is mild fullness of the left renal collecting system. OTHER: Status post splenectomy. Foley in a decompressed bladder limits evaluation. | 1. Portal vein is patent with no evidence of thrombus. 2. Increased echogenicity of the renal parenchyma, right greater than left, nonspecific, suggestive of medical renal disease. 3. Mild fullness of the left renal collecting system. |
Generate impression based on medical findings. | 22-year-old male status post OLT remote history of HCC. LIVER: Coarse echogenicity of the liver measuring 12.5 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well-visualized.RIGHT KIDNEY: Measures 10.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen is normal in echogenicity measuring 11.4 cm in length.Left kidney measures 11.0-cm in length. No hydronephrosis or shadowing calculi are noted. | Coarse echogenicity of the liver suggestive of hepatic dysfunction/fatty infiltration. No focal hepatic lesion. |
Generate impression based on medical findings. | 55 year old with history of diabetes and obesity with chronic elevated LFTs; evaluate for NASH/NAFLD vs cirrhosis. LIVER: The liver measures 18.8 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. 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.BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 6 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.6 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal echotexture. Simple cyst measuring 6.4 x 7.9 x 6.5. LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. | 1.Cholelithiasis.2.Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on medical findings. | Reason: 74 yo male with htn, CKD History: ckd, never had renal u/s RIGHT KIDNEY: The right kidney measures 10.1 cm in length. Unremarkable renal parenchymal echogenicity and echotexture. No hydronephrosis or shadowing renal calculi.LEFT KIDNEY: The left kidney measures 11.1 cm in length. Unremarkable renal parenchymal echogenicity and echotexture. No hydronephrosis or shadowing renal calculi. Anechoic left upper pole cyst measures 4.6 x 4.2 x 5.2 cm.OTHER: Multiple geographic hyperechoic lesions in the liver may represent multifocal hepatic steatosis or multiple hemangiomas. Mildly nodular prostate. | 1. No acute renal abnormality.2. Multiple hepatic hemangiomas or multifocal hepatic steatosis. |
Generate impression based on medical findings. | 57 years Female with postoperative acute kidney injury, rule out obstruction. RIGHT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. A simple cyst is present in the mid/lower pole measuring 2.7 x 2.7 x 2.6 cm.LEFT KIDNEY: Kidney measures 10.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.BLADDER: Foley catheter is present within the collapsed bladder.. OTHER: The liver demonstrates increased echogenicity. | No hydronephrosis. Probable hepatic steatosis. |
Generate impression based on medical findings. | Female 31 years old Reason: Vague upper and LUQ pain. Exclude splenomegaly, pancreatic abnormalities LIVER: Normal, relatively homogeneous appearance of the liver parenchyma. No focal hepatic mass is visualized. Main portal vein is patent with normal directional flow and a peak velocity 26 cm/s.BILIARY TRACT: No intra or extra hepatic biliary ductal dilatation. Common bile duct measures up to 5 mm. No evidence of acute inflammation of the gallbladder. No gallstones. Gallbladder wall is within normal limits measuring 2 mm.PANCREAS: The visualized portions of the pancreas are normal.SPLEEN: Spleen is normal in appearance measuring 8.8 cm.RIGHT KIDNEY: Normal cortical echogenicity. No hydronephrosis or shadowing calculus. Right kidney measures 11.8 cm.LEFT KIDNEY: Per technologist the left kidney is somewhat inferiorly displaced and has a configuration that is somewhat altered, which may be seen in ptotic kidney. Visualized portions of the cortex of normal echogenicity. No hydronephrosis or shadowing calculus. Left kidney measures 9.3 cm. OTHER: No significant abnormalities noted. | The left kidney is somewhat inferiorly displaced and has a somewhat altered orientation, appearance may be seen in setting of ptotic kidney. If there is further clinical concern for anatomic abnormality causing patient's symptoms, contrast enhanced CT may be helpful for further evaluation (would provide improved evaluation of pancreas as well). No evidence of splenomegaly as clinically questioned. |
Generate impression based on medical findings. | 62 years Male with history of thyroidectomy for micropapillary carcinoma. RIGHT LOBE: Status post thyroidectomy. No discrete nodules within the thyroidectomy bed.LEFT LOBE: Status post thyroidectomy. No discrete nodules within the thyroidectomy bed.ISTHMUS: Status post thyroidectomy. No discrete nodules within the thyroidectomy bed.PARATHYROID GLANDS: No significant abnormalities.LYMPH NODES: Small, normal-appearing lymph nodes are present in the right level 2 and left level 6 cervical regions.OTHER: No significant abnormalities. | Status post thyroidectomy without mass or regional adenopathy. |
Generate impression based on medical findings. | Enlarged thyroid RIGHT LOBE MEASUREMENTS: 6.5 x 2.5 x 2.6 cmLEFT LOBE MEASUREMENTS: 6.6 x 2.5 x 2.5 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: 0.5 x 0.8 x 0.6 cm spongiform nodule lower poleLEFT LOBE: 0.5 x 0.3 x 0.5 cm spongiform nodule lower poleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral subcentimeter benign-appearing spongiform nodules. No regional adenopathy. |
Generate impression based on medical findings. | 32-year-old male with hepatitis B. LIVER: Hepatic echogenicity and morphology within normal limits. No discrete hepatic masses.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. | Unremarkable examination without evidence of hepatic mass lesion. |
Generate impression based on medical findings. | Abdominal pain and increasing LFTs.; pregnant with coagulopathy LIVER: Mildly heterogeneous liver echotexture without mass. Liver length 20.6 cm. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatationPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.2 cm in lengthOTHER: No ascites | Hepatomegaly with mildly heterogeneous liver echotexture suggestive for parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | Elevated LFTs LIVER: Coarse echogenic liver echotexture without mass. Liver length 13.9 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.4 cm in lengthOTHER: Left kidney 12.5 cm in length. Spleen 7.4 cm in length. No ascites. | Coarse echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | 66-year-old female with history of hepatitis C. Evaluate for portal hypertension. LIVER:The liver measures 13.4 cm. There is increased, coarse echogenicity and nodular contour of the liver. The liver has a cirrhotic morphology. The main portal vein is patent with normal hepatopedal flow with velocity of 17 cm/s. No ascites or intrahepatic biliary dilation.GALLBLADDER, BILIARY TRACT: The gallbladder wall measures 0.2 cm and the common duct measures 0.4 cm. The gallbladder is nondistended. No evidence of stones, sludge, or pericholecystic fluid.PANCREAS: Evaluation the pancreas limited by overlying bowel gas.SPLEEN: The spleen measures 14.8 cm without sonographic abnormalities.KIDNEYS: The right kidney measures 12.2 cm. No hydronephrosis, shadowing calculus or mass.The left kidney measures 11.7 cm. No focal mass or shadowing calculi. Anechoic area arising from the left kidney represents an enlarged extrarenal pelvis with associated mild prominence of the intrarenal collecting systemOTHER: No significant abnormality noted. | 1. Increased echogenicity and nodular contour of liver consistent with cirrhosis. The main portal vein is patent with normal hepatopedal flow as described above2. Splenomegaly. |
Generate impression based on medical findings. | Varices noted on endoscopy LIVER: Normal parenchymal echogenicity without mass. Noncirrhotic morphology. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 14 cm.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.3 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 9.4 cm in lengthOTHER: Left renal cyst. Left kidney 8.3 cm in length. No ascites. | Normal hepatic morphology and echogenicity without mass or duct dilatation. No evidence for hepatobiliary abnormality. No ascites. |
Generate impression based on medical findings. | 45-year-old male with history of ERCP. Evaluate for biliary pathology and fluid reaccumulation. LIVER: Patent portal vein with antegrade flow. Large fluid collection in the right hepatic lobe measures 19.6 x 14.6 cm, not significant changed. The more medial right hepatic lobe lesion seen on prior CT are not clearly visualized on this study.BILIARY TRACT: Interval placement of a biliary stent with intrahepatic biliary duct dilation is less conspicuous compared with recent CT allowing for differences in technique. Partially collapsed gallbladder without evidence of acute inflammation.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 ascites. | 1.Interval placement of a biliary stent with intrahepatic biliary ductal dilation appearing less conspicuous compared with the prior CT.2.Large homogeneous fluid collection the right hepatic lobe without significant interval change since the prior study. No evidence of ascites.3.Other suspicious lesions in the medial right hepatic lobe are not clearly visualized on the study. Please see prior CT for comparison. |
Generate impression based on medical findings. | 80 year old female patient with a thyroid nodule. RIGHT LOBE MEASUREMENTS: 4.6 x 1.9 x 1.5 cm.LEFT LOBE MEASUREMENTS: 3.2 x 1.4 x 1.6 cm. ISTHMUS MEASUREMENTS: 0.2 cm in thickness. RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity. There is a 1.1 x 1.0 x 1.0 cm solid right lower pole thyroid nodule with an hypoechoic rim. LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity. There is a 0.4 x 0.6 x 0.6 cm solid, hyperechoic nodule with irregular borders within the left lower pole.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 which are amenable to biopsy. |
Generate impression based on medical findings. | Hepatitis C LIVER: Coarsened hepatic echotexture without focal mass. The portal vein is patent.GALLBLADDER, BILIARY TRACT: The gallbladder is sonographically normal in appearance. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 13.1 cm. Superior pole cyst measures 5 cm. No hydronephrosis.OTHER: The left kidney measures 13.47 m in length. No hydronephrosis or mass. Spleen measures 10.4 cm in length. | Coarsened hepatic echotexture without focal mass. |
Generate impression based on medical findings. | 66-year-old female with abnormality noted on carotid ultrasound RIGHT LOBE MEASUREMENTS: 2.0 x 1.7 x 4.9 cmLEFT LOBE MEASUREMENTS: 1.3 x 1.7 x 5.2 cmISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: 0.7 x 0.5 x 0.8 cm nodule in the right mid polar region with mixed solid and cystic components and a hypoechoic halo. No microcalcifications.LEFT LOBE: 0.6 x 0.4 x 0.8 cm mixed solid/cystic nodule in the left isthmus/left lower lobe.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Subcentimeter thyroid nodules. |
Generate impression based on medical findings. | 66-year-old with multicentric left breast cancer with metastatic left axillary lymph node, status post neoadjuvant chemotherapy. Repeat mammogram and ultrasound for left axilla to look for a marker clip. MLO, exaggerated CC, and spot compression views of the left breast (axilla) were performed digitally. Previously seen enlarged lymph node in the left axilla has become smaller, measuring 7 mm. Hydromark clip is again identified within this lymph node.Focused ultrasound was performed for the left axilla with 12-5 MHz transducer. Within a normal appearing lymph node, there is a hyperechoic material, likely a metallic clip. There is no hypoechoic portion, which is usually seen for Hydromark clip, surrounding this metallic clip. A BB marker was placed on the skin over the metallic clip, and MLO view of mammogram was performed. BB marker is the same level of the lymph node with Hydromark clip, confirming the metallic clip seen on the ultrasound study is a metallic component of the Hydromark clip. | Successful visualization of the Hydromark clip by ultrasound within the left axillary lymph node, which has become smaller after neoadjuvant chemotherapy. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | Reason: Advanced CKD History: advanced CKD RIGHT KIDNEY: The right kidney measures 12.5 cm in length. Unremarkable renal parenchymal echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 11.7 cm in length. Unremarkable renal parenchymal echogenicity. No shadowing stones or hydronephrosis.OTHER: Renal jets visualized bilaterally. Unremarkable urinary bladder. | No acute renal abnormality. |
Generate impression based on medical findings. | Renal transplant with pulmonary edema RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality noted. 11.3 cm in lengthCOLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels.Abnormal delay and dampening of arterial systolic waveform noted at renal arterial anastomosis and distally. Measured renal artery velocities are 83.5 cm/s proximally, 56.4 cm/s mid, and 56.4 cm/s distally. OTHER: No significant abnormality noted | Abnormal delay and dampening of arterial systolic waveform noted at renal arterial anastomosis and distally; findings suggestive for inflow compromise/stenosis. Patent renal veins. No perinephric fluid collection or hydronephrosis. |
Generate impression based on medical findings. | 55 year-old female with Hashimoto's, left lobe slightly more prominent. RIGHT LOBE MEASUREMENTS: 3.7 cm x 1.2 cm x 1.2 cm.LEFT LOBE MEASUREMENTS: 3.7 cm x 1.3 cm x 0.7 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: Minimally heterogeneous echotexture with no discrete nodule identified.LEFT LOBE: Minimally heterogeneous echotexture with no discrete nodule identified.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted. | Unremarkable examination. |
Generate impression based on medical findings. | A patient submitted outside study for review. Submitted for review are ultrasound images of right breast and right axilla (9/15/15) performed at Glen Ellyn Clinic. For comparison, ultrasound images of right breast and right axilla (3/6/13) are available. ULTRASOUND IMAGES OF RIGHT BREAST AND RIGHT AXILLA (9/15/15):There are no abnormal findings in the right breast. One normal appearing lymph node is present in the right axilla. | No sonographic evidence of malignancy. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | 74-year-old male with abdominal pain and leukocytosis. Evaluate for cholecystitis. LIVER: Liver appears mildly echogenic without focal abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein. GALLBLADDER, BILIARY TRACT: Gallbladder is adequately visualized without wall thickening, pericholecystic fluid or definite gallstones. However, the patient was unable to turn for decubitus views which limits this exam.PANCREAS: Not adequately visualized due to bowel gas.RIGHT KIDNEY: Limited without hydronephrosis.OTHER: Left upper quadrant could not be evaluated due to patient's inability to cooperate | No gallbladder abnormality on limited exam. |
Generate impression based on medical findings. | Reason: thyroid nodule on ct scan RIGHT LOBE MEASUREMENTS: 4.6 x 2.5 x 2.6 cm.LEFT LOBE MEASUREMENTS: 4.8 x 2.0 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.4 cm in thickness.RIGHT LOBE: Inferior pole nodule measures 2.3 x 1.5 x 2.2 cm, is spongiform in appearance, contains mild internal vascularity, lacks internal calcifications, and is of very low suspicion for low suspicion for malignancy.LEFT LOBE: Inferior pole nodule measures 1.1 x 0.9 x 1.0 cm, is predominantly isoechoic in appearance, contains mild peripheral vascularity, lacks internal calcifications, has an hypoechoic halo, and is of intermediate suspicion for neoplasm. Second more inferior inferior pole nodule measures 0.9 x 0.7 x 1.2 cm, is partially cystic and partially solid in appearance, contains mild internal vascularity, lacks internal calcifications, and is of very low suspicion for neoplasm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Single benign morphology left level 2 cervical lymph node noted.OTHER: No significant abnormality noted. | Multiple thyroid nodules as described above. 1.1 cm nodule in the inferior pole of the left lobe is of intermediate suspicion for neoplasm and would be amenable to FNA biopsy as clinically warranted. |
Generate impression based on medical findings. | Pregnant patient with right upper quadrant pain LIVER: No significant abnormalities noted. 14.1 cm in lengthGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Minimal prominence of collecting system. No mass or stone. Right kidney 11.8 cm in length.OTHER: Left kidney 11.5 cm in length. Spleen 11.4 cm in length. | Negative right upper quadrant ultrasound. Specifically, no evidence for significant renal obstruction, acute inflammation, or stone. No hepatobiliary abnormality. |
Generate impression based on medical findings. | 36-year-old female patient with bilateral thyroid nodules. RIGHT LOBE MEASUREMENTS: 8.6 x 4.2 x 3.5 cm.LEFT LOBE MEASUREMENTS: 10.2 x 3.5 x 3.4 cm.ISTHMUS MEASUREMENTS: 8 mm in thickness.RIGHT LOBE: The right thyroid lobe is enlarged and heterogeneous in echogenicity. There is a 3.0 x 2.6 x 3.1 cm complex, heterogeneous, mostly solid nodule with the right mid lobe.LEFT LOBE: The left thyroid lobe is enlarged and heterogeneous in echogenicity, predominantly within the lower pole. No discrete measurable nodule is identified within this large area of heterogeneity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter. |
Generate impression based on medical findings. | Male 75 years old Reason: AKI on CKD with uptrending Cr despite holding diuresis, reduced UOP. Please assess. History: As above RIGHT KIDNEY: The right kidney measures 10.1 cm. The renal cortex is increased in echogenicity. There is no hydronephrosis or shadowing calculus.LEFT KIDNEY: The left kidney measures 10.3 cm. The renal cortex is increased in echogenicity. There is no hydronephrosis or shadowing calculus. Left upper pole renal cyst is again noted.OTHER: The bladder is incompletely distended. | No evidence of hydronephrosis. Echogenic renal cortex bilaterally consistent with medical renal disease. |
Generate impression based on medical findings. | Ms. Bishop is a 15 year old female presenting follow-up of left breast mass, likely fibroadenoma. She denies overlying skin changes and nipple discharge. Family history of breast cancer in maternal grandmother. A targeted left ultrasound was performed. In the left breast 10:00 location, approximately 4 cm from the nipple there is redemonstration of a lobulated hypoechoic mass measuring 1.6 x 0.5 x 1.7 cm, previously 2.4 x 1.2 x 2.2 cm . There is mild associated vascularity. | 1.7 cm lobulated mass in the left upper inner breast, likely representing a fibroadenoma, decreased in size from previous exam. Given patient's age and palpability of mass, a surgical consultation is recommended for further evaluation. All results and recommendations were discussed with the patient and her mother. Findings also discussed with patient's breast surgeon, Dr. Bao. BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on medical 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 medical findings. | 32-year-old male with history of testicle pain and swelling. Evaluate for hemorrhage versus torsion versus cellulitis. RIGHT TESTIS: The right testicle measures 3 x 2.6 x 3 cm, and is normal in morphology and vascularity.LEFT TESTIS: Left testicle measures 3.4 x 3.5 x 2 .7 cm, and is normal in morphology. Subtle increased vascularity.RIGHT EPIDIDYMIS: Right epididymis measures 1 x 0.4 x 0.4 cm, and is normal in morphology and vascularity.LEFT EPIDIDYMIS: Left epididymis measures 0.6 x 0.9 x 0.7 cm, and demonstrates subtle increased vascularity.OTHER: Small amount of bilateral scrotal fluid is seen. Small left inguinal lymph nodes are seen, one measuring up to 1.3 x 0 .6 cm, likely reactive. | Findings suggestive of left epididymitis/orchitis and mild bilateral hydrocele. |
Generate impression based on medical findings. | Reason: 62 year-old female with elevated alkaline phosphatase. RUQ ultrasound requested to further evaluate. LIVER: The liver measures 16.1 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. 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.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.4 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 7.6 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. 2.Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis.3.Atrophy left kidney. |
Generate impression based on medical findings. | 29-year-old male with history of thyroid cancer, evaluate for change in nodules, lymph nodes. RIGHT LOBE MEASUREMENTS: Surgically absentLEFT LOBE MEASUREMENTS: Surgically absentISTHMUS MEASUREMENTS: Surgical absenceRIGHT LOBE: 0.6 x 0.4 x 0.3 cm hypoechoic focus in the right thyroid bed is unchanged since the prior study. No new suspicious lesions are identified.LEFT LOBE: 0.7 x 0.4 x 0.4 hyper/hypoechoic focus in the left thyroid bed is unchanged since the prior study. No new suspicious lesions are identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: 1.4 cm left level II lymph node with overall benign morphologic features is not significantly changed. No new suspicious lymphadenopathy.OTHER: No significant abnormality noted. | No significant interval change since the prior study. No new suspicious nodules or lymphadenopathy. |
Generate impression based on medical findings. | Male 19 years old Reason: ?RAS, CKD History: elevated bp ULTRASOUND KIDNEYSRIGHT KIDNEY: 11 cm in length. Normal echogenicity. No hydronephrosis.LEFT KIDNEY: 11 cm in length. No hydronephrosis.OTHER:Bladder collapsed. | No evidence of renal artery stenosis. Morphologically normal kidneys. |
Generate impression based on medical findings. | 59 year-old female with hepatitis C virus. Evaluate for cirrhosis. LIVER: Liver is moderately and coarsely echogenic. The liver capsule is mildly undulating and there is enlargement of the left lobe suggestive of cirrhosis. There is no focal hepatic mass seen. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: Upper normal in size.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Echogenic liver with suggestion of cirrhotic morphology. No discrete mass. |
Generate impression based on medical findings. | 65 years old, Female, Reason: eval for obstruction, medical renal disease History: AKI (cr 2.1 up from baseline 1) RIGHT KIDNEY: Kidney measures 12.2 cm in length. Increased echogenicity kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 10.6 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. No evidence of hydronephrosis or shadowing calculus.BLADDER: No significant abnormalities. A Foley is visualized in the bladder.OTHER: Bilateral pleural effusions are present. A mild amount of ascites is noted within the pelvis. | 1.Increased echogenicity of the kidneys consistent with medical renal disease without evidence of hydronephrosis or shadowing calculus.2.Bilateral pleural effusions and a mild amount of ascites is present. |
Generate impression based on medical findings. | Male 68 years old Reason: Concern for cyst History: Asx Focused ultrasound performed over the patient's palpable lump in the left upper back demonstrated 9.5 x 8.9 x 2.7 cm well-circumscribed, solid lesion, hypoechoic with linear undulating hyperechoic foci. The lesion is larger in length than width and demonstrates posterior acoustic enhancement. | Superficial mass in the left back which does not have the appearance of cyst. Lipoma is a differential consideration. |
Generate impression based on medical findings. | Female 34 years old Reason: Change in node History: Thyroid cancer with elevated thyroglobulin and previous indeterminate node MEASUREMENTS: Patient is status post thyroidectomy.RIGHT LOBE: A nodule is present within the right thyroidectomy bed. Solid-appearing nodule in the right thyroidectomy bed with homogeneous isoechoic echotexture measures 1.2 x 0.5 x 0.6 cm, previously 1.1 x 0.4 x 0.4 cm. There is a newly recognized hypoechoic nodule posterior to the carotid, which is favored to represent a lymph node measuring 0.6 x 0.6 x 0.9 cm.LEFT LOBE: Unchanged, small hypoechoic nodule in the left thyroid lobe measuring 0.5 x 0.4 x 0.4 cm.ISTHMUS: There is a new hypoechoic nodule in the area of the isthmus, which is favored to represent a small lymph node measuring 1.0 x 0.7 x 0.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Unchanged small benign-appearing lymph nodes are present within the right and left neck.OTHER: No significant abnormality noted. | 1.Multiple small thyroid nodules are not significantly changed.2.There is a new hypoechoic nodule in the area of the isthmus. Recommend attention to this area on follow-up exams to ensure stability.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | 84-year-old male with elevated creatinine. RIGHT KIDNEY: Measures 8.8 cm in length. 3.0 and 2.6 cm renal cysts without septation or solid component. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 9.4 cm in length. 2.0 cm superior pole renal cyst without septation or solid component. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | 1. Increased renal echogenicity consistent with medical renal disease. 2. No nephrolithiasis, hydronephrosis, or suspicious mass. |
Generate impression based on medical findings. | Right upper quadrant pain and tenderness. LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No intrahepatic biliary ductal dilation. Subcentimeter gallstones identified. Mild dilation of the common bile duct up to 8 mm, previously 7 mm. No choledocholithiasis evident. No gallbladder wall thickening, pericholecystic fluid, or sonographic Murphy 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 11.5 cm in length. The left kidney is 11.3 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 11.9 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid identified. | 1. Cholelithiasis without evidence of cholecystitis.2. Mild dilation of the common bile duct, also seen on 10/12/2015 when patient presented with similar symptoms. Correlation for obstructive pattern of liver function tests and possibly MRCP may be considered. |
Generate impression based on medical findings. | 56-year-old female with right upper quadrant pain in the context of a recent cholecystectomy. LIVER:Measures 14.9 cm. Increased, coarse echogenicity of the liver parenchyma. No ascites, focal mass. No intrahepatic biliary dilation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. The common hepatic duct measures 0.5 cm.PANCREAS: Evaluation the pancreas is limited by overlying bowel gas.SPLEEN: Measures 5.6 cm without sonographic abnormalities.KIDNEYS: Right kidney measures 10.9 cm. Left kidney measures 10.4 cm. The cortices have normal echogenicity. No shadowing calculi, hydronephrosis, or focal mass. OTHER: No significant abnormality noted. | 1. Coarse, echogenic liver consistent with chronic liver disease/parenchymal dysfunction. No focal mass or ascites.2. Surgical changes of a prior cholecystectomy. |
Generate impression based on medical findings. | 38-year-old male post thyroidectomy for cancer. Follow-up for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: There is again noted in the inferior right bed extending to midline a hypoechoic ovoid mass measuring 0.4 x 0.6 x 0.8 cm without significant change. Previously noted second mass more superiorly in the bed is no longer visualized.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable hypoechoic mass in the inferior right bed extending to midline.Second right bed abnormality no longer visualized. |
Generate impression based on medical findings. | 66-year-old woman with a ventral hernia on physical exam. No history of abdominal surgery. There is tenderness in the area and the patient is concerned that the hernia is expanding. In the midline, superior to the umbilicus, there are two fascial defects with protruding fat. The most superior has a neck which measures 1.9 cm in transverse dimension and 0.8 cm craniocaudal while the more inferior defect measures 1.8 cm in transverse dimension and 0.7 cm craniocaudal. No bowel or fluid is seen within the hernias despite provocative maneuvers including Valsalva and standing. These defects correspond to small fat containing hernias also seen on prior CT sagittal image #60. | Two small midline supraumbilical fat-containing ventral hernias. |
Generate impression based on medical findings. | Renal stones RIGHT KIDNEY: Normal parenchymal echogenicity without worrisome mass or hydronephrosis. Benign renal cyst. Right kidney 11 cm in length.Multiple subcentimeter echogenic foci within the lower pole of the right kidney with posterior shadowing consistent with nonobstructing subcentimeter renal stonesLEFT KIDNEY: AbsentOTHER: Bladder nondistended. Enlarged prostate | Multiple subcentimeter nonobstructing lower pole right renal stones. No worrisome mass or obstruction. Left kidney absent. Enlarged prostate. |
Generate impression based on medical findings. | 55-year-old female patient with history of left thyroid cyst status post aspiration. RIGHT LOBE MEASUREMENTS: 1.7 x 1.3 x 5.2 cm.LEFT LOBE MEASUREMENTS: 2.2 x 1.9 x 5.6 cm.ISTHMUS MEASUREMENTS: 1 mm in thickness.RIGHT LOBE: The right thyroid lobe is homogeneous in echogenicity containing a spongiform-appearing nodule in the upper pole measuring 0.7 x 0.4 x 0.5 cm, previously 0.7 x 0.4 x 0.4 cm. Additional subcentimeter cystic nodules are again noted.LEFT LOBE: There is a 3.5 x 1.5 x 2.1 cm cystic nodule with a peripheral solid nodular component within the left lobe, which corresponds to a previously aspirated benign colloid nodule. Prior to near complete cyst aspiration, it measured approximately 3.7 x 2.0 x 2.6 cm. An additional smaller cystic nodule is also noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Reaccumulation of fluid within a previously aspirated benign cystic left thyroid nodule.2. Stable right upper pole thyroid nodule. |
Generate impression based on medical findings. | Medullary thyroid cancer status post surgery RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE surgical bed: Unchanged 7 x 5 x 7 mm hypoechoic focus in the right lobe surgical bed.LEFT LOBE surgical bed: No significant abnormality noted.ISTHMUS surgical bed: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes are identified and are unchanged.OTHER: No significant abnormality noted. | Unchanged subcentimeter hypoechoic focus in the right thyroid bed. |
Generate impression based on medical findings. | Female 57 years old Reason: HCV, eval for Cirrhosis and HCC History: HCV LIVER: No sonographic evidence of liver cirrhosis. No focal hepatic mass. Liver measures 15.7 cm. Main portal vein is patent with normal directional flow measuring 22.0 cm/s.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 3 mm. Within the gallbladder wall there is a heterogeneous nodule measuring 1.2 x 0.8 x 0.7 cm, which may represent a small polyp or a focus of adenomyomatosis. No evidence of inflammation. No gallstones.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 10.1 cmKIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Right kidney measures 10.2 cm. Left kidney measures 11.2 cm.OTHER: No significant abnormalities noted. | 1.Within the gallbladder wall there is a heterogeneous focus which may represent a small polyp or a focus of adenomyomatosis; special attention to this focus on future surveillance scans recommended.2.No focal hepatic mass. |
Generate impression based on medical findings. | 42-year-old female with gallbladder wall thickening on CT presents for further evaluation. LIVER:No significant abnormality noted.GALLBLADDER, BILIARY TRACT: The gallbladder is nondistended with an anechoic lumen. No stones or sludge. No pericholecystic fluid. The wall measures 0.3 cm. The common duct measures 0.3 cm.OTHER: No significant abnormality noted. | 1. Normal ultrasound of the gallbladder. |
Generate impression based on medical findings. | Suspected metastatic lesion in the brain. Evaluate for testicular neoplasm. RIGHT TESTIS: 4.2 x 2.7 x 3.4 cm. Normal parenchymal echotexture and vascularity. No focal mass is evident.LEFT TESTIS: 2.9 x 3.4 x 3.2 cm. Normal parenchymal echotexture and vascularity. No focal masses evident.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Small bilateral hydroceles are present. | Small bilateral hydroceles, without suspicious testicular lesion identified. |
Generate impression based on medical findings. | Reason: r/o adenopathy, recurrence History: h/o thyroid cancer. RIGHT LOBE MEASUREMENTS: Interval status post thyroidectomy.LEFT LOBE MEASUREMENTS: Interval status post thyroidectomy.ISTHMUS MEASUREMENTS: Interval status post thyroidectomy.RIGHT LOBE: No evidence of residual disease or recurrence.LEFT LOBE: No evidence of residual disease or recurrence.ISTHMUS: No evidence of residual disease or recurrence.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 2 lymph node measures 1.5 x 0.5 x 2.2 cm with suggestion of a fatty hilum. Left level 2 lymph node measures 0.8 x 0.5 x 1.4 cm, nonspecific. OTHER: No significant abnormality noted. | No evidence of residual disease or recurrence. Nonspecific small left level 2 lymph node. |
Generate impression based on medical findings. | Reason: evaluate for obstruction, AKi, needs to be done at bedside RIGHT KIDNEY: The right kidney measures 8.8 cm in length. Markedly increased renal parenchymal echogenicity. Minimal to mild hydronephrosis without evidence of obstructive lesion. Anechoic simple cyst in the right lower pole measures 1.4 x 1.1 x 1.4 cm. The right ureter is not visualized. No shadowing calculi.LEFT KIDNEY: The left kidney measures 8.5 cm in length. Markedly increased renal parenchymal echogenicity. No hydronephrosis or shadowing calculi.OTHER: The urinary bladder is decompressed by Foley catheter, precluding its evaluation. Ureteral jets not visualized. | 1. Minimal to mild right hydronephrosis without evidence of obstruction.2. Markedly increased renal parenchymal echogenicity, consistent with medical renal disease. |
Generate impression based on medical findings. | Evaluate for malignancy, worsening portal hypertension, 52-year-old male with hereditary hemachromatosis related cirrhosis LIVER: Liver measures 19.1 cm with nodular contour and increased coarse echogenicity consistent with cirrhotic morphology. Main portal vein is patent with normal flow directionality. No intra or extrahepatic ductal dilatation.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures up to 6 mm.PANCREAS: The liver parenchyma was not visualized due to overlying bowel gas. Body appears unremarkable. A lymph node in the ectatic head now measures 4.4 x 2.9 x 2.6 cm, previously measured 5.3 cm, reduced in size.Spleen and KIDNEY: Right kidney measures 12.6 cm and left kidney measures 13.3 cm. Normal echo texture. No focal lesions. A simple cyst noted in the left kidney that measures 0.9 x 0.9 x 1.4 cm.No hydronephrosisSpleen measures 16.7 cm, mildly centimeters without any focal lesion.OTHER: No ascites | Cervical morphology of the liver without any focal lesion. No ascites. Interval reduction in size of the lymph node seen in the pancreatic head, now measures 4.4 cmMild splenomegaly noted. |
Generate impression based on medical findings. | 58 year-old female with history of small thyroid nodules. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: 4.5 cm x 1.5 cm x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 cm x 1.3 cm x 1.4 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: Heterogeneous echotexture. Small primarily cystic appearing nodule at the midpole measures 4 mm x 4 mm x 4 mm, unchanged.LEFT LOBE: Heterogeneous echotexture. Small primarily cystic appearing nodule at the midpole measures 3 mm x 3 mm x 3 mm unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2 lymph node measures 1.1 cm x 0.8 cm x 0.4 cm. Left neck level 3 lymph node measures 0.8 cm x 0.5 cm x 0.4 cm.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with bilateral cystic appearing nodules unchanged. |
Generate impression based on medical findings. | 67 year old female patient with a right thyroid nodule. Evaluate thyroid. RIGHT LOBE MEASUREMENTS: 5.0 x 2.5 x 2.3 cm.LEFT LOBE MEASUREMENTS: 4.2 x 1.9 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.3 cm in thickness. RIGHT LOBE: The right thyroid lobe is heterogeneous in echogenicity. There is a dominant solid appearing, partially calcified nodule within the upper pole measuring 0.9 x 0.9 x 1.3 cm. An additional solid nodule near the isthmus measures 1.2 x 1.0 x 1.0 cm. Additional nodules have imaging features of colloid nodules.LEFT LOBE: The left thyroid lobe is heterogeneous in echogenicity. There is a solid nodule within the left lower pole with a hypoechoic rim measuring 1.2 x 0.8 x 0.8 cm. Additional nodules have imaging features of colloid nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A left level III lymph node is present.OTHER: No significant abnormality noted. | Multinodular goiter as above. |
Generate impression based on medical findings. | 65-year-old female presents for follow-up of a multinodular thyroid. RIGHT LOBE MEASUREMENTS: 5.0 x 1.7 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.7 x 1.9 x 2.2 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Nodule 1 (superior right lobe): Measures approximately 2.1 x 1.3 x 1.1 cm. Mixed cystic-solid nodule with some spongiform components. Appears stable in comparison to the prior study.Nodule 2 (mid-inferior right lobe): Measures approximately 1.7 x 1.0 x 1.6 cm. Mixed cystic-solid with some spongiform components. Was not measured on the previous study but appears stable in comparison.LEFT LOBE: Nodule 1: Measures approximately 2.5 x 1.8 x 1.8 cm. Appears similar to the nodules on the right and is of stable size.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Multinodular goiter as described above. Stable in comparison to the prior study. |
Generate impression based on medical findings. | 57 years old, Female, Reason: eval for parathyroid adenomas/hyperplasia, plan for possible parathyroidectomy History: primary hyperparathyroidism (hypercalemia, hyperparathyroidism), fatigue, renal stones, nausea RIGHT LOBE MEASUREMENTS: 5.4 x 2.9 x 3.4 cmLEFT LOBE MEASUREMENTS: The inferior aspect of the left thyroid lobe is below the field of view and appears to extend retrosternally. Measurements are approximately 9.5 x 2.4 x 2.8 cm.ISTHMUS MEASUREMENTS: 1.5 cmRIGHT LOBE: Right spongiform nodule, most consistent with a colloid nodule measuring 2.6 x 1.8 x 2.4 cm.LEFT LOBE: Left lower lobe spongiform nodule measures 3.1 x 2.7 by 3.4 cm. and likely represents a colloid nodule. Inferior portion of the left lower lobe appears nodular and extends retrosternally and is therefore incompletely visualized. We cannot exclude an extrathyroidal mass.ISTHMUS: Spongiform thyroid nodule likely representing a colloid nodule measuring 1.7 x 1.1 x 1.7 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Inferior portion of the left thyroid lobe appears nodular and extends retrosternally beyond the field-of-view on this ultrasound examination. We cannot exclude an extrathyroidal mass or adenoma.2.Multiple bilateral thyroid nodules the largest of which is on the left measuring up to 3.4 cm. |
Generate impression based on medical findings. | Left renal mass noted on outside hospital CT. A cortically based exophytic mass is partially visualized arising from the superior pole of the left kidney. Due to limited visualization, after discussion with the patient, the decision was made to proceed with a CT-guided biopsy. No biopsy was performed as part of the ultrasound examination. | Limited images obtained of the left kidney as part of an aborted biopsy procedure. CT-guided biopsy will now be performed. |
Generate impression based on medical findings. | 37-year-old male with HBV. HCC screening. LIVER: Increased echogenicity of the liver measuring 14.9 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized pancreas is normal in echogenicity.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 9.5 centimeters in length. Incidental cyst is noted at the upper pole measuring 1.3 cm x 1.3 cm x 1.6 cm. No hydronephrosis or shadowing calculi.OTHER: Normal echogenicity the spleen measures 11.4 the liver cm in length. Normal echogenicity of the left kidney measuring 10.3 cm in length. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. 2. Incidental benign right renal cyst is noted. |
Generate impression based on medical findings. | 57-year-old male with worsening proteinuria. Ultrasound guidance provided for biopsy of transplanted kidney. Biopsy needle is seen traversing the renal parenchyma. | Ultrasound guidance provided for biopsy of transplanted kidney which was performed by the nephrology team. |
Generate impression based on medical findings. | Hepatitis B carrier LIVER: Heterogeneous coarse liver architecture again noted without mass. Liver length 13.3 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 11.1 cm in length.OTHER: Left kidney 10.8 cm in length. Spleen is 9.1 cm in length. No ascites. | Stable heterogeneous coarse liver echotexture consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on medical findings. | 79-year-old female patient with gallbladder wall thickening on CT. LIVER: The liver measures 15.4 cm in length. No focal hepatic lesion is identified Hepatic parenchyma echogenicity is mildly heterogeneous. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains numerous shadowing gallstones. There is no pericholecystic fluid or gallbladder wall thickening. Sonographic Murphy's sign is negative. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 6 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 9.9 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is slightly increased.OTHER: The left kidney measures 9.9 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is slightly increased. There is a 4.1 x 4.3 x 4.3 cm left upper pole simple renal cyst.The spleen measures 8.5 cm in length. | 1. Cholelithiasis without sonographic evidence of acute cholecystitis.2. Medical renal disease and simple left upper pole renal cyst. |
Generate impression based on medical findings. | Female 49 years old Reason: R popliteal mass History: R popliteal pain No masses is seen in the popliteal fossa. No evidence of Baker's cyst. Normal blood flow is seen in the popliteal artery and vein. | Normal exam. |
Generate impression based on medical findings. | Female 25 years old; Reason: 25 y.o. female with hyperparathyroidism. Ultrasound shows left thyroid nodule measuring 1.5x0.7x0.8cm. RIGHT LOBE MEASUREMENTS: 4.1 x 1.1 x 1.2 cmLEFT LOBE MEASUREMENTS: 4.1 x 1.2 x 1.3 cmISTHMUS MEASUREMENT: 0.1 cmRIGHT LOBE: Normal appearing thyroid gland with no dominant nodule.LEFT LOBE: Normal appearing thyroid gland with no dominant nodule.ISTHMUS: No significant abnormality noted.LYMPH NODES: 0.9 x 0.7 x 0.2 cm left level 5 lymph node with a fatty hilum, favoring benignity.OTHER: Posterior to the superior pole of the left lobe of the thyroid is a 1.3 x 1.0 x 0.6 cm hypoechoic structure with increased vascularity relative to the adjacent thyroid. This correlates with the structure seen on the outside study where it measured 1.5 x 0.7 x 0.8 cm. | 1.Hypoechoic structure with increased vascularity relative to the adjacent thyroid appears extrathyroidal in location. The characteristics of this lesion support the diagnosis of a parathyroid adenoma rather than a thyroid nodule. |
Generate impression based on medical findings. | 48-year-old male with history of ascites. There is trace to mild ascites which contains loculations and debris. | Trace to mild complex ascites. |
Generate impression based on medical findings. | Without The patient identified and CT is not seen with certainty. There is no is for mass or fluid collection. | No mass or fluid collection identified. |
Generate impression based on medical findings. | Reason: evaluate mass over L upper extremity fistula History: mass over L upper extremity fistula, fistula functioning appropriately Immediately adjacent to the fistula is a large hypoechoic mass measuring 4.0 cm x 3.2 cm x 3.5 cm with internal vascularity in a swirling pattern demonstrating irregular waveforms with suggestion of arterial flow. This appears to be connected with the patient's known fistula. | Findings suspicious for pseudoaneurysm arising for the left upper extremity fistula as described above.Findings were discussed with Dr. Chandni Patel by phone on 9/24/2015 at 4:00 PM. |
Generate impression based on medical findings. | 64-year-old male with myeloma-related kidney disease and increasing creatinine. Ultrasound guidance was provided for renal biopsy. | Ultrasound guidance. |
Generate impression based on medical findings. | 52-year-old male patient with HCV, cirrhosis. Evaluate for HCC. LIVER: The liver measures 19 cm in length and demonstrates increased, coarsened echogenicity. No focal hepatic lesion is identified. Main portal vein flow is hepatopetal and measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is absent. There is no intrahepatic biliary ductal dilatation. The common duct measures 10 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.2 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 12.7 cm in length. No evidence of hydronephrosis.The spleen measures 19.3 cm in length. | 1. Increased, coarsened hepatic echogenicity consistent with chronic liver disease.2. Hepatomegaly without focal lesion. |
Generate impression based on medical findings. | 68-year-old male heart failure and cardiogenic shock. Elevated total bilirubin. Examination is limited by inability to reposition the patient due to medical condition and early truncation by the clinical service.LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood direction with pulsatile flow, likely reflecting the patient's heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Distended gallbladder with biliary sludge. No specific evidence of cholecystitis.PANCREAS: The pancreas is obscured by bowel gas.KIDNEYS: The right kidney is 9.1 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen. The left kidney was not examined due to inability to position the patient.SPLEEN: The spleen was not examined due to inability to position the patient.OTHER: Small right pleural effusion identified. No ascites identified. | 1. Truncated examination due to inability to reposition the patient due to medical condition and by request of the clinical service. 2. Increased hepatic echogenicity, compatible with parenchymal dysfunction.3. Small right pleural effusion. |
Generate impression based on medical findings. | 80-year-old male with a history of cirrhosis. Evaluate for ascites. Moderate ascites in all 4 quadrants. Additionally, there are small bilateral pleural effusions. | 1. Moderate ascites, as described above.2. Small bilateral pleural effusions. |
Generate impression based on medical findings. | 55 years old, Male, Reason: r/o cholecystitis History: sepsis of unclear source with elevated bilirubin LIVER: The liver measures 16.6 cm in length. Echogenicity of the liver 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 0.4 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. Mild intrahepatic biliary ductal dilatation which is nonspecific but may be further evaluated with MRCP if clinically warranted. The common bile duct measures 3 mm in diameter. Focus of adenomyomatosis or cholesterolosis is noted in the anterior portion of the gallbladder.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.8 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.8 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Gallbladder sludge without evidence of cholecystitis.2.Mild intrahepatic ductal dilatation which can be further evaluate MRCP if further evaluation is clinically warranted. |
Generate impression based on medical findings. | Abdominal pain, tenderness to palpation in right upper quadrant LIVER: The liver measures 14.5 cm in length. Unremarkable hepatic parenchyma and echotexture. The portal vein is patent with normal directional hepatopetal blood flow, peak velocity 22.7 cm/s. No focal mass.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. No cholelithiasis. Negative sonographic Murphy's sign. The gallbladder wall measures 0.1 cm. The common hepatic duct measures 0.2 cm. No biliary ductal dilatation.PANCREAS: Obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 10.37 m in length. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney measures 11.1 cm in length. No hydronephrosis or shadowing stones.OTHER: No ascites. | No acute abnormality. No findings to account for patient's abdominal pain. |
Generate impression based on medical findings. | Targeted ultrasound of the right upper breast at 1:00 and 11:00 is requested by the clinical service. Personal history of known right breast cancer. A targeted right ultrasound was performed for the areas requested at 1:00 and 11:00. Multiple masses are seen in the right upper breast. Two adjacent masses in the right breast near the 1:00 position measure 9 x 7 and 9 x 8 mm. Overall extent of these 2 masses near 1:00 is 2.4 cm, a slightly larger extent than can be measured on the prior study. An additional possible superficially located mass near the right 1:00 scar measures 7 mm. Additionally, an area of hypodensity and shadowing near the right breast 11:00 scarring is nonspecific, though similar to the prior study. | Multiple right upper breast masses as described above compatible with known malignancy. Treatment recommendations have been made by the breast surgery team.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | Bilateral flank pain with hematuria RIGHT KIDNEY: Multiple subcentimeter nonobstructing echogenic foci with posterior shadowing consistent with stones. The largest within the lower pole measures 0.6 x 0.5 x 0.3 cm. No worrisome mass or hydronephrosis. Right kidney 10.7 cm in length.LEFT KIDNEY: 1.8 x 1.7 x 1.4 cm hypoechoic focus upper pole left kidney with internal complexity. No stone or hydronephrosis. Left kidney 10.2 cm in length.OTHER: Bladder nondistended | Multiple subcentimeter nonobstructing right renal stones. Hypoechoic focus upper pole left kidney with internal complexity. While this may represent a complex benign cyst, it is best considered indeterminate. Would pay special attention to this lesion on future surveillance scans. If further characterization is clinically indicated, would recommend dedicated renal CT. |
Generate impression based on medical findings. | 71-year-old female with chronic kidney disease. RIGHT KIDNEY: Measures 9.8 cm in length. 1.3 cm cyst without septation or solid component. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 9.2 cm in length. 6.8 x 5.2 cm cyst without septation or solid component. Increased echogenicity without hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | 1. Increased renal echogenicity consistent with medical renal disease. 2. No nephrolithiasis, hydronephrosis, or suspicious mass. |
Generate impression based on medical findings. | 70-year-old female with neutropenia and fever during chronic healing wound on the left forearm, concern for infection. Over the area of concern on the right forearm, the subcutaneous soft tissues appears enlarged and edematous. There are no drainable fluid collection seen. | Subcutaneous edema in the area of concern over the right forearm. These findings can be seen in cellulitis. No drainable fluid collection is visualized. |
Generate impression based on medical findings. | 26 year old female with a history of hypothyroidism. RIGHT LOBE MEASUREMENTS: 4.8 x 1.6 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.2 x 1.5 x 1.3 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Heterogeneous thyroid parenchyma with hyperechoic fibrous bands compatible with thyroiditis. Coarse shadowing calcification within the superior pole.6 x 5 x 7 mm hyperechoic well defined hypervascular nodule in the inferior pole.LEFT LOBE: Heterogeneous thyroid parenchyma with hyperechoic fibrous bands compatible with thyroiditis. 3-mm hyperechoic well defined nodule in the inferior pole.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology and size cervical lymph nodes.OTHER: No significant abnormality noted. | 1. Heterogeneous thyroid parenchyma compatible with history of thyroiditis.2. Hyperechoic subcentimeter nodules are classically benign in the setting of thyroiditis. |
Generate impression based on medical findings. | 61-year-old male with right upper quadrant pain. LIVER: Liver 17 cm in length. No focal hepatic lesions. No intrahepatic biliary ductal dilation. Main portal vein is patent with normal directional flow and peak systolic velocity of 0.3 m/s.GALLBLADDER, BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening or pericholecystic fluid. Negative sonographic Murphy's sign. Normal caliber of the common duct measuring up to 4 mm.PANCREAS: No focal pancreatic lesions in the pancreatic head. The remainder of the pancreas is poorly visualized due to overlying bowel gas.RIGHT KIDNEY: Right kidney is 12.7 cm in length. Left kidney is 12.4 cm in length. Increased nonspecific cortical echogenicity of both kidneys. Moderate left hydronephrosis and bilateral perinephric free fluid, similar to CT from yesterday.OTHER: No significant abnormalities noted. | 1. No cholelithiasis or acute cholecystitis.2. Left hydronephrosis, similar to CT from yesterday.3. Increased nonspecific cortical echogenicity of both kidneys, which may be related to medical renal disease. |
Generate impression based on medical findings. | 48-year-old female with left breast IDC October 20, 2015 and metastatic axillary lymph node undergoing neoadjuvant chemotherapy. Assess for response prior to surgery. Three standard views of the left breast, left CC exaggerated, and left spot MLO 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. Again seen is a biopsy clip in the left upper outer breast with adjacent calcifications anteriorly and inferiorly measuring up to 15 mm in extent. The previously seen mammographic mass in this location has resolved, and no measurable mass is present currently. The left axillary biopsy clip is also partially imaged.ULTRASOUND | Favorable treatment response as described above, with no measurable residual disease in the left upper outer breast index malignancy, and significantly decreased size of previously biopsy left axillary lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on medical findings. | Reason: evaluate left renal cyst/mass RIGHT KIDNEY: The right kidney measures 12.4 cm in length. Normal renal parenchymal echogenicity. No hydronephrosis or shadowing stones. No focal masses.LEFT KIDNEY: The left kidney measures 12.2 cm in length. Normal renal parenchymal echogenicity. No hydronephrosis or shadowing stones. No focal masses. Numerous simple left renal cysts which are simple, some of which are septated.Left lower pole cyst: 2.0 x 1.6 x 1.4 cm, previously 2.1 x 1.9 x 1.8 cm.Left mid pole cyst: 1.3 x 1.3 x 1.2 cm, previously 1.3 x 1.0 x 1.2 cm.OTHER: Coarse, echogenic hepatic parenchyma. | 1. Stable appearance and size of simple left renal cysts with septation. No focal mass.2. Echogenic hepatic parenchyma, consistent with hepatic steatosis or parenchymal dysfunction. |
Generate impression based on medical findings. | 59-year-old female presents for 6 month follow-up of high probability benign right breast asymmetries. Personal history of endometrial carcinoma. No family history of breast cancer. MAMMOGRAM: Three standard views of the right breast, additional right CC view, and multiple spot compression views 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. Multiple circumscribed masses are again noted in the lower inner right breast, unchanged. A focal asymmetry is present within the upper outer right breast, posterior depth, which persists on spot compression imaging. ULTRASOUND: On physical examination, no palpable abnormality is identified. Targeted right ultrasound was performed for the mammographic area of concern. A 0.7 x 0.5 x 0.5 cm circumscribed, hypoechoic lesion is present at the 11:00 position of the right breast, 10 cm from the nipple, without increased vascularity. This is felt to represent a cyst. | High probability benign cyst at the 11 o'clock position of the right breast. Follow up mammogram and ultrasound is recommended in 6 months to assess stability. The patient will be due for annual bilateral mammogram at this time. Results recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on medical findings. | Ms. Byrd is a 43-year-old female presenting for short term ultrasound follow-up for a high probability benign fibroadenoma of the right breast. On physical exam, an oval mobile mass is palpated inferior to the nipple.Targeted right ultrasound of the right breast, 6:00 position 3 cm from the nipple, reveals an oval circumscribed parallel hypoechoic shadowing mass measuring 2.4 x 1.2 x 2.1 cm and demonstrating mild internal vascularity, stable in size and sonographic appearance dating back to ultrasound study of 2009. | Stable right breast mass, with imaging appearance most characteristic of a fibroadenoma. Considering the stable imaging appearance of this mass dating back to 8/17/2009, patient may return for a bilateral diagnostic mammogram in April 2017. No need for repeat ultrasound evaluation.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on medical findings. | Reason: Evaluate fistula for abscess History: fever Images demonstrate a tubular structure within the superficial soft tissues of the left anterior arm which presumably represents a dialysis AV fistula. Color Doppler flow is present within the structure with some aliasing suggestive of turbulent flow. No abnormal fluid collections are identified within the adjacent surrounding soft tissues to suggest abscess. | 1.No evidence of abscess associated with the left upper arm AV fistula. 2.Turbulent flow within the fistula. Dedicated vascular ultrasound can be considered as clinically warranted. |
Generate impression based on medical findings. | Female 26 years old; Reason: eval cholecystitis, ductal blockage History: RUQ abdominal pain, gallstones on CT The exam was slightly limited due to patient's body habitus.The gallbladder wall measures 3.9 mm. Two echogenic shadowing foci are seen within the gallbladder with a small amount of sludge. The patient did have a positive sonographic Murphy's sign. No pericholecystic fluid is seen. The common bile duct measures 3.8 mm in diameter. The portal vein is patent with hepatopetal flow. The liver is only partially visualized however no worrisome masses or intrahepatic ductal dilation are seen. | Cholelithiasis with equivocal sonographic evidence for acute cholecystitis. |
Generate impression based on medical findings. | Elevated creatinine RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. Right kidney 9.1 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Left renal cyst. Left kidney 9.6 cm in lengthOTHER: Bladder nondistended | Mildly echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction. |
Generate impression based on medical findings. | Male 65 years old Reason: assess for liver lesions History: hx of HCV with SVR; cirrhosis per biopsy LIVER: Coarse and mildly nodular appearance of the liver consistent with history of cirrhosis. Liver measures 18.4 cm. Nonspecific hypoechoic area adjacent to the gallbladder may represent a focus of fat sparing. No focal hepatic mass. Main portal vein is patent with normal directional flow and a peak velocity of 17.2 cm/s.BILIARY TRACT: Gallbladder is normal in appearance. No gallstones. No intra or extrahepatic biliary ductal dilatation. The common bile duct measures 3 mm.PANCREAS: Head of the pancreas is normal in appearance without pancreatic ductal dilatation. Body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: Spleen is normal in appearance measuring 10.0 cm.KIDNEYS: Right kidney measures 11.6 cm in length. Normal cortical medullary differentiation. No hydronephrosis or shadowing calculi. In the upper pole there is a cystic lesion with a thin septation and no internal vascularity, similar to the prior exam measuring 0.8 x 1.0 x 1.1 cm. Another cyst with a thin septation in the mid pole measures 2.0 x 1.6 x 1.6 cm.Left kidney measures 10.8 cm in length. Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Left upper pole cyst which may have a septation, however is difficult to characterize measures 1.0 x 0.8 x 1.1 cm, appearing similar to the prior exam. Another anechoic cyst in the midpole of the left kidney measures 1.4 x 0.7 x 0.9 cm.OTHER: No significant abnormalities noted. | 1.Coarsened and mildly nodular appearance of the liver consistent with history of cirrhosis. No focal hepatic mass.2.Multiple probable renal cysts bilaterally, which do not appear significantly changed. |
Generate impression based on medical findings. | Female 33 years old follow-up right renal mass (1.3 cm), stable on MRI. RIGHT KIDNEY: The right kidney measures 10.5 cm in length. There is a 1.6 x 1.6 x 1.4 cm hypoechoic lesion in the midpole of the right kidney with low-level internal echoes and no vascularity. The superior pole of the right kidney appears heterogeneous which may be due to a prominent medullary pyramid. No lesion was present at this location on the prior MRI. No shadowing renal stone hydronephrosis.LEFT KIDNEY: The left kidney measures 11.4 cm in length. There is no suspicious renal mass, shadowing renal stone or hydronephrosis.OTHER: The bladder was mildly distended and unremarkable in appearance.A 2.4 x 1.5 x 1.9 cm well marginated hyperechoic subcapsular hepatic segment 7 lesion which correlates with a hemangioma seen on the previous MRI. | 1. Right midpole renal lesion is likely unchanged in size from the prior MRI after allowing for differences in technique.2. The superior pole of the right kidney appears heterogeneous which is nonspecific and may be due to a prominent medullary pyramid. No lesion was present at this location on the prior MRI. |
Generate impression based on medical findings. | Right perinephric hematoma. Chronic renal disease. Abdominal pain RIGHT KIDNEY: Echogenic parenchyma again noted. No hydronephrosis. Stable multiple renal cysts. Right kidney 13.3 cm in length. Right perinephric hematoma again noted largely unchanged measuring approximately 8.5 x 5.1 cm. No obvious evidence for active bleeding at this timeLEFT KIDNEY: Echogenic parenchyma again noted. No hydronephrosis. 11.7 cm in length.OTHER: No significant abnormalities noted. | No significant change in right perinephric hematoma without obvious evidence for active bleeding. Echogenic renal parenchyma unchanged consistent with medical renal disease/parenchymal dysfunction without hydronephrosis. |
Generate impression based on medical findings. | Reason: r/o growth, adenopathy History: bilateral thyroid nodules. 1 year follow up study RIGHT LOBE MEASUREMENTS: 5.0 x 1.9 x 1.5 cm.LEFT LOBE MEASUREMENTS: 4.9 x 1.3 x 1.8 cm.ISTHMUS MEASUREMENTS: Up to 0.3 cm in thickness.RIGHT LOBE: Mid pole partially solid, partially cystic nodule measuring 1.5 x 1.6 x 1.4 cm, not significantly changed.LEFT LOBE: Upper pole predominantly solid, hyperechoic nodule measuring 1.5 x 0.6 x 1.0 cm, previously 1.3 x 0.9 x 0.8 cm, not significantly changed in size allowing for differences in technique. Overall, nodule is of low suspicion for neoplasm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology left cervical lymph node.OTHER: No significant abnormality noted. | No significant change in bilateral thyroid nodules as described above. |
Generate impression based on medical findings. | 66 years old, Male, Reason: rising creatinine History: rising creatinine ULTRASOUND KIDNEYSRIGHT KIDNEY: No evidence of hydronephrosis or nephrolithiasis.LEFT KIDNEY: No evidence of hydronephrosis or nephrolithiasis.OTHER:No significant abnormalities noted. | Max velocity in the right renal artery is at the upper limits of normal. The velocity left renal artery is not significantly higher than that of the aorta. |
Generate impression based on medical findings. | 48-year-old male with history of pancreatic cancer. Status post I. R. percutaneous drain for perihepatic fluid collection. LIVER: The liver is within normal limits. Findings of chronic gallbladder inflammation, such as gallbladder wall thickening without significant pericholecystic fluid. The gallbladder is not well distended, and likely has small gallstones/sludge.BILIARY TRACT: No biliary dilatation.PANCREAS: Pancreas is not well visualized.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: The previously seen perihepatic anterior superficial fluid collection contains a pigtail drain, and no significant amount of fluid. | Perihepatic drain within a near completely collapsed pocket as above. |
Generate impression based on medical findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. Personal history of bilateral saline implants. Family history of breast cancer maternal great aunt. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Bilateral saline implants are identified. There is no solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on medical findings. | 79-year-old male with history of CHF, VT ablation with rising LFTs, AMS. Evaluate patency of portal and hepatic vasculature. LIMITED ABDOMENLIVER: Increased echogenicity the liver measuring 15.4 cm in length. No focal hepatic lesions.BILIARY TRACT: The gallbladder is not visualized. No intra-or extrahepatic noted ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.SPLEEN: Normal echogenicity of the spleen measuring 11.0 cm in length. RIGHT KIDNEY: Mildly echogenic right kidney measuring 10.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Mildly echogenic left kidney measuring 9.3 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No hepatic mass. Patent inflow and outflow hepatic vasculature.2. Mildly echogenic kidneys suggestive of parenchymal dysfunction. |
Generate impression based on medical findings. | Assuming 12 rib bearing vertebrae, there appear to be 4 truly lumbar appearing vertebrae. There is suggestion of a segmentation anomaly at L5-S1 without evidence of intervening disk, although there are two sets of posterior elements. For the purposes of this exam, the last fully formed disk is at S1-S2.The lumbar spine is in normal alignment, with significant straightening of the normal lumbar lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is abnormal ventral T2 hyperintensity within the distal cord with axial confirmation to the lower T12 level from the tip of the conus, although sagittal images suggest additional abnormality extending cranially although not well delineated. This measures up to 3 x 2 mm at the T12-L1 level. The distal spinal cord and conus are otherwise within normal limits with the conus terminating at the L3-L4 level. There is no evidence of fat signal intensity along the distal thecal sac. On prone imaging, there does appear to be some degree of ventral movement of the distal cord and conus. Under within the thecal sac.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the lumbar spine. | 1. Transitional spinal anatomy, incompletely assessed as the counting sequence is not available. For the purposes of this exam, the last fully formed disk is at S1-S2. If surgery is to be contemplated, correlation with imaging of the entire spine is recommended.2. Segmentation anomaly of L5-S1 without intervening disk although with separate posterior elements.3. Utilizing the above counting convention, conus termination is abnormally low at L3-L4 without evidence of a fatty filum. Some degree of ventral motion of the distal cord and conus are noted on the images. Please correlate clinically for tethered cord.4. Small caliber syringohydromyelia within the visualized distal cord extending at least to the lower T12 level is confirmed on axial imaging, although likely also involving additional lower thoracic cord which extends out of the field-of-view. Consider dedicated MRI cervical and thoracic spine as clinically indicated. |
Generate impression based on medical findings. | Stage V chronic kidney disease now requiring hemodialysis. Study limited by poor soft tissue penetration.RIGHT KIDNEY: Atrophic echogenic kidney measuring 9 cm in length without hydronephrosis, nephrolithiasis or discrete lesion. LEFT KIDNEY: The left kidney is not visualized.URINARY BLADDER: Normally distended urinary bladder.OTHER: No significant abnormalities noted. | Atrophic echogenic right kidney without hydronephrosis, compatible with chronic medical renal disease. The left kidney is not visualized. |
Generate impression based on medical findings. | Acute renal insufficiency with history of chronic renal disease RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. 11.2 cm in lengthLEFT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Left renal cyst. Left kidney 11.1 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction. |