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CT Head wo contrast 1/7/2022 12:54 PM Clinical Information: Headache, new or worsening, post traumatic, R51.9 Headache, unspecified Comparison: None available Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 208 mm. DLP: 1032 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. The nasal septum is mildly deviated to the left posteriorly with a nasal septal spur partially contacting the middle turbinate. Impression: No CT evidence of acute intracranial abnormality. If the patient's headaches are sufficiently clinically suspicious, associated with signs of elevated ICP or focal neurologic deficits, nausea, or vomiting, further evaluation with MRI is recommended, unless otherwise contraindicated.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. The nasal septum is mildly deviated to the left posteriorly with a nasal septal spur partially contacting the middle turbinate.
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Findings: There are no maxillofacial fractures. The visualized paranasal sinuses are clear of acute process. There are minimal aerated secretions in the posterior right ethmoid air cells. There are bilateral small concha bullosa. The mandible is intact.
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3,201
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 58-year-old female with abdominal pain and watery stools. COMPARISON: CT abdomen pelvis 3/12/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 124 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Oral contrast Omnipaque: 17 oz. Saline flush: 75 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 72 sec. Scan field of view: 328 mm. DLP: 412.50 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Mild bibasilar linear atelectasis. Calcified granuloma within the left lower lung. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable nonobstructing left upper pole renal calculus measuring up to 6 mm (series 201 image 70). No hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: There is a left upper quadrant colostomy. There is diffuse circumferential wall thickening, mucosal hyperemia, and fat stranding surrounding the colon proximal to and involving the colostomy site (series 201 image 142). The rectal/sigmoid stump is unremarkable, with adjacent small bowel tethering again seen. Appendix is minimally thickened without adjacent soft tissue stranding. No evidence of obstruction PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcifications of the abdominal aorta which is normal in caliber. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is unremarkable. No adnexal masses. BODY WALL: Left upper quadrant colostomy with surrounding dermal thickening and subcutaneous fat stranding. Rectus diastases. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most prominent at L3-L4 and L5-S1. No aggressive osseous lesions. CONCLUSION: 1. Diffuse mucosal edema and hyperenhancement of the colon proximal to and involving the left upper quadrant colostomy site, appears worsened from prior, without previously noted dilatation consistent with severe colitis. 2. Stable nonobstructing left renal calculus. 3. Additional chronic and incidental findings as described above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Mild bibasilar linear atelectasis. Calcified granuloma within the left lower lung. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable nonobstructing left upper pole renal calculus measuring up to 6 mm (series 201 image 70). No hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: There is a left upper quadrant colostomy. There is diffuse circumferential wall thickening, mucosal hyperemia, and fat stranding surrounding the colon proximal to and involving the colostomy site (series 201 image 142). The rectal/sigmoid stump is unremarkable, with adjacent small bowel tethering again seen. Appendix is minimally thickened without adjacent soft tissue stranding. No evidence of obstruction PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcifications of the abdominal aorta which is normal in caliber. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is unremarkable. No adnexal masses. BODY WALL: Left upper quadrant colostomy with surrounding dermal thickening and subcutaneous fat stranding. Rectus diastases. MUSCULOSKELETAL: Multilevel discogenic degenerative changes most prominent at L3-L4 and L5-S1. No aggressive osseous lesions.
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FINDINGS: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. RIGHT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. The right vertebral artery is dominant. LEFT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. No contrast extravasation or pseudoaneurysm is identified. Left shoulder soft tissue seatbelt contusion.
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3,202
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CT head without contrast Clinical Information: Malignant melanoma of skin on his back Comparison: Technique: Axial helical images of the head were obtained. Coronal and sagittal reformatted images were obtained from the axial data set. DLP: 798.53 mGy cm. Findings: There is slight diffuse atrophy but the ventricles are not enlarged. There is no mass, hemorrhage, visible infarct or extracerebral collection. There is preservation of gray-white margins. No hypodensity is seen in the white matter. The posterior fossa contents are unremarkable. No defect is seen in the calvarium and skull base. ---------------- Conclusion: Essentially negative cranial CT scan.
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Findings: There is slight diffuse atrophy but the ventricles are not enlarged. There is no mass, hemorrhage, visible infarct or extracerebral collection. There is preservation of gray-white margins. No hypodensity is seen in the white matter. The posterior fossa contents are unremarkable. No defect is seen in the calvarium and skull base. ----------------
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Findings: The quality of study is excellent for evaluation of aortic root and was not tailored for coronary artery evaluation. There is calcification of the prosthetic aortic leaflets with restricted opening during systole. The aortic root measurements done in systolic phase are as follows (all using double oblique method): Prosthetic aortic ring: Ring Area: 240 sq mm Ring to left main distance: 4.2 mm Ring to RCA distance: 4.3 mm Native annulus: Annulus: 22.4 x 19.4 mm Annulus area: 333.8 sq mm Perimeter: 67.0 mm Distance of LM coronary artery from Annulus: 5.3 mm Distance of Right coronary artery from Annulus: 9.3 mm Annulus angulation: 48.6 degrees Suitable Valve deployment angle: RAO 5 Cranial 29 LVEF: 67.7% LVED volume: 120.2 mL LVES volume: 38.8 mL Stroke volume: 81.4 mL Native coronary arteries: Three-vessel atherosclerotic disease. CABG: Sequential right SVG to PDA and distal RCA appears patent. Its proximal course is more anterior coming close approximately 3 mm of a from sternotomy. Cardiac chambers are normal in size. There is mild LV myocardial hypertrophy. No significant mitral annular calcification. The aorta and pulmonary arteries and veins are normal. No intracardiac mass or thrombus is seen. The pericardium is normal without pericardial thickening or effusion. A large hiatal hernia is present without proximal esophageal dilatation. Only small subcentimeter size nodes are present in the mediastinum. There is no pleural effusion and visualized bones are unremarkable.
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3,203
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain, multiple prior GI surgeries COMPARISON: July 4, 2019 CT TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 110 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 66sec Scan field of view: 360 mm. DLP: 386.30 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Emphysematous changes, bronchiectasis and mild bronchial wall thickening are demonstrated in the lung bases. There is scarring at the right middle lobe and lingula. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. CHEST WALL: Right chest wall/breast soft tissue thickening is unchanged from prior and partially visualized. ABDOMEN and PELVIS: LIVER: A cyst in the right lobe posterior hepatic segment is unchanged. Scattered subcentimeter hypodensities are redemonstrated throughout the liver, indeterminate due to small size and grossly unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter bilateral renal hypodensities are indeterminate due to small size and grossly stable from prior. There is a small nonobstructive nephrolithiasis in the upper pole of the right kidney. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach is nondilated. The small bowel is nondilated. There are multiple small bowel anastomoses in the low pelvis and right lower quadrant of the abdomen with interval takedown of the right lower quadrant ileostomy. The anastomoses appear patent. COLON / APPENDIX: There are partial hemicolectomy changes and the colonic anastomosis appears patent. The colon is unremarkable. The appendix is not visualized. PERITONEUM / MESENTERY: No free fluid or free air. RETROPERITONEUM: Normal. VESSELS: There is atherosclerotic calcification in the inferior abdominal aorta with minimal ectasia. Atherosclerotic calcifications extend into the iliac territories. URINARY BLADDER: Bladder is largely decompressed and otherwise unremarkable. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal mass evident. BODY WALL: Interval takedown of the right lower quadrant ostomy. Postoperative changes of scarring along the abdominal wall. MUSCULOSKELETAL: There are severe degenerative changes at the right. There is chronic appearing compression fracture of L2. There is osteopenia/demineralization. No acute osseous abnormality evident. There are healed right-sided rib fracture deformities. CONCLUSION: 1. No acute intra-abdominal or pelvic abnormality evident. Postoperative changes of prior hemicolectomy and small bowel anastomoses. No convincing evidence of bowel obstruction. 2. Emphysema, additional and ancillary findings are discussed above. 3. There is partially visualized but similar appearance of right anterior chest wall/breast skin thickening. Recommend outpatient breast imaging clinic follow-up/characterization if not already performed.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Emphysematous changes, bronchiectasis and mild bronchial wall thickening are demonstrated in the lung bases. There is scarring at the right middle lobe and lingula. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. CHEST WALL: Right chest wall/breast soft tissue thickening is unchanged from prior and partially visualized. ABDOMEN and PELVIS: LIVER: A cyst in the right lobe posterior hepatic segment is unchanged. Scattered subcentimeter hypodensities are redemonstrated throughout the liver, indeterminate due to small size and grossly unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter bilateral renal hypodensities are indeterminate due to small size and grossly stable from prior. There is a small nonobstructive nephrolithiasis in the upper pole of the right kidney. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach is nondilated. The small bowel is nondilated. There are multiple small bowel anastomoses in the low pelvis and right lower quadrant of the abdomen with interval takedown of the right lower quadrant ileostomy. The anastomoses appear patent. COLON / APPENDIX: There are partial hemicolectomy changes and the colonic anastomosis appears patent. The colon is unremarkable. The appendix is not visualized. PERITONEUM / MESENTERY: No free fluid or free air. RETROPERITONEUM: Normal. VESSELS: There is atherosclerotic calcification in the inferior abdominal aorta with minimal ectasia. Atherosclerotic calcifications extend into the iliac territories. URINARY BLADDER: Bladder is largely decompressed and otherwise unremarkable. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal mass evident. BODY WALL: Interval takedown of the right lower quadrant ostomy. Postoperative changes of scarring along the abdominal wall. MUSCULOSKELETAL: There are severe degenerative changes at the right. There is chronic appearing compression fracture of L2. There is osteopenia/demineralization. No acute osseous abnormality evident. There are healed right-sided rib fracture deformities.
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FINDINGS: STRUCTURED REPORT: CTA TAVR Protocol VASCULATURE: ABDOMINAL AORTA: Mild eccentric calcific atherosclerosis without aneurysmal dilatation, dissection, or evidence of flow-limiting stenosis. CELIAC AXIS: Mild ostial calcifications without aneurysmal dilatation, dissection, or evidence of flow-limiting stenosis. Conventional branching pattern. SMA: Mild ostial calcifications without aneurysmal dilatation, dissection, or evidence of flow-limiting stenosis. RIGHT RENAL: Patent with mild proximal atherosclerotic calcifications without evidence of flow-limiting stenosis. LEFT RENAL: Patent with mild proximal atherosclerotic calculations without evidence of flow-limiting stenosis. Early bifurcation of the left renal artery is incidentally noted. IMA: Patent. RIGHT ILIAC ARTERIES: Mild calcific atherosclerosis of the widely patent common and internal iliac arteries without evidence of flow-limiting stenosis. The external iliac artery is widely patent without any significant at cirrhotic disease. RIGHT COMMON FEMORAL ARTERY: Normal caliber and patent with mild eccentric atherosclerotic calcifications. LEFT ILIAC ARTERIES: Mild calcific atherosclerosis of the widely patent common and internal iliac arteries without evidence of flow-limiting stenosis. The external iliac artery is widely patent without any significant at cirrhotic disease. LEFT COMMON FEMORAL ARTERY: Normal caliber and patent with mild eccentric atherosclerotic calcifications. MEASUREMENTS: Right Common iliac dimensions: avg = 10.0, min = 8.5, max = 11.0 mm. Right External iliac dimensions: avg = 7.6, min = 6.6, max = 8.4 mm. Right Common femoral dimensions: avg = 7.5, min = 6.3, max = 8.3 mm. Left Common iliac dimensions: avg = 8.5, min = 8.2, max = 8.9 mm. Left External iliac dimensions: avg = 6.7, min = 5.7, max = 7.6 mm. Left Common femoral dimensions: avg = 7.2, min = 5.4, max = 9.0 mm. ------------------------------------------------------------- LOWER CHEST: A cardiac CTA was performed in conjunction with this examination and will be dictated in a separate report. Please see that report for all findings above the diaphragm. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Post-cholecystectomy changes. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mildly atrophic with bilateral renal cysts present. No hydroureteronephrosis. STOMACH / SMALL BOWEL: Large sliding hiatal hernia. Stomach and small bowel are otherwise unremarkable. COLON / APPENDIX: Scattered noninflamed colonic diverticula. The appendix is not visualized. PERITONEUM / MESENTERY: No intraperitoneal free fluid or free air. RETROPERITONEUM: No lymph node enlargement. URINARY BLADDER: Partially distended with a suspected small posterior bladder diverticulum. REPRODUCTIVE ORGANS: Evaluation of the pelvic viscera is limited by beam hardening artifact from right knee arthroplasty prosthesis. Posthysterectomy changes are noted. BODY WALL: No significant abnormality. MUSCULOSKELETAL: There are mild scattered chronic degenerative changes of the spine. Right hip total arthroplasty prosthesis is noted.
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3,204
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CT Head wo contrast 1/13/2022 5:15 AM Clinical Information: Stroke follow-up Comparison: CT head 1/6/2022. Technique: Unenhanced axial brain CT. Bone and soft tissue windows were reviewed. Sagittal and coronal images were generated from the axial data. Scan field of view: 220 mm. DLP: 1290.30 mGy cm. Findings: Expected interval evolutionary changes in bilateral frontal and temporal hemorrhagic contusions with interval decrease in attenuation of high density component. Index high attenuation component in the right frontal lobe measures approximately 3.8 x 2.2 cm. There is stable appearance of perifocal edema in the above-described regions with hemorrhage. There is stable mass effect in the anterior right frontal region with mild effacement of the right frontal horn and anterior right to left subfalcine herniation with a midline shift of approximately 7 mm, not significantly changed from prior study. No evidence for hydrocephalus. Stable subdural intermediate density fluid along the left cerebral convexity measuring approximately 5 mm in thickness. Interval resolution of previously seen right hemispheric subdural low-density fluid collection. Stable appearance of subdural hygromas involving posterior fossa with maximal thickness of approximately 3 mm. Scattered subarachnoid hemorrhage. No new or worsening intracranial hemorrhage. Basal cisterns are patent. Stable fracture involving the right orbital roof and right frontal bone. Stable fracture involving the cribriform plate in the anterior right frontal region. Hemosinus involving the sphenoid, right maxillary and right ethmoid sinuses. Stable extra conal blood product in the superior right orbit. Stable similar extraconal blood product in the superior left orbit, to a smaller volume towards the apex. Stable appearance of fracture of the left orbital roof. Nasopharyngeal tube in place. Conclusion: 1. Stable appearance of multifocal hemorrhagic contusions with expected interval evolutionary changes involving bilateral frontal lobes and bilateral temporal lobes. Additional multicompartment intracranial hemorrhages also demonstrate expected interval evolutionary changes. No worsening or unexpected findings at this time. 2. Right hemispheric subdural fluid collection is resolved. Stable appearance of left hemispheric subdural fluid collection and subdural fluid collection in the posterior fossa. 3. Stable appearance of right frontal bone, superior right orbit, superior left orbit and anterior skull base/cribriform plate fractures as described above with hemosinus involving the sphenoid sinus, right maxillary sinus and right ethmoid air cells. 4. Stable extraconal hemorrhage in superior aspect of bilateral orbits, greater on right compared to left as described above.
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Findings: Expected interval evolutionary changes in bilateral frontal and temporal hemorrhagic contusions with interval decrease in attenuation of high density component. Index high attenuation component in the right frontal lobe measures approximately 3.8 x 2.2 cm. There is stable appearance of perifocal edema in the above-described regions with hemorrhage. There is stable mass effect in the anterior right frontal region with mild effacement of the right frontal horn and anterior right to left subfalcine herniation with a midline shift of approximately 7 mm, not significantly changed from prior study. No evidence for hydrocephalus. Stable subdural intermediate density fluid along the left cerebral convexity measuring approximately 5 mm in thickness. Interval resolution of previously seen right hemispheric subdural low-density fluid collection. Stable appearance of subdural hygromas involving posterior fossa with maximal thickness of approximately 3 mm. Scattered subarachnoid hemorrhage. No new or worsening intracranial hemorrhage. Basal cisterns are patent. Stable fracture involving the right orbital roof and right frontal bone. Stable fracture involving the cribriform plate in the anterior right frontal region. Hemosinus involving the sphenoid, right maxillary and right ethmoid sinuses. Stable extra conal blood product in the superior right orbit. Stable similar extraconal blood product in the superior left orbit, to a smaller volume towards the apex. Stable appearance of fracture of the left orbital roof. Nasopharyngeal tube in place.
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Findings: CTA neck: The top aortic arch brachiocephalic arteries have calcified plaques but no significant stenosis expected appearance. The common carotid arteries are essentially negative. There or calcified plaques at the bifurcations with approximately 20% stenosis on the left as stenosis on the right.. The cervical ICAs are tortuous but otherwise normal. Both vertebral arteries are sizable, larger on the left with no apparent defect. The right vertebral artery is obscured at C4. The basilar artery and the circle of Willis are not included. There are degenerative changes in the spine but otherwise normal appearance. ----------------
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3,205
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: 49-year-old male with recent surgery and postoperative issues. COMPARISON: MRI abdomen 10/1/2021 and CT abdomen 9/13/2021 TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 143 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 370 mm. DLP: 1166 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small to moderate right pleural effusion with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. ABDOMEN and PELVIS: LIVER: Cirrhosis. Ill-defined area of hyperenhancement in the posterior right hepatic lobe (series 301 image 83), likely perfusional. Gastrohepatic, coronary, periumbilical, splenic mesenteric, and retroperitoneal varices noted. BILIARY TRACT: Normal. GALLBLADDER: Similar appearance of the mild gallbladder wall edema, likely secondary to the patient's cirrhosis. Cholelithiasis PANCREAS: Normal. SPLEEN: Splenomegaly. ADRENALS: Normal. KIDNEYS: No hydronephrosis bilaterally. Postsurgical changes from a prior left partial nephrectomy. No focal fluid collection LYMPH NODES: Prominent para-aortic, peripancreatic and periportal lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is not visualized. PERITONEUM / MESENTERY: Small volume ascites. RETROPERITONEUM: Mild bilateral perinephric stranding, left greater than right. VESSELS: Scattered mild to moderate atherosclerotic calcifications of the abdominal aorta which is normal in caliber. URINARY BLADDER: Distended. REPRODUCTIVE ORGANS: Prostate is prominent BODY WALL: Postsurgical changes from a prior midline abdominal incision. MUSCULOSKELETAL: No destructive osseous lesions seen. CONCLUSION: 1. Cirrhosis with sequela of portal hypertension including small volume ascites, splenomegaly, and varices. 2. Postsurgical changes from a partial left nephrectomy with perinephric fat stranding. No focal collection or hydronephrosis. 3. Small to moderate right pleural effusion with adjacent atelectasis. 4. Additional chronic and incidental findings as described above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small to moderate right pleural effusion with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. ABDOMEN and PELVIS: LIVER: Cirrhosis. Ill-defined area of hyperenhancement in the posterior right hepatic lobe (series 301 image 83), likely perfusional. Gastrohepatic, coronary, periumbilical, splenic mesenteric, and retroperitoneal varices noted. BILIARY TRACT: Normal. GALLBLADDER: Similar appearance of the mild gallbladder wall edema, likely secondary to the patient's cirrhosis. Cholelithiasis PANCREAS: Normal. SPLEEN: Splenomegaly. ADRENALS: Normal. KIDNEYS: No hydronephrosis bilaterally. Postsurgical changes from a prior left partial nephrectomy. No focal fluid collection LYMPH NODES: Prominent para-aortic, peripancreatic and periportal lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is not visualized. PERITONEUM / MESENTERY: Small volume ascites. RETROPERITONEUM: Mild bilateral perinephric stranding, left greater than right. VESSELS: Scattered mild to moderate atherosclerotic calcifications of the abdominal aorta which is normal in caliber. URINARY BLADDER: Distended. REPRODUCTIVE ORGANS: Prostate is prominent BODY WALL: Postsurgical changes from a prior midline abdominal incision. MUSCULOSKELETAL: No destructive osseous lesions seen.
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FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: Minute subcentimeter left thyroid nodule. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is a indeterminate 4 mm right upper lobe pulmonary nodule. There is a semisolid nodule in the right middle lobe measuring 3 mm. No focal consolidation or pleural effusion. HEART / OTHER VESSELS: There is moderate coronary artery atherosclerotic calcification. The heart is borderline enlarged. There is no pericardial effusion. There is mild thoracic aortic atherosclerosis. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: There is mild peripancreatic stranding. There is a questionable lesion arising from the pancreatic tail measuring 1.3 cm on image 86, series 501. SPLEEN: Normal. ADRENALS: There are bilateral adrenal nodules. A left adrenal nodule measures 4.0 x 4.0 cm on image 95, series 501. A right adrenal nodule measures 2.3 cm on image 91, series 501. There is extensive periadrenal nodularity. KIDNEYS: Minute subcentimeter hypodensities seen within the right kidney, indeterminate. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: There is a PEG tube with the PEG tube balloon seen within the second portion the duodenum. The stomach is slightly distended. The small bowel is normal in caliber. COLON / APPENDIX: The appendix is not well-visualized but there are no secondary signs of appendicitis. There are few scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: There are scattered foci of free air seen in the upper abdomen. RETROPERITONEUM: There is a partially solid and cystic lesion seen posterior to the descending colon in the right retroperitoneum and abutting the suspected adrenal vein measuring 4.3 x 2.3 cm on image 112, series 501. There is irregular low attenuated thickening of the right paravertebral soft tissues/psoas musculature measuring approximately 5.2 x 2.1 cm on image 123, series 501. There are numerous scattered nodules seen in the bilateral retroperitoneum, nonspecific. OTHER VESSELS: There is mild aortoiliac atherosclerosis without aneurysmal dilatation. There is a common origin of the celiac and SMA. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is borderline anasarca. There is a low attenuated lesion seen in the posterior paraspinal musculature and adjacent to the spinous processes of L3 and L4 measuring 4.5 x 2.5 cm on image 184, series 501. MUSCULOSKELETAL: Mild multilevel discogenic degenerative changes seen within the spine. No focal destructive osseous lesion is identified. There may be epidural thickening seen in the spinal canal on image 133, series 501 at approximately L1-L2. There is additional areas of thickening involving the spinal canal seen at L4-L5.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Renal cancer COMPARISON: CT abdomen 12/16/2020. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 214 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 3 ml per sec. Scan delay: BOLUS TRACK, 100 SEC. sec. Scan field of view: 400 mm. DLP: 1545.33 mGy cm. FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Postsurgical changes of left nephrectomy. No evidence of recurrent disease. Right kidney demonstrates normal appearance. Stable small simple right renal cyst. No hydronephrosis or hydroureter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially distended. REPRODUCTIVE ORGANS: Penile prosthesis is seen in place. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multilevel degenerative changes in lumbar spine. No suspicious destructive lesions. CONCLUSION: 1. No evidence of recurrent or metastatic disease in abdomen. Other stable findings as described above.
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FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Postsurgical changes of left nephrectomy. No evidence of recurrent disease. Right kidney demonstrates normal appearance. Stable small simple right renal cyst. No hydronephrosis or hydroureter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially distended. REPRODUCTIVE ORGANS: Penile prosthesis is seen in place. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multilevel degenerative changes in lumbar spine. No suspicious destructive lesions.
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FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: Minute subcentimeter left thyroid nodule. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is a indeterminate 4 mm right upper lobe pulmonary nodule. There is a semisolid nodule in the right middle lobe measuring 3 mm. No focal consolidation or pleural effusion. HEART / OTHER VESSELS: There is moderate coronary artery atherosclerotic calcification. The heart is borderline enlarged. There is no pericardial effusion. There is mild thoracic aortic atherosclerosis. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: There is mild peripancreatic stranding. There is a questionable lesion arising from the pancreatic tail measuring 1.3 cm on image 86, series 501. SPLEEN: Normal. ADRENALS: There are bilateral adrenal nodules. A left adrenal nodule measures 4.0 x 4.0 cm on image 95, series 501. A right adrenal nodule measures 2.3 cm on image 91, series 501. There is extensive periadrenal nodularity. KIDNEYS: Minute subcentimeter hypodensities seen within the right kidney, indeterminate. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: There is a PEG tube with the PEG tube balloon seen within the second portion the duodenum. The stomach is slightly distended. The small bowel is normal in caliber. COLON / APPENDIX: The appendix is not well-visualized but there are no secondary signs of appendicitis. There are few scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: There are scattered foci of free air seen in the upper abdomen. RETROPERITONEUM: There is a partially solid and cystic lesion seen posterior to the descending colon in the right retroperitoneum and abutting the suspected adrenal vein measuring 4.3 x 2.3 cm on image 112, series 501. There is irregular low attenuated thickening of the right paravertebral soft tissues/psoas musculature measuring approximately 5.2 x 2.1 cm on image 123, series 501. There are numerous scattered nodules seen in the bilateral retroperitoneum, nonspecific. OTHER VESSELS: There is mild aortoiliac atherosclerosis without aneurysmal dilatation. There is a common origin of the celiac and SMA. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is borderline anasarca. There is a low attenuated lesion seen in the posterior paraspinal musculature and adjacent to the spinous processes of L3 and L4 measuring 4.5 x 2.5 cm on image 184, series 501. MUSCULOSKELETAL: Mild multilevel discogenic degenerative changes seen within the spine. No focal destructive osseous lesion is identified. There may be epidural thickening seen in the spinal canal on image 133, series 501 at approximately L1-L2. There is additional areas of thickening involving the spinal canal seen at L4-L5.
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3,207
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EXAM: CT Head wo contrast, CT Cervical Spine wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Fall COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Cervical Spine wo contrast, CT Maxillofacial wo contrast Scan field of view: 315 mm. DLPV: 1494.10 mGy cm. (accession CT220003807), Scan field of view: 194 mm. DLP: 1041 mGy cm. (accession CT220003808), Scan field of view: 239 mm. DLP: 1043.60 mGy cm. (accession CT220003806) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Borderline cirrhotic. No steatosis. No new lesion. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 8 - Size: 8.8 x 8.5 cm on image 50, series 11 (previously measured 8.3 x 7.7 cm) - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 2 - Enhancing "capsule": Present. - Nonperipheral "washout": Present. - Threshold growth (>= 50% in <= 6 months): Not present. - Other features: None. - LI-RADS: LR-5 LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Interval embolization of the posterior right portal vein. The main left portal veins patent. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: None. - Other varices or collaterals: None. LIVER RELATED FINDINGS: BILIARY DUCTS: Mild intrauterine extra hepatic biliary ductal dilation. GALLBLADDER: Absent. LYMPH NODES: Stable size of a prominent cardiophrenic lymph nodes. Stable shotty periportal lymph nodes. SPLEEN: Normal size and appearance. PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Simple left renal cyst. Kidneys are otherwise normal. STOMACH / SMALL BOWEL: Small duodenal lipoma is unchanged. Small bowel is otherwise unremarkable. COLON / APPENDIX: Noninflamed colonic diverticula. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: Mild atherosclerotic calcification of the abdominal aorta without. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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3,208
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EXAM: CT Head wo contrast, CT Cervical Spine wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Fall COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Cervical Spine wo contrast, CT Maxillofacial wo contrast Scan field of view: 315 mm. DLPV: 1494.10 mGy cm. (accession CT220003807), Scan field of view: 194 mm. DLP: 1041 mGy cm. (accession CT220003808), Scan field of view: 239 mm. DLP: 1043.60 mGy cm. (accession CT220003806) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. Interval mild decrease in size of ablation defect measures 3.7 x 1.6 cm in segment five. No nodular enhancement in the ablated zone noted. Stable small cyst in the left lobe. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 6 - Size: 1.7 x 1.4 - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 1 - Enhancing "capsule": Not present. - Nonperipheral "washout": Not present. - Threshold growth (>= 50% in <= 6 months): Present. - Other features: None. - LI-RADS: LR-4 An additional peripheral triangular hyperenhancement in segment six, unchanged and likely represent perfusional. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: Small (
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3,209
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EXAM: CT Head wo contrast, CT Cervical Spine wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Fall COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Cervical Spine wo contrast, CT Maxillofacial wo contrast Scan field of view: 315 mm. DLPV: 1494.10 mGy cm. (accession CT220003807), Scan field of view: 194 mm. DLP: 1041 mGy cm. (accession CT220003808), Scan field of view: 239 mm. DLP: 1043.60 mGy cm. (accession CT220003806) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Multiple small pulmonary nodules measuring up to 6 cm in bilateral visualized lungs. DISTAL ESOPHAGUS: Small hiatal hernia and mildly patulous esophagus. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Multifocal cortical scarring in the right kidney. UPPER URINARY TRACTS: - Calculi: There is a stone measures 8 x 7 mm in the right distal ureter adjacent to the internal iliac vessel image #246 series #10 without significant proximal hydroureter. Multiple small nonobstructing stones in bilateral kidneys measuring up to 6 mm.. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: No abnormal bladder wall thickening or enhancement. No bladder mass. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Small cholelithiasis. No abnormal wall thickening seen. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes of gastric bypass. Otherwise, no significant abnormality noted. COLON / APPENDIX: Uncomplicated colon diverticulosis. Otherwise, colon and appendix are normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses identified. BODY WALL: Normal. MUSCULOSKELETAL: Scattered degenerative changes spine. No aggressive bony lesion is identified.
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3,210
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CT Head wo contrast 1/7/2022 1:09 PM Clinical Information: HEADACHE, R51.9 Headache, unspecified Comparison: Head CT 12/13/2021 Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 224 mm. DLP: 1034 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is a partially empty sella There is mild mucosal thickening in the left maxillary sinus with a mucous retention cyst. There is minimal mucosal thickening in the right ethmoid air cells. The remaining visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: No CT evidence of acute intracranial abnormality. If the patient's headaches are sufficiently clinically suspicious, associated with signs of elevated ICP or focal neurologic deficits, nausea, or vomiting, further evaluation with MRI is recommended, unless otherwise contraindicated.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is a partially empty sella There is mild mucosal thickening in the left maxillary sinus with a mucous retention cyst. There is minimal mucosal thickening in the right ethmoid air cells. The remaining visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
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Findings: CT angiogram of the brain: There are minimal atherosclerotic calcifications The visualized portions of the ICAs and vertebrobasilar system otherwise appear within normal limits. The visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. There is mild prominence of the vessels in and around the left central sulcus related to sulcal effacement and compatible with mass effect on the sulci. CT angiogram of the neck: There are mild atherosclerotic calcifications. Otherwise , there is a normal three great vessel arch. The visualized portions of the common, as well as cervical portions of the internal, and external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. - There are mild degenerative changes of the cervical spine, most prominent at C5-6 with uncovertebral DJD causing moderate right and mild left foraminal narrowing.
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3,211
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EXAM: CT Elbow Left wo contrast CLINICAL INFORMATION: Worsening left elbow pain. COMPARISON: Radiograph 1/5/2022. TECHNIQUE: CT Elbow Left wo contrast Scan field of view: 216 mm. DLP: 697.70 mGy cm. FINDINGS: Motion slightly limits the exam. BONES/JOINTS: No acute fracture or malalignment. Moderate joint effusion. SOFT TISSUES: No large hematoma or fluid collection. CONCLUSION: 1. No acute fracture. 2. Moderate joint effusion which may be infectious or inflammatory in etiology. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: Motion slightly limits the exam. BONES/JOINTS: No acute fracture or malalignment. Moderate joint effusion. SOFT TISSUES: No large hematoma or fluid collection.
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Findings: CT angiogram of the brain: There are minimal atherosclerotic calcifications The visualized portions of the ICAs and vertebrobasilar system otherwise appear within normal limits. The visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. There is mild prominence of the vessels in and around the left central sulcus related to sulcal effacement and compatible with mass effect on the sulci. CT angiogram of the neck: There are mild atherosclerotic calcifications. Otherwise , there is a normal three great vessel arch. The visualized portions of the common, as well as cervical portions of the internal, and external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. - There are mild degenerative changes of the cervical spine, most prominent at C5-6 with uncovertebral DJD causing moderate right and mild left foraminal narrowing.
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3,212
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Cervical Spine wo contrast CLINICAL INFORMATION: Assault, head and facial pain COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Cervical Spine wo contrast Scan field of view: 237.30 mm. DLP: 1353.70 mGy cm. (accession CT220003811), Scan field of view: 221.90 mm. DLP: 1112.70 mGy cm. (accession CT220003813), Scan field of view: 220 mm. DLP: 440.60 mGy cm. (accession CT220003812) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Minimal ethmoid sinus mucosal thickening. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. There is a chronic appearing fracture defect of the right medial orbital wall/lamina papyracea with small amount of extraconal fat herniating into the defect. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Minimal ethmoid sinus mucosal thickening. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. There is a chronic appearing fracture defect of the right medial orbital wall/lamina papyracea with small amount of extraconal fat herniating into the defect. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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Findings: There is no evidence of acute hemorrhage or hydrocephalus. There is no mass effect or midline shift. There is asymmetry of the central sulci with decreased visualization of the left central sulcus, concerning for subtle edema, although no significant density change is noted. There is a likely prominent perivascular space in the left inferior basal ganglia. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
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3,213
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Cervical Spine wo contrast CLINICAL INFORMATION: Assault, head and facial pain COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Cervical Spine wo contrast Scan field of view: 237.30 mm. DLP: 1353.70 mGy cm. (accession CT220003811), Scan field of view: 221.90 mm. DLP: 1112.70 mGy cm. (accession CT220003813), Scan field of view: 220 mm. DLP: 440.60 mGy cm. (accession CT220003812) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Minimal ethmoid sinus mucosal thickening. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. There is a chronic appearing fracture defect of the right medial orbital wall/lamina papyracea with small amount of extraconal fat herniating into the defect. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Minimal ethmoid sinus mucosal thickening. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. There is a chronic appearing fracture defect of the right medial orbital wall/lamina papyracea with small amount of extraconal fat herniating into the defect. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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Findings: RAPID images demonstrate CBF less than 30% volume: 0 ml and T. Max greater than 6seconds volume: 0 ml . Mismatch volume is 0 ml. There is no abnormal MTT, T max, CBV and CBF to suggest significant ischemia or infarction at the territory of the major intracranial arteries.
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3,214
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Cervical Spine wo contrast CLINICAL INFORMATION: Assault, head and facial pain COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Cervical Spine wo contrast Scan field of view: 237.30 mm. DLP: 1353.70 mGy cm. (accession CT220003811), Scan field of view: 221.90 mm. DLP: 1112.70 mGy cm. (accession CT220003813), Scan field of view: 220 mm. DLP: 440.60 mGy cm. (accession CT220003812) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Minimal ethmoid sinus mucosal thickening. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. There is a chronic appearing fracture defect of the right medial orbital wall/lamina papyracea with small amount of extraconal fat herniating into the defect. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Minimal ethmoid sinus mucosal thickening. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. There is a chronic appearing fracture defect of the right medial orbital wall/lamina papyracea with small amount of extraconal fat herniating into the defect. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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Findings: There is asymmetric fat density along the lateral margin of the inferior right mandible along the mid to posterior body (best seen on coronal series 306 image 196). This measures approximately 1.8 x 1.6 x 2.6 cm and could represent a lipoma. No associated abnormal soft tissue enhancement is noted. There is no aggressive osseous lesion in the visualized osseous structures. The mandible is intact. The remaining soft tissues appear unremarkable. The visualized intracranial structures appear normal. The paranasal sinuses and mastoid air cells are clear. There are a few small upper cervical lymph nodes without enlargement by size criteria. The visualized salivary glands appear unremarkable.
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3,215
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CT Chest with contrast Clinical Information: 83-year-old female Peritoneal Carcinoma, C80.1 Malignant (primary) neoplasm, unspecified Spec Inst: Evaluate undifferentiated CA, staging Comparison: 6/1/2006 Technique: Following injection of non-ionic contrast 2.5 mm images were obtained through the chest and upper abdomen. Patient weight: 140 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 55 sec. Scan field of view: 332 mm. DLP: 209.50 mGy cm. Findings: Calcified right mediastinal and right hilar nodes are seen. Surgical clips are seen in the right axilla. No enlarged intrathoracic nodes are present. A moderate hiatal hernia is seen clearly increased from the 2006 exam. Coronary artery calcification is noted. The heart size and mediastinum are otherwise normal. Biapical pleural parenchymal scarring now contains calcification but is otherwise unchanged from 2006. Right upper lobe noncalcified nodule measures 7 x 10 mm with only slight linear opacity seen in that area on the 2006 exam. Additional 4 x 9 mm nodule in the medial right upper lung on image 26 is not significantly changed from the prior exam given the difference in slice thickness. A 5 mm nodule posteriorly in the RLL on image 63 and was present at 2006 exam with possible minimal interval increase. A new nodule measuring 17 x 20 mm is present in the right base adjacent to the diaphragm on image 101. Additional new nodules adjacent to the right cardiac fat pad are present on image 94. The five mm noncalcified peripheral LLL nodule on image 75 measured approximately 3 mm on the prior. The lungs are otherwise normal except for a few areas of atelectasis.. No pleural effusion. Surgical clips and calcification is seen in the right breast suggesting previous lumpectomy. No focal destructive osseous lesions identified. A few tiny low-attenuation hepatic lesions are seen at least two these present on the prior exam and these may all represent small cysts. Right renal cysts are seen with the anterior cyst have increased in size from 2006. Limited images of the upper abdomen are otherwise unremarkable. Impression: 1. Several new nodular densities along the right hemidiaphragm concerning for metastatic disease. 2. A few scattered parenchymal nodules two of which are increased from 2006 and the others are unchanged. Continued attention on follow-up will be needed. 3. Moderate hiatal hernia now seen. Additional incidental findings as above.
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Findings: Calcified right mediastinal and right hilar nodes are seen. Surgical clips are seen in the right axilla. No enlarged intrathoracic nodes are present. A moderate hiatal hernia is seen clearly increased from the 2006 exam. Coronary artery calcification is noted. The heart size and mediastinum are otherwise normal. Biapical pleural parenchymal scarring now contains calcification but is otherwise unchanged from 2006. Right upper lobe noncalcified nodule measures 7 x 10 mm with only slight linear opacity seen in that area on the 2006 exam. Additional 4 x 9 mm nodule in the medial right upper lung on image 26 is not significantly changed from the prior exam given the difference in slice thickness. A 5 mm nodule posteriorly in the RLL on image 63 and was present at 2006 exam with possible minimal interval increase. A new nodule measuring 17 x 20 mm is present in the right base adjacent to the diaphragm on image 101. Additional new nodules adjacent to the right cardiac fat pad are present on image 94. The five mm noncalcified peripheral LLL nodule on image 75 measured approximately 3 mm on the prior. The lungs are otherwise normal except for a few areas of atelectasis.. No pleural effusion. Surgical clips and calcification is seen in the right breast suggesting previous lumpectomy. No focal destructive osseous lesions identified. A few tiny low-attenuation hepatic lesions are seen at least two these present on the prior exam and these may all represent small cysts. Right renal cysts are seen with the anterior cyst have increased in size from 2006. Limited images of the upper abdomen are otherwise unremarkable.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Hepatic steatosis. Few simple hepatic cyst, unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Diffuse atrophy of the pancreas, predominantly in the ventral aspect of the head, body and tail. Unchanged mild dilated main pancreatic duct in the body region measures 6 mm. Nonenhancing pancreatic cyst measures 1.2 x 1.1 cm in the pancreatic head and 8 mm and atrophic body, unchanged. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable simple renal cysts in bilateral kidneys. No suspicious mass, nephrolithiasis, hydronephrosis noted. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Scattered degenerative changes in the spine.
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3,216
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CT Head Partial Study Clinical Information: COVID Confirmed encephalopathy, immunocompromised Spec Inst: COVID +, neck pain, cf crypto Comparison: CT head dated 5/9/2019 Findings/Conclusion: Lateral and severely limited AP scout images of the head were obtained, which demonstrated no acute abnormality. No cross-sectional images were not obtained secondary to patient refusal and inability to cooperate with the exam. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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Findings/Conclusion: Lateral and severely limited AP scout images of the head were obtained, which demonstrated no acute abnormality. No cross-sectional images were not obtained secondary to patient refusal and inability to cooperate with the exam. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: There is decreased attenuation of periventricular white matter. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. Partially healed left zygomatic arch fracture. VENTRICULAR SYSTEM: Symmetric and prominent in size, consistent with involutional changes of aging. ORBITS: Normal. SINUSES: Opacification of the right mastoid air cells. Opacification of the right maxillary sinus. Air-fluid level in the left maxillary sinus with associated fracture of the posterior lateral maxillary wall and left orbital floor.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 65-year-old male, for follow-up of lung nodule. COMPARISON: CT chest without contrast dated 5/21/2021 and 6/29/2005. TECHNIQUE: CT Chest wo contrast. Scan field of view: 370 mm. DLP: 501 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Trachea and central airways are patent with postsurgical changes from prior wedge resection in the bilateral upper lobes, with redemonstrated large cavitation in the left upper lobe with interval increase in the size of intracavitary low-attenuation density with peripheral calcifications. Trachea and bronchi leading to this cavitary lesion with adjacent postsurgical changes are again noted. Small volume loculated pleural effusion surrounding the left upper lobe surrounding left upper lobe is again seen. Advanced emphysema. A linear scarring in the left lower with mild pleural thickening abutting the fissure near the left lower and middle lobes, unchanged. No new suspicious nodule. HEART / VESSELS: Normal sized cardiac chambers. No pericardial effusion. Ascending thoracic aorta measures up to 3.8 cm (axial image 170; series 2). Mildly dilated pulmonary artery. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: A few scattered nonenlarged mediastinal lymph nodes, overall unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Chronic T8 compression fracture is again seen. Anterior cervical spine fusion hardware, overall unchanged. CONCLUSION: 1. Postsurgical changes related to left upper lobe wedge resection with interval increase in the ovoid low-attenuation density in the left upper lobe cavitary lesion, could again be related to fungal ball/mycetoma, with persistent bronchopleural fistula. Loculated effusion surrounds these cavitary lesion. 2. Extensive advanced emphysema and stable postsurgical changes from right upper lobe wedge resection. No new nodule.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Trachea and central airways are patent with postsurgical changes from prior wedge resection in the bilateral upper lobes, with redemonstrated large cavitation in the left upper lobe with interval increase in the size of intracavitary low-attenuation density with peripheral calcifications. Trachea and bronchi leading to this cavitary lesion with adjacent postsurgical changes are again noted. Small volume loculated pleural effusion surrounding the left upper lobe surrounding left upper lobe is again seen. Advanced emphysema. A linear scarring in the left lower with mild pleural thickening abutting the fissure near the left lower and middle lobes, unchanged. No new suspicious nodule. HEART / VESSELS: Normal sized cardiac chambers. No pericardial effusion. Ascending thoracic aorta measures up to 3.8 cm (axial image 170; series 2). Mildly dilated pulmonary artery. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: A few scattered nonenlarged mediastinal lymph nodes, overall unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Chronic T8 compression fracture is again seen. Anterior cervical spine fusion hardware, overall unchanged.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Tiny hypoattenuating hepatic lesion in the posterior right lobe near the dome is unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Atrophic native right kidney. Prior left nephrectomy without nodularity in the postsurgical bed. Transplant kidney in the right lower quadrant with an unremarkable CT appearance with exception of a tiny hypoattenuating focus is too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hyperenhancing lesion adjacent to the duodenum measures approximately 4.0 x 3.8 cm, previously 3.8 x 3 5 cm with hyperenhancing focus in the duodenal wall roughly similar. COLON / APPENDIX: Scattered colonic diverticula. PERITONEUM / MESENTERY: Diffuse infiltration of the mesentery is again present though appears more conspicuous today. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: No new destructive osseous lesions. Degenerative changes in the spine. Areas of sclerosis and lucency in the pelvis are similar to previous exams, potentially in part due to prior renal disease.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: 53-year-old male with history of renal transplantation; follow-up seroma. COMPARISON: CT abdomen pelvis 12/29/2021 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 370 mm. Oral contrast Omnipaque: 16 oz. DLP: 643.80 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Cardiomegaly with dense mitral annular calcifications. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild bilateral native renal atrophy. Right lower quadrant renal transplant appears normal for technique. Peritransplant collection appears resolved following placement of a drainage catheter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Moderate to large amount of air and fluid noted throughout the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Interval resolution of the previously noted low-density peritransplant fluid collection following placement of a drainage catheter. Drainage catheter remains in place. VESSELS: Advanced atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic bilateral L4 pars defects with mild to moderate anterolisthesis of L4 on L5 with advanced degenerative changes at the L4-L5 intervertebral disc space. CONCLUSION: 1. Interval placement of a right lower abdominal drainage catheter with resolution of the previously observed right lower quadrant peritransplant collection. Otherwise normal appearance of the right lower quadrant renal transplant given the limitations of a noncontrast study. 2. Moderate to large amount of air and fluid noted throughout the colon. This appearance may be seen in the setting of diarrhea. Recommend clinical correlation. 3. Chronic bilateral L4 pars defects with associated anterolisthesis and advanced degenerative endplate changes.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Cardiomegaly with dense mitral annular calcifications. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild bilateral native renal atrophy. Right lower quadrant renal transplant appears normal for technique. Peritransplant collection appears resolved following placement of a drainage catheter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Moderate to large amount of air and fluid noted throughout the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Interval resolution of the previously noted low-density peritransplant fluid collection following placement of a drainage catheter. Drainage catheter remains in place. VESSELS: Advanced atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic bilateral L4 pars defects with mild to moderate anterolisthesis of L4 on L5 with advanced degenerative changes at the L4-L5 intervertebral disc space.
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FINDINGS: No enlarged nodes are seen in the mediastinum or either hila. Persistent eccentric soft tissue thickening of the mid thoracic esophagus with calcification below the level of carina. Calcified subpleural granuloma in the left upper lobe with minimal dependent left lower lobe atelectasis and focal linear atelectasis in the lingula. No pleural or pericardial effusion is noted and visualized bones are unremarkable.
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CT Chest High Resolution wo contrast CLINICAL INFORMATION: 39-year-old female with history of chronic cough, Post-COVID, rule out ILD, Z86.16 Personal history of COVID-19 Spec Inst: prone position, inspiration and expiration TECHNIQUE: Scout images were obtained for localization. Entire chest was scanned in prone position at end inspiration only (as the patient could not be due to expiratory phase), with retrospective axial, sagittal and coronal reconstructions. Scan field of view: 280 mm. DLP: 92.49 mGy cm. COMPARISON: No prior chest CT available for comparison. Prior chest radiograph dated 8/5/2021 showed no significant abnormalities. FINDINGS: Scouts: No additional findings. Mediastinum: Evaluation of the mediastinal structures is limited in such a noncontrast study. Mildly patulous mid and lower esophagus. No pathologically enlarged mediastinal or hilar lymph nodes within the limits of the noncontrast scan. Heart and great vessels: Cardiac chambers are normal in size. No pericardial effusion. Mediastinal great arteries are normal in caliber. Airways: Trachea and central bronchi are patent and clear. Lungs : Evaluation of the pulmonary parenchyma is a slightly limited by multiple respiratory motion artifacts. Within the scanned limitations, the lungs are clear bilaterally without evidence of focal pulmonary opacities, pulmonary reticulations, pulmonary fibrosis, traction bronchiectasis or honeycombing. Pleural: No pleural effusion or pneumothorax. Upper abdomen: Limited noncontrast visualization of the upper abdomen is without acute abnormalities. Bones and soft tissues: The visualized chest wall soft tissues are unremarkable. No aggressive or destructive intrathoracic osseous lesions. Mild pectus excavatum deformity, with Haller index of 2.5 (as measured on series 2, image 118), normally < 2.0. CONCLUSION: 1. Evaluation of the pulmonary parenchyma is a slightly limited by multiple respiratory motion artifacts. Within the scan limitations, the lungs are clear bilaterally without evidence of focal pulmonary opacities, pulmonary reticulations, pulmonary fibrosis, traction bronchiectasis or honeycombing. 2. Mild pectus excavatum deformity, with Haller index of 2.5.
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FINDINGS: Scouts: No additional findings. Mediastinum: Evaluation of the mediastinal structures is limited in such a noncontrast study. Mildly patulous mid and lower esophagus. No pathologically enlarged mediastinal or hilar lymph nodes within the limits of the noncontrast scan. Heart and great vessels: Cardiac chambers are normal in size. No pericardial effusion. Mediastinal great arteries are normal in caliber. Airways: Trachea and central bronchi are patent and clear. Lungs : Evaluation of the pulmonary parenchyma is a slightly limited by multiple respiratory motion artifacts. Within the scanned limitations, the lungs are clear bilaterally without evidence of focal pulmonary opacities, pulmonary reticulations, pulmonary fibrosis, traction bronchiectasis or honeycombing. Pleural: No pleural effusion or pneumothorax. Upper abdomen: Limited noncontrast visualization of the upper abdomen is without acute abnormalities. Bones and soft tissues: The visualized chest wall soft tissues are unremarkable. No aggressive or destructive intrathoracic osseous lesions. Mild pectus excavatum deformity, with Haller index of 2.5 (as measured on series 2, image 118), normally < 2.0.
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FINDINGS: STRUCTURED REPORT: CT HCC Follow-up IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. TREATED LIVER LESIONS: - Lesion Number: 1 - Description: Treated lesion in the right lobe near the medial dome - Location: Segment(s) medial hepatic dome, segment seven and eight - Size of largest enhancing portion of the mass: None - Enhancement: No lesional enhancement - LI-RADS: LR-TR Nonviable UNTREATED OR NEW LIVER LESION(S): None LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with replaced right hepatic artery from SMA. - Portal venous system: Chronic thrombosis of the left portal vein. Main portal vein and the right portal vein are patent but appear attenuated. - Hepatic veins: Right hepatic vein is attenuated but patent. Middle hepatic vein is difficult to visualized. Left hepatic vein is patent. - Esophageal varices: Small (
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CT Angio Head wo+w contrast 1/7/2022 4:56 PM Clinical information: 42 years Female patient with SAH Spec Inst: with 3D reconstruction Comparison: None available. Technique: Multiple, contiguous, axial CT images of the head were first performed without administration of intravenous contrast. Intravenous iodinated contrast was then administered and multiple, contiguous, axial CT images of the head were performed in the arterial phase using CT head angiogram protocol. Postprocessing reformatted sagittal and coronal maximum intensity projections were also obtained. 3-D volume rendered and maximum intensity projection reconstructions were generated from the axial CT angiographic data set on an independent 3-D workstation per the ordering physician's request. These were created from the axial data. This process was performed under the supervision of the interpreting radiologist. Findings related to the 3-D reconstructions are included in this report. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 94 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus track Scan field of view: 209.60 mm. DLP: 6116 mGy cm. FINDINGS: VASCULAR FINDINGS: Intracranial internal carotid arteries: Patent with no hemodynamically significant stenosis. Anterior cerebral arteries: Patent with no hemodynamically significant stenosis. Middle cerebral arteries: Patent with no hemodynamically significant stenosis. Posterior cerebral arteries: Patent with no hemodynamically significant stenosis. Intracranial vertebral arteries: Dominant right vertebral artery. Patent with no hemodynamically significant stenosis. Basilar artery: Patent with no hemodynamically significant stenosis. Aneurysm/vascular malformation: Large lobulated saccular aneurysm is noted arising from the anterior communicating artery, measuring approximately 12.6 x 11.6 mm, with anterior projection and a 3.0 mm neck. NONVASCULAR FINDINGS: Small volume of subarachnoid hemorrhage is noted in the bilateral frontal sulci extending into the sylvian fissures and anterior aspect of the suprasellar cistern, with minimal dependent intraventricular extension, without obstructive hydrocephalus. The brain has normal morphology and volume. The brain parenchyma has a normal appearance. The ventricles have normal configuration and size. There is no mass effect, midline shift, or effacement of the basilar cisterns. No abnormal extra-axial fluid collection is seen. The superficial soft tissues are without significant focal abnormality. The orbits are grossly normal in appearance. No acute fracture or suspicious osseous lesion is identified. The paranasal sinuses are well-developed and clear. The bilateral mastoid air cells are mildly underpneumatized. IMPRESSION: 1. Small volume of subarachnoid hemorrhage in the bilateral frontal sulci extending into the sylvian fissures and anterior aspect of the suprasellar cistern, with minimal dependent intraventricular extension, without obstructive hydrocephalus. 2. Large lobulated saccular aneurysm arising from the anterior communicating artery, measuring approximately 12.6 x 11.6 mm, with anterior projection and a 3.0 mm neck. Requesting provider was paged on 1/7/2022 at 5:12 PM to communicate findings directly.
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FINDINGS: VASCULAR FINDINGS: Intracranial internal carotid arteries: Patent with no hemodynamically significant stenosis. Anterior cerebral arteries: Patent with no hemodynamically significant stenosis. Middle cerebral arteries: Patent with no hemodynamically significant stenosis. Posterior cerebral arteries: Patent with no hemodynamically significant stenosis. Intracranial vertebral arteries: Dominant right vertebral artery. Patent with no hemodynamically significant stenosis. Basilar artery: Patent with no hemodynamically significant stenosis. Aneurysm/vascular malformation: Large lobulated saccular aneurysm is noted arising from the anterior communicating artery, measuring approximately 12.6 x 11.6 mm, with anterior projection and a 3.0 mm neck. NONVASCULAR FINDINGS: Small volume of subarachnoid hemorrhage is noted in the bilateral frontal sulci extending into the sylvian fissures and anterior aspect of the suprasellar cistern, with minimal dependent intraventricular extension, without obstructive hydrocephalus. The brain has normal morphology and volume. The brain parenchyma has a normal appearance. The ventricles have normal configuration and size. There is no mass effect, midline shift, or effacement of the basilar cisterns. No abnormal extra-axial fluid collection is seen. The superficial soft tissues are without significant focal abnormality. The orbits are grossly normal in appearance. No acute fracture or suspicious osseous lesion is identified. The paranasal sinuses are well-developed and clear. The bilateral mastoid air cells are mildly underpneumatized.
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Findings: Postsurgical changes are stable in the left hemitongue. No residual or recurrent tumor seen. The nasopharynx is unremarkable and the oral cavity appear normal. No abnormal adenopathy is seen. The hypopharynx and larynx have normal appearance. The infraglottic visceral space appears normal. The remaining soft tissues of the neck are unremarkable. ---------------
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Left flank pain COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 366 mm. DLP: 743.70 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: 4 mm obstructing stone in the left distal ureter near the UVJ resulting in moderate left hydroureteronephrosis and reactive periureteral and perinephric stranding. Kidneys are otherwise normal. No additional urinary tract stones. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free fluid or free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No acute abnormality. Prior hysterectomy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Obstructing 4 mm stone in the left distal ureter near the UVJ with moderate left hydroureteronephrosis.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: 4 mm obstructing stone in the left distal ureter near the UVJ resulting in moderate left hydroureteronephrosis and reactive periureteral and perinephric stranding. Kidneys are otherwise normal. No additional urinary tract stones. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free fluid or free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No acute abnormality. Prior hysterectomy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: Left frontoparietal decompressive craniectomy changes are again noted. There is decreased overlying soft tissue swelling. The left frontal lobe now demonstrates mildly concave configuration. There has been expected evolution of encephalomalacia within the left frontal temporal and parietal lobes and also portions of the left basal ganglia secondary to large left MCA infarction. There has been resolution of small foci of hemorrhagic conversion within the region of infarction. There is decreased mass effect with reexpansion of the left lateral ventricle There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Abdominal pain COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 382 mm. Oral contrast Omnipaque: 16.9 oz. DLP: 736.70 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: New small to moderate bilateral pleural effusions with subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild coronary calcifications. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Persistent CT findings of interstitial pancreatitis with extensive peripancreatic inflammatory stranding and edema. Increasing peripancreatic fluid collection along the tibial extends caudally in the anterior and posterior pararenal interfascial planes. Trace fluid extending to the right paracolic gutter and perihepatic region. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Demonstrate normal size. Tiny nonobstructing right renal calculus. Mild nonspecific bilateral perinephric stranding without any discrete fluid collection. LYMPH NODES: Several mildly enlarged periaortic and iliac lymph nodes. STOMACH / SMALL BOWEL: Small nasogastric tube is in stomach. Oral contrast has progressed to the mid small bowel loops. Moderate diffuse distention of small bowel loops without any transition zone secondary to adynamic ileus. COLON / APPENDIX: Large bowel loops are not distended. There is trace retained contrast within the distal colon. PERITONEUM / MESENTERY: Small volume intra-abdominal free fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: Moderate aortic calcifications without aneurysmal dilatation. URINARY BLADDER: Partially distended bladder, contains Foleys catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild diffuse body wall edema. MUSCULOSKELETAL: Lumbar vertebrae demonstrate normal height and multilevel degenerative changes. CONCLUSION: 1. Redemonstrated CT findings of acute interstitial pancreatitis with worsening peripancreatic inflammatory edema/stranding and increasing fluid collection in the left paracolic gutter and left retroperitoneal interfascial planes. 2. Moderate diffuse small bowel distention likely secondary to reactive ileus. 3. Small volume bilateral pleural effusions.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: New small to moderate bilateral pleural effusions with subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild coronary calcifications. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Persistent CT findings of interstitial pancreatitis with extensive peripancreatic inflammatory stranding and edema. Increasing peripancreatic fluid collection along the tibial extends caudally in the anterior and posterior pararenal interfascial planes. Trace fluid extending to the right paracolic gutter and perihepatic region. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Demonstrate normal size. Tiny nonobstructing right renal calculus. Mild nonspecific bilateral perinephric stranding without any discrete fluid collection. LYMPH NODES: Several mildly enlarged periaortic and iliac lymph nodes. STOMACH / SMALL BOWEL: Small nasogastric tube is in stomach. Oral contrast has progressed to the mid small bowel loops. Moderate diffuse distention of small bowel loops without any transition zone secondary to adynamic ileus. COLON / APPENDIX: Large bowel loops are not distended. There is trace retained contrast within the distal colon. PERITONEUM / MESENTERY: Small volume intra-abdominal free fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: Moderate aortic calcifications without aneurysmal dilatation. URINARY BLADDER: Partially distended bladder, contains Foleys catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild diffuse body wall edema. MUSCULOSKELETAL: Lumbar vertebrae demonstrate normal height and multilevel degenerative changes.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Moderate bilateral pleural effusions with adjacent atelectasis. Redemonstration of scattered bilateral groundglass opacities. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable simple and hemorrhagic/proteinaceous renal cysts in bilateral atrophic native kidneys. Normal-appearing transplant kidney with ureteral stent in place in the right lower quadrant. No hydronephrosis noted. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No surgical changes of sleeve gastrectomy. Otherwise, stomach and small bowel are normal.. COLON / APPENDIX: Uncomplicated colon diverticulosis. Otherwise, colon and appendix are normal.. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is mixed high density fluid collection around the lower pole of the transplant kidney in the right lower quadrant and extending around iliac vessels measuring up to 8.4 x 6.2 cm. VESSELS: Mild scattered atherosclerosis. URINARY BLADDER: Partially collapsed. REPRODUCTIVE ORGANS: Surgically absent uterus. BODY WALL: Right lower quadrant staple line with adjacent subcutaneous fluid collection measures 7.9 x 2.6 cm likely represent postsurgical seroma. . Subcutaneous emphysema likely related to recent procedure. Small fat and fluid-containing periumbilical hernia. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Metastatic breast cancer COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 172 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: BOLUS TRACK, 98 SEC. sec. Scan field of view: 400 mm. DLP: 810.37 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Numerous lung metastasis as seen on recent chest CT from 12/13/2021. No pleural effusion or lung consolidation. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Numerous hepatic metastasis, largest of them measures about 2.2 cm. BILIARY TRACT: Normal GALLBLADDER: Contracted PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Left adrenal gland thickening is probable nodule measuring about 1.4 cm. Right adrenal gland is normal. KIDNEYS: Kidneys demonstrate symmetric enhancement. No hydronephrosis. LYMPH NODES: Small gastrohepatic lymph node measuring 1.0 cm. STOMACH / SMALL BOWEL: Stomach and duodenum are partially distended no abnormal dilatation of small bowel loops. COLON / APPENDIX: Uncomplicated colonic diverticulosis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially distended REPRODUCTIVE ORGANS: Surgically absent. BODY WALL: Small fat-containing umbilical hernia MUSCULOSKELETAL: No acute osseous findings. Stable T12 vertebral and left 11th rib lesion. Small sclerotic lesion in the inferior endplate of L2 body, right pedicle of L1 vertebral body and inferior endplate of L5 vertebra. CONCLUSION: 1. Numerous hepatic metastasis. Osseous metastasis in the lumbar spine. 2. Numerous metastatic lung nodules as seen on recent chest CT 12/13/2021. Other incidental/chronic findings as described above.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Numerous lung metastasis as seen on recent chest CT from 12/13/2021. No pleural effusion or lung consolidation. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Numerous hepatic metastasis, largest of them measures about 2.2 cm. BILIARY TRACT: Normal GALLBLADDER: Contracted PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Left adrenal gland thickening is probable nodule measuring about 1.4 cm. Right adrenal gland is normal. KIDNEYS: Kidneys demonstrate symmetric enhancement. No hydronephrosis. LYMPH NODES: Small gastrohepatic lymph node measuring 1.0 cm. STOMACH / SMALL BOWEL: Stomach and duodenum are partially distended no abnormal dilatation of small bowel loops. COLON / APPENDIX: Uncomplicated colonic diverticulosis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially distended REPRODUCTIVE ORGANS: Surgically absent. BODY WALL: Small fat-containing umbilical hernia MUSCULOSKELETAL: No acute osseous findings. Stable T12 vertebral and left 11th rib lesion. Small sclerotic lesion in the inferior endplate of L2 body, right pedicle of L1 vertebral body and inferior endplate of L5 vertebra.
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FINDINGS: Motion limited evaluation. Generalized decreased osseous mineralization. SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. Severe degenerative changes at atlantoodontoid articulation. ATLANTODENTAL INTERVAL: Normal (
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EXAM: CT Abdomen wo+w contrast CLINICAL INFORMATION: 58-year-old male with cirrhosis; HCC screening with indeterminate lesion seen on prior ultrasound. COMPARISON: CT abdomen 7/9/2020 TECHNIQUE: CT Abdomen wo+w contrast. Patient weight: 220 lbs. IV contrast: Omnipaque 350, 180 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 452 mm. DLP: 1663 mGy cm. FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 4B - Size: 1.3 x 1.1 cm - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 1 - Enhancing "capsule": Not present. - Nonperipheral "washout": Present. - Threshold growth (>= 50% in 5 mm diameter). - Other varices or collaterals: Large splenorenal varices also noted. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: No abnormality. LYMPH NODES: Prominent periportal lymph nodes, likely reactive. SPLEEN: Mild, stable enlargement. PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Large nonobstructing calculus within the lower pole of the left kidney measures 10 mm on axial series 2, image 152. Punctate nonobstructing stone in the interpolar region of the right kidney noted on axial series 2, image 113. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No suspicious osseous lesion. Stable areas of a sclerotic lesion involving the right iliac bone. Chronic bilateral L5 pars defects. CONCLUSION: 1. Cirrhosis with arterially enhancing LR 4/5 lesion in hepatic segment 4B near the gallbladder fossa. No other suspicious hepatic lesion. 2. Mild splenomegaly with portosystemic collaterals including large esophageal varices. 3. Bilateral nonobstructive nephrolithiasis.
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FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. LIVER LESIONS: - Lesion Number: 1 - Location: Segment(s) 4B - Size: 1.3 x 1.1 cm - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 1 - Enhancing "capsule": Not present. - Nonperipheral "washout": Present. - Threshold growth (>= 50% in 5 mm diameter). - Other varices or collaterals: Large splenorenal varices also noted. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: No abnormality. LYMPH NODES: Prominent periportal lymph nodes, likely reactive. SPLEEN: Mild, stable enlargement. PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Large nonobstructing calculus within the lower pole of the left kidney measures 10 mm on axial series 2, image 152. Punctate nonobstructing stone in the interpolar region of the right kidney noted on axial series 2, image 113. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No suspicious osseous lesion. Stable areas of a sclerotic lesion involving the right iliac bone. Chronic bilateral L5 pars defects.
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FINDINGS: BRAIN PARENCHYMA: Loss of the normal gray-white matter differentiation in the right superior parietal lobe. No intracranial hemorrhage. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Bladder cancer follow-up. High-grade urothelial carcinoma plasmacytoma features status post laparoscopic radical cystoprostatectomy. COMPARISON: 6/14/2021. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 420 mm. Oral contrast Omnipaque: 16.9 oz. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Hepatic cyst is unchanged from prior BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Prominent to mildly enlarged, similar to prior ADRENALS: Normal. KIDNEYS: Nonobstructing right renal stone. Right lower quadrant ileostomy. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small bowel anastomosis is unremarkable. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild to moderate atherosclerotic disease URINARY BLADDER: Status post cystoprostatectomy. Loculated fluid collection in the urinary bladder bed measures 7.4 x 8.7 cm on image 384 series 3. REPRODUCTIVE ORGANS: Status post cystoprostatectomy. BODY WALL: Anterior abdominal wall hernia just to the left of midline containing small bowel without evidence of obstruction MUSCULOSKELETAL: No destructive osseous lesions seen. CONCLUSION: 1. Loculated fluid collection in the pelvis status post post cystoprostatectomy and right lower quadrant ileostomy. 2. No definite evidence of metastatic disease in abdomen pelvis. 3. Chest findings to be reported separately. 4. Incidental findings as detailed above.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Hepatic cyst is unchanged from prior BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Prominent to mildly enlarged, similar to prior ADRENALS: Normal. KIDNEYS: Nonobstructing right renal stone. Right lower quadrant ileostomy. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small bowel anastomosis is unremarkable. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild to moderate atherosclerotic disease URINARY BLADDER: Status post cystoprostatectomy. Loculated fluid collection in the urinary bladder bed measures 7.4 x 8.7 cm on image 384 series 3. REPRODUCTIVE ORGANS: Status post cystoprostatectomy. BODY WALL: Anterior abdominal wall hernia just to the left of midline containing small bowel without evidence of obstruction MUSCULOSKELETAL: No destructive osseous lesions seen.
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Findings: There is stable appearance of the cystic defect in the left frontal deep white matter abutting the left frontal horn which is slightly dilated. This may be a remote infarct versus dilated perivascular spaces. There is a slightly dilated perivascular space in the left caudate head. The slight diffuse atrophy but the ventricles are not enlarged. There are hypodensities in the anterior centrum semiovale and there are dilated perivascular spaces in the basal ganglia bilaterally. There is no mass, hemorrhage, new infarct or extracerebral collection. There is slight mucosal thickening in ethmoid cells. The remainder of the paranasal sinuses, mastoids and middle ears are clear. There is slight dolichoectasia basilar artery. The posterior fossa contents are otherwise unremarkable. No defect is seen in the calvarium and skull base. ---------------
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 68-year-old male with urinary bladder malignancy. COMPARISON: CT chest with contrast dated 12/28/2016.. TECHNIQUE: CT Chest wo contrast. Scan field of view: 420 mm. DLP: 779 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Mild centrilobular emphysema. A few cystic areas in bilateral dependent lower lobe with ill-defined groundglass opacities, overall unchanged. A calcified nodule in the right lower lobe, again seen. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: No destructive osseous lesion. CONCLUSION: Stable chest findings, without evidence of intrathoracic metastasis.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Mild centrilobular emphysema. A few cystic areas in bilateral dependent lower lobe with ill-defined groundglass opacities, overall unchanged. A calcified nodule in the right lower lobe, again seen. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: No destructive osseous lesion.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Decreased attenuation in the periventricular white matter. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Covid confirmed, evaluate for PTE COMPARISON: None. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 235 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracker Scan field of view: 316 mm. KVP: 120 DLP: 497.20 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: Enlarged multinodular thyroid. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Ground glass opacity within the left upper lobe adjacent to the fissure on image 53, series 5. The lungs are otherwise clear. Mild central and lower lobe peribronchial thickening. HEART / OTHER VESSELS: Moderate cardiac enlargement. Small pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Small perihepatic free fluid. MUSCULOSKELETAL: No acute fracture or suspicious osseous lesions. CONCLUSION: 1. No pulmonary embolism. 2. Nonspecific infectious versus inflammatory ground glass opacity in the left upper lobe. 3. Moderate cardiomegaly, trace perihepatic free fluid, and additional findings as above.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: Enlarged multinodular thyroid. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Ground glass opacity within the left upper lobe adjacent to the fissure on image 53, series 5. The lungs are otherwise clear. Mild central and lower lobe peribronchial thickening. HEART / OTHER VESSELS: Moderate cardiac enlargement. Small pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Small perihepatic free fluid. MUSCULOSKELETAL: No acute fracture or suspicious osseous lesions.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: Hematuria COMPARISON: CT 12/2/2020. TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 119 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 60 sec. Scan field of view: 350 mm. DLP: 625 mGy cm. FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Multiple subcentimeter bilateral renal cortical lesions likely simple cysts. No suspicious enhancing solid renal mass. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Partially distended, suboptimally evaluated LIVER: Multiple subcentimeter hepatic cysts.. Liver is otherwise unremarkable. No suspicious enhancing solid lesions.Stable subcentimeter right hepatic lobe hemangioma. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Extensive sigmoid colonic diverticulosis. Small to moderate colonic stool burden. PERITONEUM / MESENTERY: No ascites or pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing umbilical hernia MUSCULOSKELETAL: No acute osseous findings. Multilevel degenerative changes in lumbar spine. CONCLUSION: 1. Subcentimeter bilateral renal cortical simple cysts. Partially distended bladder without any large focal enhancing lesion or filling defects. Otherwise unremarkable CT urogram. 2. Other stable findings as described above.
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FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Multiple subcentimeter bilateral renal cortical lesions likely simple cysts. No suspicious enhancing solid renal mass. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Partially distended, suboptimally evaluated LIVER: Multiple subcentimeter hepatic cysts.. Liver is otherwise unremarkable. No suspicious enhancing solid lesions.Stable subcentimeter right hepatic lobe hemangioma. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Extensive sigmoid colonic diverticulosis. Small to moderate colonic stool burden. PERITONEUM / MESENTERY: No ascites or pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing umbilical hernia MUSCULOSKELETAL: No acute osseous findings. Multilevel degenerative changes in lumbar spine.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Chest findings to be dictated separately; please see separate chest CT report same day. ABDOMEN and PELVIS: LIVER: Subcentimeter hypoattenuating focus in the inferior right hepatic lobe is to small to characterize but unchanged. No new hepatic lesion BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Horseshoe kidney is once again noted. Small cyst in the superior pole left kidney is unchanged LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small bowel anastomosis in the right abdomen. COLON / APPENDIX: Rectosigmoid anastomosis. Scattered colonic diverticula. There is perirectal nodularity along the right and posterior aspect of the rectum are again observed with interval increase in calcification compared to the prior exam. There is persistent presacral soft tissue thickening. Diffuse rectal wall thickening. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild aortobiiliac atherosclerosis without aneurysm URINARY BLADDER: Diffuse urinary bladder wall thickening REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Operative changes from prior right abdominal ostomy takedown. Midline ventral abdominal surgical changes are observed. MUSCULOSKELETAL: Multilevel degenerative changes in the lumbar spine.
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CT Chest wo contrast CLINICAL INFORMATION: 72-year-old male with RCC staging, C64.9 Malignant neoplasm of unspecified kidney, except renal pelvis TECHNIQUE: Scout images were obtained for localization. Helical CT examination of the chest was performed without IV contrast administration. Axial, sagittal and Coronal reformatted images were reconstructed at 3.0 mm and reviewed. Scan field of view: 570 mm. Oral contrast Omnipaque: 16 oz. DLP: 2312 mGy cm. COMPARISON: Prior chest CT dated 10/5/2021. FINDINGS: Scouts: No additional findings. Lower neck and Mediastinum: Evaluation of the mediastinal structures is limited in such a noncontrast study. Partially visualized thyroid gland is unremarkable. No evidence of focal esophageal wall abnormalities. Lymph nodes: The previously indexed right hilar lymph node now measures up to 10 mm in short axis (series 3, image 95), previously measured the same. The previously described enlarged right inferior bronchial lymph nodes are difficult to evaluate in such a noncontrast study, but appear overall slightly increased in size when compared to prior, now measuring up to 20 mm (series 3, image 133), previously measured up to 17 mm (series 16, image 69 of the prior exam). No new pathologically enlarged supraclavicular, mediastinal or axillary lymph nodes. Heart and great arteries: The cardiac chambers appear normal in size. No pericardial effusion. The main pulmonary artery is normal in caliber. The ascending thoracic aorta is mildly dilated and measures up to 4 cm, unchanged from prior. Airways: Trachea and central bronchi are patent and clear. There is mild diffuse bronchial thickening, which could be seen with bronchitis. Lungs : Upper lobe predominant emphysematous changes and right middle lobe with adjacent anterior basal right lower lobe peripheral scarring with traction bronchiectasis are similar. Multiple noncalcified pulmonary nodules appears slightly larger when compared to prior, for example: * A right upper lobe nodule now measures up to 6 mm (series 3, image 47), previously measured up to 4 mm, * a nodule within the inferior lingula now measures 6 x 8 mm (series 3, image 131), previously measured 5 x 7 mm, * while a nodule within the superior lingula now measures 7 x 7 mm (series 3, image 98), previously measured up to 5 x 6 mm. Pleura: No pleural effusion or pneumothorax. Upper abdomen: The CT of the abdomen and pelvis will be reported separately. Bones and soft tissues: Unchanged multiple nodular densities within the subcutaneous upper pack of the patient, which likely represent multiple sebaceous cysts. Chest wall soft tissues are otherwise unremarkable. Severe degenerative bony changes are again noted, without evidence of aggressive or destructive intrathoracic osseous lesions. CONCLUSION: 1. Multiple scattered bilateral noncalcified pulmonary nodules are slightly larger when compared to prior, concerning for worsening pulmonary metastatic disease. Attention on follow up scans recommended. 2. Evaluation of the perihilar endobronchial lymph nodes is limited in such a noncontrast study, however, there appears to be an interval worsening of the previously noted enlarged right inferior bronchial lymph nodes, concerning for worsening metastatic nodal disease to the chest. Recommend attention on follow-up scans versus further evaluation with PET/CT, if clinically warranted. 3. Other incidental findings as described.
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FINDINGS: Scouts: No additional findings. Lower neck and Mediastinum: Evaluation of the mediastinal structures is limited in such a noncontrast study. Partially visualized thyroid gland is unremarkable. No evidence of focal esophageal wall abnormalities. Lymph nodes: The previously indexed right hilar lymph node now measures up to 10 mm in short axis (series 3, image 95), previously measured the same. The previously described enlarged right inferior bronchial lymph nodes are difficult to evaluate in such a noncontrast study, but appear overall slightly increased in size when compared to prior, now measuring up to 20 mm (series 3, image 133), previously measured up to 17 mm (series 16, image 69 of the prior exam). No new pathologically enlarged supraclavicular, mediastinal or axillary lymph nodes. Heart and great arteries: The cardiac chambers appear normal in size. No pericardial effusion. The main pulmonary artery is normal in caliber. The ascending thoracic aorta is mildly dilated and measures up to 4 cm, unchanged from prior. Airways: Trachea and central bronchi are patent and clear. There is mild diffuse bronchial thickening, which could be seen with bronchitis. Lungs : Upper lobe predominant emphysematous changes and right middle lobe with adjacent anterior basal right lower lobe peripheral scarring with traction bronchiectasis are similar. Multiple noncalcified pulmonary nodules appears slightly larger when compared to prior, for example: * A right upper lobe nodule now measures up to 6 mm (series 3, image 47), previously measured up to 4 mm, * a nodule within the inferior lingula now measures 6 x 8 mm (series 3, image 131), previously measured 5 x 7 mm, * while a nodule within the superior lingula now measures 7 x 7 mm (series 3, image 98), previously measured up to 5 x 6 mm. Pleura: No pleural effusion or pneumothorax. Upper abdomen: The CT of the abdomen and pelvis will be reported separately. Bones and soft tissues: Unchanged multiple nodular densities within the subcutaneous upper pack of the patient, which likely represent multiple sebaceous cysts. Chest wall soft tissues are otherwise unremarkable. Severe degenerative bony changes are again noted, without evidence of aggressive or destructive intrathoracic osseous lesions.
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FINDINGS: The right chest port catheter tip projects near the superior cavoatrial junction. The thyroid gland is unremarkable. Central airways are widely patent. The thoracic aorta is nonaneurysmal. The pulmonary arteries are not dilated. The heart is not enlarged. There is no pericardial effusion. Small hiatal hernia. The esophagus is not dilated. Enlarged mediastinal and bilateral hilar lymph nodes are not significantly changed from 2019. For example, a 2.4 x 1.4 cm subcarinal lymph node on image 127 of series 2 is unchanged. Left hilar lymph node measuring up to 12 mm in short axis on image 111 is also unchanged. No new or enlarging thoracic lymph nodes. There is no acute lung abnormality. A tiny right apical nodule on image 48 is unchanged in size. No new or enlarging lung nodules. No pleural effusion or pleural thickening. The CT of the abdomen and pelvis will be dictated separately. No acute or aggressive osseous abnormality.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: RCC staging COMPARISON: CT 10/05/2021 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 570 mm. Oral contrast Omnipaque: 16 oz. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Chest CT is reported separately. ABDOMEN and PELVIS: LIVER: Numerous hepatic metastatic disease have progressed compared to prior CT, increased in size and number.. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic pancreas. SPLEEN: Normal. ADRENALS: Enlargement of the left adrenal metastasis, measuring about 7.8 x 6.6 cm (series 3/image 208). Stable small right adrenal nodule. KIDNEYS: Surgically absent left kidney. Interval enlargement of small nodules along the medial aspect of superior splenic pole (series 3/image 201) measuring 1.8 cm in along the posterior pararenal fascia measuring 1.6 cm (series 2/image 231). Normal unenhanced right kidney without hydronephrosis. No perinephric collection. LYMPH NODES: Interval enlargement of several periportal, gastrohepatic and periaortic lymph nodes. The larger periportal lymph node measures 4.6 x 3.2 cm (series 3/image 222). STOMACH / SMALL BOWEL: Stomach is partially distended with is abnormal dilatation small bowel loops. Oral contrast has progressed to the distal small bowel loops. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No ascites or pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: Moderate severe aortic calcifications. URINARY BLADDER: Partially distended REPRODUCTIVE ORGANS: Mildly enlarged prostate with calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multiple level degenerative changes in lumbar spine. No destructive osseous lesions. CONCLUSION: 1. Interval worsening of hepatic, left adrenal and retroperitoneal lymph node metastatic disease. Small peritoneal metastasis in the perisplenic region and left posterior pararenal fascia have increased in size. 2. Other stable abdominal findings as described above. Chest CT is reported separately.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Chest CT is reported separately. ABDOMEN and PELVIS: LIVER: Numerous hepatic metastatic disease have progressed compared to prior CT, increased in size and number.. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic pancreas. SPLEEN: Normal. ADRENALS: Enlargement of the left adrenal metastasis, measuring about 7.8 x 6.6 cm (series 3/image 208). Stable small right adrenal nodule. KIDNEYS: Surgically absent left kidney. Interval enlargement of small nodules along the medial aspect of superior splenic pole (series 3/image 201) measuring 1.8 cm in along the posterior pararenal fascia measuring 1.6 cm (series 2/image 231). Normal unenhanced right kidney without hydronephrosis. No perinephric collection. LYMPH NODES: Interval enlargement of several periportal, gastrohepatic and periaortic lymph nodes. The larger periportal lymph node measures 4.6 x 3.2 cm (series 3/image 222). STOMACH / SMALL BOWEL: Stomach is partially distended with is abnormal dilatation small bowel loops. Oral contrast has progressed to the distal small bowel loops. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No ascites or pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: Moderate severe aortic calcifications. URINARY BLADDER: Partially distended REPRODUCTIVE ORGANS: Mildly enlarged prostate with calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multiple level degenerative changes in lumbar spine. No destructive osseous lesions.
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Findings: Lines and Tubes: None. Body Wall and Abdomen: No destructive osseous lesions. CT of abdomen and pelvis will be reported separately. Lymph Nodes, Mediastinum and Neck: No axillary or mediastinal adenopathy. Lungs and Pleura: No pleural effusion. In the right lower lobe at the level of the posterior 10th rib there is a region of the extrapleural fat proliferation and overlying spiculation. Sagittally reformatted images suggest this may be related to scarring. No suspicious appearing pulmonary nodules. No marked bronchial wall thickening. Cardiovascular: Heart size is normal. No central PTE. Mild coronary artery atherosclerotic calcifications.
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EXAM: CT Angio Abdomen and Pelvis CLINICAL INFORMATION: 75-year-old male with abdominal aortic aneurysm; follow-up COMPARISON: Multiple prior CTs of the abdomen pelvis, most recently 1/12/2020 TECHNIQUE: CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 169 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 400 mm. DLP: 1022 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Mild atherosclerotic disease. ABDOMINAL AORTA: Stable fusiform aneurysmal enlargement of the infrarenal abdominal aorta, measuring up to 3.6 x 3.2 cm on axial series 7, image 139 (previously 3.5 x 3.27 m). Just cranially, there is a focal short segment dissection (axial series 7, image 107). CELIAC AXIS: No significant abnormality. SMA: Mild atherosclerotic narrowing. RIGHT RENAL: Small saccular aneurysm arising from the distal right renal artery, measuring up to 18 mm in diameter on axial series 7, image 94. LEFT RENAL: No significant abnormality. Accessory left renal artery. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: Coronary atherosclerotic disease. ABDOMEN and PELVIS: LIVER: Well-circumscribed subcentimeter hypodensity in the left hepatic lobe, technically indeterminate but most suggestive of a cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate is surgically absent with multiple surgical clips in the surgical bed. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Stable fusiform aneurysm of the infrarenal abdominal aorta as described above. 2. Stable appearance of a focal short segment dissection involving the infrarenal abdominal aorta just cranial to the fusiform aneurysm. 3. Small saccular aneurysm arising from the distal right renal artery.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Mild atherosclerotic disease. ABDOMINAL AORTA: Stable fusiform aneurysmal enlargement of the infrarenal abdominal aorta, measuring up to 3.6 x 3.2 cm on axial series 7, image 139 (previously 3.5 x 3.27 m). Just cranially, there is a focal short segment dissection (axial series 7, image 107). CELIAC AXIS: No significant abnormality. SMA: Mild atherosclerotic narrowing. RIGHT RENAL: Small saccular aneurysm arising from the distal right renal artery, measuring up to 18 mm in diameter on axial series 7, image 94. LEFT RENAL: No significant abnormality. Accessory left renal artery. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: Coronary atherosclerotic disease. ABDOMEN and PELVIS: LIVER: Well-circumscribed subcentimeter hypodensity in the left hepatic lobe, technically indeterminate but most suggestive of a cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate is surgically absent with multiple surgical clips in the surgical bed. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis The chest portion of the exam will be reported separately. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: There is a 1.0 cm area that measures soft tissue density near the gallbladder fundus. The gallbladder is otherwise unremarkable. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Enhance symmetrically. There is a simple appearing 1.7 cm right renal cyst. Additional subcentimeter hypoattenuating renal lesions are too small characterize, likely additional cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Focus of increased attenuation within the gastric antrum may represent ingested material as this area was also bright on the virtual unenhanced images. COLON / APPENDIX: Numerous noninflamed colonic diverticula are present in the sigmoid colon with additional diverticula scattered throughout the colon. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification of the aorta without aneurysmal dilation. Stents are present in the left common iliac and external iliac vein. There is angulation at the segments of both of these remain grossly patent. URINARY BLADDER: Urinary bladder is thick-walled. REPRODUCTIVE ORGANS: The prostate is enlarged and abuts the bladder base. BODY WALL: There are bilateral fat-containing inguinal hernias. MUSCULOSKELETAL: Degenerative and postsurgical changes are noted within the lumbar spine and left iliac bone.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 62-year-old male with left lung carcinoma status post radiation in November 2020 and cryoablation in September 2021 COMPARISON: FDG PET/CT dated 11/8/2021. CT chest with contrast dated 10/19/2021. TECHNIQUE: CT Chest with contrast. Patient weight: 190 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 390 mm. DLP: 911.13 mGy cm. FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Diffuse bronchial wall thickening. Moderate centrilobular emphysema. A 0.9 x 0.9 cm left upper lobe nodule on axial image 93; series 2, previously measured 0.8 x 0.7 cm. Interval improvement in the post procedure changes in the superior segment of the left lower lobe, with low-attenuation mass measuring 4.1 x 3.4 cm adjacent to the fiducial markers on axial image 144; series 2, previously 4.1 x 3.5 cm. Interval enlargement of the left lower lobe nodule, that measures 1.9 x 1.4 cm on axial image 194; series 2, previously 1.5 x 0.9 cm. A small peripheral right lower lobe nodule on axial image six; series 2, appears overall unchanged. No new nodule HEART / VESSELS: Normal sized cardiac chambers. No pericardial effusion. No central PE. MEDIASTINUM / ESOPHAGUS: Trace hiatal hernia with mild distal esophageal wall thickening. LYMPH NODES: AP window node measures 1.8 x 1.2 cm on axial image 111; series 2, previously 2.0 x 1.3 cm. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: No destructive osseous lesion. CONCLUSION: 1. Interval enlargement of the left lower lobe nodule, worrisome for worsening metastasis. A subcentimeter left upper lobe nodule, appears overall unchanged. 2. Evolving post cryoablation changes in the left lower lobe mass. 3. Nonenlarged inguinal nodes, overall unchanged. 3. Incidental findings as above.
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FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Diffuse bronchial wall thickening. Moderate centrilobular emphysema. A 0.9 x 0.9 cm left upper lobe nodule on axial image 93; series 2, previously measured 0.8 x 0.7 cm. Interval improvement in the post procedure changes in the superior segment of the left lower lobe, with low-attenuation mass measuring 4.1 x 3.4 cm adjacent to the fiducial markers on axial image 144; series 2, previously 4.1 x 3.5 cm. Interval enlargement of the left lower lobe nodule, that measures 1.9 x 1.4 cm on axial image 194; series 2, previously 1.5 x 0.9 cm. A small peripheral right lower lobe nodule on axial image six; series 2, appears overall unchanged. No new nodule HEART / VESSELS: Normal sized cardiac chambers. No pericardial effusion. No central PE. MEDIASTINUM / ESOPHAGUS: Trace hiatal hernia with mild distal esophageal wall thickening. LYMPH NODES: AP window node measures 1.8 x 1.2 cm on axial image 111; series 2, previously 2.0 x 1.3 cm. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: No destructive osseous lesion.
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FINDINGS: Mild paraseptal emphysematous changes especially in the right upper lobe apex. Minimal increased peribronchial thickening without focal consolidation or interstitial abnormality.. Calcified left upper lobe granuloma along with lateral aortic and left hilar calcified nodes. There is minimal dependent atelectasis. No endobronchial lesion is identified. Only small subcentimeter size noncalcified nodes are seen in the mediastinum. Atherosclerotic calcification of the LAD. There is no pleural or pericardial effusion and visualized bones are unremarkable
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 60-year-old male with history of lung cancer; restaging evaluation. COMPARISON: CT abdomen pelvis 9/3/2017 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 190 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 390 mm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis CT chest findings are reported separately. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Simple right renal cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Previously observed colorectal wall thickening has resolved. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to advanced atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild to moderate prostatomegaly. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: No evidence of metastatic disease involving the abdomen or pelvis.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis CT chest findings are reported separately. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Simple right renal cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Previously observed colorectal wall thickening has resolved. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to advanced atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild to moderate prostatomegaly. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS/CONCLUSION: Minimally displaced fracture of the posterior wall of the right acetabulum. No other acute displaced fracture is seen. The femoral heads are well-seated within their respective acetabula. No pubic symphyseal or SI joint diastasis. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Recent fall and cardiac arrest COMPARISON: None. TECHNIQUE: CT Head wo contrastScan field of view: 212 mm. DLP: 1037 mGy cm. STRUCTURED REPORT: CT Head Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white differentiation is preserved. Diffuse cerebral parenchymal volume loss is appropriate for patient's age. Periventricular hypoattenuation is likely related to mild chronic microangiopathic change. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Mild atherosclerotic calcifications of the bilateral carotid siphons and vertebral arteries. VENTRICULAR SYSTEM: Mild ex vacuo ventriculomegaly.. ORBITS: Normal. Incidental bilateral lens replacements. SINUSES: Normal. IMPRESSION: 1. No acute intracranial process. 2. Age-appropriate brain involution and mild chronic microvascular ischemic disease. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white differentiation is preserved. Diffuse cerebral parenchymal volume loss is appropriate for patient's age. Periventricular hypoattenuation is likely related to mild chronic microangiopathic change. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Mild atherosclerotic calcifications of the bilateral carotid siphons and vertebral arteries. VENTRICULAR SYSTEM: Mild ex vacuo ventriculomegaly.. ORBITS: Normal. Incidental bilateral lens replacements. SINUSES: Normal.
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Findings: There is no mass, hemorrhage, visible infarct or extracerebral collection. There is slight diffuse atrophy but the ventricles are small with normal appearance. There are minor hypodensities in the white matter, likely microvascular ischemia. The posterior fossa contents appear normal. There is mucosal thickening in the frontal sinuses and in ethmoid cells. No defect is seen in the calvarium or skull base. There is no significant change compared to the prior scan. ----------------
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 82-year-old male with recent cardiac arrest, status post cardiovascular surgery. COMPARISON: Prior same-day chest radiograph TECHNIQUE: CT Chest wo contrast. Scan field of view: 329 mm. DLP: 582 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube in place with tip 2.3 cm above the carina. Narrowing and obstruction of bilateral posterior lower lobe bronchi with associated atelectatic changes. There are additional superimposed airspace opacities in the posterior left lung base which may be infectious or inflammatory. Interlobular septal thickening. Moderate right and small left pleural effusions. No pneumothorax. HEART / VESSELS: Cardiomegaly. Postsurgical changes from CABG and left atrial appendage ligation. Severe coronary artery calcifications. Mild atherosclerotic calcifications of the thoracic aorta and proximal great vessels. Right subclavian approach dual chamber pacing leads in place. Trace pericardial effusion. Borderline enlarged main pulmonary artery. MEDIASTINUM / ESOPHAGUS: No significant abnormality. LYMPH NODES: None enlarged. CHEST WALL: Postsurgical changes in the ventral chest wall. Mild chest wall anasarca. UPPER ABDOMEN: Cholecystectomy clips in place. No other significant abnormality. MUSCULOSKELETAL: Median sternotomy changes. Partially visualized right shoulder arthroplasty hardware with associated streak artifact. Multilevel degenerative changes of the thoracic spine. No aggressive osseous lesion. CONCLUSION: 1. Borderline enlarged main pulmonary artery with mild pulmonary edema. 2. Cardiomegaly with stable appearing postprocedural changes, as above. No mediastinal hematoma. 3. Bibasilar atelectasis. Superimposed airspace opacities in the posterior left lower and right middle lobes may additionally represent atelectasis, however superimposed infection or inflammation is not excluded. 4. Moderate right and small left pleural effusions. Additional chronic and incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube in place with tip 2.3 cm above the carina. Narrowing and obstruction of bilateral posterior lower lobe bronchi with associated atelectatic changes. There are additional superimposed airspace opacities in the posterior left lung base which may be infectious or inflammatory. Interlobular septal thickening. Moderate right and small left pleural effusions. No pneumothorax. HEART / VESSELS: Cardiomegaly. Postsurgical changes from CABG and left atrial appendage ligation. Severe coronary artery calcifications. Mild atherosclerotic calcifications of the thoracic aorta and proximal great vessels. Right subclavian approach dual chamber pacing leads in place. Trace pericardial effusion. Borderline enlarged main pulmonary artery. MEDIASTINUM / ESOPHAGUS: No significant abnormality. LYMPH NODES: None enlarged. CHEST WALL: Postsurgical changes in the ventral chest wall. Mild chest wall anasarca. UPPER ABDOMEN: Cholecystectomy clips in place. No other significant abnormality. MUSCULOSKELETAL: Median sternotomy changes. Partially visualized right shoulder arthroplasty hardware with associated streak artifact. Multilevel degenerative changes of the thoracic spine. No aggressive osseous lesion.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is a depressed fracture of the left orbital floor and left lamina papyracea with herniation of intraorbital fat and left maxillary hemosinus. There is proptosis of the left globe with stretching of the optic nerve. Soft tissue gas seen around the left orbit. The rest of the visualized paranasal sinuses and mastoid air cells are clear.
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EXAM: CT Chest High Resolution without contrast CLINICAL INFORMATION: 71-year-old female with history of mucopurulent chronic bronchitis and mild persistent asthma. Assess for bronchiectasis. COMPARISON: Chest radiograph 12/13/2021 TECHNIQUE: CT Chest High Resolution wo contrast. Scan field of view: 321 mm. DLP: 447 mGy cm. High-resolution CT imaging of the chest was performed per protocol with inspiratory and expiratory technique in prone position. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent and clear. Evidence of insufficient inspiratory efforts. Linear scarring in the medial right lower lobe, likely related to the nearby vertebral body osteophytes. Bilateral dependent atelectasis. Linear scarring/atelectasis within the inferior lingula is noted. Mild bilateral diffuse air trapping is also noted on expiratory images. No suspicious nodules or masses. No pleural effusion. HEART / VESSELS: The heart is normal in size. No pericardial effusion. Mild coronary artery atherosclerotic calcifications. Mild calcified atherosclerotic disease of the thoracic aorta and proximal arch vessels. Common origin of the innominate and left common carotid arteries. The main pulmonary artery is normal in caliber. MEDIASTINUM / ESOPHAGUS: Unremarkable. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Multiple hepatic cysts and additional subcentimeter hypoattenuating lesions in the liver that are too small to characterize. MUSCULOSKELETAL: Decreased osseous mineralization. No aggressive osseous lesion. Mild multilevel degenerative changes of the thoracic spine. CONCLUSION: 1. Linear scarring/atelectasis within the inferior lingula, which could be seen post infectious. 2. Mild bilateral diffuse air trapping, which can be seen with small airway disease. 3. No bronchiectasis or otherwise significant pulmonary parenchymal abnormalities. 4. Other incidental findings as described. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent and clear. Evidence of insufficient inspiratory efforts. Linear scarring in the medial right lower lobe, likely related to the nearby vertebral body osteophytes. Bilateral dependent atelectasis. Linear scarring/atelectasis within the inferior lingula is noted. Mild bilateral diffuse air trapping is also noted on expiratory images. No suspicious nodules or masses. No pleural effusion. HEART / VESSELS: The heart is normal in size. No pericardial effusion. Mild coronary artery atherosclerotic calcifications. Mild calcified atherosclerotic disease of the thoracic aorta and proximal arch vessels. Common origin of the innominate and left common carotid arteries. The main pulmonary artery is normal in caliber. MEDIASTINUM / ESOPHAGUS: Unremarkable. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Multiple hepatic cysts and additional subcentimeter hypoattenuating lesions in the liver that are too small to characterize. MUSCULOSKELETAL: Decreased osseous mineralization. No aggressive osseous lesion. Mild multilevel degenerative changes of the thoracic spine.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: There is soft tissue gas seen in the posterior left forearm soft tissues. ABDOMEN and PELVIS: LIVER: The liver is mildly heterogeneous. . BILIARY TRACT: There is a small amount of pneumobilia seen in the left hepatic lobe. There is minimal intra and extra hepatic biliary duct dilatation, probably related to prior cholecystectomy GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Small subcentimeter hypodensities seen within the spleen on image 258, series 501, indeterminate. No perisplenic free fluid. ADRENALS: Normal. KIDNEYS: A right upper pole renal cyst is noted. There is a cyst also seen in the lower pole the left kidney. There are a few subcentimeter hypodensities in both kidneys which are technically indeterminant but statistically likely cysts. There is a small left extrarenal pelvis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: Trace pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially decompressed REPRODUCTIVE ORGANS: There is a partially cystic lesion seen posterior to the uterus on image 470, series 501 measuring approximately 2.6 x 2.0 cm. BODY WALL: Small subcutaneous contusion is seen along the left flank. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Renal transplant evaluation. Status post bronchoscopy 12/13/2021. On COMPARISON: 9/8/2021. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 360 mm. DLP: 682.39 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Interval improvement in patchy multifocal groundglass opacification. Right inferior middle lobe soft tissue density is not as well seen. A few new areas of groundglass opacification right middle lobe and left lingula. DISTAL ESOPHAGUS: Normal. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Very atrophic native kidneys and right lower quadrant transplant kidney. Left lower quadrant transplant kidney is grossly unremarkable on this noncontrasted study. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis PERITONEUM / MESENTERY: Trace ascites. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification is seen in the aorta and right common iliac artery. Minimal calcification is seen in both external iliac arteries near the renal transplant anastomoses. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate is unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No destructive osseous lesions seen CONCLUSION: 1. New areas of groundglass opacifications right middle lobe and left lingula. It is unclear whether this could be residual from prior bronchoscopy 12/13/2021. Interval improvement in patchy multifocal groundglass opacification. Right inferior middle lobe soft tissue density not as well seen. Differential includes atypical infection. 2. No calcified atherosclerotic disease which would preclude renal transplantation as above. 3. Incidental findings as detailed above.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Interval improvement in patchy multifocal groundglass opacification. Right inferior middle lobe soft tissue density is not as well seen. A few new areas of groundglass opacification right middle lobe and left lingula. DISTAL ESOPHAGUS: Normal. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Very atrophic native kidneys and right lower quadrant transplant kidney. Left lower quadrant transplant kidney is grossly unremarkable on this noncontrasted study. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis PERITONEUM / MESENTERY: Trace ascites. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcification is seen in the aorta and right common iliac artery. Minimal calcification is seen in both external iliac arteries near the renal transplant anastomoses. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate is unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No destructive osseous lesions seen
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: There is soft tissue gas seen in the posterior left forearm soft tissues. ABDOMEN and PELVIS: LIVER: The liver is mildly heterogeneous. . BILIARY TRACT: There is a small amount of pneumobilia seen in the left hepatic lobe. There is minimal intra and extra hepatic biliary duct dilatation, probably related to prior cholecystectomy GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Small subcentimeter hypodensities seen within the spleen on image 258, series 501, indeterminate. No perisplenic free fluid. ADRENALS: Normal. KIDNEYS: A right upper pole renal cyst is noted. There is a cyst also seen in the lower pole the left kidney. There are a few subcentimeter hypodensities in both kidneys which are technically indeterminant but statistically likely cysts. There is a small left extrarenal pelvis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: Trace pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially decompressed REPRODUCTIVE ORGANS: There is a partially cystic lesion seen posterior to the uterus on image 470, series 501 measuring approximately 2.6 x 2.0 cm. BODY WALL: Small subcutaneous contusion is seen along the left flank. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Endometrial cancer. New onset pain and swelling, rule out recurrence. COMPARISON: 8/17/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 318 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 84 sec. Scan field of view: 500 mm. DLP: 1115 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Status post gastric bypass COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Status post hysterectomy. Right ovary and left adnexa appear unremarkable. BODY WALL: Diastasis of the rectus muscle. Fat and small bowel containing hernia without definite evidence of obstruction, similar to prior. Small amount of soft tissue thickening is seen in the caudal pelvis on image 316 series 302, similar to prior. Lateral soft tissue is not completely imaged due to body habitus MUSCULOSKELETAL: No destructive osseous lesions seen CONCLUSION: 1. Anterior abdominal wall fat and small bowel containing hernia without evidence of obstruction is again seen, similar to prior. 2. No definite evidence of metastatic disease in the abdomen pelvis
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Status post gastric bypass COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Status post hysterectomy. Right ovary and left adnexa appear unremarkable. BODY WALL: Diastasis of the rectus muscle. Fat and small bowel containing hernia without definite evidence of obstruction, similar to prior. Small amount of soft tissue thickening is seen in the caudal pelvis on image 316 series 302, similar to prior. Lateral soft tissue is not completely imaged due to body habitus MUSCULOSKELETAL: No destructive osseous lesions seen
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FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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EXAM: CT Chest with contrast CLINICAL INFORMATION: History of endometrial cancer. COMPARISON: CTA chest 8/17/2021 TECHNIQUE: CT Chest with contrast. Patient weight: 318 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 35 sec. Scan field of view: 369 mm. DLP: 336 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Mild bilateral dependent atelectasis. No suspicious nodules or masses. Tiny peripheral right apical nodule is unchanged from 2015. Tiny peripheral posterior left upper lobe nodule on series 2, image 27 is also unchanged from 2015. Unchanged peripheral left upper lobe noncalcified nodule on image 35 is stable since 2015 and almost certainly benign. A few additional tiny peripheral RLL nodules are also unchanged from 2015. Calcified granuloma in the right lower lobe. No pleural effusion, focal airspace consolidation, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions. Mild multilevel degenerative changes of the thoracic spine CT abdomen and pelvis will be reported separately. CONCLUSION: A few small nodules are stable since 2015 consistent with benign nodules. No evidence of intrathoracic metastatic disease or acute abnormality. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Mild bilateral dependent atelectasis. No suspicious nodules or masses. Tiny peripheral right apical nodule is unchanged from 2015. Tiny peripheral posterior left upper lobe nodule on series 2, image 27 is also unchanged from 2015. Unchanged peripheral left upper lobe noncalcified nodule on image 35 is stable since 2015 and almost certainly benign. A few additional tiny peripheral RLL nodules are also unchanged from 2015. Calcified granuloma in the right lower lobe. No pleural effusion, focal airspace consolidation, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions. Mild multilevel degenerative changes of the thoracic spine CT abdomen and pelvis will be reported separately.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: There is soft tissue gas seen in the posterior left forearm soft tissues. ABDOMEN and PELVIS: LIVER: The liver is mildly heterogeneous. . BILIARY TRACT: There is a small amount of pneumobilia seen in the left hepatic lobe. There is minimal intra and extra hepatic biliary duct dilatation, probably related to prior cholecystectomy GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Small subcentimeter hypodensities seen within the spleen on image 258, series 501, indeterminate. No perisplenic free fluid. ADRENALS: Normal. KIDNEYS: A right upper pole renal cyst is noted. There is a cyst also seen in the lower pole the left kidney. There are a few subcentimeter hypodensities in both kidneys which are technically indeterminant but statistically likely cysts. There is a small left extrarenal pelvis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: Trace pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially decompressed REPRODUCTIVE ORGANS: There is a partially cystic lesion seen posterior to the uterus on image 470, series 501 measuring approximately 2.6 x 2.0 cm. BODY WALL: Small subcutaneous contusion is seen along the left flank. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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CT head with and without contrast Indication: Chronic headaches, subjective scalp swelling, subjective mass to right forehead, R51.9 Headache, unspecified. Comparison: No previous similar studies are available for comparison at this time.. Technique: Multiple contiguous axial images of the brain were obtained from base to the vertex pre- and post the administration of intravenous contrast. Patient weight: 186 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 300 sec. Scan field of view: 238 mm. DLP: 2189.40 mGy cm. . Findings: There is no evidence of acute intra- or extra-axial hemorrhage. There is no midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation appears maintained. There is mild diffuse cerebral volume loss. The ventricular system are normal in configuration. The basal cisterns are clear. Post administration of contrast material, there is no evidence of enhancing intracranial pathology. Extracranially, there is minimal mucosal thickening in the right frontal recess and sphenoid sinuses. The remaining visualized paranasal sinuses and mastoid air cells are clear of acute process. The visualized bones of the calvarium demonstrate no acute osseous abnormality. There is left pseudophakia. There is fat stranding in bilateral malar soft tissues, likely from prior cosmetic postprocedural changes. A fracture is noted through the second left molar tooth. There is a chronic right orbital floor fracture deformity with mild protrusion of orbital fat inferiorly. Impression: 1. No acute intracranial process. No evidence of enhancing intracranial pathology at this time. 2. No abnormal enhancing scalp mass is clearly identified, although an area of concern was not marked on the images. 3. Additional findings above.
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Findings: There is no evidence of acute intra- or extra-axial hemorrhage. There is no midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation appears maintained. There is mild diffuse cerebral volume loss. The ventricular system are normal in configuration. The basal cisterns are clear. Post administration of contrast material, there is no evidence of enhancing intracranial pathology. Extracranially, there is minimal mucosal thickening in the right frontal recess and sphenoid sinuses. The remaining visualized paranasal sinuses and mastoid air cells are clear of acute process. The visualized bones of the calvarium demonstrate no acute osseous abnormality. There is left pseudophakia. There is fat stranding in bilateral malar soft tissues, likely from prior cosmetic postprocedural changes. A fracture is noted through the second left molar tooth. There is a chronic right orbital floor fracture deformity with mild protrusion of orbital fat inferiorly.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: There is soft tissue gas seen in the posterior left forearm soft tissues. ABDOMEN and PELVIS: LIVER: The liver is mildly heterogeneous. . BILIARY TRACT: There is a small amount of pneumobilia seen in the left hepatic lobe. There is minimal intra and extra hepatic biliary duct dilatation, probably related to prior cholecystectomy GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Small subcentimeter hypodensities seen within the spleen on image 258, series 501, indeterminate. No perisplenic free fluid. ADRENALS: Normal. KIDNEYS: A right upper pole renal cyst is noted. There is a cyst also seen in the lower pole the left kidney. There are a few subcentimeter hypodensities in both kidneys which are technically indeterminant but statistically likely cysts. There is a small left extrarenal pelvis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. PERITONEUM / MESENTERY: Trace pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially decompressed REPRODUCTIVE ORGANS: There is a partially cystic lesion seen posterior to the uterus on image 470, series 501 measuring approximately 2.6 x 2.0 cm. BODY WALL: Small subcutaneous contusion is seen along the left flank. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1370.10 mGy cm. (accession CT220003844), Scan field of view: 210 mm. DLP: 1009.80 mGy cm. (accession CT220003850), Patient weight: 170 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 253 mm. DLP: 894 mGy cm. (accession CT220003851) FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is a depressed fracture of the left orbital floor and left lamina papyracea with herniation of intraorbital fat and left maxillary hemosinus. There is proptosis of the left globe with stretching of the optic nerve. Soft tissue gas seen around the left orbit. The rest of the visualized paranasal sinuses and mastoid air cells are clear.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 81 sec Scan field of view: 415 mm. (accession CT220003845), per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 84 sec Scan field of view: 415 mm. DLP: 1040 mGy cm. (accession CT220003846) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Suspected T4 burst fracture. 2. Otherwise, no convincing acute traumatic injury identified within the chest, abdomen, or pelvis. 3. Mild hepatic congestion. There is an indeterminate hypodense lesion in the right hepatic lobe without associated perihepatic fluid. This is atypical for a traumatic injury. A follow-up nonemergent multiphase MRI with Eovist recommended, as clinically indicated. 4. Trace nonspecific pelvic free fluid, abnormal in a patient of this age. An occult injury cannot be entirely excluded. 5. Severe atherosclerotic disease. 6. Fat-containing umbilical hernia containing a small amount of fluid. Correlation for pain/strangulation and/or reducibility. 7. Additional findings above.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 81 sec Scan field of view: 415 mm. (accession CT220003845), per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 84 sec Scan field of view: 415 mm. DLP: 1040 mGy cm. (accession CT220003846) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Suspected T4 burst fracture. 2. Otherwise, no convincing acute traumatic injury identified within the chest, abdomen, or pelvis. 3. Mild hepatic congestion. There is an indeterminate hypodense lesion in the right hepatic lobe without associated perihepatic fluid. This is atypical for a traumatic injury. A follow-up nonemergent multiphase MRI with Eovist recommended, as clinically indicated. 4. Trace nonspecific pelvic free fluid, abnormal in a patient of this age. An occult injury cannot be entirely excluded. 5. Severe atherosclerotic disease. 6. Fat-containing umbilical hernia containing a small amount of fluid. Correlation for pain/strangulation and/or reducibility. 7. Additional findings above.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Emphysematous changes and subsegmental atelectasis is seen in the lower lungs. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Intra and extrahepatic biliary duct dilatation is grossly unchanged. The common bile duct measures approximately 17 mm, unchanged. GALLBLADDER: Surgically absent PANCREAS: . The cystic lesion within the periampullary region of the pancreatic head has decreased in size measuring 1.2 cm on image 142, series 301 (previously 2.0 cm. There is no new pancreatic duct dilatation. There is a small amount of fluid potentially in the pancreaticoduodenal groove. No extensive peripancreatic stranding is seen. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Minute subcentimeter hypodensities are seen within both kidneys which are technically indeterminate but unchanged. Hyperdensities in both kidneys is thought to probably represent excreted contrast rather than stones. However, there may be a small punctate nonobstructing stone in the lower pole the right kidney. There is no hydronephrosis. There is subtle right periureteral stranding, similar to the prior. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: There is a small amount of fluid with peripheral enhancement seen posterior to the descending duodenum, stable to slightly improved. There is a large duodenal diverticulum inferior to the pancreatic head, unchanged. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: , As above. VESSELS: There is moderately severe aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Trace scrotal hydroceles are noted. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Right femoral fixation rod is again partially visualized. No focal destructive osseous lesion is identified.
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1370.10 mGy cm. (accession CT220003844), Scan field of view: 210 mm. DLP: 1009.80 mGy cm. (accession CT220003850), Patient weight: 170 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 253 mm. DLP: 894 mGy cm. (accession CT220003851) FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis CHEST: Please see separately dictated chest report. ABDOMEN and PELVIS: LIVER: Ill-defined geographic hypoattenuating region in segment VIII extends into the inferior aspect of the anterior hepatic segment without visible hyperemia or calcifications. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. No renal calculi or hydronephrosis. Mild bilateral perinephric stranding is nonspecific. LYMPH NODES: Multiple enlarged periaortic and retroperitoneal lymph nodes. For example, series 201 image 280 and image 338. Numerous small mesenteric nodes are present. Mildly enlarged pelvic nodes involve the right external iliac, right internal iliac, bilateral obturator, and bilateral common femoral regions. Additional enlarged bilateral inguinal lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. Uterus and ovaries appear normal. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Ill-defined stranding in the soft tissues of the lower back overlying the L4 spinous process measuring 3.5 x 3.3 cm. This corresponds to the region of the patient's prior paraspinal abscess. There is no rim enhancement or bland fluid. The L4 vertebral body is slightly sclerotic, likely reflecting prior inflammation or infection. No aggressive osseous lesion.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 81 sec Scan field of view: 415 mm. (accession CT220003845), per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 84 sec Scan field of view: 415 mm. DLP: 1040 mGy cm. (accession CT220003846) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Suspected T4 burst fracture. 2. Otherwise, no convincing acute traumatic injury identified within the chest, abdomen, or pelvis. 3. Mild hepatic congestion. There is an indeterminate hypodense lesion in the right hepatic lobe without associated perihepatic fluid. This is atypical for a traumatic injury. A follow-up nonemergent multiphase MRI with Eovist recommended, as clinically indicated. 4. Trace nonspecific pelvic free fluid, abnormal in a patient of this age. An occult injury cannot be entirely excluded. 5. Severe atherosclerotic disease. 6. Fat-containing umbilical hernia containing a small amount of fluid. Correlation for pain/strangulation and/or reducibility. 7. Additional findings above.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Subtle subpleural reticulations and ill-defined groundglass changes in the lower lobes right more than left without focal consolidation, pleural effusion, pneumothorax. Central airways are patent. HEART / VESSELS: Heart size is normal. Trace pericardial effusion. Right upper extremity PICC is present, tip terminates in the cranial SVC. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Prominent lymph nodes throughout the mediastinum and bilateral hila. Prominent bilateral axillary lymph nodes. CHEST WALL: Mild subcutaneous inflammatory stranding along the upper midline chest wall and lower anterior neck. UPPER ABDOMEN: Please see same day CT abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 81 sec Scan field of view: 415 mm. (accession CT220003845), per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 84 sec Scan field of view: 415 mm. DLP: 1040 mGy cm. (accession CT220003846) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Suspected T4 burst fracture. 2. Otherwise, no convincing acute traumatic injury identified within the chest, abdomen, or pelvis. 3. Mild hepatic congestion. There is an indeterminate hypodense lesion in the right hepatic lobe without associated perihepatic fluid. This is atypical for a traumatic injury. A follow-up nonemergent multiphase MRI with Eovist recommended, as clinically indicated. 4. Trace nonspecific pelvic free fluid, abnormal in a patient of this age. An occult injury cannot be entirely excluded. 5. Severe atherosclerotic disease. 6. Fat-containing umbilical hernia containing a small amount of fluid. Correlation for pain/strangulation and/or reducibility. 7. Additional findings above.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: The heart appears mildly enlarged. There is severe coronary artery atherosclerotic calcification. There is a trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: There are calcified and noncalcified shotty mediastinal lymph nodes. No bulky adenopathy is seen.. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: There is a mottled appearance to the liver. There is a indeterminate subcentimeter hypodensity within the right hepatic lobe which is technically indeterminate measuring 1 cm on image 263, series 501. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No bulky adenopathy is seen. STOMACH / SMALL BOWEL: There is a small hiatal hernia. The stomach and small bowel are otherwise unremarkable.. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: There is severe aortoiliac atherosclerosis without aneurysmal dilatation. There are coarse calcified lesion seen in the left renal and SMA which may cause mild to moderate stenoses. There is multifocal severe stenoses seen in the superficial femoral arteries, right worse than left. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: There is a fat-containing umbilical hernia with a small amount of fluid MUSCULOSKELETAL: There is a focal sclerosis seen in the mid sternum which appears chronic and may be degenerative/posttraumatic. There is a left femoral internal fixation rod. THORACIC SPINE: VERTEBRA: There is a compression burst fracture seen at C4 with mild retropulsion and minimal spinal canal stenosis, possibly acute. No additional fracture is identified. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative changes are seen within the spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction. There is stable size of hypoattenuation within the posterior right frontal lobe white matter representing evolving subacute infarction. Hypoattenuation appears slightly more marginated. There is no hemorrhagic conversion. There is also stable small focus of hypoattenuation within the left frontal lobe representing remote infarction. There are also stable small areas of hypoattenuation within the right thalamus and left caudate head also representing remote infarctions. There is mild generalized atrophy with proportionate enlargement of the ventricles. There are stable mild periventricular hypodensities likely representing microangiopathic changes. There is no mass effect. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1370.10 mGy cm. (accession CT220003844), Scan field of view: 210 mm. DLP: 1009.80 mGy cm. (accession CT220003850), Patient weight: 170 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 253 mm. DLP: 894 mGy cm. (accession CT220003851) FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: Asymmetric upper lobe dominant mixed emphysema with several tiny 2-3 mm noncalcified subpleural nodules in both lungs; right upper lobe image 37, 86; right lower lobe image 135, 178 and 227; left upper lobe image 82, all seen in series 602 and were present before without significant change. There are few subcentimeter size nodes in the mediastinum in the paratracheal, subcarinal and paraesophageal location along with right hila. No pleural or pericardial effusion is seen and visualized bones are unremarkable. The tip of the left subclavian Mediport catheter terminating in the distal SVC.
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1370.10 mGy cm. (accession CT220003844), Scan field of view: 210 mm. DLP: 1009.80 mGy cm. (accession CT220003850), Patient weight: 170 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 253 mm. DLP: 894 mGy cm. (accession CT220003851) FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: pp BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Chronic periventricular white matter microangiopathic changes and volume loss. Chronic lacunar infarct within the right thalamus. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. [Left frontal scalp laceration and small subgaleal hematoma. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: There are no acute maxillofacial or mandibular fractures. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal configuration. Hepatic metastatic lesion with calcifications measures 7.1 x 5.1 cm on image 237, series 602 (previously measured 7.5 x 5.6 cm on image 22, series 5). No new hepatic lesion. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Stable shotty mesenteric lymph nodes. STOMACH / SMALL BOWEL: Parastomal hernia contains nonobstructed small bowel. COLON / APPENDIX: Interval decrease in size of the mass adjacent to the colonic suture line which measures 3.6 x 3.6 cm on image 400, series 602 (previously measured six 6.7 x 6.1 cm on image 57, series 5). Gas is again noted within the mass. There is mild surrounding stranding and it abuts adjacent segments of small bowel. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Pain and vomiting COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 95 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 66sec Scan field of view: 438.80 mm. DLP: 526.60 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: There is severe coronary artery atherosclerotic calcification. No large pericardial effusion. ABDOMEN and PELVIS: LIVER: Focal fat is seen adjacent to the intersegmental fissure BILIARY TRACT: There is borderline dilated extrahepatic biliary duct dilatation. GALLBLADDER: The gallbladder is distended.. There is possible mild gallbladder wall edema although evaluation is limited due to motion. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Adrenals are hyperplastic without discrete nodule. KIDNEYS: Left upper pole renal cyst. Additional minute subcentimeter hypodensities within the left kidney are technically indeterminant but also statistically likely cysts. There is extensive vascular calcification. A couple punctate calcifications in both kidneys could be vascular or nonobstructing nephrolithiasis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not definitely visualized although there are no secondary signs of appendicitis. There are extensive sigmoid diverticula but no convincing evidence of diverticulitis PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Severe coronary artery atherosclerotic calcification is noted. There is mild stenosis of the celiac and probably the bilateral renal arteries are noted. URINARY BLADDER: Gas within the urinary bladder is likely secondary to Foley catheter placement. The bladder is not decompressed. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass is identified. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Moderate degenerative changes are seen within the spine. No focal destructive osseous lesion is identified. CONCLUSION: 1. Distended gallbladder with possible subtle pericholecystic stranding. Cholecystitis is not excluded. Mild extrahepatic biliary duct dilatation. Ultrasound recommended for further evaluation. 2. Diverticulosis without CT evidence of diverticulitis. 3. The urinary bladder is not collapsed around a indwelling Foley catheter. Clinical correlation with catheter dysfunction recommended. 4. Severe atherosclerotic disease and additional findings above.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: There is severe coronary artery atherosclerotic calcification. No large pericardial effusion. ABDOMEN and PELVIS: LIVER: Focal fat is seen adjacent to the intersegmental fissure BILIARY TRACT: There is borderline dilated extrahepatic biliary duct dilatation. GALLBLADDER: The gallbladder is distended.. There is possible mild gallbladder wall edema although evaluation is limited due to motion. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Adrenals are hyperplastic without discrete nodule. KIDNEYS: Left upper pole renal cyst. Additional minute subcentimeter hypodensities within the left kidney are technically indeterminant but also statistically likely cysts. There is extensive vascular calcification. A couple punctate calcifications in both kidneys could be vascular or nonobstructing nephrolithiasis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not definitely visualized although there are no secondary signs of appendicitis. There are extensive sigmoid diverticula but no convincing evidence of diverticulitis PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Severe coronary artery atherosclerotic calcification is noted. There is mild stenosis of the celiac and probably the bilateral renal arteries are noted. URINARY BLADDER: Gas within the urinary bladder is likely secondary to Foley catheter placement. The bladder is not decompressed. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass is identified. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Moderate degenerative changes are seen within the spine. No focal destructive osseous lesion is identified.
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FINDINGS: There has been interval removal of right frontotemporal craniotomy flap. There has been apparent interval drainage of developing fluid collections within the right frontal scalp soft tissues and a surgical drain has been placed. There is continued mild right frontal scalp soft tissue swelling. The mainly hypodense epidural fluid collection underlying the previous craniotomy flap is also no longer visible. Intracranially the right frontal approach ventricular catheter has been reinserted along the prior tract. There is persistent hypoattenuation within the right frontal lobe along the catheter tract representing gliosis. There is small amount of postprocedural gas within the right frontal horn. Ventricles are stable in size without hydrocephalus. ACOM aneurysm clip is again noted. There is again stable hypoattenuation within the inferior right frontal lobe. There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
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EXAM: CT Pelvis wo IV contrast CLINICAL INFORMATION: Renal transplant evaluation. End-stage renal disease. COMPARISON: None. TECHNIQUE: CT Pelvis wo IV contrast. Scan delay: 0 sec. Scan field of view: 460 mm. DLP: 742.28 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Pelvis Renal Transplant VASCULATURE: LOWER ABDOMINAL AORTA: No calcified atherosclerotic disease. RIGHT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LOWER ABDOMEN: Visualized BOWEL: No abnormality. PERITONEUM: No ascites. OTHER: No other abnormality. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate is prominent BODY WALL: No significant abnormality. MUSCULOSKELETAL: No destructive osseous lesions seen CONCLUSION: 1. No significant calcified atherosclerotic disease which would preclude renal transplantation.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Pelvis Renal Transplant VASCULATURE: LOWER ABDOMINAL AORTA: No calcified atherosclerotic disease. RIGHT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LOWER ABDOMEN: Visualized BOWEL: No abnormality. PERITONEUM: No ascites. OTHER: No other abnormality. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate is prominent BODY WALL: No significant abnormality. MUSCULOSKELETAL: No destructive osseous lesions seen
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FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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CT Chest with contrast CLINICAL INFORMATION: 65-year-old male with prostate cancer, Z85.46 Personal history of malignant neoplasm of prostate TECHNIQUE: Scout images were obtained for localization. Helical CT examination of the chest was then performed after IV injection of nonionic contrast. Axial, sagittal and Coronal reformatted images were reconstructed at 3.0 mm and reviewed. Patient weight: 241 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 500 mm. DLP: 1696 mGy cm. COMPARISON: No prior chest CT available for comparison. FINDINGS: Scouts: No additional findings. Lower neck and Mediastinum: Thyroid gland is unremarkable. No evidence of focal esophageal wall abnormalities. Lymph nodes: Calcified mediastinal and right hilar lymph nodes are noted, likely related to prior granulomatous lung disease.. Small noncalcified mediastinal, hilar and bilateral axillary lymph nodes are noted, which appear most likely reactive. Heart and great arteries: The left atrium is mildly to moderately dilated. Other cardiac chambers appear normal in size. No pericardial effusion. The main pulmonary artery is prominent and measures up to 3.1 cm, which could be seen with pulmonary arterial hypertension. The thoracic aorta is normal in caliber. There is moderate atherosclerotic calcification of the coronary arteries. Airways: Trachea and central bronchi are patent and clear. Lungs : Ill-defined right upper lobe peripheral subpleural multiple tiny groundglass pulmonary nodules are noted (around series 3, image 70). The lungs are otherwise clear without evidence of suspicious pulmonary nodules or masses. Pleura: No pleural effusion or pneumothorax. Upper abdomen: The CT of the abdomen and pelvis will be reported separately. Bones and soft tissues: The chest wall soft tissues are unremarkable. There is a heterogeneous bone density within the T6 vertebral body (series 3, image 115), with other multiple tiny hyperdense foci, for example within the T3 vertebral body (series 3, image 61). CONCLUSION: 1. Heterogeneous bony lesion within the T6 vertebral body, together with few hyperdense osseous lesions the most prominent one is noted within the T3 vertebral body are suspicious for metastatic disease. Recommend attention on follow-up scans. 2. Tiny peripheral subpleural groundglass nodules within the right upper lobe are nonspecific to etiology, but most likely infectious/inflammatory. Recommend attention on follow-up scans. 3. Other incidental findings as described.
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FINDINGS: Scouts: No additional findings. Lower neck and Mediastinum: Thyroid gland is unremarkable. No evidence of focal esophageal wall abnormalities. Lymph nodes: Calcified mediastinal and right hilar lymph nodes are noted, likely related to prior granulomatous lung disease.. Small noncalcified mediastinal, hilar and bilateral axillary lymph nodes are noted, which appear most likely reactive. Heart and great arteries: The left atrium is mildly to moderately dilated. Other cardiac chambers appear normal in size. No pericardial effusion. The main pulmonary artery is prominent and measures up to 3.1 cm, which could be seen with pulmonary arterial hypertension. The thoracic aorta is normal in caliber. There is moderate atherosclerotic calcification of the coronary arteries. Airways: Trachea and central bronchi are patent and clear. Lungs : Ill-defined right upper lobe peripheral subpleural multiple tiny groundglass pulmonary nodules are noted (around series 3, image 70). The lungs are otherwise clear without evidence of suspicious pulmonary nodules or masses. Pleura: No pleural effusion or pneumothorax. Upper abdomen: The CT of the abdomen and pelvis will be reported separately. Bones and soft tissues: The chest wall soft tissues are unremarkable. There is a heterogeneous bone density within the T6 vertebral body (series 3, image 115), with other multiple tiny hyperdense foci, for example within the T3 vertebral body (series 3, image 61).
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Findings: There are stable postsurgical changes at the right tongue base following partial glossectomy. There is enhancement in scar tissue along the right mouth floor. The nasopharynx is unremarkable and the oral cavity appear normal. The nodal mass posterior to the right sternocleidomastoid muscle at the plane of the hyoid is smaller, now 7 x 9 mm, previously 16 x 26 mm on 3/16/2021. There is a small (1.5 cm) nodular density near the angle of the right mandible along its medial aspect, possibly a part of the submandibular gland versus a small lymph node. This has not changed significantly compared to the prior scan on 3/16/2021. No other abnormal lymphadenopathy is seen. The hypopharynx and larynx have normal appearance. The infraglottic visceral space appears normal. The remaining soft tissues of the neck are unremarkable. There is stable degenerative disc disease at C5-6. The C-spine is otherwise unremarkable --------------
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Prostate cancer. COMPARISON: 9/14/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 241 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 500 mm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticula. Otherwise normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerosis without aneurysm. URINARY BLADDER: Diffusely thickened without significant adjacent inflammation. REPRODUCTIVE ORGANS: Prostate is surgically absent. No suspicious soft tissue in the prostatectomy bed. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Unchanged sclerotic lesion in the right iliac bone. No new osseous lesion is identified. CONCLUSION: Unchanged sclerotic lesion in the right iliac bone. No new evidence of metastatic disease in the abdomen or pelvis. Postsurgical changes from prior prostatectomy.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticula. Otherwise normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerosis without aneurysm. URINARY BLADDER: Diffusely thickened without significant adjacent inflammation. REPRODUCTIVE ORGANS: Prostate is surgically absent. No suspicious soft tissue in the prostatectomy bed. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Unchanged sclerotic lesion in the right iliac bone. No new osseous lesion is identified.
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Findings: Calcified aortopulmonary window and left hilar nodes are again seen. Enlarged right hilar node measures 11 x 16 mm on series 2 image 54 and was 13 x 19 mm on the prior exam on series 6 image 131. No additional enlarged intrathoracic nodes are present. Mild coronary artery calcification is seen. The heart size and mediastinum are otherwise normal. Calcified granuloma are seen in the left lung. Small right apical nodule is seen on series 2 image 21 which appears to be present on the prior exam but part of that area is obscured by atelectasis. A 5 mm noncalcified nodule is seen in the right upper lobe on series 2 image 41 and appears to been present on the 2018 exam on series 6 image 111 measuring 4 mm. Tiny subpleural RUL nodule on image 38 is also unchanged. The lungs are otherwise normal. No pleural effusion. No focal destructive osseous lesions identified. The gallbladder has been previously surgically removed. Hepatic steatosis is seen. Left renal cysts are again identified. The right adrenal is no longer identified. Calcified granuloma are present in the spleen. Limited images the upper abdomen are otherwise unremarkable.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 74-year-old female with cutaneous T-cell lymphoma, with large cell transformation. History of radiation to the left axilla. COMPARISON: CT chest without contrast dated 6/22/2021 and FDG PET/CT dated 7/30/2020. TECHNIQUE: CT Chest wo contrast. Scan field of view: 360 mm. DLP: 276.25 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. A small peripheral right upper lobe nodule on axial image 42, and left upper lobe on axial image 50, appear unchanged. No new nodule. No pleural effusion. HEART / VESSELS: Prominent left atrium. No pericardial effusion. LAD calcifications. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: A few scattered nonenlarged mediastinal lymph nodes, overall unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Two small nodules in the right and left upper lobes, overall unchanged. No new nodule. 2. No enlarged lymph nodes. 2. Incidental findings as above.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. A small peripheral right upper lobe nodule on axial image 42, and left upper lobe on axial image 50, appear unchanged. No new nodule. No pleural effusion. HEART / VESSELS: Prominent left atrium. No pericardial effusion. LAD calcifications. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: A few scattered nonenlarged mediastinal lymph nodes, overall unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis ABDOMEN and PELVIS: LIVER: Hypoattenuating focus in the anterior right lobe series 301 image 225 is too small to characterize but favors a small hepatic cyst. BILIARY TRACT: Normal. GALLBLADDER: Prior cholecystectomy. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Possible partially septated right renal cyst. LYMPH NODES: Scattered lymph nodes are seen in the para-aortic space and along the iliac chains without pathologic enlargement. STOMACH / SMALL BOWEL: No convincing acute small bowel inflammatory change. Prior small bowel anastomosis in the left abdomen appears unremarkable. COLON / APPENDIX: Scattered diverticulosis. Prior colonic postsurgical changes. Mild thickening in the rectum with a few small adjacent mesorectal nodes. PERITONEUM / MESENTERY: There are a few scattered prominent nodes in the mesentery with surrounding halos of infiltration. The largest are two adjacent nodes on series 301 image 315, the larger measuring up to 1.4 x 0.8 cm. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Borderline prostate size. BODY WALL: Tiny umbilical hernia. MUSCULOSKELETAL: No destructive osseous lesions. The known right thigh mass is out of the field-of-view.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 58-year-old female with unintended weight loss. COMPARISON: CT abdomen pelvis 1/4/2018 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 136 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 350 mm. DLP: 474.73 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: Multiple stones within the gallbladder. No pericholecystic inflammation. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right renal cyst. Additional subcentimeter hypodensity in the right kidney is technically indeterminate but also likely represents a cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticuli without associated inflammation. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Bilateral sacroiliac degenerative changes. Multilevel facet arthrosis also noted. CONCLUSION: 1. No evident etiology to account for the patient's unintended weight loss. 2. Cholelithiasis without evidence of acute cholecystitis.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: Multiple stones within the gallbladder. No pericholecystic inflammation. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right renal cyst. Additional subcentimeter hypodensity in the right kidney is technically indeterminate but also likely represents a cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticuli without associated inflammation. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Bilateral sacroiliac degenerative changes. Multilevel facet arthrosis also noted.
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Findings: Lines and Tubes: None. Body Wall and Abdomen: No destructive osseous lesions. CT of abdomen and pelvis will be reported separately. Lymph Nodes, Mediastinum and Neck: No axillary adenopathy. A few small mediastinal lymph nodes are present. Lungs and Pleura: No pleural effusion. No suspicious appearing pulmonary nodules. Cardiovascular: Heart is at the upper limits of normal for size. No pericardial effusion, dense coronary artery atherosclerotic calcifications, or central PTE.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 74-year-old female for evaluation of pulmonary nodule. COMPARISON: CT abdomen dated 6/18/2021. TECHNIQUE: CT Chest wo contrast. Scan field of view: 320 mm. DLP: 376 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Biapical pleuroparenchymal scarring. Mild upper lobe bronchiectasis. A 3 mm left lower lobe nodule on axial image 124; series 2. A 6 mm left lower lobe nodule on axial image 205; series 2, previously measured 7 mm. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. Trace pericardial fluid. Scattered coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. A 6 mm left lower lobe nodule, overall unchanged. Additional 3 mm left lower lobe nodule. A follow-up CT chest in one year would be helpful to monitor for stability. 2. Mild upper lobe bronchiectasis and pleuroparenchymal scarring.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Biapical pleuroparenchymal scarring. Mild upper lobe bronchiectasis. A 3 mm left lower lobe nodule on axial image 124; series 2. A 6 mm left lower lobe nodule on axial image 205; series 2, previously measured 7 mm. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. Trace pericardial fluid. Scattered coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small hiatal hernia HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. Area of low-attenuation adjacent to gallbladder fossa is likely focal fat. BILIARY TRACT: Mild biliary duct dilatation is likely related to prior cholecystectomy. GALLBLADDER: Surgically absent PANCREAS: Fatty atrophy SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is surgically absent. There is a small amount of indeterminate soft tissue seen along the left vaginal fornix measuring 3.1 x 2.8 cm on image 241, series 201. The bilateral ovaries are unremarkable. No drainable fluid collection.. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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CT Head wo contrast 1/7/2022 3:01 PM Clinical Information: Altered Mental Status Comparison: None Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 209 mm. DLP: 2571 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Chronic appearing left lamina papyracea fracture. Impression: No CT evidence of acute intracranial abnormality.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Chronic appearing left lamina papyracea fracture.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Minute subcentimeter hypodensity within the left hepatic lobe is technically indeterminate but statistically likely a cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Minute subcentimeter hypodensity within the spleen is technically indeterminate but of questionable significance. ADRENALS: Normal KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: There is trace pelvic free fluid, likely physiologic. RETROPERITONEUM: Normal. VESSELS: Mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is mildly heterogeneous which could represent uterine fibroids or adenomyosis. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute fracture identified. Lumbar spine CT: No acute fracture or dislocation of the lumbar spine. There is mild multilevel discogenic degenerative changes are seen within the spine. There are small posterior disc osteophyte complexes at L4-L5 and L5-S1, nonspecific. Mild bilateral neural foraminal stenosis is seen at L5-S1.
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EXAM: CT Knee Right wo contrast CLINICAL INFORMATION: Knee swelling and pain after fall COMPARISON: None. TECHNIQUE: CT Knee Right wo contrast Scan field of view: 232 mm. DLP: 431.20 mGy cm. Findings: There is a moderate amount of heterogeneous density hemorrhage in the anterior distal thigh. Hemorrhage is primarily in the vastus intermedius muscle and prefemoral fat, and it is slightly greater medially than laterally. The vastus medialis is superficially displaced by the hemorrhage. Measurement is difficult due to irregular shape, but the region involved is approximately 7.5 x 3.1 6.6 cm. No osseous fracture is seen. There is artifact from the arthroplasty hardware. Knee joint alignment is normal. Impression: Prefemoral hematoma in the distal thigh. No underlying fracture or hardware abnormality is seen.
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Findings: There is a moderate amount of heterogeneous density hemorrhage in the anterior distal thigh. Hemorrhage is primarily in the vastus intermedius muscle and prefemoral fat, and it is slightly greater medially than laterally. The vastus medialis is superficially displaced by the hemorrhage. Measurement is difficult due to irregular shape, but the region involved is approximately 7.5 x 3.1 6.6 cm. No osseous fracture is seen. There is artifact from the arthroplasty hardware. Knee joint alignment is normal.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Minute subcentimeter hypodensity within the left hepatic lobe is technically indeterminate but statistically likely a cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Minute subcentimeter hypodensity within the spleen is technically indeterminate but of questionable significance. ADRENALS: Normal KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is normal. The colon is otherwise unremarkable. PERITONEUM / MESENTERY: There is trace pelvic free fluid, likely physiologic. RETROPERITONEUM: Normal. VESSELS: Mild aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is mildly heterogeneous which could represent uterine fibroids or adenomyosis. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute fracture identified. Lumbar spine CT: No acute fracture or dislocation of the lumbar spine. There is mild multilevel discogenic degenerative changes are seen within the spine. There are small posterior disc osteophyte complexes at L4-L5 and L5-S1, nonspecific. Mild bilateral neural foraminal stenosis is seen at L5-S1.
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EXAM: CT Angio Abdomen and Pelvis CLINICAL INFORMATION: 78-year-old female with abdominal pain and concern for mesenteric ischemia. COMPARISON: None. TECHNIQUE: CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 371 mm. DLP: 738 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Mild atherosclerotic disease. ABDOMINAL AORTA: Mild atherosclerotic disease. CELIAC AXIS: No significant abnormality. SMA: Mild atherosclerotic disease without significant luminal narrowing. RIGHT RENAL: Mild atherosclerotic disease without significant luminal narrowing. LEFT RENAL: Mild atherosclerotic disease without significant luminal narrowing. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Borderline diffuse hepatic steatosis. BILIARY TRACT: Expected postcholecystectomy prominence of the common bile duct. GALLBLADDER: Gallbladder surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus appears surgically absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. CONCLUSION: No evidence of etiology for the patient's abdominal pain. Specifically, no evidence of significant atherosclerotic narrowing of the mesenteric vasculature.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Mild atherosclerotic disease. ABDOMINAL AORTA: Mild atherosclerotic disease. CELIAC AXIS: No significant abnormality. SMA: Mild atherosclerotic disease without significant luminal narrowing. RIGHT RENAL: Mild atherosclerotic disease without significant luminal narrowing. LEFT RENAL: Mild atherosclerotic disease without significant luminal narrowing. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Borderline diffuse hepatic steatosis. BILIARY TRACT: Expected postcholecystectomy prominence of the common bile duct. GALLBLADDER: Gallbladder surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus appears surgically absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization.
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Findings: The AP window node on series 2 image 43 measures 11 mm in short axis unchanged from the previous exam. No additional enlarged intrathoracic nodes are present. A moderate hiatal hernia is redemonstrated. The heart size and mediastinum are otherwise normal. Elevation of the right hemidiaphragm is redemonstrated with atelectasis in the RLL and RML again noted. The patchy airspace densities seen in the right lung on the prior exam have resolved. Tiny nodule is seen anteriorly in the left upper lobe on series 2 image 51 and motion artifact obscures this area on the last two exams. The lungs are otherwise normal. Previous vertebral plasties at T10 and 11 are redemonstrated. No acute or new focal destructive osseous lesions identified. Limited images of the upper abdomen are unremarkable.
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Lung Cancer Screening Clinical Information: Lung cancer screening Technique: Scan field of view: 340 mm. Height: 63 in. Patient weight: 154 lbs. CTDI vol: 0.83 mGy. DLP: 31.45 mGy cm. 0.60 mm images were obtained through the chest. The CT is jointly interpreted by Drs. Singh and Ahmed Smoking Status: Former If not current, quit years ago: 7 Pack Years: 60 Screen Year: 5 Comparison: Lung cancer screening chest CT from 11/18/2020. Interpretation and recommendations are based on 2019 version of ACR LungRads recommendations Findings: No enlarged hilar or mediastinal nodes are present. Severe calcification of the aortic valve leaflets and mitral anulus is again noted. Few tiny probably calcified right upper lobe nodules are unchanged, likely related to prior granulomatous lung disease. A tiny oval nodule along with the right major fissure (series 2, image 110) is unchanged and likely a juxta fissural pulmonary parenchymal lymph node. No new suspicious noncalcified pulmonary nodules or masses. Mild upper lobe predominant centrilobular emphysema is similar. Bilateral lower lobe mild central tubular bronchiectasis is again noted. Linear opacities of subsegmental scarring/atelectasis within the right lower lobe and lingula are similar. Interval worsening of the linear subsegmental atelectasis/scarring within the left lower lobe, with subtle increase in the left hemidiaphragm elevation. No pleural or pericardial effusion. Coronary artery calcification: The visual score of calcification is 4 (unchanged). (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: Unremarkable, apart from degenerative bony changes. Impression: 1. Few tiny calcified nodules within the right upper lobe, likely related to prior healed granulomatous lung disease. 2. No new abnormality suspicious for lung cancer. 3. Persistent upper lobe predominant mild centrilobular emphysema and bilateral lower lobe bronchiectasis. 4. Interval increased subsegmental atelectasis within the basal left lower lobe, with associated mildly elevated left hemidiaphragm, nonspecific. LungRads category: 1 Lung-Rads Modifier S: No clinically significant or potentially clinically significant findings. Recommendation: Continued annual low-dose lung cancer screening chest CT. ====================================================================================== REFERENCES: http://www.acr.org/\R\/media/ACR/Documents/PDF/QualitySafety/Resources/LungRADS/AssessmentCateg ries http://www.acr.org/Quality-Safety/Lung-Cancer-Screening-Center Category 0: Incomplete. Category 1: Negative - No nodules or definitely benign nodules. Category 2: Benign Appearance or Behavior - Nodules with a very low likelihood of becoming a clinically active cancer due to size or lack of growth. Category 3: Probably benign finding(s) - Short term follow-up suggested; includes nodules with a low likelihood of becoming a clinically active cancer. Category 4A: Suspicious - Findings for which additional diagnostic testing is recommended. Category 4B and 4X: Very Suspicious - Findings for which additional diagnostic testing and/or tissue sampling is recommended. Modifier S: Other Findings - Clinically significant or potentially clinically significant findings (non-lung cancer). References: http://www.acr.org/\R\/media/ACR/Documents/PDF/QualitySafety/Resources/LungRADS/AssessmentCateg ries http://www.acr.org/Quality-Safety/Lung-Cancer-Screening-Center
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Findings: No enlarged hilar or mediastinal nodes are present. Severe calcification of the aortic valve leaflets and mitral anulus is again noted. Few tiny probably calcified right upper lobe nodules are unchanged, likely related to prior granulomatous lung disease. A tiny oval nodule along with the right major fissure (series 2, image 110) is unchanged and likely a juxta fissural pulmonary parenchymal lymph node. No new suspicious noncalcified pulmonary nodules or masses. Mild upper lobe predominant centrilobular emphysema is similar. Bilateral lower lobe mild central tubular bronchiectasis is again noted. Linear opacities of subsegmental scarring/atelectasis within the right lower lobe and lingula are similar. Interval worsening of the linear subsegmental atelectasis/scarring within the left lower lobe, with subtle increase in the left hemidiaphragm elevation. No pleural or pericardial effusion. Coronary artery calcification: The visual score of calcification is 4 (unchanged). (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: Unremarkable, apart from degenerative bony changes.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Right and left internal jugular central venous catheters are present, tips terminate at the level of the superior cavoatrial junction. CHEST: LUNGS / AIRWAYS / PLEURA: Moderate size loculated hydropneumothorax is present, chest tube is present in the left lung base pleural space. The density of the pleural fluid is greater than on the previous measuring approximately 60-70 Hounsfield units. There are bilateral consolidative opacities primarily in the dependent aspects of the lower lobes additional scattered groundglass and consolidative opacities throughout the bilateral lungs. Endotracheal tube is in place, tip terminates 3.2 cm superior to the carina. There is small volume layering secretions within the thoracic trachea and right mainstem bronchus. HEART / VESSELS: Heart size normal. Trace pericardial effusion. Moderate to severe calcifications of the thoracic aorta and moderate coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube in place, courses into the stomach and terminates outside the field-of-view. LYMPH NODES: Prominent lymph nodes throughout the mediastinum measuring up to 1.0 cm in diameter in the right paratracheal distribution on series 2 image 21, overall similar to prior examination. CHEST WALL: Diffuse anasarca. Scattered calcifications in the paraspinal musculature. UPPER ABDOMEN: Marked atherosclerotic calcifications. Gallbladder is absent. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: 74-year-old female with hematuria. COMPARISON: Renal ultrasound 10/6/2021. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 470 mm. DLP: 1056.08 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Mild thickening of the left adrenal gland. The right adrenal gland is unremarkable. KIDNEYS: Large right upper and lower pole renal cysts. No hydronephrosis or renal calculi bilaterally. Several phleboliths lie in close proximity to the ureters without evidence of calculi within the ureters. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially collapsed. REPRODUCTIVE ORGANS: Uterus is unremarkable. No suspicious adnexal masses. BODY WALL: Tiny fat-containing periumbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes. No aggressive osseous lesions. CONCLUSION: 1. No abnormality within the abdomen or pelvis to explain the patient's hematuria on this noncontrast exam. 2. Additional chronic and incidental findings as described above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Mild thickening of the left adrenal gland. The right adrenal gland is unremarkable. KIDNEYS: Large right upper and lower pole renal cysts. No hydronephrosis or renal calculi bilaterally. Several phleboliths lie in close proximity to the ureters without evidence of calculi within the ureters. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Partially collapsed. REPRODUCTIVE ORGANS: Uterus is unremarkable. No suspicious adnexal masses. BODY WALL: Tiny fat-containing periumbilical hernia. MUSCULOSKELETAL: Multilevel discogenic degenerative changes. No aggressive osseous lesions.
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FINDINGS: Few overlying size nodes are present in the upper mediastinum with one such node in image 28, series 201 anterior to the upper trachea and in between the SVC and left innominate artery, measures 18 x 12 mm. Three-vessel coronary artery atherosclerotic disease changes. Trace pericardial effusion is present. Asymmetric upper lobe dominant mixed emphysema. There is an ill-defined groundglass density 3 mm nodular density in the left upper lobe in image 31, series 201. Small dependent pleural effusions are noted which is partly loculated on the left with adjacent linear left lower lobe lung atelectasis. No focal lytic or sclerotic bone lesion.
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EXAM: CT Angio Abdomen and Pelvis CLINICAL INFORMATION: 81-year-old male with endovascular right iliac aneurysm repair and right hypogastric embolization. COMPARISON: CTA abdomen and pelvis 10/14/2021 TECHNIQUE: CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 175 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 420 mm. DLP: 1258 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis Stent VASCULATURE: ENDOVASCULAR STENT: Interval insertion of a endovascular stent within the infrarenal abdominal aorta extending into the bilateral common iliac arteries. The stent extends into the right external iliac artery. ENDOLEAK: None. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Stent within the infrarenal abdominal aorta extending into the left common iliac artery and right external iliac artery. The distal abdominal measures 3.1 cm on image 419 series 11, previously 3.1 cm on image 427 series 401. CELIAC AXIS: Mild to moderate narrowing at the origin of the aorta (series 10 image 55) with possible small dissection flap. There is poststenotic dilation up to 1.4 cm (series 10 image 58), unchanged from prior. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Interval stenting of the right common iliac artery aneurysm without evidence of endovascular leak; the common iliac artery aneurysm measures 2.7 cm on image 493 series 11, previously 3.7 cm on image 463 series 401. The stent extends into the right external iliac artery. Interval embolization of the internal right iliac artery, with a large amount of artifact limiting evaluation in this area somewhat. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: The stent extends into the left common iliac artery without evidence of stenosis or aneurysm. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Right lower lung volume loss with atelectasis and pleural thickening and plaques of calcification. Mild left basilar dependent atelectasis. DISTAL ESOPHAGUS: Small hiatal hernia. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Contracted. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable appearance of the multiple bilateral simple cysts. There is hypodense lesion within the mid to upper right renal pole measuring 1.3 cm (series 9 image 67), previously 1.2 cm (series 401 image 304), with Hounsfield units of 66 on image 67 series 9. Additional subcentimeter hypodensities are too small to characterize; however, likely representing cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is not well visualized. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Small periumbilical fat-containing hernia. MUSCULOSKELETAL: Sclerotic lesion within the L5 vertebral body, likely representing a bone island. No aggressive osseous lesions. Mild degenerative changes. CONCLUSION: 1. Possible small dissection flap in the proximal celiac artery is more prominent than on the prior study, with mild to moderate narrowing at the aortic origin again noted, with poststenotic dilatation. 2.Interval insertion of an infrarenal abdominal aortic stent extending into the bilateral common iliac arteries and into the right external iliac artery aneurysm without evidence of endoleak. 3. Indeterminate lesion mid to upper right renal pole measuring 1.2 cm does not quite meet criteria for hyperdense cyst on noncontrasted study and a portal venous phase was not performed. Continued attention on follow-up is recommended. 4. Additional stable chronic and incidental findings as described above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis Stent VASCULATURE: ENDOVASCULAR STENT: Interval insertion of a endovascular stent within the infrarenal abdominal aorta extending into the bilateral common iliac arteries. The stent extends into the right external iliac artery. ENDOLEAK: None. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Stent within the infrarenal abdominal aorta extending into the left common iliac artery and right external iliac artery. The distal abdominal measures 3.1 cm on image 419 series 11, previously 3.1 cm on image 427 series 401. CELIAC AXIS: Mild to moderate narrowing at the origin of the aorta (series 10 image 55) with possible small dissection flap. There is poststenotic dilation up to 1.4 cm (series 10 image 58), unchanged from prior. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Interval stenting of the right common iliac artery aneurysm without evidence of endovascular leak; the common iliac artery aneurysm measures 2.7 cm on image 493 series 11, previously 3.7 cm on image 463 series 401. The stent extends into the right external iliac artery. Interval embolization of the internal right iliac artery, with a large amount of artifact limiting evaluation in this area somewhat. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: The stent extends into the left common iliac artery without evidence of stenosis or aneurysm. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Right lower lung volume loss with atelectasis and pleural thickening and plaques of calcification. Mild left basilar dependent atelectasis. DISTAL ESOPHAGUS: Small hiatal hernia. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Contracted. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Stable appearance of the multiple bilateral simple cysts. There is hypodense lesion within the mid to upper right renal pole measuring 1.3 cm (series 9 image 67), previously 1.2 cm (series 401 image 304), with Hounsfield units of 66 on image 67 series 9. Additional subcentimeter hypodensities are too small to characterize; however, likely representing cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is not well visualized. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Small periumbilical fat-containing hernia. MUSCULOSKELETAL: Sclerotic lesion within the L5 vertebral body, likely representing a bone island. No aggressive osseous lesions. Mild degenerative changes.
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FINDINGS/CONCLUSION: No acute fracture or dislocation. The knee joint spaces are maintained. Small joint effusion. Popliteal cyst is noted. Quadriceps enthesopathy. The soft tissues are unremarkable.
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CT Head wo contrast 1/7/2022 3:34 PM Clinical Information: Altered Mental Status Comparison: None available Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 200 mm. DLP: 1291.60 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is mild ventricular prominence, likely on an ex vacuo basis from volume loss. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: No CT evidence of acute intracranial abnormality.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. There is mild ventricular prominence, likely on an ex vacuo basis from volume loss. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Mosaic attenuation of the lung bases, similar to prior, may reflect mosaic perfusion versus small airways disease. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Redemonstration of a mass in the pancreatic head which is centrally hypoenhancing and peripherally hyperenhancing measuring 3.1 x 2.2 cm (series 4 image 73), similar to the prior examination. The pancreas is otherwise stable appearance. SPLEEN: Splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Few diverticula. PERITONEUM / MESENTERY: Misty mesentery with small lymph nodes consistent with mesenteric panniculitis RETROPERITONEUM: Normal. VESSELS: Moderate aortobiiliac atherosclerosis without aneurysm URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Minute umbilical protrusion. MUSCULOSKELETAL: Multilevel degenerative changes in the lumbar spine
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CT angiogram of the brain with contrast CT angiogram of the neck with contrast - Indication: R sided weakness. - Comparison: Noncontrast head CT earlier the same date. - Technique: During the administration of IV contrast bolus, axial CTA images of the head and neck were obtained and reformatted in overlapping images. 3-D CT angiographic images were generated from the axial data set. "Sliding MIP" images were also generated in the sagittal, axial, and coronal planes. Patient weight: 168 lbs. IV contrast: Omnipaque 350, 84 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 259 mm. DLP: 2573.40 mGy cm. (accession CT220003867), Patient weight: 168 lbs. IV contrast: Omnipaque 350, 84 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 259 mm. (accession CT220003868) - Findings: CT angiogram of the brain: The visualized portions of the ICAs and vertebrobasilar system appear within normal limits. There is a fetal supply of the left posterior cerebral artery. Otherwise visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. - CT angiogram of the neck: There is a normal three great vessel arch. The visualized portions of the common, as well as cervical portions of the internal, and external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. - There is dehiscence of the sigmoid plate adjacent to the right jugular bulb. No additional lateral outpouching is however noted. There is prominence of the adenoids. There are small scattered cervical lymph nodes, which are likely reactive. Impression: No evidence of acute craniocervical arterial abnormality.
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Findings: CT angiogram of the brain: The visualized portions of the ICAs and vertebrobasilar system appear within normal limits. There is a fetal supply of the left posterior cerebral artery. Otherwise visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. - CT angiogram of the neck: There is a normal three great vessel arch. The visualized portions of the common, as well as cervical portions of the internal, and external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. - There is dehiscence of the sigmoid plate adjacent to the right jugular bulb. No additional lateral outpouching is however noted. There is prominence of the adenoids. There are small scattered cervical lymph nodes, which are likely reactive.
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FINDINGS: There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction or remote infarction. The gray-white junction is maintained. The ventricles, cisterns and sulci are unremarkable. There is no mass effect. The calvarium is intact. There is a small right mastoid effusion. The remaining visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
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CT angiogram of the brain with contrast CT angiogram of the neck with contrast - Indication: R sided weakness. - Comparison: Noncontrast head CT earlier the same date. - Technique: During the administration of IV contrast bolus, axial CTA images of the head and neck were obtained and reformatted in overlapping images. 3-D CT angiographic images were generated from the axial data set. "Sliding MIP" images were also generated in the sagittal, axial, and coronal planes. Patient weight: 168 lbs. IV contrast: Omnipaque 350, 84 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 259 mm. DLP: 2573.40 mGy cm. (accession CT220003867), Patient weight: 168 lbs. IV contrast: Omnipaque 350, 84 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 259 mm. (accession CT220003868) - Findings: CT angiogram of the brain: The visualized portions of the ICAs and vertebrobasilar system appear within normal limits. There is a fetal supply of the left posterior cerebral artery. Otherwise visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. - CT angiogram of the neck: There is a normal three great vessel arch. The visualized portions of the common, as well as cervical portions of the internal, and external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. - There is dehiscence of the sigmoid plate adjacent to the right jugular bulb. No additional lateral outpouching is however noted. There is prominence of the adenoids. There are small scattered cervical lymph nodes, which are likely reactive. Impression: No evidence of acute craniocervical arterial abnormality.
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Findings: CT angiogram of the brain: The visualized portions of the ICAs and vertebrobasilar system appear within normal limits. There is a fetal supply of the left posterior cerebral artery. Otherwise visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. - CT angiogram of the neck: There is a normal three great vessel arch. The visualized portions of the common, as well as cervical portions of the internal, and external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. - There is dehiscence of the sigmoid plate adjacent to the right jugular bulb. No additional lateral outpouching is however noted. There is prominence of the adenoids. There are small scattered cervical lymph nodes, which are likely reactive.
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Findings: No enlarged hilar or mediastinal nodes are present. The mediastinum is normal. Moderate upper lobe predominant centrilobular emphysema with chronic bronchial wall thickening.. Solid 3 mm subpleural nodule within the lateral basal segment of the right lower lobe on image 153 of series 3. Solid perifissural 5 x 4 mm nodule within the left lower lobe adjacent to the major fissure on image 98. A few tiny calcified nodules are seen. Subsegmental atelectasis in the middle lobe and lingula. Mild basilar predominant subpleural reticulation most significant in the lower lobes. Dependent secretions within the trachea. No pleural effusion or pleural thickening. Coronary artery calcification: The visual score of calcification is 9. (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: No acute or aggressive osseous abnormality.
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CT Head wo No Charge 1/7/2022 2:26 PM Clinical Information: 44y BF ESRD (iHD, via LUE AVG, TTHSa), HTN, DM2, anemia presented (1230) HED with bilateral foot pain with draining blisters, BLE edema Comparison: None available Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 244 mm. DLP: 1370.10 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: No CT evidence of acute intracranial abnormality.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
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Findings: Irregularity of the superficial soft tissue of the left external ear for example axial series 7, image 138, consistent with patient's known conchal bowl lesion. Lymph nodes are unremarkable without pathologic enlargement or abnormal morphology. The frontal, sphenoid, maxillary sinuses and ethmoid air cells are clear. The nasopharynx and oropharynx are normal. The base of the tongue and lymphoid tissue within Waldeyer's ring are unremarkable. Small tonsilloliths on the right. The hypopharynx and larynx are normal. The parotid and submandibular glands are normal. Multiple subcentimeter hypoattenuating lesions in the thyroid. Mild diffuse cerebral volume loss with associated ex vacuo ventriculomegaly. Mild atherosclerotic calcifications of the carotid siphons. Bilateral lens replacement. Multilevel degenerative changes of the spine. Patient is mostly edentulous with multiple dental caries in the remaining teeth. ---------------
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CT Perfusion 1/7/2022 2:41 PM Clinical Information: 44y BF ESRD (iHD, via LUE AVG, TTHSa), HTN, DM2, anemia presented (1230) HED with bilateral foot pain with draining blisters, BLE edema Comparison: No prior perfusion studies are available for comparison. Technique: A CT perfusion study was performed during single pass of 40 cc contrast bolus. Axial images were acquired at 16 axial locations and time-attenuation curves generated from this dataset were utilized to calculate cerebral blood flow, mean transit time, time to peak, and cerebral blood volume maps as well as region of interest specific quantitative data. "Prognostic" color maps were also generated using RAPID processing software Patient weight: 150 lbs. IV contrast: Omnipaque 350, 40 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 0 sec. Scan field of view: 210 mm. DLP: 1440 mGy cm. Findings: RAPID images demonstrate CBF less than 30% volume: 0 ml and T. Max greater than 6seconds volume: 0 ml . Mismatch volume is 0 ml. There is no abnormal MTT, T max, CBV and CBF to suggest significant ischemia or infarction at the territory of the major intracranial arteries. Conclusion: No significant ischemia or infarction at the territory of major intracranial arteries.
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Findings: RAPID images demonstrate CBF less than 30% volume: 0 ml and T. Max greater than 6seconds volume: 0 ml . Mismatch volume is 0 ml. There is no abnormal MTT, T max, CBV and CBF to suggest significant ischemia or infarction at the territory of the major intracranial arteries.
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Findings: Irregularity of the superficial soft tissue of the left external ear for example axial series 7, image 138, consistent with patient's known conchal bowl lesion. Lymph nodes are unremarkable without pathologic enlargement or abnormal morphology. The frontal, sphenoid, maxillary sinuses and ethmoid air cells are clear. The nasopharynx and oropharynx are normal. The base of the tongue and lymphoid tissue within Waldeyer's ring are unremarkable. Small tonsilloliths on the right. The hypopharynx and larynx are normal. The parotid and submandibular glands are normal. Multiple subcentimeter hypoattenuating lesions in the thyroid. Mild diffuse cerebral volume loss with associated ex vacuo ventriculomegaly. Mild atherosclerotic calcifications of the carotid siphons. Bilateral lens replacement. Multilevel degenerative changes of the spine. Patient is mostly edentulous with multiple dental caries in the remaining teeth. ---------------
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CT head without contrast Indication: post op. Comparison: MRI brain dated 12/9/2021. Technique: Multiple contiguous axial images of the brain were obtained from base to the vertex without the use of intravenous contrast. Sagittal and coronal reconstruction images were formatted in postprocessing. Scan field of view: 231 mm. DLP: 994 mGy cm. . Findings: Interval right parietal craniotomy and resection of right parietal mass, with expected postoperative changes including moderate pneumocephalus within and adjacent to resection bed and extra-axial gas overlying both frontal lobes and minimal amount within anterior right middle cranial fossa. Scattered small volume extra-axial hemorrhage is seen at the site of resection, with the largest focus measuring up to 1.7 x 1.3 cm on coronal image 50. There is continued large amount of hypoattenuation within the right cerebral hemisphere resulting in effacement of adjacent sulci and 5 mm of leftward midline shift. There is mild mass effect on the ventricular system from the aforementioned edema, without intraventricular hemorrhage or hydrocephalus. There is also a large hypodense subdural fluid collection along the posterior interhemispheric fissure which is new The orbits appear normal. Paranasal sinuses and mastoid air cells are clear. Postsurgical changes to the calvarium from a right parietal craniotomy. Overlying skin staples and subcutaneous gas with surgical drain without postoperative fluid collection. Impression: 01. Expected postsurgical changes from right parietal craniotomy and mass resection detailed above. Small volume scattered extra-axial hemorrhage is seen adjacent to the resection bed, and scattered small volume pneumocephalus is also present. 02. Large amount of vasogenic edema within the right cerebral hemisphere. Mild leftward midline shift 03.There is a new moderate-sized hypodense subdural collection on the right along the posterior interhemispheric fissure resulting in focal mass effect upon the medial right parietal lobe. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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Findings: Interval right parietal craniotomy and resection of right parietal mass, with expected postoperative changes including moderate pneumocephalus within and adjacent to resection bed and extra-axial gas overlying both frontal lobes and minimal amount within anterior right middle cranial fossa. Scattered small volume extra-axial hemorrhage is seen at the site of resection, with the largest focus measuring up to 1.7 x 1.3 cm on coronal image 50. There is continued large amount of hypoattenuation within the right cerebral hemisphere resulting in effacement of adjacent sulci and 5 mm of leftward midline shift. There is mild mass effect on the ventricular system from the aforementioned edema, without intraventricular hemorrhage or hydrocephalus. There is also a large hypodense subdural fluid collection along the posterior interhemispheric fissure which is new The orbits appear normal. Paranasal sinuses and mastoid air cells are clear. Postsurgical changes to the calvarium from a right parietal craniotomy. Overlying skin staples and subcutaneous gas with surgical drain without postoperative fluid collection.
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Findings: The paranasal sinuses are normally formed and developed. No mucosal thickening or fluid retention is seen. The maxillofacial bones, orbits and orbital contents are unremarkable. No defect is seen in the anterior skull base or calvarium. ---------------
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 57-year-old male with epigastric/periumbilical pain. COMPARISON: Multiple prior CTs of the abdomen pelvis, most recently 7/12/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 172 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 SEC. sec. Scan field of view: 390 mm. DLP: 571.92 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Simple right renal cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Circumferential bladder wall thickening. Previously identified nodular lesion along the right lateral urinary bladder wall appears inconspicuous/absent. REPRODUCTIVE ORGANS: Prostate is borderline enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No evident etiology to account for the patient's epigastric pain. 2. Circumferential urinary bladder wall thickening without definite visualization of the previously described lesion along the right lateral urinary bladder wall.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Simple right renal cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Circumferential bladder wall thickening. Previously identified nodular lesion along the right lateral urinary bladder wall appears inconspicuous/absent. REPRODUCTIVE ORGANS: Prostate is borderline enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separate CT chest report. ABDOMEN and PELVIS: LIVER: Mild hepatic steatosis. No focal lesion is identified. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Left angiomyolipoma measures 4.1 x 2.9 (series 202, image 275), previously 4.2 x 2.8. Unchanged focal scarring of the right kidney. LYMPH NODES: Interval decrease in size of retroperitoneal lymph nodes, now sole enlarged pericaval lymph node measures 2.3 x 1.2 cm (series 202, image 327), previously 4.0 x 2.0 cm. STOMACH / SMALL BOWEL: Small hiatal hernia. Oral contrast progressed to the terminal ileum. COLON / APPENDIX: Scattered diverticulosis. PERITONEUM / MESENTERY: Redemonstration of small splenule anterior to the descending colon, unchanged. RETROPERITONEUM: Normal. VESSELS: Mild scattered atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Surgically absent uterus. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Bilateral facet arthropathy. No suspicious osseous lesion.
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EXAM: CT Enterography CLINICAL INFORMATION: 20-year-old female with abdominal pain and weight loss; concern for Crohn's disease. COMPARISON: None. TECHNIQUE: CT imaging of the abdomen and pelvis was performed with IV contrast per CT enterography protocol. CT Enterography Patient weight: 84 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Breeza: 1500 ml. Water: 16 oz. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 80 sec. Scan field of view: 320 mm. DLP: 131 mGy cm. STRUCTURED REPORT: CT Enterography FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: Please note, evaluation is partially limited given the extensive streak artifact associated with posterior thoracolumbar spinal fusion hardware. STOMACH: No abnormality. SMALL BOWEL: No abnormal bowel wall thickening or enhancement. No dilated bowel loops. PERITONEUM / MESENTERY: No fistula or abscess. COLORECTAL: No abnormal bowel wall thickening or enhancement. APPENDIX: Normal. PERIANAL TISSUES: No fistula or abscess. LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Heterogeneously hypoenhancing region of the anterior uterine body, measuring 2.4 x 1.8 cm and best demonstrated on sagittal series 5, image 98. Bilateral, left greater the right, cysts in the posterior lingula, likely a Bartholin's cysts. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Posterior thoracolumbar spinal fusion hardware. CONCLUSION: 1. Partially limited examination secondary to extensive streak artifact from thoracolumbar spinal fusion hardware. Within these limitations, no evidence of active inflammatory bowel disease. 2. Heterogeneously hypoenhancing region within the anterior uterine body. Overall appearance is nonspecific but may reflect underlying uterine fibroids. Recommend clinical correlation and consideration of further evaluation with pelvic ultrasound.
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FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: Please note, evaluation is partially limited given the extensive streak artifact associated with posterior thoracolumbar spinal fusion hardware. STOMACH: No abnormality. SMALL BOWEL: No abnormal bowel wall thickening or enhancement. No dilated bowel loops. PERITONEUM / MESENTERY: No fistula or abscess. COLORECTAL: No abnormal bowel wall thickening or enhancement. APPENDIX: Normal. PERIANAL TISSUES: No fistula or abscess. LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Heterogeneously hypoenhancing region of the anterior uterine body, measuring 2.4 x 1.8 cm and best demonstrated on sagittal series 5, image 98. Bilateral, left greater the right, cysts in the posterior lingula, likely a Bartholin's cysts. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Posterior thoracolumbar spinal fusion hardware.
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FINDINGS: Left lower lobe noncalcified nodule near the diaphragm in image 224, series 202 is stable at 5 mm. Linear atelectasis in both lower lobes with mild diffuse increased peribronchial thickening as before. No new nodule/mass, airspace consolidation or interstitial abnormality seen. Multiple collaterals are present in the left posterior chest wall and mediastinum due to narrowing of the left innominate vein. A left subclavian indwelling Mediport catheter tip terminates in the proximal SVC. There are subcentimeter size nodes in the mediastinum which are stable in size. There is no pleural or pericardial effusion and visualized bones are unremarkable.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 83-year-old female with Actinomyces bacteremia. COMPARISON: Chest radiograph 1/6/2022; CT chest 12/23/2021 TECHNIQUE: CT Chest wo contrast. Scan field of view: 311 mm. DLP: 172.10 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Peripherally calcified subcentimeter left thyroid nodule. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Multifocal patchy groundglass opacities are seen diffusely along with developing consolidative changes in bilateral lung bases. Moderate-sized right pleural effusion. No pneumothorax. HEART / VESSELS: Severe cardiomegaly. Redemonstrated postsurgical changes of the aortic root repair and left atrial appendage clipping. Atherosclerotic calcifications of the thoracic aorta, coronary arteries and proximal great vessels. Main pulmonary artery is enlarged. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube courses through the esophagus with tip in the distal stomach. No evidence of mediastinal hematoma. LYMPH NODES: Prominent paratracheal, subcarinal and bilateral hilar lymph nodes, likely reactive. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Cholecystectomy clips in place. No significant abnormality. MUSCULOSKELETAL: Postsurgical changes from median sternotomy. Chronic degenerative changes of the thoracic spine. Chronic compression deformities of T11 and T12. CONCLUSION: 1. Multifocal predominantly subpleural groundglass/consolidative changes in bilateral lung bases, concerning for developing multifocal/atypical pneumonia. 2. Moderate size right pleural ef1fusion. 3. Severe cardiomegaly and superimposed changes of mild volume overload in the lungs. Redemonstrated mediastinal postsurgical changes, as above. 4. Additional chronic and incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Peripherally calcified subcentimeter left thyroid nodule. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Multifocal patchy groundglass opacities are seen diffusely along with developing consolidative changes in bilateral lung bases. Moderate-sized right pleural effusion. No pneumothorax. HEART / VESSELS: Severe cardiomegaly. Redemonstrated postsurgical changes of the aortic root repair and left atrial appendage clipping. Atherosclerotic calcifications of the thoracic aorta, coronary arteries and proximal great vessels. Main pulmonary artery is enlarged. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube courses through the esophagus with tip in the distal stomach. No evidence of mediastinal hematoma. LYMPH NODES: Prominent paratracheal, subcarinal and bilateral hilar lymph nodes, likely reactive. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Cholecystectomy clips in place. No significant abnormality. MUSCULOSKELETAL: Postsurgical changes from median sternotomy. Chronic degenerative changes of the thoracic spine. Chronic compression deformities of T11 and T12.
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The calculated liver volumes are as follows: Total liver volume: 2159 mL Left hepatic lobe volume: 889 mL (41%) Right hepatic lobe volume: 1271 mL (59%) Left hepatic lobe lateral segment volume: 639 mL (30%) Left hepatic lobe medial segment volume: 249 mL (12%) Right hepatic lobe anterior segment volume: 845 mL (39%) Right hepatic lobe posterior segment volume: 426 mL (20%)
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EXAM: CT Abdomen with contrast CLINICAL INFORMATION: 58-year-old female with pancreatic mass and nondiagnostic EUS. COMPARISON: Multiple prior CTs of the abdomen pelvis, most recently 6/22/2021 TECHNIQUE: CT Abdomen with contrast. Patient weight: 126 lbs. IV contrast: Omnipaque 350, 99 ml, per protocol. Water: 16 oz. Saline flush: 20 ml. IV contrast injection rate: 3 ml per sec. Scan delay: Bolus Tracked. Scan field of view: 359 mm. DLP: 301 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Scarring versus subsegmental atelectasis in the left lower lobe. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Indeterminate 10 mm region of arterial enhancement in the posterior right hepatic lobe on axial series 9 seven, image 48. This persists on the venous phase, suggestive of a hemangioma. BILIARY TRACT: Small amount of pneumobilia, perhaps related to prior intervention/endoscopy. GALLBLADDER: No abnormality. PANCREAS: Slight interval increase in size of a hypoenhancing pancreatic head mass which currently measures approximately 2.0 x 1.3 cm on axial series 907, image 71 (previously 1.7 x 1.2 cm). The pancreatic head mass is inseparable from the adjacent duodenum (coronal series 9, image 76). The lesion abuts less than 180 degrees of the adjacent left hepatic artery. The right hepatic artery appears completely encased and otherwise not well seen on the arterial phase images. There is no significant upstream parenchymal atrophy. Mild to moderate upstream pancreatic ductal dilatation, grossly unchanged. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Portions of the duodenum are inseparable from the adjacent ill-defined pancreatic head mass (for example coronal series 9, image 76). COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to advanced atherosclerotic disease. Ill-defined hypoenhancing pancreatic head lesion abuts less than 180 degrees of the left hepatic artery. The right hepatic artery appears completely encased. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Posterior lumbar spinal fixation hardware in place. CONCLUSION: 1. Slight interval increase in size of the ill-defined hypoenhancing pancreatic head mass with vascular abutment as described above. The mass is also in close proximity to the adjacent duodenal wall. No evidence of metastatic disease elsewhere in the abdomen or pelvis. 2. New pneumobilia, likely related to recent intervention/endoscopy. 3. Small enhancing lesion in the posterior right hepatic lobe, most suggestive of a hemangioma.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Scarring versus subsegmental atelectasis in the left lower lobe. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Indeterminate 10 mm region of arterial enhancement in the posterior right hepatic lobe on axial series 9 seven, image 48. This persists on the venous phase, suggestive of a hemangioma. BILIARY TRACT: Small amount of pneumobilia, perhaps related to prior intervention/endoscopy. GALLBLADDER: No abnormality. PANCREAS: Slight interval increase in size of a hypoenhancing pancreatic head mass which currently measures approximately 2.0 x 1.3 cm on axial series 907, image 71 (previously 1.7 x 1.2 cm). The pancreatic head mass is inseparable from the adjacent duodenum (coronal series 9, image 76). The lesion abuts less than 180 degrees of the adjacent left hepatic artery. The right hepatic artery appears completely encased and otherwise not well seen on the arterial phase images. There is no significant upstream parenchymal atrophy. Mild to moderate upstream pancreatic ductal dilatation, grossly unchanged. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Portions of the duodenum are inseparable from the adjacent ill-defined pancreatic head mass (for example coronal series 9, image 76). COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to advanced atherosclerotic disease. Ill-defined hypoenhancing pancreatic head lesion abuts less than 180 degrees of the left hepatic artery. The right hepatic artery appears completely encased. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Posterior lumbar spinal fixation hardware in place.
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FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Interval development of a large right pleural effusion with compressive subsegmental atelectasis of the right lower lobe. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. LIVER LESIONS: 1 - Lesion Number: 1 - Location: Segment(s) 3 - Sizer: 1.2 cm - Enhancement: Nonrim arterial phase hyperenhancement - Vascular invasion: No - Additional major features present: 0 - Enhancing "capsule": Not present. - Nonperipheral "washout": Not present. - Threshold growth (>= 50% in <= 6 months): Not present. - Other features: None. - LI-RADS: LR-3 Segment 8 arterial hyperenhancing lesion without washout measures 7 mm (series 900 image 70), previously 7.5 mm. There is no new suspicious liver lesion. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Mural hypodense filling defect in the TIPS stent at the hepatic venous aspect, concerning for nonocclusive thrombus. Main portal vein measures 20 mm in diameter from 18 mm. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: None. - Other varices or collaterals: Similar appearance of a recanalized umbilical vein and periumbilical collaterals. Small coronary vein collaterals. LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: Absent. LYMPH NODES: None enlarged. SPLEEN: Mild splenomegaly. PERITONEUM / ASCITES: Small volume ascites has developed in the interval. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Tiny nonobstructing left calyceal renal calculus. Unchanged simple left renal cyst. Tiny fatty left angiomyolipoma. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is normal. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: Mild abdominal aortic atherosclerotic calcifications. BODY WALL: Diffuse body wall edema has increased in the interval. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 57-year-old male with lower abdominal pain, nausea without emesis, dysuria. COMPARISON: CT abdomen pelvis 6/1/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 145 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 80 secs Scan field of view: 403.40 mm. DLP: 530.30 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral lower lobe bronchial wall thickening with adjacent nodular opacities, right greater than left, unchanged from prior. There is bilateral lower lobe bronchiectasis. DISTAL ESOPHAGUS: Small hiatal hernia. Mild circumferential distal esophageal wall thickening, similar to prior. A small amount of paraesophageal fluid is again noted. HEART / VESSELS: No significant abnormality. CHEST WALL: Nodular lesion within the left lateral chest wall measures approximately 1.1 x 1.0 cm (series 201 image one), previously 1.0 x 1.0 cm. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Slightly worsened fluid and fat stranding surrounding the head and body of the pancreas. No evidence of pancreatic parenchymal hypoenhancement. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypodensity within the right kidney is too small to characterize, however, statistically representing a cyst. Similar appearance of the bilateral perinephric stranding with worsened extension of the fluid and stranding inferiorly along the ureters and psoas muscles. No hydronephrosis or renal calculi. The kidneys enhance symmetrically. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Mild stranding surrounding the duodenum. No evidence of bowel obstruction. Mild thickening of the proximal stomach is seen. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Mesenteric stranding within the midabdomen. There is a small amount of perisigmoid fat stranding in the left lower quadrant which could represent a focus of fat necrosis versus epiploic appendigitis. RETROPERITONEUM: Retroperitoneal stranding and fluid tracking inferiorly from the kidneys or ureters and bilateral psoas muscles as described above. VESSELS: No significant abnormality. URINARY BLADDER: Partially collapsed. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny periumbilical fat-containing hernia. Small bilateral fat-containing hernias. MUSCULOSKELETAL: Bilateral L5 pars defects. Grade 1 anterolisthesis of L5 on S1. No aggressive osseous lesions. CONCLUSION: 1. Findings most suggestive of acute interstitial pancreatitis. No peripancreatic fluid collection is identified. 2. Periduodenal and gastric wall thickening is probably related to duodenitis and/or gastritis with findings suggestive of esophagitis/reflux esophagitis. 3. Bilateral lower lobe bronchiectasis and bronchial wall thickening, likely sequelae of chronic aspiration. 4. Stable subcutaneous nodule along the left breast/chest wall. 5. Left lower quadrant fat necrosis/epiploic appendigitis Additional findings above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral lower lobe bronchial wall thickening with adjacent nodular opacities, right greater than left, unchanged from prior. There is bilateral lower lobe bronchiectasis. DISTAL ESOPHAGUS: Small hiatal hernia. Mild circumferential distal esophageal wall thickening, similar to prior. A small amount of paraesophageal fluid is again noted. HEART / VESSELS: No significant abnormality. CHEST WALL: Nodular lesion within the left lateral chest wall measures approximately 1.1 x 1.0 cm (series 201 image one), previously 1.0 x 1.0 cm. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Slightly worsened fluid and fat stranding surrounding the head and body of the pancreas. No evidence of pancreatic parenchymal hypoenhancement. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypodensity within the right kidney is too small to characterize, however, statistically representing a cyst. Similar appearance of the bilateral perinephric stranding with worsened extension of the fluid and stranding inferiorly along the ureters and psoas muscles. No hydronephrosis or renal calculi. The kidneys enhance symmetrically. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Mild stranding surrounding the duodenum. No evidence of bowel obstruction. Mild thickening of the proximal stomach is seen. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. The appendix is normal. PERITONEUM / MESENTERY: Mesenteric stranding within the midabdomen. There is a small amount of perisigmoid fat stranding in the left lower quadrant which could represent a focus of fat necrosis versus epiploic appendigitis. RETROPERITONEUM: Retroperitoneal stranding and fluid tracking inferiorly from the kidneys or ureters and bilateral psoas muscles as described above. VESSELS: No significant abnormality. URINARY BLADDER: Partially collapsed. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny periumbilical fat-containing hernia. Small bilateral fat-containing hernias. MUSCULOSKELETAL: Bilateral L5 pars defects. Grade 1 anterolisthesis of L5 on S1. No aggressive osseous lesions.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Severe hepatic steatosis with focal sparing of the gallbladder fossa. A focal malformation with location in the left portal vein branch left hepatic vein in the medial segment measures 9 mm (image 103, series 2), unchanged from prior studies. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Small hypodense lesion within the posterior aspect of spleen is unchanged. Otherwise normal. ADRENALS: Normal. KIDNEYS: Tiny left renal cyst. Otherwise normal. LYMPH NODES: Prior lymph node dissection, unchanged. Scattered nonenlarged lymph nodes are unchanged. No adenopathy. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No acute abnormality. Normal appendix. PERITONEUM / MESENTERY: Anterior omental stranding now has more nodular soft tissue appearance on image 115, 125, and 130, series 2. No free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Mild circumferential wall thickening is unchanged without focal mass or adjacent stranding. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny anterior midline hernia contains fat. Midline scar is unchanged. MUSCULOSKELETAL: No osseous metastases.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Meningeal metastases. Evaluate for malignancy. COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 85 sec Scan field of view: 428 mm. DLP: 1284 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis. No suspicious nodules or masses. HEART / VESSELS: The heart is normal in size with annular mitral and aortic valve calcifications. Right upper lobar and bilateral lower lobe segmental pulmonary artery filling defects. No right ventricular dilatation or intraventricular septal bowing. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Multiple right cortical cysts and additional subcentimeter hypoattenuating lesions in the bilateral kidneys, which are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Right femoral and common femoral vein filling defects. URINARY BLADDER: Circumferential urinary bladder wall thickening. The urinary bladder is decompressed around the Foley catheter. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous lesions. Decreased osseous mineralization. Osseous hemangioma in the T9 vertebral body. Right anterior rib chronic fracture deformity. Advanced degenerative changes of the right glenohumeral joint. Moderate multilevel degenerative changes of the thoracolumbar spine. CONCLUSION: 1. No evidence of malignancy in the chest, abdomen, or pelvis. 2. Right lobar and bilateral segmental pulmonary emboli. Right femoral and common femoral vein deep venous thromboses. 3. Circumferential urinary bladder wall thickening may be related to cystitis or chronic bladder outlet obstruction given prostatomegaly. Correlate with urinalysis if clinically indicated. Preliminary findings discussed with Aubrey Young M.D. by Ivan Morales, M.D. on 1/8/2022 9:01 AM As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis. No suspicious nodules or masses. HEART / VESSELS: The heart is normal in size with annular mitral and aortic valve calcifications. Right upper lobar and bilateral lower lobe segmental pulmonary artery filling defects. No right ventricular dilatation or intraventricular septal bowing. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Multiple right cortical cysts and additional subcentimeter hypoattenuating lesions in the bilateral kidneys, which are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Right femoral and common femoral vein filling defects. URINARY BLADDER: Circumferential urinary bladder wall thickening. The urinary bladder is decompressed around the Foley catheter. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous lesions. Decreased osseous mineralization. Osseous hemangioma in the T9 vertebral body. Right anterior rib chronic fracture deformity. Advanced degenerative changes of the right glenohumeral joint. Moderate multilevel degenerative changes of the thoracolumbar spine.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Meningeal metastases. Evaluate for malignancy. COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 85 sec Scan field of view: 428 mm. DLP: 1284 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis. No suspicious nodules or masses. HEART / VESSELS: The heart is normal in size with annular mitral and aortic valve calcifications. Right upper lobar and bilateral lower lobe segmental pulmonary artery filling defects. No right ventricular dilatation or intraventricular septal bowing. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Multiple right cortical cysts and additional subcentimeter hypoattenuating lesions in the bilateral kidneys, which are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Right femoral and common femoral vein filling defects. URINARY BLADDER: Circumferential urinary bladder wall thickening. The urinary bladder is decompressed around the Foley catheter. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous lesions. Decreased osseous mineralization. Osseous hemangioma in the T9 vertebral body. Right anterior rib chronic fracture deformity. Advanced degenerative changes of the right glenohumeral joint. Moderate multilevel degenerative changes of the thoracolumbar spine. CONCLUSION: 1. No evidence of malignancy in the chest, abdomen, or pelvis. 2. Right lobar and bilateral segmental pulmonary emboli. Right femoral and common femoral vein deep venous thromboses. 3. Circumferential urinary bladder wall thickening may be related to cystitis or chronic bladder outlet obstruction given prostatomegaly. Correlate with urinalysis if clinically indicated. Preliminary findings discussed with Aubrey Young M.D. by Ivan Morales, M.D. on 1/8/2022 9:01 AM As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis. No suspicious nodules or masses. HEART / VESSELS: The heart is normal in size with annular mitral and aortic valve calcifications. Right upper lobar and bilateral lower lobe segmental pulmonary artery filling defects. No right ventricular dilatation or intraventricular septal bowing. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Multiple right cortical cysts and additional subcentimeter hypoattenuating lesions in the bilateral kidneys, which are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Right femoral and common femoral vein filling defects. URINARY BLADDER: Circumferential urinary bladder wall thickening. The urinary bladder is decompressed around the Foley catheter. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous lesions. Decreased osseous mineralization. Osseous hemangioma in the T9 vertebral body. Right anterior rib chronic fracture deformity. Advanced degenerative changes of the right glenohumeral joint. Moderate multilevel degenerative changes of the thoracolumbar spine.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Refer to the concurrent dedicated CT chest report. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. No focal hepatic lesion is identified. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild scattered atheromatous calcification the abdominal aorta without evidence of dilatation significant stenosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: 65-year-old female with history of microscopic hematuria. COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 153 lbs. IV contrast: Omnipaque 350, 143 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 60/300 sec. Scan field of view: 400 mm. DLP: 1092 mGy cm. FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Multiple peripelvic left renal cysts. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Diffuse mural and more pronounced focal nodularity at the dome measuring up to 10 to 12 mm, series 10 image 240. LIVER: Normal as imaged. Hepatic dome not entirely included. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Unremarkable stomach and normal caliber small bowel. COLON / APPENDIX: Diverticulosis. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Accessory right renal artery. REPRODUCTIVE ORGANS: Uterus present. No adnexal mass is noted. BODY WALL: Normal. MUSCULOSKELETAL: L2 vertebral body hemangioma. No aggressive osseous lesion CONCLUSION: 1. Diffuse mural thickening of the urinary bladder and more pronounced focal nodularity near the dome as detailed above, could be secondary to cystitis. However, neoplastic process cannot be excluded entirely. Correlate with urinalysis and cystoscopy. No additional evidence of urinary tract mass or calculus identified. 2. Additional incidental findings including small hiatal hernia and colonic diverticulosis. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Multiple peripelvic left renal cysts. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Diffuse mural and more pronounced focal nodularity at the dome measuring up to 10 to 12 mm, series 10 image 240. LIVER: Normal as imaged. Hepatic dome not entirely included. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Unremarkable stomach and normal caliber small bowel. COLON / APPENDIX: Diverticulosis. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Accessory right renal artery. REPRODUCTIVE ORGANS: Uterus present. No adnexal mass is noted. BODY WALL: Normal. MUSCULOSKELETAL: L2 vertebral body hemangioma. No aggressive osseous lesion
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Findings: Lines and Tubes: None. Body Wall and Abdomen: No destructive osseous lesions. A few subtle vertebral body lucencies are unchanged. CT of the abdomen and pelvis will be reported separately. Lymph Nodes, Mediastinum and Neck: Several surgical clips and probable postoperative changes are present in the left axilla. A left axillary lymph node is larger compared to the previous, currently 1.6 x 1.2 cm image 21 series 2. This measured approximately 0.8 x 0.6 cm on the previous. Lungs and Pleura: No pleural effusion. No suspicious appearing pulmonary nodules. Cardiovascular: Heart size is normal. No PTE, pericardial effusion. Moderate coronary artery atherosclerotic calcifications are present.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 34-year-old male with lymphoma. COMPARISON: CT chest dated 5/14/2019. TECHNIQUE: CT Chest with contrast. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 90 sec. Scan field of view: 440 mm. DLP: 1293.50 mGy cm. FINDINGS: LOWER NECK: A new 3.3 x 2.2 cm left supraclavicular lymph node on axial image 13; series 2. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. A no suspicious nodule. HEART / VESSELS: Normal sized cardiac chambers. Trace pericardial fluid. No central PE. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Interval worsening with multiple enlarged mediastinal, internal mammary, supraclavicular and bilateral hilar and bronchial lymph nodes. A representative AP window nodal conglomerate measures 4.1 x 1.2 cm on axial image 97; series 2, previously 1.7 x 0.7 cm. A right hilar nodal conglomerate measures 2.9 x 1.8 cm on axial image 111; series 2, previously 2.1 x 0.9 cm. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Will be reported separately. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Interval disease progression with multiple enlarged mediastinal, hilar, supra clavicular and internal mammary lymph nodes.
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FINDINGS: LOWER NECK: A new 3.3 x 2.2 cm left supraclavicular lymph node on axial image 13; series 2. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. A no suspicious nodule. HEART / VESSELS: Normal sized cardiac chambers. Trace pericardial fluid. No central PE. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Interval worsening with multiple enlarged mediastinal, internal mammary, supraclavicular and bilateral hilar and bronchial lymph nodes. A representative AP window nodal conglomerate measures 4.1 x 1.2 cm on axial image 97; series 2, previously 1.7 x 0.7 cm. A right hilar nodal conglomerate measures 2.9 x 1.8 cm on axial image 111; series 2, previously 2.1 x 0.9 cm. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Will be reported separately. MUSCULOSKELETAL: No significant abnormality.
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Findings: CT head: BRAIN PARENCHYMA: Focal area of hyperattenuation in the right insular region with adjacent brain hypoattenuation, may suggest small focal intraparenchymal hemorrhage versus calcification (image 38, series 204). Otherwise, no large intracranial hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Moderate brain involution. Subcortical hypodensities in the right frontal lobe likely represent chronic microangiopathic ischemic changes. Encephalomalacic changes in the right frontal lobe. Old lacunar infarct in the left basal ganglia region. Moderate atherosclerotic calcifications of bilateral carotid artery siphons. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 34-year-old male with history of lymphoma; follow-up. COMPARISON: Multiple prior CTs of the abdomen pelvis, most recently 5/14/2019 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 90 sec. Scan field of view: 440 mm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis CT chest findings are reported separately. ABDOMEN and PELVIS: LIVER: Interval enlargement of the liver with development of multiple hypoattenuating hepatic lesions, largest near hepatic segment 8/4A and measuring approximately 6.5 x 5.1 cm on axial series 2, image 198. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Displaced leftward secondary to marked enlargement of periportal lymph nodes. SPLEEN: Interval development of multiple hypoattenuating splenic lesions replacing much of the normal splenic parenchyma. ADRENALS: Normal. KIDNEYS: Simple left renal cyst. Additional subcentimeter hypodensities bilaterally are technically indeterminate but most suggestive of cysts. LYMPH NODES: Interval enlargement of multiple periportal and gastrohepatic lymph nodes. Reference retrocaval nodal conglomerate measures approximately 7.0 x 4.4 cm on axial series 2, image 252. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing abdominal hernia. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Interval development of hepatomegaly with multiple discrete hepatic lesions. Although nonspecific, in the setting of lymphoma, this likely represents hepatic lymphoma. 2. Interval development of multiple discrete splenic lesions, also likely reflecting sequelae of lymphoma. 3. Marked interval enlargement of multiple gastrohepatic and periportal lymph nodes as described above, consistent with reported history of lymphoma.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis CT chest findings are reported separately. ABDOMEN and PELVIS: LIVER: Interval enlargement of the liver with development of multiple hypoattenuating hepatic lesions, largest near hepatic segment 8/4A and measuring approximately 6.5 x 5.1 cm on axial series 2, image 198. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Displaced leftward secondary to marked enlargement of periportal lymph nodes. SPLEEN: Interval development of multiple hypoattenuating splenic lesions replacing much of the normal splenic parenchyma. ADRENALS: Normal. KIDNEYS: Simple left renal cyst. Additional subcentimeter hypodensities bilaterally are technically indeterminate but most suggestive of cysts. LYMPH NODES: Interval enlargement of multiple periportal and gastrohepatic lymph nodes. Reference retrocaval nodal conglomerate measures approximately 7.0 x 4.4 cm on axial series 2, image 252. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing abdominal hernia. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules.. CHEST: LUNGS / AIRWAYS / PLEURA: Partially obscured due to mild respiratory motion. There is a trace left pleural effusion. No focal consolidation or large pneumothorax. HEART / VESSELS: There is severe coronary artery atherosclerotic calcification. There is no pericardial effusion. Cardiomegaly. MEDIASTINUM / ESOPHAGUS: There is diffuse esophageal thickening with mild patulous appearance and fluid. DIAPHRAGM: There is elevation of the right hemidiaphragm. No definite defect. LYMPH NODES: None enlarged. CHEST WALL: There is a ill-defined fat-containing lesion seen within the right breast measuring 5.1 x 2.4 cm on image 107, series 501. ABDOMEN and PELVIS: LIVER: Left hepatic lobe cyst. The liver is otherwise unremarkable.. BILIARY TRACT: Normal. . Thick-walled urinary bladder is probably related to GALLBLADDER: Thick-walled and partially decompressed PANCREAS: Punctate pancreatic calcifications are noted likely related to chronic calcific pancreatitis. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Small subcentimeter hypodensities in both kidneys are technically indeterminate. There is thick-walled cystic versus necrotic lesion seen within the posterior left kidney measuring 1.8 x 1.5 cm on image 301, series 501. There is a indeterminate hyperdense lesion seen in the lower pole left kidney measuring 2.4 x 1.8 cm on image 321, series 501. There is a indeterminate hyperdense lesion seen in the anterior right kidney measuring 1.3 cm on image 288, series 501. Nonobstructing right nephrolithiasis. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed colonic diverticula. The appendix is normal PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is mild-to-moderate aortoiliac atherosclerosis. There is suspected median arcuate compression of the celiac axis. There is a dissecting aneurysm of the left common iliac artery measuring 2 cm. The dissection flap extends to the bifurcation. The left external iliac artery is patent and supplied by the true lumen. The left internal iliac artery is patent and probably supplied by the false lumen. URINARY BLADDER: Thick-walled and partially decompressed. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. ACDF is seen in the lower cervical spine. Old bilateral rib fractures are noted. There is a sclerotic lesion seen within the left third rib with associated pleural thickening. THORACIC SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine, most pronounced at T8-T9. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine most pronounced at L2-L3 with moderate facet arthropathy and associated neuroforaminal stenosis and subtle scoliotic deformity. Bastrop's morphology to the L3-L5 posterior spinous processes. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Tachycardia, hypoxia. Covid positive COMPARISON: 11/15/21 TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 165 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 30 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus track Scan field of view: 383.60 mm. KVP: 100 DLP: 206 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Interval decrease size of left pleural fluid collection with trace residual left-sided effusion. Resolving bilateral cystic/cavitary lung lesions and surrounding airspace opacities with only a few residual small left lung cystic lesions. Residual linear and few nodular airspace consolidations bilaterally HEART / OTHER VESSELS: Pericardial effusion has largely resolved. MEDIASTINUM / ESOPHAGUS: Median sternotomy changes with trace unorganized retrosternal fluid, decreased since prior. LYMPH NODES: Mildly enlarged mediastinal and right hilar lymph nodes are similar to prior. No new or worsening lymphadenopathy UPPER ABDOMEN: No acute abnormality. MUSCULOSKELETAL: Median sternotomy changes without evidence of dehiscence or erosive change. CONCLUSION: 1. No pulmonary embolism. 2. Improving bilateral cystic/cavitary lesions and additional airspace opacities with few residual small cystic lesions. No new or worsening abnormality. 3. Decreased size of left pleural fluid collection. Pericardial effusion has also largely resolved. 4. Stable mildly enlarged mediastinal and right hilar lymph nodes. No new or worsening lymphadenopathy.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Interval decrease size of left pleural fluid collection with trace residual left-sided effusion. Resolving bilateral cystic/cavitary lung lesions and surrounding airspace opacities with only a few residual small left lung cystic lesions. Residual linear and few nodular airspace consolidations bilaterally HEART / OTHER VESSELS: Pericardial effusion has largely resolved. MEDIASTINUM / ESOPHAGUS: Median sternotomy changes with trace unorganized retrosternal fluid, decreased since prior. LYMPH NODES: Mildly enlarged mediastinal and right hilar lymph nodes are similar to prior. No new or worsening lymphadenopathy UPPER ABDOMEN: No acute abnormality. MUSCULOSKELETAL: Median sternotomy changes without evidence of dehiscence or erosive change.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules.. CHEST: LUNGS / AIRWAYS / PLEURA: Partially obscured due to mild respiratory motion. There is a trace left pleural effusion. No focal consolidation or large pneumothorax. HEART / VESSELS: There is severe coronary artery atherosclerotic calcification. There is no pericardial effusion. Cardiomegaly. MEDIASTINUM / ESOPHAGUS: There is diffuse esophageal thickening with mild patulous appearance and fluid. DIAPHRAGM: There is elevation of the right hemidiaphragm. No definite defect. LYMPH NODES: None enlarged. CHEST WALL: There is a ill-defined fat-containing lesion seen within the right breast measuring 5.1 x 2.4 cm on image 107, series 501. ABDOMEN and PELVIS: LIVER: Left hepatic lobe cyst. The liver is otherwise unremarkable.. BILIARY TRACT: Normal. . Thick-walled urinary bladder is probably related to GALLBLADDER: Thick-walled and partially decompressed PANCREAS: Punctate pancreatic calcifications are noted likely related to chronic calcific pancreatitis. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Small subcentimeter hypodensities in both kidneys are technically indeterminate. There is thick-walled cystic versus necrotic lesion seen within the posterior left kidney measuring 1.8 x 1.5 cm on image 301, series 501. There is a indeterminate hyperdense lesion seen in the lower pole left kidney measuring 2.4 x 1.8 cm on image 321, series 501. There is a indeterminate hyperdense lesion seen in the anterior right kidney measuring 1.3 cm on image 288, series 501. Nonobstructing right nephrolithiasis. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed colonic diverticula. The appendix is normal PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is mild-to-moderate aortoiliac atherosclerosis. There is suspected median arcuate compression of the celiac axis. There is a dissecting aneurysm of the left common iliac artery measuring 2 cm. The dissection flap extends to the bifurcation. The left external iliac artery is patent and supplied by the true lumen. The left internal iliac artery is patent and probably supplied by the false lumen. URINARY BLADDER: Thick-walled and partially decompressed. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. ACDF is seen in the lower cervical spine. Old bilateral rib fractures are noted. There is a sclerotic lesion seen within the left third rib with associated pleural thickening. THORACIC SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine, most pronounced at T8-T9. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine most pronounced at L2-L3 with moderate facet arthropathy and associated neuroforaminal stenosis and subtle scoliotic deformity. Bastrop's morphology to the L3-L5 posterior spinous processes. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: 27-year-old female with altered mental status COMPARISON: None available TECHNIQUE: CT Head wo contrastScan field of view: 218 mm. DLP: 1300.20 mGy cm. STRUCTURED REPORT: CT Head Trauma FINDINGS: BRAIN PARENCHYMA: The brain parenchyma volume appears normal. No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Partially opacified right maxillary sinus. The paranasal sinuses appear otherwise well aerated. Pneumatized petrous apices bilaterally. IMPRESSION: No acute intracranial process. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: The brain parenchyma volume appears normal. No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Partially opacified right maxillary sinus. The paranasal sinuses appear otherwise well aerated. Pneumatized petrous apices bilaterally.
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FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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CT angiograms of the neck and head. Clinical Information: Prior stroke. Technical: The injection of Omnipaque 350, 1255 mL per protocol, 0.6 mm axial scans were obtained from the aortic arch to the vertex. Sagittal, axial and coronal MIP angiograms were generated.. 3-D color surface rendered angiograms were constructed on an independent workstation. DLP: 4004 mGy cm. Findings: CTA neck: The brachiocephalic arteries have expected appearance. The common carotid arteries and bifurcations are essentially negative. The cervical ICAs are normal. Both vertebral arteries are sizable with no apparent defect. The C-spine is normal appearance with no fracture or subluxation. There is no lytic or blastic lesion. CTA head: The carotid siphons and the proximal ACAs, MCA's and PCAs have expected appearance. The basilar artery and its branches appear normal. No aneurysm, AVM or intrinsic vascular lesion is seen. The precontrast cranial CT scan has normal appearance. Postcontrast scans show no abnormal enhancement. ---------------- Conclusion: Essentially negative angiograms of the neck and head.
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Findings: CTA neck: The brachiocephalic arteries have expected appearance. The common carotid arteries and bifurcations are essentially negative. The cervical ICAs are normal. Both vertebral arteries are sizable with no apparent defect. The C-spine is normal appearance with no fracture or subluxation. There is no lytic or blastic lesion. CTA head: The carotid siphons and the proximal ACAs, MCA's and PCAs have expected appearance. The basilar artery and its branches appear normal. No aneurysm, AVM or intrinsic vascular lesion is seen. The precontrast cranial CT scan has normal appearance. Postcontrast scans show no abnormal enhancement. ----------------
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules.. CHEST: LUNGS / AIRWAYS / PLEURA: Partially obscured due to mild respiratory motion. There is a trace left pleural effusion. No focal consolidation or large pneumothorax. HEART / VESSELS: There is severe coronary artery atherosclerotic calcification. There is no pericardial effusion. Cardiomegaly. MEDIASTINUM / ESOPHAGUS: There is diffuse esophageal thickening with mild patulous appearance and fluid. DIAPHRAGM: There is elevation of the right hemidiaphragm. No definite defect. LYMPH NODES: None enlarged. CHEST WALL: There is a ill-defined fat-containing lesion seen within the right breast measuring 5.1 x 2.4 cm on image 107, series 501. ABDOMEN and PELVIS: LIVER: Left hepatic lobe cyst. The liver is otherwise unremarkable.. BILIARY TRACT: Normal. . Thick-walled urinary bladder is probably related to GALLBLADDER: Thick-walled and partially decompressed PANCREAS: Punctate pancreatic calcifications are noted likely related to chronic calcific pancreatitis. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Small subcentimeter hypodensities in both kidneys are technically indeterminate. There is thick-walled cystic versus necrotic lesion seen within the posterior left kidney measuring 1.8 x 1.5 cm on image 301, series 501. There is a indeterminate hyperdense lesion seen in the lower pole left kidney measuring 2.4 x 1.8 cm on image 321, series 501. There is a indeterminate hyperdense lesion seen in the anterior right kidney measuring 1.3 cm on image 288, series 501. Nonobstructing right nephrolithiasis. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed colonic diverticula. The appendix is normal PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is mild-to-moderate aortoiliac atherosclerosis. There is suspected median arcuate compression of the celiac axis. There is a dissecting aneurysm of the left common iliac artery measuring 2 cm. The dissection flap extends to the bifurcation. The left external iliac artery is patent and supplied by the true lumen. The left internal iliac artery is patent and probably supplied by the false lumen. URINARY BLADDER: Thick-walled and partially decompressed. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. ACDF is seen in the lower cervical spine. Old bilateral rib fractures are noted. There is a sclerotic lesion seen within the left third rib with associated pleural thickening. THORACIC SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine, most pronounced at T8-T9. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine most pronounced at L2-L3 with moderate facet arthropathy and associated neuroforaminal stenosis and subtle scoliotic deformity. Bastrop's morphology to the L3-L5 posterior spinous processes. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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CT angiograms of the neck and head. Clinical Information: Prior stroke. Technical: The injection of Omnipaque 350, 1255 mL per protocol, 0.6 mm axial scans were obtained from the aortic arch to the vertex. Sagittal, axial and coronal MIP angiograms were generated.. 3-D color surface rendered angiograms were constructed on an independent workstation. DLP: 4004 mGy cm. Findings: CTA neck: The brachiocephalic arteries have expected appearance. The common carotid arteries and bifurcations are essentially negative. The cervical ICAs are normal. Both vertebral arteries are sizable with no apparent defect. The C-spine is normal appearance with no fracture or subluxation. There is no lytic or blastic lesion. CTA head: The carotid siphons and the proximal ACAs, MCA's and PCAs have expected appearance. The basilar artery and its branches appear normal. No aneurysm, AVM or intrinsic vascular lesion is seen. The precontrast cranial CT scan has normal appearance. Postcontrast scans show no abnormal enhancement. ---------------- Conclusion: Essentially negative angiograms of the neck and head.
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Findings: CTA neck: The brachiocephalic arteries have expected appearance. The common carotid arteries and bifurcations are essentially negative. The cervical ICAs are normal. Both vertebral arteries are sizable with no apparent defect. The C-spine is normal appearance with no fracture or subluxation. There is no lytic or blastic lesion. CTA head: The carotid siphons and the proximal ACAs, MCA's and PCAs have expected appearance. The basilar artery and its branches appear normal. No aneurysm, AVM or intrinsic vascular lesion is seen. The precontrast cranial CT scan has normal appearance. Postcontrast scans show no abnormal enhancement. ----------------
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral indeterminate thyroid nodules.. CHEST: LUNGS / AIRWAYS / PLEURA: Partially obscured due to mild respiratory motion. There is a trace left pleural effusion. No focal consolidation or large pneumothorax. HEART / VESSELS: There is severe coronary artery atherosclerotic calcification. There is no pericardial effusion. Cardiomegaly. MEDIASTINUM / ESOPHAGUS: There is diffuse esophageal thickening with mild patulous appearance and fluid. DIAPHRAGM: There is elevation of the right hemidiaphragm. No definite defect. LYMPH NODES: None enlarged. CHEST WALL: There is a ill-defined fat-containing lesion seen within the right breast measuring 5.1 x 2.4 cm on image 107, series 501. ABDOMEN and PELVIS: LIVER: Left hepatic lobe cyst. The liver is otherwise unremarkable.. BILIARY TRACT: Normal. . Thick-walled urinary bladder is probably related to GALLBLADDER: Thick-walled and partially decompressed PANCREAS: Punctate pancreatic calcifications are noted likely related to chronic calcific pancreatitis. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Small subcentimeter hypodensities in both kidneys are technically indeterminate. There is thick-walled cystic versus necrotic lesion seen within the posterior left kidney measuring 1.8 x 1.5 cm on image 301, series 501. There is a indeterminate hyperdense lesion seen in the lower pole left kidney measuring 2.4 x 1.8 cm on image 321, series 501. There is a indeterminate hyperdense lesion seen in the anterior right kidney measuring 1.3 cm on image 288, series 501. Nonobstructing right nephrolithiasis. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed colonic diverticula. The appendix is normal PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is mild-to-moderate aortoiliac atherosclerosis. There is suspected median arcuate compression of the celiac axis. There is a dissecting aneurysm of the left common iliac artery measuring 2 cm. The dissection flap extends to the bifurcation. The left external iliac artery is patent and supplied by the true lumen. The left internal iliac artery is patent and probably supplied by the false lumen. URINARY BLADDER: Thick-walled and partially decompressed. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: Fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. ACDF is seen in the lower cervical spine. Old bilateral rib fractures are noted. There is a sclerotic lesion seen within the left third rib with associated pleural thickening. THORACIC SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine, most pronounced at T8-T9. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Mild multilevel discogenic degenerative changes are seen within the spine most pronounced at L2-L3 with moderate facet arthropathy and associated neuroforaminal stenosis and subtle scoliotic deformity. Bastrop's morphology to the L3-L5 posterior spinous processes. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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Maxillofacial CT scan without contrast. Clinical: Sinus disease. Technical: Maxillofacial CT protocol. DLP: 859.68 mGy cm. Comparison: MR scans of the head and neck 8/6/2021. Findings: The left maxillary sinus is small and almost completely opacified. There is slight retraction of the walls of the sinus and slight lowering of the floor of the orbit, silent sinus syndrome. There is slight widening of the walls of the sinus. There are linear areas of calcification in the inferior aspect of the left antrum. The left ostiomeatal complex is widely patent. The remainder of the paranasal sinuses are normally formed and developed. No other mucosal thickening or fluid retention is seen. The maxillofacial bones, orbits and orbital contents are unremarkable. No defect is seen in the anterior skull base or calvarium. --------------- Conclusion: Chronic left sphenoid sinusitis; silent sinus syndrome.
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Findings: The left maxillary sinus is small and almost completely opacified. There is slight retraction of the walls of the sinus and slight lowering of the floor of the orbit, silent sinus syndrome. There is slight widening of the walls of the sinus. There are linear areas of calcification in the inferior aspect of the left antrum. The left ostiomeatal complex is widely patent. The remainder of the paranasal sinuses are normally formed and developed. No other mucosal thickening or fluid retention is seen. The maxillofacial bones, orbits and orbital contents are unremarkable. No defect is seen in the anterior skull base or calvarium. ---------------
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FINDINGS: CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain COMPARISON: 8/29/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 350 mm. DLP: 659.30 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Minute subcentimeter hypodensities seen in the left kidney are technically indeterminant but statistically likely cysts. LYMPH NODES: There are shotty borderline enlarged retroperitoneal lymph nodes, likely reactive. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not well-visualized but there are no definite secondary signs of appendicitis. Specifically, the pelvic inflammatory process does not appear localized around the cecum. PERITONEUM / MESENTERY: There is extensive inflammatory fat stranding seen within the pelvis with a small amount of ill-defined fluid seen in the bilateral adnexa and cul-de-sac. There is a possible ill-defined enhancing area of fluid in the cul-de-sac measuring 2.4 cm on image 244, series 201 which is not definitely within bowel, possibly a small developing abscess. However, evaluation is region is limited due to extensive inflammatory stranding. There is indeterminate fluid also seen in the bilateral adnexa. RETROPERITONEUM: Normal. VESSELS: Unremarkable URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is extensive inflammatory stranding seen in the bilateral adnexa with ill-defined areas of enhancing fluid within the cul-de-sac as well as the bilateral adnexa. A small enhancing abscess is difficult to exclude. There is a questionable dilated tube in the left adnexa.. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Extensive pelvic/bilateral adnexal inflammatory changes and fluid most concerning for pelvic inflammatory disease and possible bilateral tubo-ovarian complex/tubo-ovarian abscesses. Possible ill-defined enhancing fluid collection in the cul-de-sac, concerning for a small evolving abscess. Correlate with pelvic ultrasound. 2. Additional findings above.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Minute subcentimeter hypodensities seen in the left kidney are technically indeterminant but statistically likely cysts. LYMPH NODES: There are shotty borderline enlarged retroperitoneal lymph nodes, likely reactive. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix is not well-visualized but there are no definite secondary signs of appendicitis. Specifically, the pelvic inflammatory process does not appear localized around the cecum. PERITONEUM / MESENTERY: There is extensive inflammatory fat stranding seen within the pelvis with a small amount of ill-defined fluid seen in the bilateral adnexa and cul-de-sac. There is a possible ill-defined enhancing area of fluid in the cul-de-sac measuring 2.4 cm on image 244, series 201 which is not definitely within bowel, possibly a small developing abscess. However, evaluation is region is limited due to extensive inflammatory stranding. There is indeterminate fluid also seen in the bilateral adnexa. RETROPERITONEUM: Normal. VESSELS: Unremarkable URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is extensive inflammatory stranding seen in the bilateral adnexa with ill-defined areas of enhancing fluid within the cul-de-sac as well as the bilateral adnexa. A small enhancing abscess is difficult to exclude. There is a questionable dilated tube in the left adnexa.. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic. No steatosis. There is mild increase in size of hyperenhancing lesions without washout in the lateral segment of the left lobe measuring 11 x 6 mm image #91 series #5 and 10 x 9 mm image #73 series series #5. Additionally, multiple hyperenhancing subcentimeter foci in the right lobe are unchanged, image #78, 87, and 120 series #5. Ill-defined nonenhancing hypoattenuating lesion measures 1.2 x 0.8 cm in the right lobe image #67 series #11. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Replaced right hepatic artery from SMA. - Portal venous system: Patent intra- and extra-hepatic portal venous system. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: None. - Other varices or collaterals: Splenorenal and paraesophageal collaterals LIVER RELATED FINDINGS: BILIARY DUCTS: No biliary dilatation. GALLBLADDER: No abnormality. LYMPH NODES: None enlarged. SPLEEN: Mildly enlarged PERITONEUM / ASCITES: No ascites. OTHER FINDINGS: PANCREAS: Normal. ADRENALS: Normal. KIDNEYS: Normal. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 58-year-old female with abdominal pain and suspected hernia. COMPARISON: CT abdomen pelvis 9/22/2020 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 240 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Oral contrast Omnipaque: 16 oz. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 115 SEC. sec. Scan field of view: 470 mm. DLP: 1400.39 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Stable appearance of a subcentimeter noncalcified nodule on axial series 2, image 18. This nodule is grossly unchanged since 2019. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Prominent Riedel's lobe. Otherwise normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Multiple bilateral simple renal cysts. Additional subcentimeter hypodensities are technically indeterminate but also likely reflect cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Rectal anastomotic suture line is noted. Colon is otherwise normal for technique. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Interval development of a small fat-containing right lower anterolateral abdominal wall hernia which measures 9.1 x 3.07 m on axial series 2, image 252. MUSCULOSKELETAL: No suspicious osseous lesion. Chronic L2 compression deformity. CONCLUSION: Interval development of a small fat-containing right spigelian hernia. No other notable abnormality within the abdomen or pelvis.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Stable appearance of a subcentimeter noncalcified nodule on axial series 2, image 18. This nodule is grossly unchanged since 2019. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Prominent Riedel's lobe. Otherwise normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Multiple bilateral simple renal cysts. Additional subcentimeter hypodensities are technically indeterminate but also likely reflect cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Rectal anastomotic suture line is noted. Colon is otherwise normal for technique. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Interval development of a small fat-containing right lower anterolateral abdominal wall hernia which measures 9.1 x 3.07 m on axial series 2, image 252. MUSCULOSKELETAL: No suspicious osseous lesion. Chronic L2 compression deformity.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Patchy bibasilar groundglass opacities DISTAL ESOPHAGUS: No significant abnormality HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis PANCREAS: Mildly atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right-sided double-J ureteral stent is observed in position. No hydronephrosis. 3 mm nonobstructing calculus in the interpolar right kidney. There is also an 8 mm nonobstructing calculus in the inferior pole right kidney. 1 mm nonobstructing calculus in the superior pole left kidney. There is a subcentimeter hyperdense cyst in the interpolar left kidney. LYMPH NODES: Unchanged enlarged periaortic, pelvic sidewall and inguinal lymph nodes. STOMACH / SMALL BOWEL: Left lower abdominal ostomy with a small parastomal hernia. No intestinal obstruction COLON / APPENDIX: Status post total colectomy PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Calcifications in the IVC are noted with interval removal of IVC filter. The linear calcification best seen on series 3 image 100 is similar to prior study and may reflect changes from chronic thrombus. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing lower ventral abdominal hernia to the left midline. Small parastomal hernia associated with the left lower abdominal ostomy MUSCULOSKELETAL: No significant abnormality.
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CT scan of the soft tissues of the neck with contrast. Clinical: Right facial pain radiating to right ear. Right swollen node in the neck. Technical: Soft tissue neck protocol with contrast. Findings: There is an apparent accessory right submandibular gland abutting the posterior body of the right mandible measuring 11 x 18 mm and having normal appearance. The adjacent normal-appearing right submandibular gland measures 15 x 16 mm with normal internal architecture. The normal-appearing left submandibular gland measures 18 x 23 mm. No ductal dilatation or stone is seen. The nasopharynx is unremarkable and the oral cavity and tongue base appear normal. No abnormal adenopathy is seen. The hypopharynx and larynx have normal appearance. The infraglottic visceral space appears normal. The remaining soft tissues of the neck are unremarkable. There myelopathic changes in the cervical spine. No fracture or subluxation is seen and there is no lytic or blastic lesion. -------------- Conclusion: Essentially negative CT scan of soft tissues of the neck. Normal-appearing accessory right submandibular gland.
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Findings: There is an apparent accessory right submandibular gland abutting the posterior body of the right mandible measuring 11 x 18 mm and having normal appearance. The adjacent normal-appearing right submandibular gland measures 15 x 16 mm with normal internal architecture. The normal-appearing left submandibular gland measures 18 x 23 mm. No ductal dilatation or stone is seen. The nasopharynx is unremarkable and the oral cavity and tongue base appear normal. No abnormal adenopathy is seen. The hypopharynx and larynx have normal appearance. The infraglottic visceral space appears normal. The remaining soft tissues of the neck are unremarkable. There myelopathic changes in the cervical spine. No fracture or subluxation is seen and there is no lytic or blastic lesion. --------------
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Findings: Multiple small mediastinal nodes are seen. The enlarged lower right peribronchial node measures 11 mm in short axis unchanged from the prior exam. No additional enlarged intrathoracic nodes are present. Small hiatal hernia is redemonstrated. There is dilatation of the mid esophagus with an air-fluid level seen. Calcific atherosclerosis is present in the aorta with mild calcification in the coronary arteries. The heart size and mediastinum are otherwise normal. Biapical pleural parenchymal scarring is unchanged. A few scattered calcified granuloma are seen. Noncalcified peripheral left lower lobe nodule on series 2 image 158 measures 7 x 7 mm unchanged from the recent exam and unchanged from 2019. Small lateral left lower lobe nodules on images 168 and 175 are also unchanged back to 2019. Lingular nodule on image 136 is also unchanged back to 2019. The lungs are otherwise normal. No pleural effusion.. CT abdomen and pelvis will be reported separately. No focal destructive osseous lesions.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 82-year-old female, evaluation for constipation. COMPARISON: Right hip radiograph 12/24/2021; CT pelvis 12/20/2021; CT thoracic and lumbar spine 12/20/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 140 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 80sec Scan field of view: 326 mm. DLP: 838 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Airspace opacities in the left greater than right posterior and dependent lung bases with associated septal thickening. Trace left pleural effusion. DISTAL ESOPHAGUS: Large hiatal hernia containing almost all of the stomach. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Partially decompressed with a subtle amount of pericholecystic thickening and enhancement.. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia containing almost all of the stomach. Small bowel is unremarkable. COLON / APPENDIX: Large colorectal fecal burden. The colon is redundant. Prominent rectal fecaloma with subtle rectal wall thickening and perirectal stranding. The sigmoid colon is redundant. Appendix is not visualized. PERITONEUM / MESENTERY: Normal. No free fluid or pneumoperitoneum. RETROPERITONEUM: No significant abnormality. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. Infrarenal IVC filter in expected position. URINARY BLADDER: Distended with minimal wall thickening and perivesicular stranding. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: No significant abnormality. Surgical tacks are seen in the lower pelvic body wall. MUSCULOSKELETAL: Right femoral head and neck fixation hardware in place securing a subcapital fracture deformity. Chronic compression deformities of the T10, T12 and L1 vertebral bodies are redemonstrated. Bone cement is seen within the T10 and L1 vertebral bodies. CONCLUSION: 1. Large colon and rectal fecal burden. Prominent fecaloma with subtle rectal wall thickening and perirectal stranding which may represent developing stercoral colitis or secondary to fecal impaction. 2. Mild circumferential urinary bladder wall thickening and perivesicular stranding. Correlation with urinalysis is recommended to exclude acute cystitis. 3. Left greater than right lung base airspace opacities which likely represent atelectasis/scarring, however superimposed infection/aspiration is not excluded. 4. Large hiatal hernia containing almost the entire stomach, likely in the organoaxial configuration. No convincing evidence of obstruction. 5. Gallbladder thickening probably due to lack distention, although correlation for cholecystitis is recommended. 6. Additional chronic and incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Airspace opacities in the left greater than right posterior and dependent lung bases with associated septal thickening. Trace left pleural effusion. DISTAL ESOPHAGUS: Large hiatal hernia containing almost all of the stomach. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Partially decompressed with a subtle amount of pericholecystic thickening and enhancement.. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia containing almost all of the stomach. Small bowel is unremarkable. COLON / APPENDIX: Large colorectal fecal burden. The colon is redundant. Prominent rectal fecaloma with subtle rectal wall thickening and perirectal stranding. The sigmoid colon is redundant. Appendix is not visualized. PERITONEUM / MESENTERY: Normal. No free fluid or pneumoperitoneum. RETROPERITONEUM: No significant abnormality. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. Infrarenal IVC filter in expected position. URINARY BLADDER: Distended with minimal wall thickening and perivesicular stranding. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: No significant abnormality. Surgical tacks are seen in the lower pelvic body wall. MUSCULOSKELETAL: Right femoral head and neck fixation hardware in place securing a subcapital fracture deformity. Chronic compression deformities of the T10, T12 and L1 vertebral bodies are redemonstrated. Bone cement is seen within the T10 and L1 vertebral bodies.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Chest findings to be dictated separately; please see separate chest CT report same day. ABDOMEN and PELVIS: LIVER: Normal BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Unchanged peripherally calcified cystic lesion ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate aortic atherosclerosis without aneurysm URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The uterus is surgically absent. No adnexal mass BODY WALL: Subcutaneous nodularity in the left gluteal region is unchanged MUSCULOSKELETAL: Multilevel degenerative changes in the lumbar spine.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 70-year-old female with concern for hernia near site of prior ostomy COMPARISON: Multiple prior CTs of the abdomen pelvis, most recent 10/20/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 190 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 97 sec Scan field of view: 453 mm. DLP: 1186.60 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Anastomotic suture line in the left anterior hemiabdomen is noted, otherwise normal in appearance. COLON / APPENDIX: Rectal anastomotic suture line is noted. Persistent rectal wall thickening, not significantly changed from prior. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Interval development of a small fat-containing hernia near the site of prior left hemiabdomen ostomy which measures 6.9 x 2.1 cm on axial series 2, image 66. Tiny fluid collection in the anterior abdominal wall near the site of the ostomy observed on the prior study has resolved. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Interval development of a small fat-containing hernia near the site of prior left hemiabdomen ostomy. 2. Persistent rectal wall thickening. Recommend clinical correlation if there is any concern for proctitis.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Anastomotic suture line in the left anterior hemiabdomen is noted, otherwise normal in appearance. COLON / APPENDIX: Rectal anastomotic suture line is noted. Persistent rectal wall thickening, not significantly changed from prior. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Interval development of a small fat-containing hernia near the site of prior left hemiabdomen ostomy which measures 6.9 x 2.1 cm on axial series 2, image 66. Tiny fluid collection in the anterior abdominal wall near the site of the ostomy observed on the prior study has resolved. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Mild frontoparietal cerebral volume loss. Partial empty sella. Mild periventricular white matter hypoattenuation, similar to prior, likely mild chronic microangiopathic changes. Trace bilateral carotid siphon atherosclerotic ossifications. EXTRA-AXIAL SPACES: Interval decrease in size of bilateral subdural hygromas, with superimposed residual mixed-density subacute epidural hematoma at the right frontal convexity up to 0.4 cm in greatest coronal dimension (series 601, image 16), previously 1.4 cm (series 3, image 21). SKULL AND SKULL BASE: No fracture. Bilateral frontoparietal burr holes from prior subdural drainage catheters, unchanged. VENTRICULAR SYSTEM: Proportionate ex vacuo ventricular dilatation. ORBITS: Normal. SINUSES: Scattered opacification of the bilateral ethmoid air cells with mucosal thickening, extending into the frontal ethmoidal recesses and left sphenoethmoidal recess. The inferior bilateral maxillary sinuses are not imaged. The nasal sinuses and mastoid air cells are otherwise clear. SOFT TISSUES: Postsurgical changes from prior frontoparietal burr hole placements. --------------------
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CT Head wo contrast 1/7/2022 3:15 PM Clinical Information: AMS, headache Comparison: 3/13/2014 Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 231 mm. DLP: 1122 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: No CT evidence of acute intracranial abnormality.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
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FINDINGS: Aortic arch: Patent without flow-limiting stenosis. Normal three vessel aortic arch is noted. Punctate nonflow limiting atherosclerotic calcifications of the bilateral carotid bifurcations. Right carotid: Patent without flow-limiting stenosis. Left carotid: Patent without flow-limiting stenosis. Right vertebral artery: Patent without flow-limiting stenosis. Left vertebral artery: Dominant. Patent without flow-limiting stenosis. Intracranial arteries: Punctate nonflow limiting atherosclerotic calcification of the right cavernous ICA. The bilateral ACAs, MCAs and PCAs appear patent, without flow-limiting stenoses or discrete aneurysms. The vertebrobasilar axis is mildly tortuous, without flow-limiting stenoses. NONVASCULAR FINDINGS: Postsurgical left temporal craniectomy changes are noted, with multiple ballistic fragments in the left middle cranial fossa and underlying resection cavity/encephalomalacia. Mild diffuse age-appropriate brain parenchymal volume loss is otherwise seen. Mild periventricular white matter hypoattenuation is noted, suggestive of mild chronic microvascular ischemic disease. The white-gray matter differentiation is preserved. There is no abnormal enhancement, acute intracranial hemorrhage, midline shift, basal cistern effacement, hydrocephalus or abnormal extra-axial fluid collections. The visualized paranasal sinuses, mastoid air cells and orbits appear otherwise unremarkable. Punctate calcifications of the bilateral palatine tonsils, likely sequela of prior infections. The oral cavity, nasopharynx, oropharynx, and laryngopharynx have otherwise normal appearance. No intrinsic abnormality is seen within the larynx or trachea. The true and false vocal cords are without focal abnormality. The superficial soft tissues of the neck have a normal appearance with no enhancing lesion identified. No enlarged lymph nodes are seen. The parotid and submandibular glands are normal in appearance. The thyroid gland is diffusely enlarged and heterogeneous in appearance, with replacement of the left thyroid lobe by a large soft tissue lesion, measuring up to 76.5 x 53 mm, extending caudally to the level of the great vessels, unchanged according to previous thyroid ultrasound.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 37-year-old male with buttock abscess. COMPARISON: CT pelvis 12/9/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 170 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 80sec Scan field of view: 360 mm. DLP: 750 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Redemonstrated multiloculated fluid collections involving the left greater than right gluteal soft tissues and extending along the perineum anteriorly. The right-sided gluteal fluid collection contains a small focus of gas on axial image 277 series 201. The right-sided fluid collection has mildly decreased in size from prior and appears more complex with thick walls. There are phlegmonous changes in bilateral superficial groin soft tissues and along the base of the scrotum bilaterally. The largest well-defined fluid collection is seen in the left gluteal soft tissues and measures approximately 5.9 x 3.5 cm in greatest axial dimension (axial image 33). Inflammatory changes extend from this collection to abut the anus and a perianal fistula cannot be excluded. Few focal areas of cutaneous inflammatory stranding in the ventral pelvic wall without underlying fluid collection. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Cutaneous thickening along with multiloculated fluid collections in the left greater than right gluteal soft tissues compatible with abscesses are again demonstrated. The left-sided gluteal collection is larger from prior and the right-sided gluteal collection is slightly smaller compared to prior. Inflammatory stranding extends along the perineum to the groin bilaterally. Findings remain compatible with hidradenitis suppurativa. The largest well-defined fluid collection is seen in the left gluteal soft tissues measuring up to 5.9 x 3.5 cm in greatest dimension. 2. The left-sided fluid collection extends in close proximity to the anus and a perianal fistula cannot be entirely excluded. If there is clinical concern for a perianal fistula, recommend outpatient nonemergent MR fistula protocol. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Redemonstrated multiloculated fluid collections involving the left greater than right gluteal soft tissues and extending along the perineum anteriorly. The right-sided gluteal fluid collection contains a small focus of gas on axial image 277 series 201. The right-sided fluid collection has mildly decreased in size from prior and appears more complex with thick walls. There are phlegmonous changes in bilateral superficial groin soft tissues and along the base of the scrotum bilaterally. The largest well-defined fluid collection is seen in the left gluteal soft tissues and measures approximately 5.9 x 3.5 cm in greatest axial dimension (axial image 33). Inflammatory changes extend from this collection to abut the anus and a perianal fistula cannot be excluded. Few focal areas of cutaneous inflammatory stranding in the ventral pelvic wall without underlying fluid collection. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: Aortic arch: Patent without flow-limiting stenosis. Normal three vessel aortic arch is noted. Punctate nonflow limiting atherosclerotic calcifications of the bilateral carotid bifurcations. Right carotid: Patent without flow-limiting stenosis. Left carotid: Patent without flow-limiting stenosis. Right vertebral artery: Patent without flow-limiting stenosis. Left vertebral artery: Dominant. Patent without flow-limiting stenosis. Intracranial arteries: Punctate nonflow limiting atherosclerotic calcification of the right cavernous ICA. The bilateral ACAs, MCAs and PCAs appear patent, without flow-limiting stenoses or discrete aneurysms. The vertebrobasilar axis is mildly tortuous, without flow-limiting stenoses. NONVASCULAR FINDINGS: Postsurgical left temporal craniectomy changes are noted, with multiple ballistic fragments in the left middle cranial fossa and underlying resection cavity/encephalomalacia. Mild diffuse age-appropriate brain parenchymal volume loss is otherwise seen. Mild periventricular white matter hypoattenuation is noted, suggestive of mild chronic microvascular ischemic disease. The white-gray matter differentiation is preserved. There is no abnormal enhancement, acute intracranial hemorrhage, midline shift, basal cistern effacement, hydrocephalus or abnormal extra-axial fluid collections. The visualized paranasal sinuses, mastoid air cells and orbits appear otherwise unremarkable. Punctate calcifications of the bilateral palatine tonsils, likely sequela of prior infections. The oral cavity, nasopharynx, oropharynx, and laryngopharynx have otherwise normal appearance. No intrinsic abnormality is seen within the larynx or trachea. The true and false vocal cords are without focal abnormality. The superficial soft tissues of the neck have a normal appearance with no enhancing lesion identified. No enlarged lymph nodes are seen. The parotid and submandibular glands are normal in appearance. The thyroid gland is diffusely enlarged and heterogeneous in appearance, with replacement of the left thyroid lobe by a large soft tissue lesion, measuring up to 76.5 x 53 mm, extending caudally to the level of the great vessels, unchanged according to previous thyroid ultrasound.
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: 78-year-old male with bladder cancer and hematuria, evaluate treatment response. COMPARISON: CT abdomen and pelvis 7/15/2020 TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 260 lbs. IV contrast: Omnipaque 350, 180 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 60/300 sec. Scan field of view: 478 mm. DLP: 2856 mGy cm. FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Unchanged small right posterior, peripheral calcification (series 3 image 22). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Cardiac pacer wires are seen. Coronary artery calcifications. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Moderate right hydroureteronephrosis, with the dilatation of the ureter all the way to the urinary bladder insertion. Small amount of soft tissue stranding seen adjacent to both kidneys, similar to prior UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Posterolateral bladder mass at the right UVJ again seen, difficult to measure exactly on this study due to no near collapse of the urinary bladder. Mild soft tissue stranding is seen surrounding the urinary bladder. LIVER: Mildly nodular. Subcentimeter hypodensity is statistically a cyst BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: Shotty peripancreatic nodes again seen. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Severe atherosclerotic disease REPRODUCTIVE ORGANS: Prostate is moderately enlarged BODY WALL: Tiny fat-containing umbilical hernia MUSCULOSKELETAL: No destructive osseous lesions seen. CONCLUSION: 1. Moderate hydroureteronephrosis has worsened from prior. The distal ureter inserts at the UVJ to the region of the urinary bladder mass, not accurately measurable due to near complete bladder is collapsed. Soft tissue stranding is seen around the bladder periphery, posttreatment change versus infection. Recommend clinical correlation. 2. Enlarged prostate. 3. Incidental findings as detailed above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report. Addendum: The report is corrected as follows: EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: 78-year-old male with bladder cancer and hematuria, evaluate treatment response. COMPARISON: CT abdomen and pelvis 7/15/2020 TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 260 lbs. IV contrast: Omnipaque 350, 180 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 60/300 sec. Scan field of view: 478 mm. DLP: 2856 mGy cm. FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Unchanged small right posterior, peripheral calcification (series 3 image 22). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Cardiac pacer wires are seen. Coronary artery calcifications. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Moderate right hydroureteronephrosis, with the dilatation of the ureter all the way to the urinary bladder insertion. Small amount of soft tissue stranding seen adjacent to both kidneys, similar to prior UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Posterolateral bladder mass at the right UVJ again seen, difficult to measure exactly on this study due to no near collapse of the urinary bladder. Mild soft tissue stranding is seen surrounding the urinary bladder. LIVER: Mildly nodular. Subcentimeter hypodensity is statistically a cyst BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: Shotty peripancreatic nodes again seen. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Severe atherosclerotic disease. Infrarenal IVC filter noted. REPRODUCTIVE ORGANS: Prostate is moderately enlarged BODY WALL: Tiny fat-containing umbilical hernia MUSCULOSKELETAL: No destructive osseous lesions seen. CONCLUSION: 1. Moderate hydroureteronephrosis has worsened from prior. The distal ureter inserts at the UVJ to the region of the urinary bladder mass, not accurately measurable due to near complete bladder is collapsed. Soft tissue stranding is seen around the bladder periphery, posttreatment change versus infection. Recommend clinical correlation. 2. Enlarged prostate. 3. Incidental findings as detailed above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Unchanged small right posterior, peripheral calcification (series 3 image 22). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Cardiac pacer wires are seen. Coronary artery calcifications. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Moderate right hydroureteronephrosis, with the dilatation of the ureter all the way to the urinary bladder insertion. Small amount of soft tissue stranding seen adjacent to both kidneys, similar to prior UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Posterolateral bladder mass at the right UVJ again seen, difficult to measure exactly on this study due to no near collapse of the urinary bladder. Mild soft tissue stranding is seen surrounding the urinary bladder. LIVER: Mildly nodular. Subcentimeter hypodensity is statistically a cyst BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: Shotty peripancreatic nodes again seen. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Severe atherosclerotic disease REPRODUCTIVE ORGANS: Prostate is moderately enlarged BODY WALL: Tiny fat-containing umbilical hernia MUSCULOSKELETAL: No destructive osseous lesions seen.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Moderate right and small left pleural effusion with adjacent atelectasis, similar to prior. No new lung consolidation or new suspicious pulmonary nodule. The trachea and main bronchi are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Mild body wall edema. Left subclavian port catheter with tip at the mid SVC. A right PICC with tip at the right atrium. ABDOMEN and PELVIS: LIVER: Unchanged subcentimeter low-attenuation right hepatic lesion (image 207, series 201, too small to characterize. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes, similar to prior. Hartmann pouch is again with wall thickening and surrounding fatty stranding/inflamed. PERITONEUM / MESENTERY: Redemonstrated dictated catheter within the deep pelvic abscess which appears slightly larger from prior with surrounding fatty stranding and wall thickening. There is high contrast attenuation material seen in the site of the deep pelvic abscess and probably coming from the oral contrast and this contrast material seen extending to the previously noted anterior abdominal wall entero-cutaneous fistula. Redemonstrated right perihepatic abscess collection, measures on the current exam 6.1 x 0.9 cm, not substantially changed since the prior exam (image 227, series 201). RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Air in the anterior bladder. REPRODUCTIVE ORGANS: Uterus is not visualized, likely surgically absent. BODY WALL: Similar-appearing of anterior abdominal wall drainage catheter with tip closely approximating the prior enterocutaneous fistula adjacent to the deep pelvic abscess (axial image 343). A second prior enterocutaneous fistula is seen more superiorly, medial to the abdominal wall drainage catheter (axial image 133) with air contrast level. Postsurgical changes of midline laparotomy. A right rectus and intramuscular abscess demonstrates interval decrease in size, now measuring 3.0 x 1.9 cm (image 290), previously 3.8 x 2.8 cm. Left lower quadrant ostomy with redness catheter with tip at the anterior lower abdomen. Body wall edema. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 76-year-old male with hernia. COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 154 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 326 mm. DLP: 559.70 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar peripheral scarring. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary atherosclerotic disease is present. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Asymmetric right renal atrophy with multiple areas of cortical scarring. Multiple bilateral subcentimeter hypodensities are technically indeterminate but most suggestive of cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticuli without associated inflammation. Normal segment of sigmoid colon projects through a moderate to large left inguinal hernia. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Normal caliber abdominal aorta. Moderate atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Trace bilateral scrotal hydroceles. Moderate to large left inguinal hernia extending into the scrotum as described below. The prostate is mildly enlarged. BODY WALL: Moderate to large left inguinal hernia containing a segment of normal-appearing sigmoid colon and associated mesocolic fat. Small fat-containing right inguinal hernia. MUSCULOSKELETAL: Multilevel endplate and facet degenerative changes. CONCLUSION: Moderate to large left inguinal hernia containing a segment of normal-appearing sigmoid colon and associated mesocolic fat. Small fat-containing right inguinal hernia also present.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar peripheral scarring. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary atherosclerotic disease is present. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Asymmetric right renal atrophy with multiple areas of cortical scarring. Multiple bilateral subcentimeter hypodensities are technically indeterminate but most suggestive of cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticuli without associated inflammation. Normal segment of sigmoid colon projects through a moderate to large left inguinal hernia. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Normal caliber abdominal aorta. Moderate atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Trace bilateral scrotal hydroceles. Moderate to large left inguinal hernia extending into the scrotum as described below. The prostate is mildly enlarged. BODY WALL: Moderate to large left inguinal hernia containing a segment of normal-appearing sigmoid colon and associated mesocolic fat. Small fat-containing right inguinal hernia. MUSCULOSKELETAL: Multilevel endplate and facet degenerative changes.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Moderate right and small left pleural effusion with adjacent atelectasis, similar to prior. No new lung consolidation or new suspicious pulmonary nodule. The trachea and main bronchi are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Mild body wall edema. Left subclavian port catheter with tip at the mid SVC. A right PICC with tip at the right atrium. ABDOMEN and PELVIS: LIVER: Unchanged subcentimeter low-attenuation right hepatic lesion (image 207, series 201, too small to characterize. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes, similar to prior. Hartmann pouch is again with wall thickening and surrounding fatty stranding/inflamed. PERITONEUM / MESENTERY: Redemonstrated dictated catheter within the deep pelvic abscess which appears slightly larger from prior with surrounding fatty stranding and wall thickening. There is high contrast attenuation material seen in the site of the deep pelvic abscess and probably coming from the oral contrast and this contrast material seen extending to the previously noted anterior abdominal wall entero-cutaneous fistula. Redemonstrated right perihepatic abscess collection, measures on the current exam 6.1 x 0.9 cm, not substantially changed since the prior exam (image 227, series 201). RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Air in the anterior bladder. REPRODUCTIVE ORGANS: Uterus is not visualized, likely surgically absent. BODY WALL: Similar-appearing of anterior abdominal wall drainage catheter with tip closely approximating the prior enterocutaneous fistula adjacent to the deep pelvic abscess (axial image 343). A second prior enterocutaneous fistula is seen more superiorly, medial to the abdominal wall drainage catheter (axial image 133) with air contrast level. Postsurgical changes of midline laparotomy. A right rectus and intramuscular abscess demonstrates interval decrease in size, now measuring 3.0 x 1.9 cm (image 290), previously 3.8 x 2.8 cm. Left lower quadrant ostomy with redness catheter with tip at the anterior lower abdomen. Body wall edema. MUSCULOSKELETAL: No significant abnormality.
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RADIOLOGIC EXAM: CT Angio Neck CLINICAL INFORMATION: Bleeding from tracheostomy site. COMPARISON: None. TECHNIQUE: CT Angio Neck 3-D CT MIP and Volume rendered angiographic images were generated in post processing. Patient weight: 226 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 238 mm. DLP: 1163 mGy cm. STRUCTURED REPORT: CT Angiogram Neck FINDINGS: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. RIGHT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. RIGHT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. Along the cranial margin of the patient's tracheostomy site, there are multiple areas of serpiginous opacification/extravasation, for example on images 394, 396, and 403 of series 8. Additional subtle areas of likely extravasation are present along the caudal margin of the tracheostomy, for example on images 442 and 449 of series 8. There is associated adjacent hematoma, measuring up to 27 mm superiorly and 12.5 mm inferiorly in craniocaudal dimension. There is diffuse opacification of the paranasal sinuses with hyperattenuating fluid in the maxillary sinuses, possibly blood products. Fluid/hemorrhage fills the nasopharynx and oropharynx extending into the trachea. Nasogastric tube is in place. Right IJ ECMO cannula and left subclavian central venous catheter are partially imaged. Partially imaged bilateral pleural effusions and areas of interlobular septal thickening, groundglass opacification, and consolidation in both lungs. Incidental pineal cyst. IMPRESSION: 1. Multiple sites of active extravasation with adjacent hematoma surrounding the patient's tracheostomy as described, which measures up to 27 mm superiorly and 12.5 mm inferiorly in craniocaudal dimension. 2. Diffuse opacification of the paranasal sinuses with hyperattenuating fluid likely representing hemorrhage. Additionally there is hemorrhage in the nasopharynx and oropharynx extending into the trachea. 3. Bilateral pleural effusions and pulmonary parenchymal abnormalities as detailed above. The findings were discussed with Dr. Jin by Dr. Watts via telephone on 1/7/2022 5:55 PM. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. RIGHT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT CAROTID: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. RIGHT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. LEFT VERTEBRAL ARTERY: There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. Along the cranial margin of the patient's tracheostomy site, there are multiple areas of serpiginous opacification/extravasation, for example on images 394, 396, and 403 of series 8. Additional subtle areas of likely extravasation are present along the caudal margin of the tracheostomy, for example on images 442 and 449 of series 8. There is associated adjacent hematoma, measuring up to 27 mm superiorly and 12.5 mm inferiorly in craniocaudal dimension. There is diffuse opacification of the paranasal sinuses with hyperattenuating fluid in the maxillary sinuses, possibly blood products. Fluid/hemorrhage fills the nasopharynx and oropharynx extending into the trachea. Nasogastric tube is in place. Right IJ ECMO cannula and left subclavian central venous catheter are partially imaged. Partially imaged bilateral pleural effusions and areas of interlobular septal thickening, groundglass opacification, and consolidation in both lungs. Incidental pineal cyst.
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FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Moderate bilateral pleural effusions with adjacent atelectasis, new from prior. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: STOMACH: No abnormality. SMALL BOWEL: Several dilated loops of bowel in the pelvis again noted. Interval improvement in bowel loop dilation in the right mid abdomen. Bowel wall mucosal hyperenhancement again noted, although wall thickening is improved from prior. PERITONEUM / MESENTERY: Diffuse mesenteric congestion. Interval decrease in size of the peripherally enhancing fluid along the right abdominal cavity measuring 2.1 x 0.7 cm (image 163 series 201), previously 2.5 x 1.1 cm. Interval removal of the left upper quadrant and pelvic pigtail drains. No residual fluid collection seen at the previous site of either drain. A small gas-filled tract noted along the course of the previously removed pelvic drain. Tiny locule of free air in the midline pelvis, probably related to drain removal. COLORECTAL: Diffuse colonic wall thickening and hyperenhancement improved compared to prior. Fecal material is seen exiting the anus. APPENDIX: Not seen. PERIANAL TISSUES: No fistula or abscess. LIVER: Mild periportal edema. Otherwise unremarkable.. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Borderline splenomegaly. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Diffuse anasarca. MUSCULOSKELETAL: Hyperdense foreign body adjacent to the T10 spinous process, unchanged.
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CT Head wo contrast Clinical Information: L sided headache Spec Inst: recent stroke and TPA intervention Technique: Axial thin slice unenhanced images of the brain were obtained. Multiplanar reformatted images were obtained from the thin slice data set. Scan field of view: 223 mm. DLP: 1122 mGy cm. Comparison: January 5, 2022 head CT Findings: There is no acute intracranial hemorrhage, brain edema, hydrocephalus, mass effect or midline shift. Gray-white matter differentiation appears maintained. No extra-axial collection. No evidence for contrast staining after reported history of TPA administration. The skull base and calvarium appear intact. No large territorial acute infarct is evident at unenhanced CT. The mastoid air cells and visualized paranasal sinuses are clear. Conclusion: No acute intracranial abnormality evident. No significant change from January 5, 2022 head CT.
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Findings: There is no acute intracranial hemorrhage, brain edema, hydrocephalus, mass effect or midline shift. Gray-white matter differentiation appears maintained. No extra-axial collection. No evidence for contrast staining after reported history of TPA administration. The skull base and calvarium appear intact. No large territorial acute infarct is evident at unenhanced CT. The mastoid air cells and visualized paranasal sinuses are clear.
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FINDINGS: Index lesions are measured in series 2. Enlarged right lower paratracheal node in image 51 is 35 x 24 mm. The subcarinal node in image 62 is 30 x 24 mm. Several enlarged nodes are present in the mediastinum including prevascular, right upper and bilateral lower paratracheal, AP window, subcarinal and bilateral lower lobe bronchopulmonary regions. Slightly enlarged right thyroid lobe with partly calcified and hypodense focal lesion There is asymmetric upper lobe dominant paraseptal emphysema along with lower lobe dominant subpleural coarse reticulations, bronchiectasis and bronchiolectasis due to chronic interstitial lung disease. No discrete lung nodule or mass is noted. There is no pleural or pericardial effusion and no focal lytic or sclerotic bone lesion is seen.
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Lung Cancer Screening Clinical Information: Lung cancer screening Technique: Scan field of view: 285 mm. Height: 61 in. Patient weight: 123 lbs. CTDI vol: 0.35 mGy. DLP: 14 mGy cm. 0.60 mm images were obtained through the chest. The CT is jointly interpreted by Drs. Singh and Ahmed Smoking Status: Former If not current, quit years ago: 7 Pack Years: 40 Screen Year: Baseline Comparison: Cardiac research Grant CT study dated 9/13/2010. Interpretation and recommendations are based on 2019 version of ACR LungRads recommendations Findings: Stable few prominent aortopulmonary lymph nodes, the largest of which measures up to 8 mm (series 6, image 97). The mediastinal is otherwise unremarkable. Upper lobe predominant mild to moderate centrilobular and paraseptal emphysema. Minimal biapical pleuroparenchymal scarring. A solid 3 mm noncalcified pulmonary nodule is noted within the subpleural apical left upper lobe (series 6, image 48). Other subtle subsolid tiny pulmonary nodules are also noted, for example: Within the right upper lobe (series 6, image 90 and within the left upper lobe (series 6, image 98). No evidence of pulmonary nodules or masses suspicious for lung cancer. No evidence of pleural or pericardial effusion. Coronary artery calcification: The visual score of calcification is 1 (LAD). (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: Degenerative bony changes. No aggressive lytic or sclerotic osseous lesions. Impression: 1. Few tiny noncalcified pulmonary nodules, all measuring less than 4 mm. No evidence of pulmonary masses or nodules suspicious for primary lung cancer. 2. Mild to moderate upper lobe predominant centrilobular and paraseptal emphysema. LungRads category: 2 Lung-Rads Modifier S: No clinically significant or potentially clinically significant findings. Recommendation: Continue annual low dose chest CT for lung cancer screening. ====================================================================================== REFERENCES: http://www.acr.org/\R\/media/ACR/Documents/PDF/QualitySafety/Resources/LungRADS/AssessmentCateg ries http://www.acr.org/Quality-Safety/Lung-Cancer-Screening-Center Category 0: Incomplete. Category 1: Negative - No nodules or definitely benign nodules. Category 2: Benign Appearance or Behavior - Nodules with a very low likelihood of becoming a clinically active cancer due to size or lack of growth. Category 3: Probably benign finding(s) - Short term follow-up suggested; includes nodules with a low likelihood of becoming a clinically active cancer. Category 4A: Suspicious - Findings for which additional diagnostic testing is recommended. Category 4B and 4X: Very Suspicious - Findings for which additional diagnostic testing and/or tissue sampling is recommended. Modifier S: Other Findings - Clinically significant or potentially clinically significant findings (non-lung cancer). References: http://www.acr.org/\R\/media/ACR/Documents/PDF/QualitySafety/Resources/LungRADS/AssessmentCateg ries http://www.acr.org/Quality-Safety/Lung-Cancer-Screening-Center
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Findings: Stable few prominent aortopulmonary lymph nodes, the largest of which measures up to 8 mm (series 6, image 97). The mediastinal is otherwise unremarkable. Upper lobe predominant mild to moderate centrilobular and paraseptal emphysema. Minimal biapical pleuroparenchymal scarring. A solid 3 mm noncalcified pulmonary nodule is noted within the subpleural apical left upper lobe (series 6, image 48). Other subtle subsolid tiny pulmonary nodules are also noted, for example: Within the right upper lobe (series 6, image 90 and within the left upper lobe (series 6, image 98). No evidence of pulmonary nodules or masses suspicious for lung cancer. No evidence of pleural or pericardial effusion. Coronary artery calcification: The visual score of calcification is 1 (LAD). (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: Degenerative bony changes. No aggressive lytic or sclerotic osseous lesions.
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FINDINGS: SOFT TISSUES: The masticator, parapharyngeal, retropharyngeal, carotid, sublingual, and submandibular spaces are unremarkable. The anterior soft tissue fascial planes are unremarkable. Small subcutaneous cyst is noted within the posterior left neck soft tissues likely a sebaceous cyst. LYMPH NODES: Two enlarged right level IV lymph nodes the largest of which measures 1.6 x 1.5 cm on axial series 3 image 95. No pathologically enlarged left cervical chain lymph nodes. AERODIGESTIVE STRUCTURES: No asymmetric contrast enhancement or asymmetric soft tissue nodularity. PAROTID GLANDS/SUBMANDIBULAR GLANDS: The bilateral parotid glands are normal. There is bilateral and symmetric prominence of the submandibular gland ducts without radiopaque sialolith identified. THYROID GLAND: The thyroid is incompletely evaluated secondary to extensive motion in this region. The thyroid is better appreciated on the same day chest CT with enlarged right thyroid lobe and heterogeneously hypodense partially calcified nodule. VASCULAR STRUCTURES: No evidence of dissection, occlusion, or aneurysm. Moderate to severe right and mild left carotid bifurcation atherosclerosis. Extensive atherosclerosis of the cavernous ICA and calcifications of the aortic arch are also noted. Fetal origin of the right PCA. OSSEOUS STRUCTURES: No fracture, dislocation, or destructive lesion. Advanced discogenic degenerative change throughout the cervical spine most pronounced at C5-C6 with partial osseous ankylosis at this level. Mild anterolisthesis of C4 on C5 and C7 on T1. There is advanced facet arthropathy with associated severe osseous neural foraminal narrowing at C2-C3 on the right, C3-C4 bilaterally, C4-C5 bilaterally, C5-6, C6-7 and C7-T1 bilaterally. There is also mild multifocal spinal canal narrowing most pronounced at C4-C5. ORBITS: Unremarkable. PARANASAL SINUSES AND MASTOID AIR CELLS: Bilateral aeration of the petrous apices. The paranasal sinuses and mastoid air cells are clear. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: Unremarkable aside from mild global atrophy consistent with patient's stated age. LUNG APICES: Emphysematous changes and mediastinal/hilar adenopathy are partially visualized. Please see separately dictated CT chest of the same day.
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EXAM: CT Chest High Resolution wo contrast CLINICAL INFORMATION: 69-year-old female with shortness of breath. History of SLE, Sjogren's syndrome. COMPARISON: CT chest dated 12/22/2021 TECHNIQUE: CT Chest High Resolution wo contrast. Scan field of view: 300 mm. DLP: 435.10 mGy cm. High-resolution CT imaging of the chest was performed per protocol with inspiratory technique in supine position. FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent, with persistent diffuse peripheral reticulations, with scattered areas of traction bronchiectasis and groundglass opacities, overall similar in distribution and severity. Scattered areas of mosaic attenuation are again seen. No new opacity. No pleural effusion. HEART / VESSELS: Prominent atria and left ventricle. No pericardial effusion. Normal caliber pulmonary artery and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: Scattered enlarged mediastinal lymph nodes, overall unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Multilevel degenerative changes in the thoracic spine. CONCLUSION: 1. Overall the extent of connective tissue disease related interstitial lung disease with a mixed cellular and fibrotic pattern of NSIP, appears similar to prior study. 2. Multiple enlarged mediastinal lymph nodes, unchanged, likely reactive. 3. Biatrial and left ventricular dilatation.
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FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent, with persistent diffuse peripheral reticulations, with scattered areas of traction bronchiectasis and groundglass opacities, overall similar in distribution and severity. Scattered areas of mosaic attenuation are again seen. No new opacity. No pleural effusion. HEART / VESSELS: Prominent atria and left ventricle. No pericardial effusion. Normal caliber pulmonary artery and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: Scattered enlarged mediastinal lymph nodes, overall unchanged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Multilevel degenerative changes in the thoracic spine.
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FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: Refer to the concurrent dedicated CT chest report. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. Simple renal cyst at the lower pole of the left kidney. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects in the opacified collecting system. Limited evaluation of the left distal ureter due to patient.. URINARY BLADDER: No abnormal bladder wall thickening or enhancement. No bladder mass. LIVER: Simple hepatic cyst in the medial segment of the left lobe measures 2 cm. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Moderate to large colorectal fecal burden noted. Otherwise, colon is normal. Appendix is not visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is marked compression of the left renal vein between the aorta and SMA and proximal dilatation of the left renal vein and its segmental tributaries. REPRODUCTIVE ORGANS: Uterus is absent. Simple renal cyst measures 2 cm in the left ovary. BODY WALL: Small fat-containing umbilical and supraumbilical midline ventral hernia. There is scalloping and focal hypertrophy of the diaphragm, more prominent on the right side. MUSCULOSKELETAL: No significant abnormality.
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CT Chest High Resolution without contrast CLINICAL INFORMATION: 74-year-old female, follow up lung nodule, R06.02 Shortness of breath, J84.9 Interstitial pulmonary disease, unspecified, R91.1 Solitary pulmonary nodule Spec Inst: supine position, inspiration only TECHNIQUE: Scout images were obtained for localization. Entire chest was scanned in supine position at end inspiration only, with retrospective axial, sagittal and coronal reconstructions. Scan field of view: 330 mm. DLP: 235.21 mGy cm. COMPARISON: Prior chest CT dated 4/9/2021. FINDINGS: Scouts: No additional findings. Mediastinum: Evaluation of the mediastinal structures is limited in such a noncontrast study. Small sliding hiatal hernia is similar. No new pathologically enlarged mediastinal lymph nodes. Multiple calcified mediastinal and left hilar lymph nodes are again noted. Heart and great vessels: The left-sided cardiac chambers are mildly dilated. No pericardial effusion. Mediastinal great arteries are normal in caliber. There is severe atherosclerotic calcification of the coronary arteries. Airways: The trachea and central bronchi are patent and clear. Lungs : Biapical pleuroparenchymal scarring is similar. Bibasilar predominant subpleural reticulations with septal thickening and associated minimal traction bronchiectasis/bronchiolectasis is similar to prior. Redemonstrated mild atelectasis within the medial right middle lobe. The previously few noncalcified pulmonary nodules are stable, for example: The right middle lobe pulmonary now measures up to 5 x 6 mm (series 2, image 121), previously measured 5 x 7 mm, while the right middle lobe nodule (series 2, image 134) is grossly unchanged. No new focal pulmonary opacities or suspicious pulmonary nodules or masses. Pleural: Pleural effusion or pneumothorax. Upper abdomen: Limited noncontrast visualization of the upper abdomen redemonstrates calcified splenic and hepatic granulomas, together with calcified splenic hilar lymph nodes. No acute upper abdominal abnormalities. Bones and soft tissues: The visualized chest wall soft tissues are unremarkable. Degenerative bony changes are again noted, without evidence of aggressive or destructive intrathoracic osseous lesions. CONCLUSION: 1. Few scattered noncalcified pulmonary nodules are unchanged, nonspecific to etiology, most likely post infectious/inflammatory. 2. Stable interstitial lung disease with subpleural and basilar predominant pulmonary reticulations, septal thickening with associated minimal traction bronchiectasis/bronchiolectasis. 3. No new intrathoracic abnormalities.
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FINDINGS: Scouts: No additional findings. Mediastinum: Evaluation of the mediastinal structures is limited in such a noncontrast study. Small sliding hiatal hernia is similar. No new pathologically enlarged mediastinal lymph nodes. Multiple calcified mediastinal and left hilar lymph nodes are again noted. Heart and great vessels: The left-sided cardiac chambers are mildly dilated. No pericardial effusion. Mediastinal great arteries are normal in caliber. There is severe atherosclerotic calcification of the coronary arteries. Airways: The trachea and central bronchi are patent and clear. Lungs : Biapical pleuroparenchymal scarring is similar. Bibasilar predominant subpleural reticulations with septal thickening and associated minimal traction bronchiectasis/bronchiolectasis is similar to prior. Redemonstrated mild atelectasis within the medial right middle lobe. The previously few noncalcified pulmonary nodules are stable, for example: The right middle lobe pulmonary now measures up to 5 x 6 mm (series 2, image 121), previously measured 5 x 7 mm, while the right middle lobe nodule (series 2, image 134) is grossly unchanged. No new focal pulmonary opacities or suspicious pulmonary nodules or masses. Pleural: Pleural effusion or pneumothorax. Upper abdomen: Limited noncontrast visualization of the upper abdomen redemonstrates calcified splenic and hepatic granulomas, together with calcified splenic hilar lymph nodes. No acute upper abdominal abnormalities. Bones and soft tissues: The visualized chest wall soft tissues are unremarkable. Degenerative bony changes are again noted, without evidence of aggressive or destructive intrathoracic osseous lesions.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The previously noted right lower lobe pulmonary elongated nodule along the inferior right major fissure today measures 1.1 x 0.9 cm on series 301 image 158, previously 1.3 x 0.9 cm as measured by this radiologist. There is associated peripheral calcification which is appreciated on today's study. Smaller additional nodules are also seen in the superior aspect of right lower lobe along the fissure. Stable appearance of additional partially calcified right lower lobe nodule measuring up to 1.8 cm in diameter on series 301 image 154 with benign-appearing, "popcorn calcifications". An additional 3 mm left upper lobe pulmonary nodule is present on series 301 image 70. There is no focal consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: Right atrial dilatation. Trace pericardial effusion. Mild atherosclerotic disease of the thoracic aorta. SVC also appears to be large in size possibly congenital variation. MEDIASTINUM / ESOPHAGUS: Patulous esophagus. LYMPH NODES: Calcified right paraesophageal and right lower lobe bronchopulmonary nodes. CHEST WALL: Focal enhancing lesion of the upper outer right breast measuring 1.1 cm in diameter on series 301 image 100. UPPER ABDOMEN: Please see same day CT abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: History of May Thurner and IR stenting of left iliac vein, now with recurrent symptoms. COMPARISON: 6/21/2018 and 6/10/2019 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 226 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 100 sec. Scan field of view: 450 mm. DLP: 784 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from sleeve gastrectomy with herniation of the proximal stomach above the diaphragm. Otherwise normal. COLON / APPENDIX: Scattered diverticula. Otherwise normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Left iliac vein stent is patent without significant in-stent stenosis or occlusion. No DVT is identified. URINARY BLADDER: Collapsed. REPRODUCTIVE ORGANS: Uterus is absent. No suspicious adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Patent left iliac vein stent without significant in-stent stenosis or occlusion. No new abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from sleeve gastrectomy with herniation of the proximal stomach above the diaphragm. Otherwise normal. COLON / APPENDIX: Scattered diverticula. Otherwise normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Left iliac vein stent is patent without significant in-stent stenosis or occlusion. No DVT is identified. URINARY BLADDER: Collapsed. REPRODUCTIVE ORGANS: Uterus is absent. No suspicious adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: The study is mildly degraded by metallic streak artifacts from dental amalgam. CT temporal bones: RIGHT: The external auditory canal is normal. The tympanic membrane is intact. The right middle ear cavity is clear. The inner ear ossicles are normal. There is no scutal or ossicular erosion. There is normal development of the cochlea, vestibule, and semicircular canals. The otic capsule is normally mineralized. The vestibular and cochlear aqueducts are not enlarged. There are no variations in vascular or facial nerve anatomy. The internal auditory canal is normal in size and configuration. The mastoid air cells are well-developed and aerated. LEFT: The external auditory canal is normal. The tympanic membrane is intact. The left middle ear cavity is clear. The inner ear ossicles are normal. There is no scutal or ossicular erosion. There is normal development of the cochlea, vestibule, and semicircular canals. The otic capsule is normally mineralized. The vestibular and cochlear aqueducts are not enlarged. There are no variations in vascular or facial nerve anatomy. The internal auditory canal is normal in size and configuration. Trace left mastoid effusion. The mastoid air cells are otherwise well-developed and aerated. CT of the head without contrast: No acute intracranial hemorrhage, vascular territorial infarct, cerebral edema, space-occupying mass, or mass effect. Gray-white matter differentiation is maintained. Age-appropriate cerebral volume. Multifocal periventricular and subcortical white matter hypoattenuation bilaterally, likely chronic microangiopathic changes. No acute osseous or orbital abnormality. Incidental hyperostosis frontalis interna. Trace mucosal thickening of the bilateral maxillary sinus floors, bilateral ethmoid sinuses, and anterior sphenoid sinuses. The paranasal sinuses are otherwise clear. CT venogram of the head: There is no evidence of venous sinus thrombosis. There is normal asymmetric size of the right transverse sinus relative to the left. The deep cerebral veins also appear patent. Included portions of the internal jugular veins appear patent. No abnormal postcontrast enhancement. CT angiogram of the head: RIGHT CAROTID: Mild carotid siphon calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Mild carotid siphon calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: Bilateral V4 segment calcific atherosclerosis with mild right and severe left luminal stenosis. There is no evidence of occlusion or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional three-vessel branching pattern. Mild aortic arch and proximal great vessel calcific atherosclerosis RIGHT CAROTID: Mild carotid bifurcation calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Retropharyngeal in course. Mild distal common carotid and carotid bifurcation calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: The right vertebral artery is dominant. Mild atherosclerotic calcifications at the subclavian artery origin. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: Mild atherosclerotic calcifications at the subclavian artery origin. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: Right thyroid lobe 7 mm hypoattenuating nodule. The imaged lung apices demonstrate multifocal groundglass opacities, similar to prior CT from April 2021. CERVICAL SPINE: Multilevel mild to moderate degenerative discogenic disease and facet arthropathy. Bony ankylosis of the right C4-C5 facet joint. Prominent disc-osteophyte complex at C3-C4 results in moderate spinal canal stenosis and deformation of the ventral cord. Disc osteophyte complex with uncovertebral hypertrophy at C6-C7 results in severe left neuroforaminal stenosis. --------------------
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EXAM: CT Shoulder Left wo contrast CLINICAL INFORMATION: 74-year-old female with left humeral head fracture. COMPARISON: None. TECHNIQUE: CT Shoulder Left wo contrast Scan field of view: 261 mm. DLP: 485.90 mGy cm. STRUCTURED REPORT: CT Bone vDec2021 FINDINGS: BONES/JOINTS: Subacute, comminuted, minimally displaced impacted fracture of the left humeral neck with extension into the greater tuberosity. The fracture line extends to the posterior inferior aspect of the humeral head with suggestion of intra-articular extension. There is a small amount of external callus at the metaphyseal fracture site. Small glenohumeral joint effusion. The humeral head maintains articulation with the glenoid. There are mild degenerative changes of the acromioclavicular joint. The coracoclavicular interval is preserved. SOFT TISSUES: No large hematoma or fluid collection. A left chest AICD generator is in place. OTHER: Mild left apical pleural parenchymal scarring with a calcified granuloma noted in the left upper lobe with partially calcified left hilar lymph nodes. CONCLUSION: Subacute, comminuted fracture of the left humeral metaphysis with fragmentation of the greater tuberosity. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BONES/JOINTS: Subacute, comminuted, minimally displaced impacted fracture of the left humeral neck with extension into the greater tuberosity. The fracture line extends to the posterior inferior aspect of the humeral head with suggestion of intra-articular extension. There is a small amount of external callus at the metaphyseal fracture site. Small glenohumeral joint effusion. The humeral head maintains articulation with the glenoid. There are mild degenerative changes of the acromioclavicular joint. The coracoclavicular interval is preserved. SOFT TISSUES: No large hematoma or fluid collection. A left chest AICD generator is in place. OTHER: Mild left apical pleural parenchymal scarring with a calcified granuloma noted in the left upper lobe with partially calcified left hilar lymph nodes.
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FINDINGS: The study is mildly degraded by metallic streak artifacts from dental amalgam. CT temporal bones: RIGHT: The external auditory canal is normal. The tympanic membrane is intact. The right middle ear cavity is clear. The inner ear ossicles are normal. There is no scutal or ossicular erosion. There is normal development of the cochlea, vestibule, and semicircular canals. The otic capsule is normally mineralized. The vestibular and cochlear aqueducts are not enlarged. There are no variations in vascular or facial nerve anatomy. The internal auditory canal is normal in size and configuration. The mastoid air cells are well-developed and aerated. LEFT: The external auditory canal is normal. The tympanic membrane is intact. The left middle ear cavity is clear. The inner ear ossicles are normal. There is no scutal or ossicular erosion. There is normal development of the cochlea, vestibule, and semicircular canals. The otic capsule is normally mineralized. The vestibular and cochlear aqueducts are not enlarged. There are no variations in vascular or facial nerve anatomy. The internal auditory canal is normal in size and configuration. Trace left mastoid effusion. The mastoid air cells are otherwise well-developed and aerated. CT of the head without contrast: No acute intracranial hemorrhage, vascular territorial infarct, cerebral edema, space-occupying mass, or mass effect. Gray-white matter differentiation is maintained. Age-appropriate cerebral volume. Multifocal periventricular and subcortical white matter hypoattenuation bilaterally, likely chronic microangiopathic changes. No acute osseous or orbital abnormality. Incidental hyperostosis frontalis interna. Trace mucosal thickening of the bilateral maxillary sinus floors, bilateral ethmoid sinuses, and anterior sphenoid sinuses. The paranasal sinuses are otherwise clear. CT venogram of the head: There is no evidence of venous sinus thrombosis. There is normal asymmetric size of the right transverse sinus relative to the left. The deep cerebral veins also appear patent. Included portions of the internal jugular veins appear patent. No abnormal postcontrast enhancement. CT angiogram of the head: RIGHT CAROTID: Mild carotid siphon calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Mild carotid siphon calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: Bilateral V4 segment calcific atherosclerosis with mild right and severe left luminal stenosis. There is no evidence of occlusion or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional three-vessel branching pattern. Mild aortic arch and proximal great vessel calcific atherosclerosis RIGHT CAROTID: Mild carotid bifurcation calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Retropharyngeal in course. Mild distal common carotid and carotid bifurcation calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: The right vertebral artery is dominant. Mild atherosclerotic calcifications at the subclavian artery origin. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: Mild atherosclerotic calcifications at the subclavian artery origin. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: Right thyroid lobe 7 mm hypoattenuating nodule. The imaged lung apices demonstrate multifocal groundglass opacities, similar to prior CT from April 2021. CERVICAL SPINE: Multilevel mild to moderate degenerative discogenic disease and facet arthropathy. Bony ankylosis of the right C4-C5 facet joint. Prominent disc-osteophyte complex at C3-C4 results in moderate spinal canal stenosis and deformation of the ventral cord. Disc osteophyte complex with uncovertebral hypertrophy at C6-C7 results in severe left neuroforaminal stenosis. --------------------
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CT Head wo contrast 1/7/2022 9:22 PM Clinical Information: AMS Comparison: CT head with and without contrast dated 1/3/2022. Technique: Unenhanced axial brain CT. Bone and soft tissue windows were reviewed. Sagittal and coronal images were generated from the axial data. Scan field of view: 234 mm. DLP: 1218.50 mGy cm. Findings: Please note evaluation is mildly limited due to motion and beam hardening artifacts. Brain parenchyma: Mild diffuse age-appropriate brain parenchymal volume loss is again seen.. The brain parenchyma has a normal appearance. The white-gray matter differentiation is preserved. Ventricular system: Normal configuration. No hydrocephalus. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Evolving mild right tentorial subdural hemorrhage. Midline shift: No significant midline shift is seen. Vascular system: Persistent calcifications of the bilateral carotid siphons and the left vertebral artery. Soft tissues: Progressive right parietal scalp hematoma, without underlying calvarial fracture. Orbits: Normal appearance. Calvarium and skull base: No acute fractures or suspicious osseous lesions identified. Progressive opacification of the bilateral mastoid air cells, extending into the bilateral middle ear cavities. Paranasal sinuses: Persistent opacification of the left greater than right maxillary sinuses, with bilateral sphenoid and scattered posterior ethmoid air cell mucosal thickening. IMPRESSION: 1. Mildly limited evaluation due to motion and beam hardening artifacts. 2. Evolving mild right tentorial subdural hemorrhage. 3. Progressive opacification of the bilateral mastoid air cells, extending into the bilateral middle ear cavities.
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Findings: Please note evaluation is mildly limited due to motion and beam hardening artifacts. Brain parenchyma: Mild diffuse age-appropriate brain parenchymal volume loss is again seen.. The brain parenchyma has a normal appearance. The white-gray matter differentiation is preserved. Ventricular system: Normal configuration. No hydrocephalus. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Evolving mild right tentorial subdural hemorrhage. Midline shift: No significant midline shift is seen. Vascular system: Persistent calcifications of the bilateral carotid siphons and the left vertebral artery. Soft tissues: Progressive right parietal scalp hematoma, without underlying calvarial fracture. Orbits: Normal appearance. Calvarium and skull base: No acute fractures or suspicious osseous lesions identified. Progressive opacification of the bilateral mastoid air cells, extending into the bilateral middle ear cavities. Paranasal sinuses: Persistent opacification of the left greater than right maxillary sinuses, with bilateral sphenoid and scattered posterior ethmoid air cell mucosal thickening.
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FINDINGS: The study is mildly degraded by metallic streak artifacts from dental amalgam. CT temporal bones: RIGHT: The external auditory canal is normal. The tympanic membrane is intact. The right middle ear cavity is clear. The inner ear ossicles are normal. There is no scutal or ossicular erosion. There is normal development of the cochlea, vestibule, and semicircular canals. The otic capsule is normally mineralized. The vestibular and cochlear aqueducts are not enlarged. There are no variations in vascular or facial nerve anatomy. The internal auditory canal is normal in size and configuration. The mastoid air cells are well-developed and aerated. LEFT: The external auditory canal is normal. The tympanic membrane is intact. The left middle ear cavity is clear. The inner ear ossicles are normal. There is no scutal or ossicular erosion. There is normal development of the cochlea, vestibule, and semicircular canals. The otic capsule is normally mineralized. The vestibular and cochlear aqueducts are not enlarged. There are no variations in vascular or facial nerve anatomy. The internal auditory canal is normal in size and configuration. Trace left mastoid effusion. The mastoid air cells are otherwise well-developed and aerated. CT of the head without contrast: No acute intracranial hemorrhage, vascular territorial infarct, cerebral edema, space-occupying mass, or mass effect. Gray-white matter differentiation is maintained. Age-appropriate cerebral volume. Multifocal periventricular and subcortical white matter hypoattenuation bilaterally, likely chronic microangiopathic changes. No acute osseous or orbital abnormality. Incidental hyperostosis frontalis interna. Trace mucosal thickening of the bilateral maxillary sinus floors, bilateral ethmoid sinuses, and anterior sphenoid sinuses. The paranasal sinuses are otherwise clear. CT venogram of the head: There is no evidence of venous sinus thrombosis. There is normal asymmetric size of the right transverse sinus relative to the left. The deep cerebral veins also appear patent. Included portions of the internal jugular veins appear patent. No abnormal postcontrast enhancement. CT angiogram of the head: RIGHT CAROTID: Mild carotid siphon calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Mild carotid siphon calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: Bilateral V4 segment calcific atherosclerosis with mild right and severe left luminal stenosis. There is no evidence of occlusion or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional three-vessel branching pattern. Mild aortic arch and proximal great vessel calcific atherosclerosis RIGHT CAROTID: Mild carotid bifurcation calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Retropharyngeal in course. Mild distal common carotid and carotid bifurcation calcific atherosclerosis. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: The right vertebral artery is dominant. Mild atherosclerotic calcifications at the subclavian artery origin. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: Mild atherosclerotic calcifications at the subclavian artery origin. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: Right thyroid lobe 7 mm hypoattenuating nodule. The imaged lung apices demonstrate multifocal groundglass opacities, similar to prior CT from April 2021. CERVICAL SPINE: Multilevel mild to moderate degenerative discogenic disease and facet arthropathy. Bony ankylosis of the right C4-C5 facet joint. Prominent disc-osteophyte complex at C3-C4 results in moderate spinal canal stenosis and deformation of the ventral cord. Disc osteophyte complex with uncovertebral hypertrophy at C6-C7 results in severe left neuroforaminal stenosis. --------------------
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