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CT-MRI_metrics_validation_dataset

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3,500
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: CT chest without contrast 6/22/2020, CT abdomen pelvis with bilateral lower external ear of 11/1/2021. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. Patient weight: 140 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 660.50 mGy cm. (accession CT220004151), Patient weight: 140 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220004152), Patient weight: 140 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 660.50 mGy cm. (accession CT220004155), Patient weight: 140 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 660.50 mGy cm. (accession CT220004154) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Hypoattenuating 2 mm nodule in the right thyroid lobe. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes. No pleural effusions or pneumothorax. HEART / VESSELS: Mild four-chamber cardiomegaly. Dense mitral annular calcifications. Advanced calcific atherosclerosis in the coronary arteries. Mild dilatation the main pulmonary artery, measuring 32 mm in diameter. The thoracic aorta is normal in caliber. Thrombosed right upper extremity HeRO graft with its tip terminating at the superior cavoatrial junction. Small amount of thrombus adherent to the graft tip. Left external jugular vein approach tunneled vascular catheter with its tip terminating at the superior cavoatrial junction. Short segment of nonocclusive thrombus in the left external jugular vein cranial to the vascular catheter. Irregular eccentric filling defects in the right atrium (series 501, images 149 and 73). Partially visualized left upper extremity vascular graft. MEDIASTINUM / ESOPHAGUS: The esophagus is diffusely distended with gas. Circumferential thickening of the distal thoracic esophageal wall, likely related to reflux esophagitis. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic morphology. Focal fatty infiltration along the falciform. Slightly mottled enhancement, likely representing congestive hepatopathy in the setting of cardiomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Unchanged mild prominence of the ventral and dorsal pancreatic ducts with smooth tapering distally. No focal enhancing lesion within the limitations of single phase technique. ADRENALS: Normal. KIDNEYS: Symmetric atrophy and enhancement. Scattered hypoattenuating lesions in both kidneys are too small to characterize, but are statistically likely to represent cysts. Similar appearance of the right lower pole hyperdense cyst. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Moderate-sized hiatal hernia. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Mild presacral stranding/edema. VESSELS: Advanced aortoiliac calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. BODY WALL: Mild body wall edema. Unchanged small fluid containing left inguinal hernia. MUSCULOSKELETAL: Osseous mineralization is diffusely decreased. Comminuted fracture through the medial right clavicle without extension into the sternoclavicular joint. Chondrocalcinosis involving the pubic symphysis. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Advanced multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. CONCLUSION: 1. Comminuted fracture through the medial aspect of the right clavicle without extension into the sternoclavicular joint. 2. No acute traumatic abnormality in the abdomen or pelvis. No acute fracture or subluxation in the thoracolumbar spine. 3. Chronically occluded right upper extremity hero graft with its wall thrombus adherent to the catheter tip. Additional eccentric filling defects in the right atrium may represent small intracardiac thrombi, less likely to be related to a prominent crista terminalis. Additional small nonocclusive thrombus in the left external jugular vein associated with a left chest tunneled dialysis catheter. Note: Preliminary findings were discussed with Dr. Miller by Dr. Cook at 1/8/2022 6:42 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Hypoattenuating 2 mm nodule in the right thyroid lobe. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes. No pleural effusions or pneumothorax. HEART / VESSELS: Mild four-chamber cardiomegaly. Dense mitral annular calcifications. Advanced calcific atherosclerosis in the coronary arteries. Mild dilatation the main pulmonary artery, measuring 32 mm in diameter. The thoracic aorta is normal in caliber. Thrombosed right upper extremity HeRO graft with its tip terminating at the superior cavoatrial junction. Small amount of thrombus adherent to the graft tip. Left external jugular vein approach tunneled vascular catheter with its tip terminating at the superior cavoatrial junction. Short segment of nonocclusive thrombus in the left external jugular vein cranial to the vascular catheter. Irregular eccentric filling defects in the right atrium (series 501, images 149 and 73). Partially visualized left upper extremity vascular graft. MEDIASTINUM / ESOPHAGUS: The esophagus is diffusely distended with gas. Circumferential thickening of the distal thoracic esophageal wall, likely related to reflux esophagitis. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic morphology. Focal fatty infiltration along the falciform. Slightly mottled enhancement, likely representing congestive hepatopathy in the setting of cardiomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Unchanged mild prominence of the ventral and dorsal pancreatic ducts with smooth tapering distally. No focal enhancing lesion within the limitations of single phase technique. ADRENALS: Normal. KIDNEYS: Symmetric atrophy and enhancement. Scattered hypoattenuating lesions in both kidneys are too small to characterize, but are statistically likely to represent cysts. Similar appearance of the right lower pole hyperdense cyst. No radiopaque nephrolithiasis. No hydroureteronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Moderate-sized hiatal hernia. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Mild presacral stranding/edema. VESSELS: Advanced aortoiliac calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. BODY WALL: Mild body wall edema. Unchanged small fluid containing left inguinal hernia. MUSCULOSKELETAL: Osseous mineralization is diffusely decreased. Comminuted fracture through the medial right clavicle without extension into the sternoclavicular joint. Chondrocalcinosis involving the pubic symphysis. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Advanced multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: A few tiny perifissural nodules along the right major fissure, likely benign intrapulmonary lymph nodes. DISTAL ESOPHAGUS: Distal esophageal varices. HEART / VESSELS: Coronary artery calcifications. ABDOMEN and PELVIS: LIVER: Cirrhosis. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Mild splenomegaly. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Multiple mildly enlarged portacaval nodes, similar to prior MRI. Prominent mesenteric nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Moderate volume ascites. No free air. RETROPERITONEUM: Normal. VESSELS: Aortoiliac atherosclerotic calcifications. Distal esophageal varices and perigastric varices. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate median hypertrophy with mild mass effect on the base of the bladder.. BODY WALL: Umbilical hernia contains a large amount of loculated ascites which protrudes into the right lower anterior abdominal wall. The loculated ascites collection measures approximately 18.7 x 8.4 x 13.9 cm (image 225 series 3, image 17 series 8048). No bowel seen within the hernia sac. MUSCULOSKELETAL: No significant abnormality.
3,501
RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma COMPARISON: Multiple prior CT heads, most recently 3/3/2021. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 243.60 mm. DLP: 1444.10 mGy cm. (accession CT220004150), Scan field of view: 198.20 mm. DLP: 1155.80 mGy cm. (accession CT220004156) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. Progressive encephalomalacia in the right occipital lobe, likely from prior infarct. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Ex vacuo dilatation, predominantly involving the right occipital horn in the region of encephalomalacia. ORBITS: Large right periorbital hematoma. No retrobulbar hemorrhage. Bilateral pseudophakia. SKULL AND SKULL BASE: No fracture. Trace left mastoid air cell effusion. Large right frontal scalp hematoma. FACIAL BONES: No fracture. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Paranasal sinuses are clear. CONCLUSION: 1. No acute intracranial process or maxillofacial fracture. 2. Large right frontal scalp and periorbital hematoma. 3. Other 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Periventricular white matter hypoattenuation consistent with chronic microangiopathic changes. Progressive encephalomalacia in the right occipital lobe, likely from prior infarct. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Ex vacuo dilatation, predominantly involving the right occipital horn in the region of encephalomalacia. ORBITS: Large right periorbital hematoma. No retrobulbar hemorrhage. Bilateral pseudophakia. SKULL AND SKULL BASE: No fracture. Trace left mastoid air cell effusion. Large right frontal scalp hematoma. FACIAL BONES: No fracture. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Paranasal sinuses are clear.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Left basilar subsegmental atelectasis. 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 gastric abnormality. Very dilated loops of small bowel are seen with a focal transition point seen on coronal image 29, series 201 and axial image 174, series 201. No pneumatosis or loss of mucosal enhancement to suggest ischemia at this time. The distal small bowel is collapsed. COLON / APPENDIX: Large rectal fecal ball. Appendix appears normal. PERITONEUM / MESENTERY: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. No portal venous gas. URINARY BLADDER: Nondistended. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
3,502
RADIOLOGIC EXAM: CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: CT neck 3/3/2021. TECHNIQUE: CT Angio Neck, CT Cervical Spine From ReformatPatient weight: 140 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 935.90 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. 3-D CT MIP were generated in post processing. 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 (
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 (
Findings: The sagittal images demonstrate mild dextrocurvature of the upper thoracic spine, with preservation of the thoracic kyphosis and lumbar lordosis, without subluxations. The vertebral bodies maintain normal height, with scattered prominent Schmorl nodes, without acute fractures or suspicious osseous lesions. Multilevel intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced at L3-L4 and in the lower thoracic spine. Circumscribed posterior paraspinal hypodense/necrotic lesion is noted, extending adjacent to the L3 spinous process bilaterally, measuring approximately 43.4 x 27 mm, without associated bony erosions, however with suspected dorsal epidural extension, resulting in severe L3-4 spinal canal stenosis. Additional heterogeneously appearing lesions are noted involving the right greater than left psoas muscles, resulting in effacement of the lateral recesses and severe spinal canal stenosis at T12-L1 and L1-L2. The prevertebral soft tissues appear normal. Atherosclerotic calcifications of the abdominal aorta and its branches.
3,503
RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: MVC, head trauma, seatbelt sign, +ETOH COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 250 mm. DLP: 1080 mGy cm. (accession CT220004158), Scan field of view: 200 mm. DLP: 374 mGy cm. (accession CT220004164) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal appearance of the globes. No orbital fracture. SKULL AND SKULL BASE: No acute fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Comminuted, mildly displaced bilateral nasal bone fractures. Bilateral pterygoid plates are intact. MANDIBLE: No acute fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral frontal, ethmoid, maxillary and right sphenoid sinuses. Layering fluid in the maxillary sinuses. CONCLUSION: 1. No acute intracranial process. 2. Comminuted, mildly displaced nasal bone fractures. 3. Layering fluid in the maxillary sinuses could reflect blood products or acute sinusitis. 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal appearance of the globes. No orbital fracture. SKULL AND SKULL BASE: No acute fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Comminuted, mildly displaced bilateral nasal bone fractures. Bilateral pterygoid plates are intact. MANDIBLE: No acute fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral frontal, ethmoid, maxillary and right sphenoid sinuses. Layering fluid in the maxillary sinuses.
Findings: The sagittal images demonstrate mild dextrocurvature of the upper thoracic spine, with preservation of the thoracic kyphosis and lumbar lordosis, without subluxations. The vertebral bodies maintain normal height, with scattered prominent Schmorl nodes, without acute fractures or suspicious osseous lesions. Multilevel intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced at L3-L4 and in the lower thoracic spine. Circumscribed posterior paraspinal hypodense/necrotic lesion is noted, extending adjacent to the L3 spinous process bilaterally, measuring approximately 43.4 x 27 mm, without associated bony erosions, however with suspected dorsal epidural extension, resulting in severe L3-4 spinal canal stenosis. Additional heterogeneously appearing lesions are noted involving the right greater than left psoas muscles, resulting in effacement of the lateral recesses and severe spinal canal stenosis at T12-L1 and L1-L2. The prevertebral soft tissues appear normal. Atherosclerotic calcifications of the abdominal aorta and its branches.
3,504
EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: MVC, seatbelt sign. COMPARISON: None available. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004159), Patient weight: 230 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: 465 mm. DLP: 1324 mGy cm. (accession CT220004160), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004163), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004162) 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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. CONCLUSION: 1. Subcutaneous contusion at the anterior lower abdomen. 2. Otherwise, no acute traumatic abnormality in the chest, abdomen, or pelvis. No acute fracture or subluxation in the thoracolumbar spine. 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.
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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. Similar appearance of patchy subcortical and periventricular white matter hypoattenuation consistent with chronic microangiopathy. Decreased cerebral cortical volume. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Ex vacuo dilation VESSELS: Bilateral V4 segment vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Bilateral pseudophakia. SINUSES: Mild ethmoid air cell mucosal thickening. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
3,505
EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: MVC, seatbelt sign. COMPARISON: None available. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004159), Patient weight: 230 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: 465 mm. DLP: 1324 mGy cm. (accession CT220004160), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004163), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004162) 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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. CONCLUSION: 1. Subcutaneous contusion at the anterior lower abdomen. 2. Otherwise, no acute traumatic abnormality in the chest, abdomen, or pelvis. No acute fracture or subluxation in the thoracolumbar spine. 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.
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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
Findings: Brain parenchyma: Predominantly frontotemporal and cerebellar parenchymal volume loss is seen, resulting in ex vacuo dilatation of the ventricular system. Superimposed thinning and bowing of the corpus callosum may represent a component of communicating hydrocephalus. Periventricular and subcortical white matter hypoattenuation is noted, suggestive of mild chronic microvascular ischemic disease. The brain parenchyma has a normal appearance. The white-gray matter differentiation is preserved. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Atherosclerotic calcifications of the bilateral carotid siphons. Soft tissues: Unremarkable without discrete fluid collections. Orbits: Normal appearance. Calvarium and skull base: No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Trace right maxillary sinus mucosal thickening. Otherwise, appear well aerated.
3,506
RADIOLOGIC EXAM: CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Angio Neck, CT Cervical Spine From ReformatPatient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 303 mm. DLP: 1324 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. 3-D CT MIP were generated in post processing. 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 (
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 (
FINDINGS: Aortic arch: Patent without flow-limiting stenosis. Incidental bovine origin of the right vessels from aortic arch. Right carotid: Patent without flow-limiting stenosis. Left carotid: Patent without flow-limiting stenosis. Short retropharyngeal course of the left ICA. Right vertebral artery: Patent without flow-limiting stenosis. Left vertebral artery: Patent without flow-limiting stenosis. Codominant vertebral arteries. Intracranial arteries: Trace atherosclerotic calcifications of the left greater than 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: Please refer to concomitant CT of the head for complete description of intracranial findings. The oral cavity, nasopharynx, oropharynx, and laryngopharynx have 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, with multiple internal hypodense nodules and scattered calcifications, suggestive of multinodular goiter. Reversal of the cervical lordosis, without subluxations. Chronic multilevel intervertebral disc space loss, endplate sclerosis and osteophytosis, moderate at C3-C4, C4-C5 and C6-C7. Partially visualized dependent atelectasis and right pleural effusion.
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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: MVC, seatbelt sign. COMPARISON: None available. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004159), Patient weight: 230 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: 465 mm. DLP: 1324 mGy cm. (accession CT220004160), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004163), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004162) 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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. CONCLUSION: 1. Subcutaneous contusion at the anterior lower abdomen. 2. Otherwise, no acute traumatic abnormality in the chest, abdomen, or pelvis. No acute fracture or subluxation in the thoracolumbar spine. 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.
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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
FINDINGS: Aortic arch: Patent without flow-limiting stenosis. Incidental bovine origin of the right vessels from aortic arch. Right carotid: Patent without flow-limiting stenosis. Left carotid: Patent without flow-limiting stenosis. Short retropharyngeal course of the left ICA. Right vertebral artery: Patent without flow-limiting stenosis. Left vertebral artery: Patent without flow-limiting stenosis. Codominant vertebral arteries. Intracranial arteries: Trace atherosclerotic calcifications of the left greater than 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: Please refer to concomitant CT of the head for complete description of intracranial findings. The oral cavity, nasopharynx, oropharynx, and laryngopharynx have 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, with multiple internal hypodense nodules and scattered calcifications, suggestive of multinodular goiter. Reversal of the cervical lordosis, without subluxations. Chronic multilevel intervertebral disc space loss, endplate sclerosis and osteophytosis, moderate at C3-C4, C4-C5 and C6-C7. Partially visualized dependent atelectasis and right pleural effusion.
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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: MVC, seatbelt sign. COMPARISON: None available. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004159), Patient weight: 230 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: 465 mm. DLP: 1324 mGy cm. (accession CT220004160), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004163), Patient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec. Scan field of view: 465 mm. DLP: 1324 mGy cm. (accession CT220004162) 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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. CONCLUSION: 1. Subcutaneous contusion at the anterior lower abdomen. 2. Otherwise, no acute traumatic abnormality in the chest, abdomen, or pelvis. No acute fracture or subluxation in the thoracolumbar spine. 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.
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: 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: No significant abnormality in the colon. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild superficial soft tissue contusive changes overlying the bilateral iliac MUSCULOSKELETAL: No aggressive osseous abnormality is identified. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: No spondylolisthesis.
Findings: Color parametric maps using the RAPID technique demonstrate no regional abnormalities in CBV, cerebral blood flow, mean transit time, or time to peak. Probability/prognostic maps demonstrate no areas of ischemia or high probability for cortical infarction.
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: MVC, head trauma, seatbelt sign, +ETOH COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 250 mm. DLP: 1080 mGy cm. (accession CT220004158), Scan field of view: 200 mm. DLP: 374 mGy cm. (accession CT220004164) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal appearance of the globes. No orbital fracture. SKULL AND SKULL BASE: No acute fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Comminuted, mildly displaced bilateral nasal bone fractures. Bilateral pterygoid plates are intact. MANDIBLE: No acute fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral frontal, ethmoid, maxillary and right sphenoid sinuses. Layering fluid in the maxillary sinuses. CONCLUSION: 1. No acute intracranial process. 2. Comminuted, mildly displaced nasal bone fractures. 3. Layering fluid in the maxillary sinuses could reflect blood products or acute sinusitis. 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal appearance of the globes. No orbital fracture. SKULL AND SKULL BASE: No acute fracture. Bilateral mastoid air cells are clear. FACIAL BONES: Comminuted, mildly displaced bilateral nasal bone fractures. Bilateral pterygoid plates are intact. MANDIBLE: No acute fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral frontal, ethmoid, maxillary and right sphenoid sinuses. Layering fluid in the maxillary sinuses.
Findings: Dataset. Evolution of left frontoparietal. Hemorrhagic fluid layers in the epidural space underlying the craniotomy and there is abundant anterior pneumocephalus bilaterally postsurgical changes. Overall there is no significant change compared to prior scan. Moderate mass effect and midline shift to the right are stable. The right hemisphere and posterior fossa contents are unchanged. ----------------
3,510
RADIOLOGIC EXAM: CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Angio Neck, CT Cervical Spine From ReformatPatient weight: 230 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 303 mm. DLP: 1324 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. 3-D CT MIP were generated in post processing. 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 (
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 (
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. There is moderate diffuse brain atrophy. Right posterior internal capsule chronic lacunar infarct versus prominent perivascular channels is unchanged. Confluent periventricular hypoattenuating areas compatible with moderate chronic microangiopathic disease. EXTRA-AXIAL SPACES: No subdural, epidural, or subarachnoid hemorrhage. SKULL AND SKULL BASE: No acute fracture. VENTRICULAR SYSTEM: Ex vacuo dilation. ORBITS: Bilateral pseudophakia. SINUSES: Normal. MASTOIDS: Trace right mastoid effusion. SOFT TISSUE: Unremarkable. VESSELS: Atherosclerotic calcifications of the carotid siphons and intracranial vertebral arteries.
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 299.80 mm. DLP: 1433.90 mGy cm. (accession CT220004166), Scan field of view: 210.10 mm. DLP: 1127.90 mGy cm. (accession CT220004172) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. There is encephalomalacia in the left paramedian frontal and parietal lobes EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: Postsurgical change status post left parietal craniotomy. No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: No fracture. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral ethmoid and right maxillary sinuses. CONCLUSION:No acute intracranial process or maxillofacial fracture. 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. There is encephalomalacia in the left paramedian frontal and parietal lobes EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: Postsurgical change status post left parietal craniotomy. No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: No fracture. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral ethmoid and right maxillary sinuses.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Scattered hypoattenuating foci within the deep white matter likely representing sequelae of microangiopathic disease. Small bilateral basal ganglia hypodensities are demonstrated and may represent chronic lacunar infarcts or dilated perivascular channels. Findings of white matter hypoattenuation appearing new from prior maxillofacial CT in 2016. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Minimal bilateral carotid siphon calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Right frontal scalp lesion/nodule has enlarged from prior maxillofacial CT and may represent enlarging epidermal inclusion cyst/sebaceous cyst for example.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 1361.90 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Patchy areas of left greater than right lung interlobular septal thickening and faint scattered groundglass opacities. Multiple thin-walled cysts in the right lung, possibly pneumatoceles. Right middle lobe noncalcified nodule measuring 5 mm (series 501, image 180). Mild bilateral dependent atelectasis. HEART / VESSELS: Heart is normal in size with prominent calcified coronary artery disease. Postsurgical changes from CABG. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. Central venous catheter tip terminates in the superior cavoatrial junction. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Right chest implantable port. ABDOMEN and PELVIS: LIVER: Postsurgical changes in the hepatic dome. Scattered hypoattenuating lesions in the right hepatic lobe. Subdiaphragmatic circumscribed, peripherally enhancing fluid collections measuring 4.1 x 1.6 cm (series 501, image 203) adjacent to the surgical bed. BILIARY TRACT: Mild intrahepatic biliary ductal dilatation with nondependent pneumobilia. Metallic common bile duct stent in the distal common bile duct terminating in the second portion of the small bowel. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mildly complex partially cystic lesion in the right interpolar kidney measuring 1.6 x 1.5 cm (series 501, image 302). No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes from Hartman's procedure with left upper quadrant end colostomy. Colonic interposition of the hepatic flexure anterior to the right hepatic lobe. The appendix is unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Multiple small fat-containing ventral hernias. Small fat-containing parastomal hernia in the left upper quadrant. MUSCULOSKELETAL: Scattered sclerotic lesions in axial skeleton and left posterior fourth rib. Postsurgical changes from sternotomy. No acute fracture. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. Postsurgical changes from partial hepatic resection with small peripherally enhancing subdiaphragmatic collections adjacent to the surgical bed, likely postoperative. 3. Scattered hypoenhancing lesions in the liver concerning for metastatic disease. Recommend correlation with prior imaging. Scattered sclerotic lesions throughout the axial skeleton and left fourth rib also concerning for metastatic disease. Please see separate dictation for CT thoracic and lumbar spine findings. 4. Hypoenhancing partially cystic complex lesion in the interpolar right kidney measuring up to 1.6 cm. Recommend correlation with prior imaging or further evaluation with renal protocol CT for further evaluation. 5. Right middle lobe noncalcified nodule measuring 5 mm. Patchy scattered areas of interlobular septal thickening and groundglass opacities may represent resolving multifocal infection. Recommend attention on follow-up. 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Patchy areas of left greater than right lung interlobular septal thickening and faint scattered groundglass opacities. Multiple thin-walled cysts in the right lung, possibly pneumatoceles. Right middle lobe noncalcified nodule measuring 5 mm (series 501, image 180). Mild bilateral dependent atelectasis. HEART / VESSELS: Heart is normal in size with prominent calcified coronary artery disease. Postsurgical changes from CABG. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. Central venous catheter tip terminates in the superior cavoatrial junction. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Right chest implantable port. ABDOMEN and PELVIS: LIVER: Postsurgical changes in the hepatic dome. Scattered hypoattenuating lesions in the right hepatic lobe. Subdiaphragmatic circumscribed, peripherally enhancing fluid collections measuring 4.1 x 1.6 cm (series 501, image 203) adjacent to the surgical bed. BILIARY TRACT: Mild intrahepatic biliary ductal dilatation with nondependent pneumobilia. Metallic common bile duct stent in the distal common bile duct terminating in the second portion of the small bowel. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mildly complex partially cystic lesion in the right interpolar kidney measuring 1.6 x 1.5 cm (series 501, image 302). No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes from Hartman's procedure with left upper quadrant end colostomy. Colonic interposition of the hepatic flexure anterior to the right hepatic lobe. The appendix is unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Multiple small fat-containing ventral hernias. Small fat-containing parastomal hernia in the left upper quadrant. MUSCULOSKELETAL: Scattered sclerotic lesions in axial skeleton and left posterior fourth rib. Postsurgical changes from sternotomy. No acute fracture.
FINDINGS: There is no acute fracture in the lumbar spine evident. Lumbar vertebral body height and posterior vertebral alignment are stable compared to prior minimal anterolisthesis of L4 and L5 again demonstrated. Multilevel degenerative discogenic changes and multilevel facet degenerative changes are again demonstrated. Degenerative changes are most pronounced in the upper lumbar spine and visualized lower thoracic spine. Bilateral foraminal narrowing at L1-L2, L4-L5 and L5-S1 appears similar to prior. Previously demonstrated enhancing tissue within the thecal sac distally cannot be evaluated on this unenhanced CT. Atherosclerotic calcifications are present in the aorta. Coronary atherosclerotic calcifications are present. The visualized lung bases are unremarkable apart from dependent atelectatic changes. Left adrenal hyperplastic thickening is again demonstrated. Indeterminate right adrenal nodule is grossly stable. Mild bilateral nonspecific perinephric stranding. Minimal bilateral pelvocaliectasis. Subtle bone infarcts in the bilateral medial iliac bones. Degenerative changes of the SI joints.
3,513
EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 1361.90 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Patchy areas of left greater than right lung interlobular septal thickening and faint scattered groundglass opacities. Multiple thin-walled cysts in the right lung, possibly pneumatoceles. Right middle lobe noncalcified nodule measuring 5 mm (series 501, image 180). Mild bilateral dependent atelectasis. HEART / VESSELS: Heart is normal in size with prominent calcified coronary artery disease. Postsurgical changes from CABG. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. Central venous catheter tip terminates in the superior cavoatrial junction. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Right chest implantable port. ABDOMEN and PELVIS: LIVER: Postsurgical changes in the hepatic dome. Scattered hypoattenuating lesions in the right hepatic lobe. Subdiaphragmatic circumscribed, peripherally enhancing fluid collections measuring 4.1 x 1.6 cm (series 501, image 203) adjacent to the surgical bed. BILIARY TRACT: Mild intrahepatic biliary ductal dilatation with nondependent pneumobilia. Metallic common bile duct stent in the distal common bile duct terminating in the second portion of the small bowel. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mildly complex partially cystic lesion in the right interpolar kidney measuring 1.6 x 1.5 cm (series 501, image 302). No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes from Hartman's procedure with left upper quadrant end colostomy. Colonic interposition of the hepatic flexure anterior to the right hepatic lobe. The appendix is unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Multiple small fat-containing ventral hernias. Small fat-containing parastomal hernia in the left upper quadrant. MUSCULOSKELETAL: Scattered sclerotic lesions in axial skeleton and left posterior fourth rib. Postsurgical changes from sternotomy. No acute fracture. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. Postsurgical changes from partial hepatic resection with small peripherally enhancing subdiaphragmatic collections adjacent to the surgical bed, likely postoperative. 3. Scattered hypoenhancing lesions in the liver concerning for metastatic disease. Recommend correlation with prior imaging. Scattered sclerotic lesions throughout the axial skeleton and left fourth rib also concerning for metastatic disease. Please see separate dictation for CT thoracic and lumbar spine findings. 4. Hypoenhancing partially cystic complex lesion in the interpolar right kidney measuring up to 1.6 cm. Recommend correlation with prior imaging or further evaluation with renal protocol CT for further evaluation. 5. Right middle lobe noncalcified nodule measuring 5 mm. Patchy scattered areas of interlobular septal thickening and groundglass opacities may represent resolving multifocal infection. Recommend attention on follow-up. 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Patchy areas of left greater than right lung interlobular septal thickening and faint scattered groundglass opacities. Multiple thin-walled cysts in the right lung, possibly pneumatoceles. Right middle lobe noncalcified nodule measuring 5 mm (series 501, image 180). Mild bilateral dependent atelectasis. HEART / VESSELS: Heart is normal in size with prominent calcified coronary artery disease. Postsurgical changes from CABG. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. Central venous catheter tip terminates in the superior cavoatrial junction. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Right chest implantable port. ABDOMEN and PELVIS: LIVER: Postsurgical changes in the hepatic dome. Scattered hypoattenuating lesions in the right hepatic lobe. Subdiaphragmatic circumscribed, peripherally enhancing fluid collections measuring 4.1 x 1.6 cm (series 501, image 203) adjacent to the surgical bed. BILIARY TRACT: Mild intrahepatic biliary ductal dilatation with nondependent pneumobilia. Metallic common bile duct stent in the distal common bile duct terminating in the second portion of the small bowel. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mildly complex partially cystic lesion in the right interpolar kidney measuring 1.6 x 1.5 cm (series 501, image 302). No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes from Hartman's procedure with left upper quadrant end colostomy. Colonic interposition of the hepatic flexure anterior to the right hepatic lobe. The appendix is unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Multiple small fat-containing ventral hernias. Small fat-containing parastomal hernia in the left upper quadrant. MUSCULOSKELETAL: Scattered sclerotic lesions in axial skeleton and left posterior fourth rib. Postsurgical changes from sternotomy. No acute fracture.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Cavum septum pellucidum. VESSELS: No significant vascular calcifications. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. Chronic right lamina papyracea fracture. MANDIBLE: Left mandibular condyle fracture which extends into the TMJ. Right mandibular condyle fracture which extends into the ramus. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
3,514
RADIOLOGIC EXAM: CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Angio Neck, CT Cervical Spine From ReformatPatient weight: 200 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 255 mm. DLP: 953.90 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. 3-D CT MIP were generated in post processing. 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 (
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 (
FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality.1 MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No acute fracture. Small amount of vacuum phenomenon at the left sternoclavicular joint. 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: No abnormality. 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. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild dextroscoliosis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal.
3,515
RADIOLOGIC EXAM: CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma. 54-year-old male with colon cancer. COMPARISON: None. TECHNIQUE: CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat Following CT of the chest, abdomen, and pelvis, reformatted images were produced to optimize visualization of the osseous structures of the thoracic and lumbar spine. STRUCTURED REPORT: CT Thoracic and Lumbar Spine FINDINGS: VERTEBRA: No acute fracture. Chronic ununited fracture of the L2 right transverse process. Scattered sclerotic lesions in T3-T5 and T7 vertebral bodies bodies or posterior fourth rib. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Mild degenerative retrolisthesis of L5 on S1. Thoracolumbar spine alignment otherwise normal. SOFT TISSUES: Please see separate dictation for CT chest, abdomen, and pelvis findings. CONCLUSION: 1. No acute osseous abnormality of the thoracolumbar spine. 2. Sclerotic lesions within the thoracic spine, left rib, and left ilium likely reflecting bone metastasis 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.
FINDINGS: VERTEBRA: No acute fracture. Chronic ununited fracture of the L2 right transverse process. Scattered sclerotic lesions in T3-T5 and T7 vertebral bodies bodies or posterior fourth rib. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Mild degenerative retrolisthesis of L5 on S1. Thoracolumbar spine alignment otherwise normal. SOFT TISSUES: Please see separate dictation for CT chest, abdomen, and pelvis findings.
FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality.1 MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No acute fracture. Small amount of vacuum phenomenon at the left sternoclavicular joint. 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: No abnormality. 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. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild dextroscoliosis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal.
3,516
RADIOLOGIC EXAM: CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma. 54-year-old male with colon cancer. COMPARISON: None. TECHNIQUE: CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat Following CT of the chest, abdomen, and pelvis, reformatted images were produced to optimize visualization of the osseous structures of the thoracic and lumbar spine. STRUCTURED REPORT: CT Thoracic and Lumbar Spine FINDINGS: VERTEBRA: No acute fracture. Chronic ununited fracture of the L2 right transverse process. Scattered sclerotic lesions in T3-T5 and T7 vertebral bodies bodies or posterior fourth rib. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Mild degenerative retrolisthesis of L5 on S1. Thoracolumbar spine alignment otherwise normal. SOFT TISSUES: Please see separate dictation for CT chest, abdomen, and pelvis findings. CONCLUSION: 1. No acute osseous abnormality of the thoracolumbar spine. 2. Sclerotic lesions within the thoracic spine, left rib, and left ilium likely reflecting bone metastasis 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.
FINDINGS: VERTEBRA: No acute fracture. Chronic ununited fracture of the L2 right transverse process. Scattered sclerotic lesions in T3-T5 and T7 vertebral bodies bodies or posterior fourth rib. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Mild degenerative retrolisthesis of L5 on S1. Thoracolumbar spine alignment otherwise normal. SOFT TISSUES: Please see separate dictation for CT chest, abdomen, and pelvis findings.
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 (
3,517
RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 299.80 mm. DLP: 1433.90 mGy cm. (accession CT220004166), Scan field of view: 210.10 mm. DLP: 1127.90 mGy cm. (accession CT220004172) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. There is encephalomalacia in the left paramedian frontal and parietal lobes EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: Postsurgical change status post left parietal craniotomy. No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: No fracture. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral ethmoid and right maxillary sinuses. CONCLUSION:No acute intracranial process or maxillofacial fracture. 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. There is encephalomalacia in the left paramedian frontal and parietal lobes EXTRA-AXIAL SPACES: No extra-axial collections. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: Postsurgical change status post left parietal craniotomy. No fracture. Bilateral mastoid air cells are clear. FACIAL BONES: No fracture. Bilateral pterygoid plates are intact. MANDIBLE: No fracture. Bilateral temporomandibular joints are intact. SINONASAL CAVITIES: Mild mucosal thickening of the bilateral ethmoid and right maxillary sinuses.
FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality.1 MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No acute fracture. Small amount of vacuum phenomenon at the left sternoclavicular joint. 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: No abnormality. 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. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild dextroscoliosis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal.
3,518
RADIOLOGIC EXAM: CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Angio Neck, CT Cervical Spine From ReformatPatient weight: 200 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 255 mm. DLP: 953.90 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. 3-D CT MIP were generated in post processing. 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 (
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 (
FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality.1 MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No acute fracture. Small amount of vacuum phenomenon at the left sternoclavicular joint. 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: No abnormality. 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. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild dextroscoliosis. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal.
3,519
RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrastScan field of view: 230 mm. DLP: 1346 mGy cm. FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild atrophy and minimal chronic small vessel schema change. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Chronic left sphenoid sinus disease. MASTOIDS: Clear. SOFT TISSUE: Unremarkable. CONCLUSION: No acute intracranial process.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild atrophy and minimal chronic small vessel schema change. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Chronic left sphenoid sinus disease. MASTOIDS: Clear. SOFT TISSUE: Unremarkable.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Cavum septum pellucidum. VESSELS: No significant vascular calcifications. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. Chronic right lamina papyracea fracture. MANDIBLE: Left mandibular condyle fracture which extends into the TMJ. Right mandibular condyle fracture which extends into the ramus. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
3,520
EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004175), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. (accession CT220004176), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004179), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004178) FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment. CONCLUSION: 1. Trace left hemopneumothorax with indwelling thoracostomy tube. Mild left upper lobe pulmonary contusions. 2. Left rib fractures 3-7 with segmental fractures of ribs 5-6. 3. Nondisplaced left distal clavicle fracture. 4. Tree-in-bud nodularity in both lungs may reflect sequela of infectious/inflammatory bronchiolitis or aspiration. 5. Additional findings detailed above.
FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment.
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 (
3,521
EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004175), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. (accession CT220004176), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004179), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004178) FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment. CONCLUSION: 1. Trace left hemopneumothorax with indwelling thoracostomy tube. Mild left upper lobe pulmonary contusions. 2. Left rib fractures 3-7 with segmental fractures of ribs 5-6. 3. Nondisplaced left distal clavicle fracture. 4. Tree-in-bud nodularity in both lungs may reflect sequela of infectious/inflammatory bronchiolitis or aspiration. 5. Additional findings detailed above.
FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment.
FINDINGS: BRAIN PARENCHYMA: Stable extensive hypoattenuation within the white matter of the left parietal and temporal lobes. Additionally, the hypoattenuation in the bifrontal white matter appears similar. Approximately 10 mm of rightward midline shift. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM/CSF SPACES: Stable ventriculostomy catheter within the temporal horn of the left lateral ventricle. Bilateral parietal ventriculostomy catheters appear unchanged. Unchanged cystic space within the upper cervical spine on the right. Similar dilation of the third ventricle, cerebral aqueduct, and fourth ventricle. Persistent effacement of the bilateral lateral ventricles. SKULL AND SKULL BASE: Stable craniocervical decompression postsurgical changes with the cerebellar tonsils protruding approximately 15 mm below the defect. ORBITS: Normal. SINUSES: Layering secretions within the left maxillary sinus. MASTOIDS: Bilateral mastoid effusions greater on the right. SOFT TISSUES: Postsurgical changes within the scalp.
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. RADIOLOGIC EXAM: CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Angio Neck, CT Cervical Spine From ReformatPatient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 220 mm. DLP: 1148 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. 3-D CT MIP were generated in post processing. 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 (
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 (
FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. There is respiratory motion artifact. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is respiratory motion artifact. Small calcified granuloma right lower lobe. Scattered subsegmental atelectasis. No focal consolidation, pneumothorax, or pleural effusion. HEART / OTHER VESSELS: Moderate calcified atherosclerosis, including three vessel coronary atherosclerosis. MEDIASTINUM / ESOPHAGUS: Esophagus is patulous and fluid-filled with postgastric bypass changes demonstrated. LYMPH NODES: Borderline enlarged precarinal node measuring 1.0 cm (series 401 image 49). CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: Motion limited evaluation. LIVER: Diffuse steatosis. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: No acute abnormality. Fatty atrophic changes are present. There is a 1.2 cm lesion at the pancreatic neck anteriorly and also adjacent to the duodenal bulb. Differential considerations include a small pancreatic cystic lesion such as IPMN versus duodenal diverticulum. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Tract from prior right nephrostomy. Interval resolution of right hydronephrosis compared to his prior CT with mild pelvocaliectasis. Subcentimeter hypoattenuating lesions on the right, too small to characterize, unchanged. Nonobstructing left nephrolithiasis. Right sided nephrolithiasis/stones no longer seen. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Post surgical changes of gastric bypass. No acute abnormality. No bowel dilatation. The gastrojejunostomy is unremarkable. The small bowel anastomosis is in the lower pelvis and slightly to the right of midline. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No abnormality. RETROPERITONEUM: Normal. OTHER VESSELS: Severe calcified atherosclerosis. URINARY BLADDER: Unremarkable apart from contrast material partially distending the bladder. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Tract from right nephrostomy. Mild anasarca. MUSCULOSKELETAL: Diffuse osteopenia/demineralization. Multilevel degenerative changes throughout the thoracolumbar spine. T6 vertebral body hemangioma. Healed bilateral rib fractures.
3,523
EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004175), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. (accession CT220004176), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004179), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004178) FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment. CONCLUSION: 1. Trace left hemopneumothorax with indwelling thoracostomy tube. Mild left upper lobe pulmonary contusions. 2. Left rib fractures 3-7 with segmental fractures of ribs 5-6. 3. Nondisplaced left distal clavicle fracture. 4. Tree-in-bud nodularity in both lungs may reflect sequela of infectious/inflammatory bronchiolitis or aspiration. 5. Additional findings detailed above.
FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. There is moderate frontoparietal predominantly cerebral atrophy. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Minimal ex vacuo dilation with expansion of the subarachnoid space. VESSELS: Bilateral ICA atherosclerotic calcifications within the cavernous sinus. SKULL AND SKULL BASE: No acute fracture. ORBITS: Bilateral pseudophakia. SINUSES: Left maxillary sinus mucus retention cyst. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
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EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004175), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. (accession CT220004176), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004179), Patient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 430 mm. DLP: 1054 mGy cm. (accession CT220004178) FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment. CONCLUSION: 1. Trace left hemopneumothorax with indwelling thoracostomy tube. Mild left upper lobe pulmonary contusions. 2. Left rib fractures 3-7 with segmental fractures of ribs 5-6. 3. Nondisplaced left distal clavicle fracture. 4. Tree-in-bud nodularity in both lungs may reflect sequela of infectious/inflammatory bronchiolitis or aspiration. 5. Additional findings detailed above.
FINDINGS: LOWER NECK: Trace soft tissue gas in the left lower neck. CHEST: LUNGS / AIRWAYS / PLEURA: Trace left pneumothorax with indwelling thoracostomy tube. Faint groundglass opacities in the left upper lobe likely reflect pulmonary contusions. Tiny left hemothorax. Tree-in-bud nodularity in the right middle lobe, lingula and right lower lobe. Biapical pleural-parenchymal scarring. HEART / VESSELS: Extensive coronary and aortic valvular calcification. Aberrant right subclavian artery. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema along the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Right lobe cyst. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hiatal hernia. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Fairly extensive scattered calcific atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate enlargement with median lobe hypertrophy. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Nondisplaced oblique fracture through the left distal clavicle. Displaced fractures of left anterolateral ribs 3-6. Posterior fractures of left ribs 5-7. THORACIC SPINE: Chronic appearing T8 compression fracture. No acute fracture or malalignment. LUMBAR SPINE: No acute fracture or malalignment.
FINDINGS/CONCLUSION: Ankle: Comminuted, distracted fracture of the medial malleolus. There is a comminuted, minimally displaced fracture of the posterior malleolus. Comminuted fracture of the distal fibular diaphysis. Well-corticated ossific density projects inferior to the lateral malleolus, likely representing sequela of remote trauma. There is mild lateral translation of the talus in relation to the tibia with associated widening of the medial ankle mortise. Extensive soft tissue edema is noted about the ankle. Scattered foci of gas are noted in the anterior ankle soft tissues concerning for open fracture. Foot: Small osseous fragments are present adjacent to the anterolateral calcaneus adjacent to the calcaneocuboid joint, possibly representing age indeterminate avulsion fractures. No other acute fracture is seen. The joint spaces are maintained. The soft tissues are unremarkable.
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. RADIOLOGIC EXAM: CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Angio Neck, CT Cervical Spine From ReformatPatient weight: 185 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 220 mm. DLP: 1148 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. 3-D CT MIP were generated in post processing. 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 (
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 (
FINDINGS/CONCLUSION: Ankle: Comminuted, distracted fracture of the medial malleolus. There is a comminuted, minimally displaced fracture of the posterior malleolus. Comminuted fracture of the distal fibular diaphysis. Well-corticated ossific density projects inferior to the lateral malleolus, likely representing sequela of remote trauma. There is mild lateral translation of the talus in relation to the tibia with associated widening of the medial ankle mortise. Extensive soft tissue edema is noted about the ankle. Scattered foci of gas are noted in the anterior ankle soft tissues concerning for open fracture. Foot: Small osseous fragments are present adjacent to the anterolateral calcaneus adjacent to the calcaneocuboid joint, possibly representing age indeterminate avulsion fractures. No other acute fracture is seen. The joint spaces are maintained. The soft tissues are unremarkable.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: History of pulmonary hypertension with shortness of breath, cough, and right lower lobe consolidation on chest radiograph. COMPARISON: CT chest 9/12/2017 TECHNIQUE: CT Chest wo contrast. Scan field of view: 334 mm. DLP: 218 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Postsurgical changes anterior to the thyroid isthmus.. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Persistent elevation of the right hemidiaphragm with subsegmental right upper and middle lobe atelectasis. Dependent atelectasis in the left lower lobe. Mosaic attenuation in the left greater than right lungs is again seen consistent with previously characterized air trapping. New patchy groundglass nodules in the bilateral upper lobes. HEART / VESSELS: Mild biatrial dilatation. Moderate multivessel coronary artery atherosclerotic calcifications. Annular mitral valve and aortic valve calcifications. No pericardial effusion. The main pulmonary artery is dilated in caliber measuring 4.0 cm. Mild calcified atherosclerotic disease of the thoracic aorta and its branches. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Several enlarged mediastinal lymph nodes. For example there is an enlarged right paratracheal lymph node measuring 1.3 cm (series 3, image 36) although evaluation is limited without intravenous contrast.. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Postsurgical changes from colonic anastomosis in the right hemiabdomen. Cholelithiasis is present. Calcification in the posterior right kidney may represent a renal stone. MUSCULOSKELETAL: Decreased osseous mineralization. Partially imaged posterior lumbar fusion hardware is again seen. Advanced multilevel degenerative changes of the spine with partial ankylosis of C7-T1 and L1-L2. No aggressive osseous lesions. CONCLUSION: 1. Mosaic attenuation the bilateral lungs consistent with air trapping seen on prior CT and can be seen with small airway disease. 2. New patchy nodular groundglass opacities in the bilateral upper lobes may be infectious or inflammatory. Follow-up in three months is recommended to ensure resolution. 3. Persistent dilatation of the main pulmonary artery measuring up to 4.0 cm, which can be seen with pulmonary arterial hypertension. 4. Mediastinal adenopathy, which may be reactive but malignancy cannot be excluded. Attention at follow-up is recommended 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.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Postsurgical changes anterior to the thyroid isthmus.. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. Persistent elevation of the right hemidiaphragm with subsegmental right upper and middle lobe atelectasis. Dependent atelectasis in the left lower lobe. Mosaic attenuation in the left greater than right lungs is again seen consistent with previously characterized air trapping. New patchy groundglass nodules in the bilateral upper lobes. HEART / VESSELS: Mild biatrial dilatation. Moderate multivessel coronary artery atherosclerotic calcifications. Annular mitral valve and aortic valve calcifications. No pericardial effusion. The main pulmonary artery is dilated in caliber measuring 4.0 cm. Mild calcified atherosclerotic disease of the thoracic aorta and its branches. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Several enlarged mediastinal lymph nodes. For example there is an enlarged right paratracheal lymph node measuring 1.3 cm (series 3, image 36) although evaluation is limited without intravenous contrast.. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Postsurgical changes from colonic anastomosis in the right hemiabdomen. Cholelithiasis is present. Calcification in the posterior right kidney may represent a renal stone. MUSCULOSKELETAL: Decreased osseous mineralization. Partially imaged posterior lumbar fusion hardware is again seen. Advanced multilevel degenerative changes of the spine with partial ankylosis of C7-T1 and L1-L2. No aggressive osseous lesions.
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 Angio Chest wo+w contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Dyspnea, hypoxia, and abdominal pain with history of sickle cell disease. COMPARISON: CT the chest abdomen and pelvis 9/10/2021 TECHNIQUE: CT Angio Chest wo+w contrast, CT Abdomen and Pelvis w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 120 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus tracked Scan field of view: 281 mm. KVP: 100 DLP: 114.40 mGy cm. (accession CT220004188), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus tracked Scan field of view: 321 mm. DLP: 382.80 mGy cm. (accession CT220004184) FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Interval development of patchy and nodular airspace opacities in the right upper and middle lobes with more confluent consolidation in the right lower lobe. Bilateral dependent atelectasis. Unchanged linear atelectasis versus pleuroparenchymal scarring in the right middle lobe. HEART / OTHER VESSELS: Stable cardiac enlargement.. No pericardial effusion. Mild atherosclerotic disease of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Bilateral axillary and mediastinal lymphadenopathy is again seen. Decreased size of the axillary lymph nodes compared to prior. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Periportal edema and hepatomegaly.. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Calcified autosplenectomy remnant. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from left hemiabdomen small bowel anastomosis are again seen. The small bowel is normal in caliber. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Small volume free fluid. Mild interval decreased size of subhepatic fluid collection. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. MUSCULOSKELETAL: H shaped vertebra. Avascular necrosis of the bilateral humeral heads with sclerosis. Diffusely sclerotic appearance of the bones. CONCLUSION: 1. New patchy and nodular airspace opacities in the right lung likely reflecting pneumonia. Axillary and mediastinal lymphadenopathy again seen with interval decreased size of axillary nodes. 2. No evidence of pulmonary embolus. 3. Mild interval decreased size of the subhepatic fluid collection. No new abdominal or pelvic abnormality. 4. Small volume ascites, sequela of sickle cell disease, an additional chronic 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.
FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Interval development of patchy and nodular airspace opacities in the right upper and middle lobes with more confluent consolidation in the right lower lobe. Bilateral dependent atelectasis. Unchanged linear atelectasis versus pleuroparenchymal scarring in the right middle lobe. HEART / OTHER VESSELS: Stable cardiac enlargement.. No pericardial effusion. Mild atherosclerotic disease of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Bilateral axillary and mediastinal lymphadenopathy is again seen. Decreased size of the axillary lymph nodes compared to prior. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Periportal edema and hepatomegaly.. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Calcified autosplenectomy remnant. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from left hemiabdomen small bowel anastomosis are again seen. The small bowel is normal in caliber. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Small volume free fluid. Mild interval decreased size of subhepatic fluid collection. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. MUSCULOSKELETAL: H shaped vertebra. Avascular necrosis of the bilateral humeral heads with sclerosis. Diffusely sclerotic appearance of the bones.
FINDINGS/CONCLUSION: Nondisplaced fracture of the posterior column and wall of the left acetabulum. The femoral heads are well-seated within their respective acetabula. No pubic symphyseal or SI joint diastasis. L5 vertebral body hemangioma. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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EXAM: CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: Concern for metastatic disease. COMPARISON: 2/6/2019 TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Chest with contrast. Patient weight: 170 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 60 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec Scan field of view: 500 mm. DLP: 1191 mGy cm FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Interval development of a 6.9 x 5 7cm mass in the right lower lobe which abuts the major fissure (series 3, image 123). There are patchy adjacent tree-in-bud opacities. Biapical scarring is noted. No additional suspicious pulmonary nodule. Trace bilateral pleural effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Moderate hiatal hernia. Otherwise normal. LYMPH NODES: Several mildly enlarged right hilar lymph nodes are noted (for example, a right hilar lymph node measuring 1.6 x 1.1 cm on series 3, image 122). No mediastinal or axillary. CHEST WALL: Bilateral breast implants. Otherwise normal. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Mild intrahepatic and extrahepatic biliary ductal dilation is likely due to postcholecystectomy change. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: No significant change in the left adrenal nodule, measuring approximately 1.2 cm. Mild thickening of the right adrenal gland appears similar. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes from sigmoidectomy without suspicious anastomotic thickening. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerosis without aneurysm. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Right lower lobe mass is suspicious for a metastasis from the patient's prior rectal cancer with adjacent right hilar adenopathy. No additional evidence of metastatic disease.
FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Interval development of a 6.9 x 5 7cm mass in the right lower lobe which abuts the major fissure (series 3, image 123). There are patchy adjacent tree-in-bud opacities. Biapical scarring is noted. No additional suspicious pulmonary nodule. Trace bilateral pleural effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Moderate hiatal hernia. Otherwise normal. LYMPH NODES: Several mildly enlarged right hilar lymph nodes are noted (for example, a right hilar lymph node measuring 1.6 x 1.1 cm on series 3, image 122). No mediastinal or axillary. CHEST WALL: Bilateral breast implants. Otherwise normal. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Mild intrahepatic and extrahepatic biliary ductal dilation is likely due to postcholecystectomy change. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: No significant change in the left adrenal nodule, measuring approximately 1.2 cm. Mild thickening of the right adrenal gland appears similar. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Postsurgical changes from sigmoidectomy without suspicious anastomotic thickening. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerosis without aneurysm. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. There is respiratory motion artifact. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is respiratory motion artifact. Small calcified granuloma right lower lobe. Scattered subsegmental atelectasis. No focal consolidation, pneumothorax, or pleural effusion. HEART / OTHER VESSELS: Moderate calcified atherosclerosis, including three vessel coronary atherosclerosis. MEDIASTINUM / ESOPHAGUS: Esophagus is patulous and fluid-filled with postgastric bypass changes demonstrated. LYMPH NODES: Borderline enlarged precarinal node measuring 1.0 cm (series 401 image 49). CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: Motion limited evaluation. LIVER: Diffuse steatosis. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: No acute abnormality. Fatty atrophic changes are present. There is a 1.2 cm lesion at the pancreatic neck anteriorly and also adjacent to the duodenal bulb. Differential considerations include a small pancreatic cystic lesion such as IPMN versus duodenal diverticulum. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Tract from prior right nephrostomy. Interval resolution of right hydronephrosis compared to his prior CT with mild pelvocaliectasis. Subcentimeter hypoattenuating lesions on the right, too small to characterize, unchanged. Nonobstructing left nephrolithiasis. Right sided nephrolithiasis/stones no longer seen. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Post surgical changes of gastric bypass. No acute abnormality. No bowel dilatation. The gastrojejunostomy is unremarkable. The small bowel anastomosis is in the lower pelvis and slightly to the right of midline. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No abnormality. RETROPERITONEUM: Normal. OTHER VESSELS: Severe calcified atherosclerosis. URINARY BLADDER: Unremarkable apart from contrast material partially distending the bladder. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Tract from right nephrostomy. Mild anasarca. MUSCULOSKELETAL: Diffuse osteopenia/demineralization. Multilevel degenerative changes throughout the thoracolumbar spine. T6 vertebral body hemangioma. Healed bilateral rib fractures.
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: Evaluate for bleed. History of recent cesarean section and hysterectomy for bleeding. COMPARISON: CT abdomen pelvis on 1/7/2022 TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus track Scan field of view: 367.90 mm. DLP: 1306.30 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small bilateral pleural effusions with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Unchanged tiny cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Hyperdense dependent layering contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hyperdense layering contents in the stomach on precontrast imaging, likely ingested contents. The small bowel is normal in caliber with postsurgical changes from small bowel anastomosis in the right hemiabdomen. No arterial intraluminal contrast extravasation. COLON / APPENDIX: Moderate amount of formed fecal material throughout colon. No intraluminal arterial contrast extravasation. PERITONEUM / MESENTERY: Moderate volume mixed density free fluid, decreased from prior. Scattered pneumoperitoneum related to prior surgery. There is a small focus of active bleeding in the left hemipelvis, first noted on series 401, image 244 and then subsequently on series 601, image 233, suspected to arise from a branch of the left gonadal vein. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed around Foley catheter. REPRODUCTIVE ORGANS: Postsurgical changes from hysterectomy. BODY WALL: Moderate anasarca. Postsurgical changes from midline laparotomy. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Postsurgical changes from interval abdominal hysterectomy with moderate volume intra-abdominal free fluid with likely mixed blood products. Suspected small volume active venous bleeding of the left pelvis arising from the left gonadal vein. 2. Small bilateral pleural effusions and moderate anasarca consistent with volume overload or third spacing. 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.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small bilateral pleural effusions with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Unchanged tiny cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Hyperdense dependent layering contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hyperdense layering contents in the stomach on precontrast imaging, likely ingested contents. The small bowel is normal in caliber with postsurgical changes from small bowel anastomosis in the right hemiabdomen. No arterial intraluminal contrast extravasation. COLON / APPENDIX: Moderate amount of formed fecal material throughout colon. No intraluminal arterial contrast extravasation. PERITONEUM / MESENTERY: Moderate volume mixed density free fluid, decreased from prior. Scattered pneumoperitoneum related to prior surgery. There is a small focus of active bleeding in the left hemipelvis, first noted on series 401, image 244 and then subsequently on series 601, image 233, suspected to arise from a branch of the left gonadal vein. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Decompressed around Foley catheter. REPRODUCTIVE ORGANS: Postsurgical changes from hysterectomy. BODY WALL: Moderate anasarca. Postsurgical changes from midline laparotomy. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: BONES/JOINTS: Minimally anteriorly displaced transcervical left proximal femoral fracture. Degenerative changes within the bilateral SI joints and imaged lumbar spine. SOFT TISSUES: No large hematoma or fluid collection. Nonspecific fluid in the right paracolic gutter.
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CLINICAL HISTORY: L peripheral vision loss, BLE weakness EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 221 mm. DLP: 1105 mGy cm. COMPARISON: None FINDINGS: There is small area of hypoattenuation extending to the cortex within the right occipital lobe representing subacute infarction. There is no hemorrhagic conversion. There is a small hyperdense lesion within the left parietal lobe without adjacent vasogenic edema. Findings most likely represents incidental cavernoma. There is no remote infarction. Ventricles are normal in size. There are mild atherosclerotic calcifications. Vessels otherwise appear unremarkable on the basis of a noncontrast CT. There is a partially empty sella The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. CONCLUSION: 01. Small subacute right occipital lobe infarction. No hemorrhagic conversion. 02. Small incidental left parietal lobe cavernoma.
FINDINGS: There is small area of hypoattenuation extending to the cortex within the right occipital lobe representing subacute infarction. There is no hemorrhagic conversion. There is a small hyperdense lesion within the left parietal lobe without adjacent vasogenic edema. Findings most likely represents incidental cavernoma. There is no remote infarction. Ventricles are normal in size. There are mild atherosclerotic calcifications. Vessels otherwise appear unremarkable on the basis of a noncontrast CT. There is a partially empty sella The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
FINDINGS: BRAIN PARENCHYMA: Mild cerebral edema involving the left cerebral hemisphere. No evidence for intraparenchymal hemorrhage. No evidence for large vascular territory acute stroke. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: Interval evacuation of left subdural hemorrhage with mild residual blood products. Left surgical drain is in place. There is persistent right cerebral convexity subdural hemorrhage and subdural hemorrhage layering along the falx and tentorium bilaterally with mild increased prominence secondary to interval redistribution. The right cerebral convexity component measures approximately 9 mm in thickness. The residual left cerebral convexity which underlies the craniotomy measures approximately 7 mm in thickness. The parafalcine component measures 5 mm in thickness. The tentorial components measure approximately 4 mm in thickness. Postoperative pneumocephalus without peaking of the anterior frontal lobes. There is 4 mm of rightward midline shift. Postoperative subarachnoid hemorrhage within the left frontal and parietal lobes. VENTRICULAR SYSTEM: Normal size and configuration. SKULL AND SKULL BASE: Left craniotomy postsurgical changes ORBITS: Bilateral pseudophakia. SINUSES: Right maxillary mucus retention cysts. MASTOIDS: Trace left mastoid effusion. SOFT TISSUES: Postsurgical changes within the left scalp.
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EXAM: CT Angio Chest wo+w contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Dyspnea, hypoxia, and abdominal pain with history of sickle cell disease. COMPARISON: CT the chest abdomen and pelvis 9/10/2021 TECHNIQUE: CT Angio Chest wo+w contrast, CT Abdomen and Pelvis w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 120 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus tracked Scan field of view: 281 mm. KVP: 100 DLP: 114.40 mGy cm. (accession CT220004188), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus tracked Scan field of view: 321 mm. DLP: 382.80 mGy cm. (accession CT220004184) FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Interval development of patchy and nodular airspace opacities in the right upper and middle lobes with more confluent consolidation in the right lower lobe. Bilateral dependent atelectasis. Unchanged linear atelectasis versus pleuroparenchymal scarring in the right middle lobe. HEART / OTHER VESSELS: Stable cardiac enlargement.. No pericardial effusion. Mild atherosclerotic disease of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Bilateral axillary and mediastinal lymphadenopathy is again seen. Decreased size of the axillary lymph nodes compared to prior. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Periportal edema and hepatomegaly.. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Calcified autosplenectomy remnant. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from left hemiabdomen small bowel anastomosis are again seen. The small bowel is normal in caliber. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Small volume free fluid. Mild interval decreased size of subhepatic fluid collection. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. MUSCULOSKELETAL: H shaped vertebra. Avascular necrosis of the bilateral humeral heads with sclerosis. Diffusely sclerotic appearance of the bones. CONCLUSION: 1. New patchy and nodular airspace opacities in the right lung likely reflecting pneumonia. Axillary and mediastinal lymphadenopathy again seen with interval decreased size of axillary nodes. 2. No evidence of pulmonary embolus. 3. Mild interval decreased size of the subhepatic fluid collection. No new abdominal or pelvic abnormality. 4. Small volume ascites, sequela of sickle cell disease, an additional chronic 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.
FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Interval development of patchy and nodular airspace opacities in the right upper and middle lobes with more confluent consolidation in the right lower lobe. Bilateral dependent atelectasis. Unchanged linear atelectasis versus pleuroparenchymal scarring in the right middle lobe. HEART / OTHER VESSELS: Stable cardiac enlargement.. No pericardial effusion. Mild atherosclerotic disease of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Bilateral axillary and mediastinal lymphadenopathy is again seen. Decreased size of the axillary lymph nodes compared to prior. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Periportal edema and hepatomegaly.. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Calcified autosplenectomy remnant. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from left hemiabdomen small bowel anastomosis are again seen. The small bowel is normal in caliber. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Small volume free fluid. Mild interval decreased size of subhepatic fluid collection. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. MUSCULOSKELETAL: H shaped vertebra. Avascular necrosis of the bilateral humeral heads with sclerosis. Diffusely sclerotic appearance of the bones.
FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Dependent atelectasis. Scattered air cysts and calcified granulomas. HEART / OTHER VESSELS: Arch and proximal vessel calcifications. Calcific coronary atherosclerosis. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Small hiatal hernia. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic morphology. Several tiny calcified granulomas. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Unchanged hypoattenuating lesion within the pancreatic tail measuring approximately 5 mm (series 503 image 82). SPLEEN: Absent. ADRENALS: Normal. KIDNEYS: Similar appearance of multiple bilateral simple renal cysts. LYMPH NODES: Similar appearance of prominent periportal lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: Moderate scattered calcific atherosclerosis of the abdominal aorta and its branch vessels. Tortuous vessels adjacent to the GE junction suggesting esophageal varices. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. Unchanged small calcification within the left ovary. BODY WALL: Multiple small midline abdominal wall defects with herniated fat (series 501 image 148) MUSCULOSKELETAL: Moderate multilevel discogenic degenerative changes most prominent at L4-L5. Slight retrolisthesis of L5 on S1. Circumferential bulging of the L4-L5 intervertebral disc with associated mild narrowing of the spinal canal.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: COVID19 with worsening chest radiograph, pneumonia. COMPARISON: Chest radiograph earlier same day. TECHNIQUE: CT Chest with contrast. Patient weight: 293 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 35 sec. Scan field of view: 350 mm. DLP: 427.60 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in the mid trachea. The central airways are otherwise patent. Moderate bilateral peribronchial thickening. Patchy groundglass and more confluent consolidative opacities scattered throughout the bilateral lungs. Trace bilateral pleural effusions with adjacent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube present.. LYMPH NODES: Borderline mediastinal lymphadenopathy. For example there is a right paratracheal lymph node measuring 1.4 cm in short axis. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Esophagogastric tube is partially imaged in the stomach. MUSCULOSKELETAL: No aggressive osseous lesions. CONCLUSION: Patchy groundglass and consolidative opacities scattered in the bilateral lungs consistent with evolving COVID 19 pneumonia. 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.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in the mid trachea. The central airways are otherwise patent. Moderate bilateral peribronchial thickening. Patchy groundglass and more confluent consolidative opacities scattered throughout the bilateral lungs. Trace bilateral pleural effusions with adjacent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Esophagogastric tube present.. LYMPH NODES: Borderline mediastinal lymphadenopathy. For example there is a right paratracheal lymph node measuring 1.4 cm in short axis. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Esophagogastric tube is partially imaged in the stomach. MUSCULOSKELETAL: No aggressive osseous lesions.
FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Dependent atelectasis. Scattered air cysts and calcified granulomas. HEART / OTHER VESSELS: Arch and proximal vessel calcifications. Calcific coronary atherosclerosis. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Small hiatal hernia. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic morphology. Several tiny calcified granulomas. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Unchanged hypoattenuating lesion within the pancreatic tail measuring approximately 5 mm (series 503 image 82). SPLEEN: Absent. ADRENALS: Normal. KIDNEYS: Similar appearance of multiple bilateral simple renal cysts. LYMPH NODES: Similar appearance of prominent periportal lymph nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: Moderate scattered calcific atherosclerosis of the abdominal aorta and its branch vessels. Tortuous vessels adjacent to the GE junction suggesting esophageal varices. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. Unchanged small calcification within the left ovary. BODY WALL: Multiple small midline abdominal wall defects with herniated fat (series 501 image 148) MUSCULOSKELETAL: Moderate multilevel discogenic degenerative changes most prominent at L4-L5. Slight retrolisthesis of L5 on S1. Circumferential bulging of the L4-L5 intervertebral disc with associated mild narrowing of the spinal canal.
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CT head without contrast Indication: ventriculitis Spec Inst: worsening CSF studies; ventriculitis; STEALTH protocol. Comparison: CT head dated 1/5/2022. 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. Patient weight: 167 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 300 sec. Scan field of view: 210 mm. DLP: 2509 mGy cm. . Findings: Redemonstration of bilateral frontal approach ventriculostomy catheters which appear to be in stable position with tip terminating near the respective foramen of Monroe. Stably decompressed ventricular system. Postcontrast images demonstrate ependymal enhancement diffusely throughout the left lateral ventricle and minimally and focally within the right lateral ventricle near the termination ventriculostomy catheter tip. There is also mild enhancement within the third ventricular lining and at the cervicomedullary junction. Overall enhancement appears greater as compared to the prior study. Mild thickening and enhancement of the falx appears similar. There is no evidence of additional abnormal postcontrast enhancement. No evidence of acute hemorrhage, infarct, mass effect or edema. Hypoattenuation within the corpus callosum appears similar. Partial absence of the corpus callosum likely present There is redemonstration of stigmata of Chiari malformation status post suboccipital decompression, including large cervical syrinx. The orbits appear normal. There is opacification of the left maxillary sinus with mucosal thickening involving the remaining paranasal sinuses. Small bilateral mastoid effusions are also present. There is no acute calvarial abnormality. Impression: 1. Redemonstration of bilateral ventriculostomy catheters in stable position with stable ventricular size and configuration. There is increased ependymal enhancement involving the bilateral lateral and third ventricles, as detailed above, compatible with ventriculitis. 2. No additional acute intracranial abnormality. Stable additional findings as above. 3. Pansinus disease as above. 4. Post Chiari decompression and probable partial absence of the corpus callosum. 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.
Findings: Redemonstration of bilateral frontal approach ventriculostomy catheters which appear to be in stable position with tip terminating near the respective foramen of Monroe. Stably decompressed ventricular system. Postcontrast images demonstrate ependymal enhancement diffusely throughout the left lateral ventricle and minimally and focally within the right lateral ventricle near the termination ventriculostomy catheter tip. There is also mild enhancement within the third ventricular lining and at the cervicomedullary junction. Overall enhancement appears greater as compared to the prior study. Mild thickening and enhancement of the falx appears similar. There is no evidence of additional abnormal postcontrast enhancement. No evidence of acute hemorrhage, infarct, mass effect or edema. Hypoattenuation within the corpus callosum appears similar. Partial absence of the corpus callosum likely present There is redemonstration of stigmata of Chiari malformation status post suboccipital decompression, including large cervical syrinx. The orbits appear normal. There is opacification of the left maxillary sinus with mucosal thickening involving the remaining paranasal sinuses. Small bilateral mastoid effusions are also present. There is no acute calvarial abnormality.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Evaluation limited due to respiratory motion. Loculated left upper lobe pleural effusion at the apex is intermediate attenuation. Trace residual left pneumothorax. Bilateral lower lobe consolidations with volume loss. A few scattered peripheral round glass opacities in the right upper lobe. HEART / VESSELS: Post-CABG changes. Borderline cardiomegaly. Moderate dependent pericardial effusion with increased density, suggesting hemopericardium. Right IJ sheath terminates in the right brachiocephalic vein. Left subcutaneous xiphoid pericardial drain terminates at the periphery of the left lower lobe. MEDIASTINUM / ESOPHAGUS: Anterior pneumomediastinum and trace hemorrhage, likely postprocedural. Anterior mediastinal drain in place. LYMPH NODES: None enlarged. CHEST WALL: Poststernotomy changes. Gas tracking in the left and midline anterior chest wall, likely related to chest tube. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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CT Head wo contrast 1/10/2022 2:44 AM Clinical Information: intracranial abscess sp evacuation Spec Inst: STEALTH Protocol Comparison: 1/5/2022 Technique: Unenhanced axial brain CT. Scan field of view: 244 mm. DLP: 1654 mGy cm. Findings: Status post surgical changes as right temporal craniotomy and evacuation of the temporal abscess. There are scattered hyperdense foci in the surgical bed, likely focal hemorrhages. There is persistent vasogenic edema in the right temporoparietal region. There is effacement of the cerebral sulci and right posterior horn of the lateral ventricle. There is again mild left ward midline shift. Left cerebral hemisphere and posterior fossa are within normal limits. Impression: Stable postsurgical changes from the evacuation of of the right temporal abscess with associated small hemorrhage. Persistent vasogenic edema in the right temporal and parietal lobes. Recommended MRI brain for further evaluation to rule out residual abscess.
Findings: Status post surgical changes as right temporal craniotomy and evacuation of the temporal abscess. There are scattered hyperdense foci in the surgical bed, likely focal hemorrhages. There is persistent vasogenic edema in the right temporoparietal region. There is effacement of the cerebral sulci and right posterior horn of the lateral ventricle. There is again mild left ward midline shift. Left cerebral hemisphere and posterior fossa are within normal limits.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: There are calcified granulomas in the right lower lobe. Lung bases are otherwise clear. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: A few calcified granulomas are present. Small splenule at the pancreatic tail region and splenic hilum. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. Shotty right lower quadrant pericolonic nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: There is diffuse pancolonic wall thickening and mucosal increased enhancement. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Abnormal nodular and masslike thickening of the anterior bladder wall to the right of midline measuring about 2.2 x 5.2 cm. 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: Left lower quadrant pain, flank pain, hematuria COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec. Scan field of view: 350 mm. DLP: 372 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary vascular calcifications. ABDOMEN and PELVIS: LIVER: Two small hemangiomas within the posterior right hepatic lobe. Otherwise normal aside from focal fat adjacent to the falciform. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. Small splenule ADRENALS: Normal. KIDNEYS: 8 mm stone in the lower left renal pelvis near the UPJ with mild left hydronephrosis. Mild left perinephric stranding. There is also mild urothelial thickening/enhancement involving the left ureter and left renal pelvis. No additional urinary tract stones identified. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Otherwise normal. No bowel obstruction. COLON / APPENDIX: Noninflamed colonic diverticula. Otherwise normal. PERITONEUM / MESENTERY: Trace pelvic free fluid. RETROPERITONEUM: Mild stranding as described above VESSELS: Aortoiliac atherosclerotic disease without aneurysm. URINARY BLADDER: Mild circumferential bladder wall thickening. REPRODUCTIVE ORGANS: No acute abnormality. Prior hysterectomy BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. 8 mm stone at the left ureteropelvic junction with mild left hydronephrosis. 2. Circumferential bladder wall thickening suggesting cystitis. Additional mild thickening/enhancement involving the left ureter and renal pelvis could reflect ascending urinary tract infection. 3. Noninflamed colonic diverticula and additional incidental findings as above.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary vascular calcifications. ABDOMEN and PELVIS: LIVER: Two small hemangiomas within the posterior right hepatic lobe. Otherwise normal aside from focal fat adjacent to the falciform. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. Small splenule ADRENALS: Normal. KIDNEYS: 8 mm stone in the lower left renal pelvis near the UPJ with mild left hydronephrosis. Mild left perinephric stranding. There is also mild urothelial thickening/enhancement involving the left ureter and left renal pelvis. No additional urinary tract stones identified. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Otherwise normal. No bowel obstruction. COLON / APPENDIX: Noninflamed colonic diverticula. Otherwise normal. PERITONEUM / MESENTERY: Trace pelvic free fluid. RETROPERITONEUM: Mild stranding as described above VESSELS: Aortoiliac atherosclerotic disease without aneurysm. URINARY BLADDER: Mild circumferential bladder wall thickening. REPRODUCTIVE ORGANS: No acute abnormality. Prior hysterectomy BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: CT of the head with and without contrast: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Minimal bilateral cavernous ICA calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Bilateral proptosis. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable. CT angiogram of the brain: RIGHT INTRACRANIAL CAROTID: Calcific and noncalcific atherosclerosis within the cavernous and clinoid segments without significant luminal narrowing. There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT INTRACRANIAL CAROTID: Calcific and noncalcific atherosclerosis within the cavernous segment without significant luminal narrowing. There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Partial fetal origin of the right PCA with hypoplastic P1 segment. There is no evidence of stenosis, occlusion, or aneurysmal dilation. VERTEBROBASILAR ARTERIES: Somewhat hypoplastic basilar artery. There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: Retropharyngeal course. There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Retropharyngeal course. Calcific and noncalcific atherosclerosis within the proximal ICA without significant luminal narrowing. There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation.
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CLINICAL HISTORY: ICH w IVH Spec Inst: STEALTH protocol EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 254 mm. DLP: 1600 mGy cm. COMPARISON: 1/8/2022 FINDINGS: There is a large right frontal lobe hemorrhage with significant adjacent vasogenic edema. Edema results in severe effacement of the right lateral ventricle. There is a left frontal approach ventricular catheter with tip near the foramen of Munro. There is stable small amount of IVH within both occipital horns. There is mild asymmetric enlargement of the left temporal horn suggesting partial entrapment. There is approximately 11 mm of right to left midline shift, previously measured 11 mm when remeasured by me.. The temporal horn is also a displaced medially resulting in mass effect upon the midbrain reflecting mild uncal herniation There is stable small amount of subarachnoid hemorrhage within the region of the posterior left sylvian fissure. There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. CONCLUSION: 01. Stable large right frontal lobe hemorrhage with adjacent vasogenic edema resulting in significant mass effect with moderate right to left midline shift. There is also uncal herniation 02. Stable shunted ventricles. There is slight enlargement of the left temporal horn suggesting left lateral ventricle partial entrapment with mild hydrocephalus. 03. Stable small amount of subarachnoid hemorrhage within the left sylvian fissure. No acute hemorrhage.
FINDINGS: There is a large right frontal lobe hemorrhage with significant adjacent vasogenic edema. Edema results in severe effacement of the right lateral ventricle. There is a left frontal approach ventricular catheter with tip near the foramen of Munro. There is stable small amount of IVH within both occipital horns. There is mild asymmetric enlargement of the left temporal horn suggesting partial entrapment. There is approximately 11 mm of right to left midline shift, previously measured 11 mm when remeasured by me.. The temporal horn is also a displaced medially resulting in mass effect upon the midbrain reflecting mild uncal herniation There is stable small amount of subarachnoid hemorrhage within the region of the posterior left sylvian fissure. There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
FINDINGS: CT of the head with and without contrast: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Minimal bilateral cavernous ICA calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Bilateral proptosis. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable. CT angiogram of the brain: RIGHT INTRACRANIAL CAROTID: Calcific and noncalcific atherosclerosis within the cavernous and clinoid segments without significant luminal narrowing. There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT INTRACRANIAL CAROTID: Calcific and noncalcific atherosclerosis within the cavernous segment without significant luminal narrowing. There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Partial fetal origin of the right PCA with hypoplastic P1 segment. There is no evidence of stenosis, occlusion, or aneurysmal dilation. VERTEBROBASILAR ARTERIES: Somewhat hypoplastic basilar artery. There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: Retropharyngeal course. There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Retropharyngeal course. Calcific and noncalcific atherosclerosis within the proximal ICA without significant luminal narrowing. There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation.
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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: 467 mm. DLP: 1094 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: Small left and trace right pleural effusions with adjacent atelectasis. Mosaic attenuation in the imaged lung bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Hypoenhancement of blood pool consistent with anemia. ABDOMEN and PELVIS: LIVER: The liver is enlarged and is cirrhotic in configuration. BILIARY TRACT: Normal. GALLBLADDER: Dependent layering material in the gallbladder, possibly biliary sludge or vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: The spleen is enlarged. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach is unremarkable. The small bowel is normal caliber. Oral contrast progresses past the ileocecal valve without evidence of obstruction. COLON / APPENDIX: The colon is decompressed. Oral contrast progresses to the distal colon. PERITONEUM / MESENTERY: Moderate volume ascites. No free air. Mild diffuse mesenteric stranding. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Minimal calcified atherosclerotic disease of the infrarenal abdominal aorta. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Cirrhosis with hepatomegaly. Sequela of portal hypertension including moderate volume ascites and splenomegaly. 2. Small left and trace right pleural effusions. Mosaic attenuation in the imaged lung bases can be seen with small airway disease or pulmonary arterial hypertension. 3. Additional 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.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small left and trace right pleural effusions with adjacent atelectasis. Mosaic attenuation in the imaged lung bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Hypoenhancement of blood pool consistent with anemia. ABDOMEN and PELVIS: LIVER: The liver is enlarged and is cirrhotic in configuration. BILIARY TRACT: Normal. GALLBLADDER: Dependent layering material in the gallbladder, possibly biliary sludge or vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: The spleen is enlarged. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach is unremarkable. The small bowel is normal caliber. Oral contrast progresses past the ileocecal valve without evidence of obstruction. COLON / APPENDIX: The colon is decompressed. Oral contrast progresses to the distal colon. PERITONEUM / MESENTERY: Moderate volume ascites. No free air. Mild diffuse mesenteric stranding. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Minimal calcified atherosclerotic disease of the infrarenal abdominal aorta. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Bilateral carotid siphon and carotid bulb calcifications. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. ORBITS: Normal. SINUSES: Bilateral maxillary sinus mucosal thickening greater on the right. MASTOIDS: Clear. CRANIOFACIAL SOFT TISSUES: Left malar soft tissue contusions and lacerations along the left mandible. CERVICOCRANIAL JUNCTION: The occipital condyles are normal. ATLANTODENTAL INTERVAL: Normal (
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CT Head wo contrast Clinical Information: AMS Comparison: None. Technique: Unenhanced axial brain CT with sagittal and coronal reformats. Scan field of view: 230 mm. DLP: 1413.90 mGy cm. Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Diffuse cerebral volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Moderate ex vacuo dilatation of the ventricles. ORBITS: Normal. SINUSES: Small mucosal retention cysts in bilateral maxillary sinuses. The remaining sinuses and mastoid air cells are clear. Conclusion: No acute intracranial 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.
Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Diffuse cerebral volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Moderate ex vacuo dilatation of the ventricles. ORBITS: Normal. SINUSES: Small mucosal retention cysts in bilateral maxillary sinuses. The remaining sinuses and mastoid air cells are clear.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Bilateral carotid siphon and carotid bulb calcifications. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. ORBITS: Normal. SINUSES: Bilateral maxillary sinus mucosal thickening greater on the right. MASTOIDS: Clear. CRANIOFACIAL SOFT TISSUES: Left malar soft tissue contusions and lacerations along the left mandible. CERVICOCRANIAL JUNCTION: The occipital condyles are normal. ATLANTODENTAL INTERVAL: Normal (
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Chest pain, evaluate for pulmonary embolus. COMPARISON: CT chest 1/5/2022 TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 115 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 315 mm. KVP: 110 DLP: 261 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 increase in size in the dense right lower lobe consolidation with air bronchograms with additional scattered areas of consolidation and groundglass opacities. No pleural effusion or pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Heart size normal. Trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Stable right hilar adenopathy, likely reactive. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No evidence of pulmonary embolus. 2. Interval increase in dense right lower lobe consolidation with air bronchograms concerning for worsening pneumonia. Recommend follow-up chest radiograph in 4-6 weeks. 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.
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 increase in size in the dense right lower lobe consolidation with air bronchograms with additional scattered areas of consolidation and groundglass opacities. No pleural effusion or pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Heart size normal. Trace pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Stable right hilar adenopathy, likely reactive. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None pathologically enlarged. STOMACH / SMALL BOWEL: Intraluminal balloon position of left subcostal gastrostomy tube. No sign of extraluminal contrast. Contrast throughout the stomach and small bowel. COLON: Colon is unremarkable. Appendix is not well visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: Similar appearance of soft tissue thickening and mild edema at the gastrostomy insertion site. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: Evaluate for metastatic disease. History of lung cancer. COMPARISON: 10/18/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Chest with contrast. Patient weight: 184 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec Scan field of view: 440 mm. DLP: 851 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: New left upper lobe consolidation with air bronchograms. No suspicious pulmonary mass or nodule. Unchanged subcentimeter nodule in the left lower lobe (series 3, image 137). HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Postsurgical changes from liver transplant. No focal liver lesion. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Atrophic but otherwise normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Tiny left renal cyst. Otherwise normal. LYMPH NODES: None enlarged. 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: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: No evidence of locally recurrent or metastatic disease in the chest, abdomen, or pelvis. Suspected left upper lobe pneumonia and additional incidental findings as above.
FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: New left upper lobe consolidation with air bronchograms. No suspicious pulmonary mass or nodule. Unchanged subcentimeter nodule in the left lower lobe (series 3, image 137). HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Postsurgical changes from liver transplant. No focal liver lesion. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Atrophic but otherwise normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Tiny left renal cyst. Otherwise normal. LYMPH NODES: None enlarged. 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: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
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EXAM: CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: Evaluate for metastatic disease. History of lung cancer. COMPARISON: 10/18/2021 TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Chest with contrast. Patient weight: 184 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec Scan field of view: 440 mm. DLP: 851 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: New left upper lobe consolidation with air bronchograms. No suspicious pulmonary mass or nodule. Unchanged subcentimeter nodule in the left lower lobe (series 3, image 137). HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Postsurgical changes from liver transplant. No focal liver lesion. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Atrophic but otherwise normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Tiny left renal cyst. Otherwise normal. LYMPH NODES: None enlarged. 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: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: No evidence of locally recurrent or metastatic disease in the chest, abdomen, or pelvis. Suspected left upper lobe pneumonia and additional incidental findings as above.
FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: New left upper lobe consolidation with air bronchograms. No suspicious pulmonary mass or nodule. Unchanged subcentimeter nodule in the left lower lobe (series 3, image 137). HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Postsurgical changes from liver transplant. No focal liver lesion. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Atrophic but otherwise normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Tiny left renal cyst. Otherwise normal. LYMPH NODES: None enlarged. 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: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral lower lobe atelectasis and questionable trace effusions. DISTAL ESOPHAGUS: Distal esophageal varices. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Enlarged. ADRENALS: Normal. KIDNEYS: No nephrolithiasis or hydronephrosis. Mild bilateral perinephric stranding is increased from prior. LYMPH NODES: None pathologically enlarged. Similar prominent periportal and mesenteric nodes. STOMACH / SMALL BOWEL: Weighted feeding tube terminates in the distal stomach. The gastroduodenal junction is narrowed. The stomach is moderately distended with large amount of oral contrast. Contrast noted throughout much of the small bowel. Small bowel is nondilated. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Trace ascites. No free air. RETROPERITONEUM: Normal. VESSELS: Right femoral central venous catheter terminates posterior to the right common iliac vein, likely in an iliolumbar branch. Multiple upper abdominal collaterals noted. URINARY BLADDER: Collapsed around a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Scattered patchy subcutaneous edema. MUSCULOSKELETAL: No significant abnormality.
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CT head without contrast Indication: Sp brain cyst aspiration. Comparison: MR brain dated 1/6/2022 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: 227 mm. DLP: 1029 mGy cm. . Findings: Cystic lesion centered within the right frontal corona radiata measures up to 4.3 x 3.4 cm) AP, TV) with a focus of hemorrhage within the cystic lesion which measures up to 3.1 x 2.7 cm. This lesion exerts mass effect on the adjacent right lateral ventricle. There is adjacent hypoattenuation within the right frontoparietal white matter and basal ganglia. Small volume of pneumocephalus is seen within the right frontal apex. The remainder of the brain is unremarkable without evidence of hemorrhage, infarct, mass effect or edema. No hydrocephalus. Bilateral orbits appear normal. Paranasal sinuses and mastoid air cells are clear. Impression: 1. Cystic lesion centered within the right frontal white matter demonstrate internal hemorrhage measuring up to 3.1 x 2.7 cm as above. 2. This lesion exerts mass effect on the adjacent ventricle, without evidence of ventricular entrapment. 3. Hypoattenuation within the adjacent white matter and basal ganglia appears similar to the T2/FLAIR hyperintensity observed on recent MRI and likely reflects vasogenic edema. 4. Postoperative pneumocephalus. 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.
Findings: Cystic lesion centered within the right frontal corona radiata measures up to 4.3 x 3.4 cm) AP, TV) with a focus of hemorrhage within the cystic lesion which measures up to 3.1 x 2.7 cm. This lesion exerts mass effect on the adjacent right lateral ventricle. There is adjacent hypoattenuation within the right frontoparietal white matter and basal ganglia. Small volume of pneumocephalus is seen within the right frontal apex. The remainder of the brain is unremarkable without evidence of hemorrhage, infarct, mass effect or edema. No hydrocephalus. Bilateral orbits appear normal. Paranasal sinuses and mastoid air cells are clear.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Bilateral carotid siphon and carotid bulb calcifications. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. ORBITS: Normal. SINUSES: Bilateral maxillary sinus mucosal thickening greater on the right. MASTOIDS: Clear. CRANIOFACIAL SOFT TISSUES: Left malar soft tissue contusions and lacerations along the left mandible. CERVICOCRANIAL JUNCTION: The occipital condyles are normal. ATLANTODENTAL INTERVAL: Normal (
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CT Head wo contrast Clinical Information: PUI for COVID with altered mental status. Comparison: 10/20/2020 and 9/22/2020. Technique: Unenhanced axial brain CT with sagittal and coronal reformats. Scan field of view: 227 mm. DLP: 1354.40 mGy cm. Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Frontal the secretions in the right frontal sinus. Mild mucosal thickening of the left frontal and bilateral ethmoid. The remaining visualized sinuses and mastoid air cells are clear. OTHER: Multiple calcifications in bilateral parotid glands are redemonstrated. Conclusion: No acute intracranial 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.
Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Frontal the secretions in the right frontal sinus. Mild mucosal thickening of the left frontal and bilateral ethmoid. The remaining visualized sinuses and mastoid air cells are clear. OTHER: Multiple calcifications in bilateral parotid glands are redemonstrated.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Similar minimal right lower lobe atelectasis adjacent to the retained ballistic fragments. Otherwise clear. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Mild steatosis, with focal fatty infiltration along the falciform ligament. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. Adjacent small splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Similar mildly prominent para-aortic nodes. Unchanged left iliac chain adenopathy. STOMACH / SMALL BOWEL: No abnormality. Resolution of previously seen fat stranding surrounding the left lower quadrant small bowel. COLON / APPENDIX: Left lower quadrant colostomy redemonstrated. Surrounding parastomal fat-containing hernia has increased in size. PERITONEUM / MESENTERY: No free fluid or free air. RETROPERITONEUM: Normal. VESSELS: Mild scattered atherosclerotic calcifications. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Left lower quadrant colostomy. Sacral decubitus ulcers and bilateral posterior hip/ischial ulcers redemonstrated. MUSCULOSKELETAL: Redemonstrated prior ballistic injury to the right inferior chest wall, lower thorax, and thoracic spine. Bilateral erosive/resorptive changes of the hips again seen, in the setting of large decubitus ulcerations communicating with both hip joints. Findings of septic arthritis and osteomyelitis complex at both hips, osteomyelitis of the bilateral inferior pubic rami. Progressive resorption of the sacrum, with the remaining portion of S4 protruding from a large sacral decubitus ulcer.
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CT Head wo contrast 1/8/2022 5:08 PM Clinical Information: surveillance Spec Inst: STEALTH Comparison: CT of the head without contrast dated 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: 250 mm. DLP: 1233 mGy cm. Findings: Brain parenchyma: Mild diffuse age-appropriate brain parenchymal volume loss is again seen. Linear hypoattenuation along the left superior frontal gyrus may represent remote encephalomalacia from prior ventriculostomy catheter. Linear hypoattenuation adjacent to the right frontal catheter may represent edema. Unchanged periventricular white matter hypoattenuation which may represent residual transependymal CSF flow in superimposed chronic microvascular ischemic disease. The white-gray matter differentiation is preserved. Ventricular system: Stable right frontal ventriculostomy catheter terminating in the right foramen of Monro, with interval slitlike appearance of the ventricular system, which may represent over shunting. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Subtle serpiginous hyperattenuation along the right anterior frontal sulci, may represent a small amount of subarachnoid hemorrhage. Resolving right temporal pneumocephalus. Midline shift: No significant midline shift is seen. Vascular system: Unchanged punctate atherosclerotic calcifications of the bilateral carotid siphons. Soft tissues: Resolving post procedural right frontoparietal scalp soft tissue swelling and subcutaneous emphysema. Orbits: Normal appearance. Calvarium and skull base: Unchanged bilateral frontal burr hole's. No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Persistent pansinus mucosal thickening, with superimposed air-fluid levels in the bilateral sphenoid and maxillary sinuses.. IMPRESSION: 1. Stable right frontal ventriculostomy catheter terminating in the right foramen of Monro, with interval slitlike appearance of the ventricular system, which may represent over shunting. 2. Subtle serpiginous hyperattenuation along the right anterior frontal sulci, may represent a small amount of subarachnoid hemorrhage. 3. Unchanged additional involutional and chronic findings as described.
Findings: Brain parenchyma: Mild diffuse age-appropriate brain parenchymal volume loss is again seen. Linear hypoattenuation along the left superior frontal gyrus may represent remote encephalomalacia from prior ventriculostomy catheter. Linear hypoattenuation adjacent to the right frontal catheter may represent edema. Unchanged periventricular white matter hypoattenuation which may represent residual transependymal CSF flow in superimposed chronic microvascular ischemic disease. The white-gray matter differentiation is preserved. Ventricular system: Stable right frontal ventriculostomy catheter terminating in the right foramen of Monro, with interval slitlike appearance of the ventricular system, which may represent over shunting. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Subtle serpiginous hyperattenuation along the right anterior frontal sulci, may represent a small amount of subarachnoid hemorrhage. Resolving right temporal pneumocephalus. Midline shift: No significant midline shift is seen. Vascular system: Unchanged punctate atherosclerotic calcifications of the bilateral carotid siphons. Soft tissues: Resolving post procedural right frontoparietal scalp soft tissue swelling and subcutaneous emphysema. Orbits: Normal appearance. Calvarium and skull base: Unchanged bilateral frontal burr hole's. No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Persistent pansinus mucosal thickening, with superimposed air-fluid levels in the bilateral sphenoid and maxillary sinuses..
FINDINGS: BRAIN PARENCHYMA: Improved appearance of bifrontal hemorrhagic contusions with persistent hypoattenuation consistent with associated vasogenic edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. No new hemorrhage. EXTRA-AXIAL SPACES: Likely persistent trace subarachnoid hemorrhage within the inferior frontal sulci. No new areas of hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: No significant vascular calcifications. SKULL AND SKULL BASE: Right occipital bone fracture extending to the foramen magnum and displaced fracture of the right mandibular condyle with dislocated mandibular condylar head anteriorly is again demonstrated.. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Evaluate for infectious source. History of trauma. COMPARISON: CT chest, abdomen, and pelvis 1/4/2022 TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 180 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Oral contrast: 16.9 oz. Saline flush: 90 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec Scan field of view: 372 mm. DLP: 743 mGy cm FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in the mid trachea. The central airways are patent. Right lower lobe consolidation and patchy groundglass opacities and tree-in-bud nodules in the right greater than left dependent lungs. Overall, these appear similar to prior. Right thoracostomy tube terminates in stable position. Trace bilateral pleural effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Enteric feeding tube in esophagus. Interval resolution of trace pneumomediastinum. LYMPH NODES: Enlarged right hilar lymph node and prominent mediastinal lymph nodes, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Redemonstration of postsurgical changes from right hepatic lobe hepatorrhaphy. Perihepatic surgical JP drain looped in the posterior right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Dependent layering hyperdense contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Small hypoenhancing foci in the spleen, likely evolving small lacerations. ADRENALS: Right adrenal hematoma is unchanged. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Enteric feeding tube is curled in the stomach. The small bowel is normal in caliber. Oral contrast progresses past the ileocecal valve. COLON / APPENDIX: Oral contrast seen throughout the colon. The appendix is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid is again seen. RETROPERITONEUM: Normal. VESSELS: Redemonstration of right common femoral and iliac vein nonocclusive thrombus previously associated with right common femoral vein catheter, which has been removed in the interim. URINARY BLADDER: Foley catheter is in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Surgical drain through the right anterior abdominal wall. Mild anasarca. MUSCULOSKELETAL: Redemonstration of lumbar spine and right rib fractures. Manubrial fracture and right clavicular fractures are again seen. CONCLUSION: 1. Bilateral airspace opacities concerning for aspiration and pneumonia, similar to prior. 2. Postsurgical changes from midline laparotomy and right hepatic lobe repair with unchanged position of the perihepatic drain. 3. Evolving left adrenal hematoma. 4. Right common femoral vein and iliac vein deep venous thrombosis is again seen. 5. Redemonstration of traumatic injuries and additional 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.
FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in the mid trachea. The central airways are patent. Right lower lobe consolidation and patchy groundglass opacities and tree-in-bud nodules in the right greater than left dependent lungs. Overall, these appear similar to prior. Right thoracostomy tube terminates in stable position. Trace bilateral pleural effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Enteric feeding tube in esophagus. Interval resolution of trace pneumomediastinum. LYMPH NODES: Enlarged right hilar lymph node and prominent mediastinal lymph nodes, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Redemonstration of postsurgical changes from right hepatic lobe hepatorrhaphy. Perihepatic surgical JP drain looped in the posterior right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Dependent layering hyperdense contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Small hypoenhancing foci in the spleen, likely evolving small lacerations. ADRENALS: Right adrenal hematoma is unchanged. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Enteric feeding tube is curled in the stomach. The small bowel is normal in caliber. Oral contrast progresses past the ileocecal valve. COLON / APPENDIX: Oral contrast seen throughout the colon. The appendix is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid is again seen. RETROPERITONEUM: Normal. VESSELS: Redemonstration of right common femoral and iliac vein nonocclusive thrombus previously associated with right common femoral vein catheter, which has been removed in the interim. URINARY BLADDER: Foley catheter is in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Surgical drain through the right anterior abdominal wall. Mild anasarca. MUSCULOSKELETAL: Redemonstration of lumbar spine and right rib fractures. Manubrial fracture and right clavicular fractures are again seen.
FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: CORONARY ARTERIES: There are severe atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. Mild atherosclerotic calcifications. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: Mild atherosclerosis. Otherwise unremarkable. ABDOMINAL AORTA: Mild circumferential atherosclerosis. CELIAC AXIS: Mild ostial narrowing. Normal branching pattern. Mild focal stenosis of the common hepatic artery due to atherosclerosis. Splenic artery calcifications. SMA: No significant abnormality. RIGHT RENAL: Moderate ostial narrowing. LEFT RENAL: Mild ostial narrowing. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Mild atherosclerosis. Mild right proximal SFA stenosis. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Mild atherosclerosis. Mild left SFA stenosis. ------------------------------------------------------------- LOWER NECK: Heterogenous hypoattenuating left thyroid nodule measures up to 2.8 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Right lower lobe nodule measures 4 mm (image 91 series 501), unchanged from 12/26/2016. No focal consolidation, pleural effusion, or pneumothorax. HEART / OTHER VESSELS: Coronary calcification. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Calcified mediastinal nodes. CHEST WALL: Old healed bilateral rib fractures. ABDOMEN and PELVIS: LIVER: Subcentimeter hypoattenuating hepatic lesions are too small to characterize but appear unchanged from 2016. BILIARY TRACT: Unchanged extrahepatic and intrahepatic biliary ductal dilatation without distal obstructing lesion or stone seen. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Bilateral adrenal thickening without discrete nodule. KIDNEYS: Unchanged tiny exophytic right renal hypodensity with associated calcification. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Moderately distended. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Intramuscular left subscapularis lipoma incidentally noted, measuring 3.0 x 2.4 cm (image 16 series 501). An adjacent smaller left latissimus dorsi intramuscular lipoma is also noted. Osseous demineralization. Advanced degenerative changes of the lumbar spine. Mild retrolisthesis of L2 over L3. Minimal grade 1 anterolisthesis of L4 over L5.
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CLINICAL HISTORY: follow up EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 224 mm. DLP: 952 mGy cm. COMPARISON: 1/2/2022 FINDINGS: Right frontal approach ventricular catheter is unchanged in position terminating near the left foramen of Munro. Right lateral ventricle is decompressed. Left lateral ventricle, third ventricle and fourth ventricle are normal in size. There is decreased small amount of hemorrhage layering within the left occipital horn. There is expected evolution of dorsal right midbrain and pontine hemorrhagse and also tiny left and right frontal lobe hemorrhages. No new hemorrhage is identified. There are multiple hypodensities within the left frontal lobe, right frontal lobe, right temporal lobe, left splenium, right thalamus right cerebellum, left cerebellum which appear less conspicuous. There is no midline shift. There is resolving trace scattered subarachnoid hemorrhage. There is trace residual subdural hemorrhage along the left cerebellar tentorium and along the posterior interhemispheric fissure The calvarium is intact. There is nearly complete opacification of the sphenoid sinuses and the mastoid air cells. There is mild interval clearing of the ethmoid air cells. There is no acute abnormality of the orbits. CONCLUSION: 01. Expected evolution of brainstem and bifrontal hemorrhages. No new parenchymal hemorrhage. 02. Multiple parenchymal hypodensities representing contusions, decreased in size and conspicuity. 03. Resolving trace scattered subarachnoid hemorrhage and subdural hemorrhage. 04. Stable shunted ventricles. Resolving IVH.
FINDINGS: Right frontal approach ventricular catheter is unchanged in position terminating near the left foramen of Munro. Right lateral ventricle is decompressed. Left lateral ventricle, third ventricle and fourth ventricle are normal in size. There is decreased small amount of hemorrhage layering within the left occipital horn. There is expected evolution of dorsal right midbrain and pontine hemorrhagse and also tiny left and right frontal lobe hemorrhages. No new hemorrhage is identified. There are multiple hypodensities within the left frontal lobe, right frontal lobe, right temporal lobe, left splenium, right thalamus right cerebellum, left cerebellum which appear less conspicuous. There is no midline shift. There is resolving trace scattered subarachnoid hemorrhage. There is trace residual subdural hemorrhage along the left cerebellar tentorium and along the posterior interhemispheric fissure The calvarium is intact. There is nearly complete opacification of the sphenoid sinuses and the mastoid air cells. There is mild interval clearing of the ethmoid air cells. There is no acute abnormality of the orbits.
FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: CORONARY ARTERIES: There are severe atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. Mild atherosclerotic calcifications. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: Mild atherosclerosis. Otherwise unremarkable. ABDOMINAL AORTA: Mild circumferential atherosclerosis. CELIAC AXIS: Mild ostial narrowing. Normal branching pattern. Mild focal stenosis of the common hepatic artery due to atherosclerosis. Splenic artery calcifications. SMA: No significant abnormality. RIGHT RENAL: Moderate ostial narrowing. LEFT RENAL: Mild ostial narrowing. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Mild atherosclerosis. Mild right proximal SFA stenosis. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Mild atherosclerosis. Mild left SFA stenosis. ------------------------------------------------------------- LOWER NECK: Heterogenous hypoattenuating left thyroid nodule measures up to 2.8 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Right lower lobe nodule measures 4 mm (image 91 series 501), unchanged from 12/26/2016. No focal consolidation, pleural effusion, or pneumothorax. HEART / OTHER VESSELS: Coronary calcification. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Calcified mediastinal nodes. CHEST WALL: Old healed bilateral rib fractures. ABDOMEN and PELVIS: LIVER: Subcentimeter hypoattenuating hepatic lesions are too small to characterize but appear unchanged from 2016. BILIARY TRACT: Unchanged extrahepatic and intrahepatic biliary ductal dilatation without distal obstructing lesion or stone seen. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Bilateral adrenal thickening without discrete nodule. KIDNEYS: Unchanged tiny exophytic right renal hypodensity with associated calcification. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Moderately distended. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Intramuscular left subscapularis lipoma incidentally noted, measuring 3.0 x 2.4 cm (image 16 series 501). An adjacent smaller left latissimus dorsi intramuscular lipoma is also noted. Osseous demineralization. Advanced degenerative changes of the lumbar spine. Mild retrolisthesis of L2 over L3. Minimal grade 1 anterolisthesis of L4 over L5.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Evaluate for infectious source. History of trauma. COMPARISON: CT chest, abdomen, and pelvis 1/4/2022 TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 180 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Oral contrast: 16.9 oz. Saline flush: 90 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec Scan field of view: 372 mm. DLP: 743 mGy cm FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in the mid trachea. The central airways are patent. Right lower lobe consolidation and patchy groundglass opacities and tree-in-bud nodules in the right greater than left dependent lungs. Overall, these appear similar to prior. Right thoracostomy tube terminates in stable position. Trace bilateral pleural effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Enteric feeding tube in esophagus. Interval resolution of trace pneumomediastinum. LYMPH NODES: Enlarged right hilar lymph node and prominent mediastinal lymph nodes, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Redemonstration of postsurgical changes from right hepatic lobe hepatorrhaphy. Perihepatic surgical JP drain looped in the posterior right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Dependent layering hyperdense contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Small hypoenhancing foci in the spleen, likely evolving small lacerations. ADRENALS: Right adrenal hematoma is unchanged. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Enteric feeding tube is curled in the stomach. The small bowel is normal in caliber. Oral contrast progresses past the ileocecal valve. COLON / APPENDIX: Oral contrast seen throughout the colon. The appendix is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid is again seen. RETROPERITONEUM: Normal. VESSELS: Redemonstration of right common femoral and iliac vein nonocclusive thrombus previously associated with right common femoral vein catheter, which has been removed in the interim. URINARY BLADDER: Foley catheter is in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Surgical drain through the right anterior abdominal wall. Mild anasarca. MUSCULOSKELETAL: Redemonstration of lumbar spine and right rib fractures. Manubrial fracture and right clavicular fractures are again seen. CONCLUSION: 1. Bilateral airspace opacities concerning for aspiration and pneumonia, similar to prior. 2. Postsurgical changes from midline laparotomy and right hepatic lobe repair with unchanged position of the perihepatic drain. 3. Evolving left adrenal hematoma. 4. Right common femoral vein and iliac vein deep venous thrombosis is again seen. 5. Redemonstration of traumatic injuries and additional 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.
FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in the mid trachea. The central airways are patent. Right lower lobe consolidation and patchy groundglass opacities and tree-in-bud nodules in the right greater than left dependent lungs. Overall, these appear similar to prior. Right thoracostomy tube terminates in stable position. Trace bilateral pleural effusions. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Enteric feeding tube in esophagus. Interval resolution of trace pneumomediastinum. LYMPH NODES: Enlarged right hilar lymph node and prominent mediastinal lymph nodes, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Redemonstration of postsurgical changes from right hepatic lobe hepatorrhaphy. Perihepatic surgical JP drain looped in the posterior right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Dependent layering hyperdense contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Small hypoenhancing foci in the spleen, likely evolving small lacerations. ADRENALS: Right adrenal hematoma is unchanged. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Enteric feeding tube is curled in the stomach. The small bowel is normal in caliber. Oral contrast progresses past the ileocecal valve. COLON / APPENDIX: Oral contrast seen throughout the colon. The appendix is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid is again seen. RETROPERITONEUM: Normal. VESSELS: Redemonstration of right common femoral and iliac vein nonocclusive thrombus previously associated with right common femoral vein catheter, which has been removed in the interim. URINARY BLADDER: Foley catheter is in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from midline laparotomy. Surgical drain through the right anterior abdominal wall. Mild anasarca. MUSCULOSKELETAL: Redemonstration of lumbar spine and right rib fractures. Manubrial fracture and right clavicular fractures are again seen.
FINDINGS: STRUCTURED REPORT: CTA Aorta Runoff VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Moderate atherosclerotic calcifications. CELIAC AXIS: Mild ostial narrowing. SMA: Patent. Mild atherosclerotic calcifications. RIGHT RENAL: Two right renal arteries arising from the aorta. Mild ostial narrowing of the caudal right renal artery. LEFT RENAL: No significant abnormality. IMA: Patent. RIGHT ILIAC ARTERIES: Advanced atherosclerosis. Occlusion of the right internal iliac artery with distal reconstitution. Near occlusive narrowing of the distal right external iliac artery. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Right common femoral artery to right posterior tibial artery bypass is patent. Occluded native SFA with partial reconstitution at the popliteal artery. Multifocal mild stenosis of the popliteal artery. RIGHT TIBIAL AND PERONEAL ARTERIES: Multifocal stenosis of the anterior tibial artery which is patent to the foot. Peroneal artery becomes diminutive at the ankle. Posterior tibial artery is patent to the foot. RIGHT FOOT ARTERIES: Atherosclerosis of the dorsalis pedis artery, which has diminished flow though remains patent. LEFT ILIAC ARTERIES: Severe atherosclerosis. Moderate focal narrowing of the distal left external iliac artery. LEFT FEMORAL \T\ POPLITEAL ARTERIES: Severe atherosclerosis. Occlusion of the caudal left femoral artery and popliteal artery with reconstitution at the distal popliteal artery just prior to the origin of the calf arteries. LEFT TIBIAL AND PERONEAL ARTERIES: Severe atherosclerosis. Multifocal occlusion of the left anterior tibial artery. Left peroneal artery is unopacified at the distal foreleg. Left posterior tibial artery is patent to the foot. LEFT FOOT ARTERIES: Minimal flow in the left anterior tibial artery. Diminished flow in the left dorsal and plantar arch as compared to the right. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Right middle lobe atelectasis versus scarring appears similar to prior CT chest. Emphysema. Groundglass opacities in the right lung base. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Focal fatty infiltration along the falciform ligament. Otherwise unremarkable for technique. 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. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Normal. MUSCULOSKELETAL: Ulceration of the right second toe with soft tissue gas noted around the distal toe, with demineralization of the tip of the right second toe distal phalanx.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Right upper quadrant and epigastric pain. History of COVID19. COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 95 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec. Scan field of view: 331 mm. DLP: 337 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Mild bilateral dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. No adjacent inflammation or gallbladder wall thickening. 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: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Peripherally enhancing left ovarian cyst, likely corpus luteal cyst. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Cholelithiasis without evidence of cholecystitis. 2. No other acute abnormality in the abdomen or pelvis. 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.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Mild bilateral dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. No adjacent inflammation or gallbladder wall thickening. 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: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Peripherally enhancing left ovarian cyst, likely corpus luteal cyst. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: Motion slightly limits exam. BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Bilateral carotid siphon vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
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CLINICAL HISTORY: sp intracranial lesion resection EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 270 mm. DLP: 1361.80 mGy cm. COMPARISON: 1/2/2022 FINDINGS: Left frontoparietal craniotomy changes are again noted. There is stable or minimally enlarged overlying scalp fluid collection. There is a small underlying extra-axial hemorrhage and also small amount of packing material. There is a catheter extending into the prior left frontal surgical bed which appears unchanged in position. There is resolution of small amount of postprocedural gas. Multiple densities are again noted within the surgical bed. There is also significant adjacent hypoattenuation throughout the left frontal, parietal and temporal lobes and also within the left thalamus without significant interval change. There is however decreased mass effect upon the left lateral ventricle which appears reexpanded. There is stable small amount of IVH. There is also a small left cerebellar tentorium subdural hemorrhage There is no significant midline shift. There are bilateral mastoid effusions. There is also patchy opacification within the left ethmoid air cells and both sphenoid sinuses and near complete opacification of the left maxillary sinus.. The orbits are unremarkable. CONCLUSION: 01. Expected evolution of postsurgical changes. There is resolving underlying extra-axial fluid and hemorrhage. 02. Multiple calcifications again noted about residual left frontal lobe tumor. Catheter remains within the surgical bed. There is again significant adjacent hypoattenuation representing edema. There is however overall mildly decreased mass effect upon the left lateral ventricle which is partially reexpanded. 03. Small resolving left cerebellar tentorium subdural hemorrhage. No acute parenchymal abnormality
FINDINGS: Left frontoparietal craniotomy changes are again noted. There is stable or minimally enlarged overlying scalp fluid collection. There is a small underlying extra-axial hemorrhage and also small amount of packing material. There is a catheter extending into the prior left frontal surgical bed which appears unchanged in position. There is resolution of small amount of postprocedural gas. Multiple densities are again noted within the surgical bed. There is also significant adjacent hypoattenuation throughout the left frontal, parietal and temporal lobes and also within the left thalamus without significant interval change. There is however decreased mass effect upon the left lateral ventricle which appears reexpanded. There is stable small amount of IVH. There is also a small left cerebellar tentorium subdural hemorrhage There is no significant midline shift. There are bilateral mastoid effusions. There is also patchy opacification within the left ethmoid air cells and both sphenoid sinuses and near complete opacification of the left maxillary sinus.. The orbits are unremarkable.
FINDINGS/CONCLUSION: Mildly displaced fracture of the inferior tip of the lateral malleolus. Comminuted fracture of the anterior calcaneal process extending into the calcaneocuboid joint. The joint spaces are maintained. Soft tissue swelling of the ankle and foot.
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CT Head wo contrast 1/8/2022 5:29 PM Clinical Information: SDH Comparison: CT of the head and MRI brain 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: 213 mm. DLP: 935 mGy cm. Findings: Brain parenchyma: Evolving punctate early subacute right posterior frontal infarct, better characterized in prior MRI of the brain, without evidence of hemorrhagic transformation. The brain parenchyma volume is appropriate for patient's age. Unchanged confluent periventricular and subcortical white matter hypoattenuation, extending into the pons, suggestive of moderate chronic microvascular ischemic disease. The white-gray matter differentiation is preserved. Unchanged bilateral physiologic basal ganglia calcifications. Ventricular system: Normal configuration. No hydrocephalus. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Stable evolving left tentorial subdural hemorrhage extending into the posterior falx. Stable trace bilateral parieto-occipital subdural hematomas, without significant midline shift. Interval resolution of previously seen subarachnoid hemorrhage, with minimal residual dependent intraventricular component. Vascular system: Persistent atherosclerotic calcifications of the bilateral carotid siphons and vertebral arteries. Soft tissues: Unremarkable without discrete fluid collections. Orbits: Normal appearance. Calvarium and skull base: No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Well aerated. IMPRESSION: 1. Stable evolving left tentorial subdural hemorrhage extending into the posterior falx. 2. Persistent trace bilateral parieto-occipital subdural hematomas, without significant midline shift. 3. Interval resolution of previously seen subarachnoid hemorrhage, with minimal residual dependent intraventricular component. 4. Evolving punctate early subacute right posterior frontal infarct, better characterized in prior MRI of the brain, without evidence of hemorrhagic transformation.
Findings: Brain parenchyma: Evolving punctate early subacute right posterior frontal infarct, better characterized in prior MRI of the brain, without evidence of hemorrhagic transformation. The brain parenchyma volume is appropriate for patient's age. Unchanged confluent periventricular and subcortical white matter hypoattenuation, extending into the pons, suggestive of moderate chronic microvascular ischemic disease. The white-gray matter differentiation is preserved. Unchanged bilateral physiologic basal ganglia calcifications. Ventricular system: Normal configuration. No hydrocephalus. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Stable evolving left tentorial subdural hemorrhage extending into the posterior falx. Stable trace bilateral parieto-occipital subdural hematomas, without significant midline shift. Interval resolution of previously seen subarachnoid hemorrhage, with minimal residual dependent intraventricular component. Vascular system: Persistent atherosclerotic calcifications of the bilateral carotid siphons and vertebral arteries. Soft tissues: Unremarkable without discrete fluid collections. Orbits: Normal appearance. Calvarium and skull base: No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Well aerated.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Trace right pleural effusion and minimal dependent atelectatic changes. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: Somewhat limited due to arm down positioning. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonspecific bilateral perinephric stranding. No hydronephrosis. Bilateral renal hypodensities are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Small multiloculated fluid collection is associated with the right piriformis, described below. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No abnormality. MUSCULOSKELETAL/LUMBAR SPINE: The right piriformis muscle is asymmetrically enlarged and hypoattenuating compared to the right and there is a rim-enhancing fluid collection measuring 3.6 x 2.3 x 3.6 cm (image 273 series 201). No acute fracture of the lumbar spine. There are multilevel facet degenerative changes in the lower thoracic and lumbar spine. There is a bone island in the left sacral ala. Moderate to advanced L5-S1 facet arthropathy with grade 1 anterolisthesis of L5 on S1. At L1-L2 there is no stenosis. At L2-L3 there is a disc bulge and facet hypertrophic change with an appearance of mild spinal canal narrowing and mild bilateral foraminal narrowing. At L3-L4 there is mild diffuse disc bulge and osteophyte complex and facet DJD producing findings of moderate to severe bilateral foraminal stenosis. At L4-L5 disc bulge and osteophyte complex and facet DJD are present resulting in severe bilateral foraminal stenosis and an appearance of mild to moderate spinal canal stenosis. At L5-S1 there is the aforementioned anterolisthesis, severe facet degenerative changes with erosive changes and diffuse disc bulge and osteophyte complex resulting in moderate to severe bilateral foraminal stenosis. There is DISH-like ankylosis of the fibrous portion of the anterior SI joints.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: Evaluate right pleural effusion versus hemothorax. COMPARISON: 1/6/2022 TECHNIQUE: CT Chest wo contrast. Scan field of view: 387 mm. DLP: 292 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Catheter terminates anterior to the postsurgical changes of the cervical spine, incompletely visualized on this exam. CHEST: LUNGS / AIRWAYS / PLEURA: Bibasilar atelectasis with small right and trace left pleural effusions. Airways are patent. Endotracheal tube terminates near the thoracic inlet. HEART / VESSELS: Multivessel coronary artery calcifications. Normal heart size. No aneurysm. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Trace perihepatic free fluid appears similar. Esophagogastric tube terminates in the stomach. Otherwise unremarkable for technique. MUSCULOSKELETAL: No new abnormality. CONCLUSION: Simple appearing small right and trace left pleural effusions. No pneumothorax is identified. Additional findings as above.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Catheter terminates anterior to the postsurgical changes of the cervical spine, incompletely visualized on this exam. CHEST: LUNGS / AIRWAYS / PLEURA: Bibasilar atelectasis with small right and trace left pleural effusions. Airways are patent. Endotracheal tube terminates near the thoracic inlet. HEART / VESSELS: Multivessel coronary artery calcifications. Normal heart size. No aneurysm. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Trace perihepatic free fluid appears similar. Esophagogastric tube terminates in the stomach. Otherwise unremarkable for technique. MUSCULOSKELETAL: No new abnormality.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Trace right pleural effusion and minimal dependent atelectatic changes. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: Somewhat limited due to arm down positioning. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonspecific bilateral perinephric stranding. No hydronephrosis. Bilateral renal hypodensities are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Small multiloculated fluid collection is associated with the right piriformis, described below. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No abnormality. MUSCULOSKELETAL/LUMBAR SPINE: The right piriformis muscle is asymmetrically enlarged and hypoattenuating compared to the right and there is a rim-enhancing fluid collection measuring 3.6 x 2.3 x 3.6 cm (image 273 series 201). No acute fracture of the lumbar spine. There are multilevel facet degenerative changes in the lower thoracic and lumbar spine. There is a bone island in the left sacral ala. Moderate to advanced L5-S1 facet arthropathy with grade 1 anterolisthesis of L5 on S1. At L1-L2 there is no stenosis. At L2-L3 there is a disc bulge and facet hypertrophic change with an appearance of mild spinal canal narrowing and mild bilateral foraminal narrowing. At L3-L4 there is mild diffuse disc bulge and osteophyte complex and facet DJD producing findings of moderate to severe bilateral foraminal stenosis. At L4-L5 disc bulge and osteophyte complex and facet DJD are present resulting in severe bilateral foraminal stenosis and an appearance of mild to moderate spinal canal stenosis. At L5-S1 there is the aforementioned anterolisthesis, severe facet degenerative changes with erosive changes and diffuse disc bulge and osteophyte complex resulting in moderate to severe bilateral foraminal stenosis. There is DISH-like ankylosis of the fibrous portion of the anterior SI joints.
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 230 mm. DLP: 1421 mGy cm. (accession CT220004212), Scan field of view: 190 mm. DLP: 1014 mGy cm. (accession CT220004218) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. Scattered dental caries SINONASAL CAVITIES: Minimal frothy secretions and mucosal thickening of the left maxillary sinus. Mild mucosal thickening of the left frontal and ethmoid sinuses. The mastoid air cells are clear. CONCLUSION: No acute intracranial process. No acute maxillofacial fractures. 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. Scattered dental caries SINONASAL CAVITIES: Minimal frothy secretions and mucosal thickening of the left maxillary sinus. Mild mucosal thickening of the left frontal and ethmoid sinuses. The mastoid air cells are clear.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Mildly enlarged, extensively cirrhotic. No suspicious lesion. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Mildly enlarged. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. VESSELS: Fairly extensive gastrohepatic, distal esophageal and splenic varices. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Stable chronic superior endplate deformity of L5.
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EXAM: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004214), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. DLP: 854.40 mGy cm. (accession CT220004213), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004217), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004216) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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. CONCLUSION: 1. No acute traumatic abnormality within the chest, abdomen, or pelvis. 2. No fracture or malalignment of the thoracic or lumbar spine. 3. Mild bilateral axillary lymphadenopathy, left greater than right, is nonspecific and could be reactive. Consider follow-up ultrasound on a nonemergent outpatient basis in one to three months. 4. Acute right radial styloid fracture. 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Similar appearance of moderate bilateral periventricular and patchy subcortical white matter hypoattenuation most consistent with chronic 1microangiopathy. Diffusely decreased cerebral cortical volume. Tiny parafalcine lipomas anteriorly. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. Intracranial ICA and vertebral atherosclerotic calcifications. VENTRICULAR SYSTEM: Ex vacuo dilation. VESSELS: V4 segment vertebral artery and carotid siphon calcifications. SKULL AND SKULL BASE: No acute fracture. Congenital nonunion of the posterior arch of C1. ORBITS: Bilateral pseudophakia SINUSES: Right maxillary sinus mucosal thickening with layering fluid. MASTOIDS: Trace bilateral mastoid effusions. SOFT TISSUES: Unremarkable.
3,554
EXAM: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004214), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. DLP: 854.40 mGy cm. (accession CT220004213), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004217), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004216) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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. CONCLUSION: 1. No acute traumatic abnormality within the chest, abdomen, or pelvis. 2. No fracture or malalignment of the thoracic or lumbar spine. 3. Mild bilateral axillary lymphadenopathy, left greater than right, is nonspecific and could be reactive. Consider follow-up ultrasound on a nonemergent outpatient basis in one to three months. 4. Acute right radial styloid fracture. 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There are mild emphysematous changes. There are areas of dependent atelectasis. In the right lower lobe there is dependent consolidation with volume loss as well as findings of right lower lobe bronchiectasis. Calcified granulomas are present in the right lower lobe. No effusion or pneumothorax evident. HEART / VESSELS: Moderate atherosclerotic calcifications in the aorta and coronary arteries. The heart size is within normal limits. No evidence of thoracic aortic aneurysm. MEDIASTINUM / ESOPHAGUS: Esophagus is patulous. LYMPH NODES: There are calcified nodes in the right hilum compatible prior granulomatous disease. CHEST WALL: Mild symmetric gynecomastia. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: There is a small sclerotic density in the T3 vertebral body, indeterminate. There is a mild chronic appearing compression fracture deformity of T6 with mild height loss anteriorly. There is osteopenia/demineralization. No acute fracture visualized.
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RADIOLOGIC EXAM: CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Cervical Spine From Reformat Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. STRUCTURED REPORT: CT Cervical Spine Trauma 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 (
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 (
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Reported separately. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Gallbladder is partially collapsed around a few calcified cholelithiasis. PANCREAS: Normal. SPLEEN: Several calcified granulomas are present. ADRENALS: Normal. KIDNEYS: The right kidney is unremarkable. There is severe atrophy of the left mid and inferior kidney with mild atrophy of the upper pole of the left kidney. There is dense atherosclerotic calcification the left main renal artery. In accessory upper pole left renal artery appears to be present. Nonobstructive nephrolithiasis in the lower pole of the left kidney. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: The appendix appears normal. Diverticulosis without acute diverticulitis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: There is a abdominal aortic aneurysm which is fusiform and begins at the origin of the left renal artery where the aneurysm measures 3.2 x 3.0 cm AP by transverse on axial image 266 series 201. In the infrarenal aspect the aneurysm sac dilates up to 5.5 x 5.3 cm on axial image 331 series 201. Dense atherosclerotic calcifications are present throughout the abdominal aortic wall. The aneurysm terminates at the bifurcation. There is mild aneurysmal dilatation of the right CIA up to 1.7 cm. Mild ectasia of the left common and external iliac artery. Moderate to severe bilateral iliac territory atherosclerotic calcifications. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Enlarged prostate with dystrophic calcifications. BODY WALL: Surgical clips at the left inguinal and right inguinal region bilaterally compatible with prior herniorrhaphy. Recurrent/residual small left inguinal area. MUSCULOSKELETAL: Bilateral femoral head osteonecrosis. No subchondral fracture or collapse. There is osteopenia/demineralization with chronic appearing superior endplate Schmorl's node or compression deformity. Small sclerotic densities at T3 and T11 are indeterminate. No acute osseous abnormality evident. Multilevel degenerative changes in the lumbar spine.
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EXAM: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004214), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. DLP: 854.40 mGy cm. (accession CT220004213), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004217), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004216) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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. CONCLUSION: 1. No acute traumatic abnormality within the chest, abdomen, or pelvis. 2. No fracture or malalignment of the thoracic or lumbar spine. 3. Mild bilateral axillary lymphadenopathy, left greater than right, is nonspecific and could be reactive. Consider follow-up ultrasound on a nonemergent outpatient basis in one to three months. 4. Acute right radial styloid fracture. 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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.
FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Bilateral basal ganglia calcifications. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: Bilateral V4 segment vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable.
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EXAM: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Chest with contrast. Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004214), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. DLP: 854.40 mGy cm. (accession CT220004213), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004217), Patient weight: 130 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 384.20 mm. (accession CT220004216) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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. CONCLUSION: 1. No acute traumatic abnormality within the chest, abdomen, or pelvis. 2. No fracture or malalignment of the thoracic or lumbar spine. 3. Mild bilateral axillary lymphadenopathy, left greater than right, is nonspecific and could be reactive. Consider follow-up ultrasound on a nonemergent outpatient basis in one to three months. 4. Acute right radial styloid fracture. 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: No acute abnormality evident. Calcified granuloma left upper lobe. Minimal paraseptal emphysematous changes bilaterally. Subtle dependent atelectatic changes. No effusion or pneumothorax evident. The airways are patent. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: Mild left greater than right axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. CHEST WALL: 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: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal masses. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic healed left second and third anteromedial rib fracture deformities with external callus. The arms are draped over the abdomen and there is a acute right distal forearm radial styloid fracture, mildly displaced. Osteitis pubis. 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.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis in the lung bases. No focal consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous contusions of the left upper chest. 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: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Simple appearing right ovarian cyst measuring up to 3.5 cm. Uterus is absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 230 mm. DLP: 1421 mGy cm. (accession CT220004212), Scan field of view: 190 mm. DLP: 1014 mGy cm. (accession CT220004218) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. Scattered dental caries SINONASAL CAVITIES: Minimal frothy secretions and mucosal thickening of the left maxillary sinus. Mild mucosal thickening of the left frontal and ethmoid sinuses. The mastoid air cells are clear. CONCLUSION: No acute intracranial process. No acute maxillofacial fractures. 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No fracture. FACIAL BONES: Normal. Scattered dental caries SINONASAL CAVITIES: Minimal frothy secretions and mucosal thickening of the left maxillary sinus. Mild mucosal thickening of the left frontal and ethmoid sinuses. The mastoid air cells are clear.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Subsegmental atelectasis in the lung bases. No focal consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous contusions of the left upper chest. 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: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Simple appearing right ovarian cyst measuring up to 3.5 cm. Uterus is absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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RADIOLOGIC EXAM: CT Angio Neck CLINICAL INFORMATION: Trauma COMPARISON: Same-day CT of the cervical spine. TECHNIQUE: CT Angio Neck IV contrast: Omnipaque 350, 120 ml, per protocol. Axial helical images of the neck were obtained following intravenous contrast administration. Coronal and sagittal reformatted images were obtained from the axial data set. 3-D CT MIP images were generated in post processing. STRUCTURED REPORT: CTA of the neck FINDINGS: NECK ANGIOGRAM: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional anatomy without acute abnormality. 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. Hypoplastic V4 segment, likely congenital abnormality. 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. SOFT TISSUES: There are multiple shotty and mildly enlarged cervical lymph nodes seen bilaterally Please see separately dictated CT of the cervical spine for osseous findings. CONCLUSION: 1. No definite CT evidence of acute abnormality or flow-limiting stenosis within the cervical vasculature. No definite evidence of arterial injury or dissection. 2. Indeterminate cervical adenopathy, probably reactive. 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.
FINDINGS: NECK ANGIOGRAM: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional anatomy without acute abnormality. 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. Hypoplastic V4 segment, likely congenital abnormality. 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. SOFT TISSUES: There are multiple shotty and mildly enlarged cervical lymph nodes seen bilaterally Please see separately dictated CT of the cervical spine for osseous findings.
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 Chest wo contrast CLINICAL INFORMATION: Shortness of breath COMPARISON: 12/27/2021. TECHNIQUE: CT Chest wo contrast. Scan field of view: 378 mm. DLP: 210.60 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Borderline enlarged right paratracheal node is 11 mm in short axis on series 201 image 16. Enlarged lower right paratracheal node is 14 x 16 mm on image 41 and was 12 x 16 mm on the prior. No additional enlarged intrathoracic lymph nodes are identified. Small hiatal hernia is seen. Calcific atherosclerosis is noted in the aorta and coronary arteries. The main pulmonary artery is enlarged at 37 mm . Biatrial enlargement is again seen with borderline cardiomegaly. Within the limits of a noncontrast exam, the mediastinum is otherwise normal. Bilateral pleural effusions are redemonstrated decreased on the left and slightly increased on the right. Adjacent compressive and dependent atelectasis of both lower lobes is seen. A pigtail catheter is present in the left basilar pleural space. Tiny pneumothorax is seen laterally in the left lung base. Bilateral interstitial prominence is again noted. Groundglass opacity in a mosaic attenuation is overall similar to the previous exam. A new area of consolidation is seen medially in the left lower lobe. Bronchial wall thickening is seen bilaterally worse on the right than the left. Opacification of the right lower lobe bronchus has increased. Gallstones are noted Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions. CONCLUSION: 1. Interval placement of basilar left pigtail pleural catheter with decrease in left pleural effusion. Tiny left-sided pneumothorax. New consolidation medially in the left lower lobe and unclear if that's atelectasis or pneumonia. 2. Right-sided loculated effusion is overall unchanged with increased dependent and compressive atelectasis in the right lower lobe. 3. Findings of interstitial edema. 4. Mildly enlarged right paratracheal nodes. 5. Enlarged main pulmonary artery concerning for component of pulmonary arterial hypertension.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Borderline enlarged right paratracheal node is 11 mm in short axis on series 201 image 16. Enlarged lower right paratracheal node is 14 x 16 mm on image 41 and was 12 x 16 mm on the prior. No additional enlarged intrathoracic lymph nodes are identified. Small hiatal hernia is seen. Calcific atherosclerosis is noted in the aorta and coronary arteries. The main pulmonary artery is enlarged at 37 mm . Biatrial enlargement is again seen with borderline cardiomegaly. Within the limits of a noncontrast exam, the mediastinum is otherwise normal. Bilateral pleural effusions are redemonstrated decreased on the left and slightly increased on the right. Adjacent compressive and dependent atelectasis of both lower lobes is seen. A pigtail catheter is present in the left basilar pleural space. Tiny pneumothorax is seen laterally in the left lung base. Bilateral interstitial prominence is again noted. Groundglass opacity in a mosaic attenuation is overall similar to the previous exam. A new area of consolidation is seen medially in the left lower lobe. Bronchial wall thickening is seen bilaterally worse on the right than the left. Opacification of the right lower lobe bronchus has increased. Gallstones are noted Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
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: Epigastric and right upper quadrant pain with vomiting. COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 180 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec. Scan field of view: 396 mm. DLP: 1031 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Noncalcified nodules in the right lung measuring up to 5 mm (series 3, images six and eight). Mild bilateral dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. 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: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesion. CONCLUSION: 1. Cholelithiasis. No definite evidence of cholecystitis. 2. Two 5 mm nodules in the imaged right lung base. According to the most recent Fleischner Society Pulmonary Nodule Guidelines, in the absence of risk factors, for multiple solid nodules measuring smaller than 6 mm, no CT follow-up is required. If the patient is considered high-risk for bronchogenic carcinoma, 1-year CT follow-up or other follow-up intervals according to size and risk. 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.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Noncalcified nodules in the right lung measuring up to 5 mm (series 3, images six and eight). Mild bilateral dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. 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: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesion.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There is a small left hemopneumothorax with a left chest tube present demonstrating a intraparenchymal course and portions of the lingula and superior segment left lower lobe. The tip terminates posteriorly at the left mid chest. There is dependent consolidation in the left lower lobe and there are possible small pneumatoceles in the left lower lobe region of consolidation on axial image 154 series 201. A less than 6 mm groundglass nodule in the right middle lobe. A few scattered tiny less than 6 mm nodules in the right upper lobe. Lungs are otherwise clear. Endotracheal tube terminates in the trachea in satisfactory position. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: No pneumomediastinum. Esophagogastric tube is present. Esophagus is mildly patulous. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Findings of penetrating trauma to the posterior medial a left chest wall subcutaneous gas tracking in the left paraspinous musculature. 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: The esophagogastric tube terminates in the stomach as expected. COLON / APPENDIX: The appendix is normal. There is diverticulosis without acute diverticulitis. PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: There is a moderate size area of active extravasation in the left retroperitoneum with hemorrhage tracking in the left retroperitoneum. There is overlying penetrating injury with laceration defect at the left posterior flank near the midline at the L3 level. VESSELS: Mild atherosclerotic disease. No acute injury evident. URINARY BLADDER: Collapsed around a Foley. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: A penetrating injury to the posterior left flank. MUSCULOSKELETAL: Left os acromiale. No acute osseous abnormality evident.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Severe worsening abdominal pain. COMPARISON: CT abdomen pelvis 11/29/2021 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: 3 ml per sec. Scan delay: 80 sec. Scan field of view: 350 mm. DLP: 455 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Trace bilateral pleural effusions with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild coronary artery atherosclerotic calcifications. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypoattenuating lesions in the bilateral kidneys are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Gastric stimulator leads are again seen in the anterior wall of the gastric antrum. The stomach is otherwise unremarkable. The small bowel is normal in caliber. COLON / APPENDIX: Moderate amount of formed fecal material in the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Pulse generator/battery pack in the right anterior abdominal wall subcutaneous tissues. Multiple collaterals are again seen throughout the abdominal wall. Right breast enlargement relative to the left, similar prior. MUSCULOSKELETAL: No aggressive osseous lesion. CONCLUSION: 1. Trace bilateral pleural effusions. 2. Venous collaterals and enlargement of the right breast is again seen, which remains concerning for central venous stenosis or occlusion in the chest. 3. No acute abnormality in the abdomen or pelvis. 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.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Trace bilateral pleural effusions with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild coronary artery atherosclerotic calcifications. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypoattenuating lesions in the bilateral kidneys are too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Gastric stimulator leads are again seen in the anterior wall of the gastric antrum. The stomach is otherwise unremarkable. The small bowel is normal in caliber. COLON / APPENDIX: Moderate amount of formed fecal material in the colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Pulse generator/battery pack in the right anterior abdominal wall subcutaneous tissues. Multiple collaterals are again seen throughout the abdominal wall. Right breast enlargement relative to the left, similar prior. MUSCULOSKELETAL: No aggressive osseous lesion.
FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There is a small left hemopneumothorax with a left chest tube present demonstrating a intraparenchymal course and portions of the lingula and superior segment left lower lobe. The tip terminates posteriorly at the left mid chest. There is dependent consolidation in the left lower lobe and there are possible small pneumatoceles in the left lower lobe region of consolidation on axial image 154 series 201. A less than 6 mm groundglass nodule in the right middle lobe. A few scattered tiny less than 6 mm nodules in the right upper lobe. Lungs are otherwise clear. Endotracheal tube terminates in the trachea in satisfactory position. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: No pneumomediastinum. Esophagogastric tube is present. Esophagus is mildly patulous. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Findings of penetrating trauma to the posterior medial a left chest wall subcutaneous gas tracking in the left paraspinous musculature. 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: The esophagogastric tube terminates in the stomach as expected. COLON / APPENDIX: The appendix is normal. There is diverticulosis without acute diverticulitis. PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: There is a moderate size area of active extravasation in the left retroperitoneum with hemorrhage tracking in the left retroperitoneum. There is overlying penetrating injury with laceration defect at the left posterior flank near the midline at the L3 level. VESSELS: Mild atherosclerotic disease. No acute injury evident. URINARY BLADDER: Collapsed around a Foley. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: A penetrating injury to the posterior left flank. MUSCULOSKELETAL: Left os acromiale. No acute osseous abnormality evident.
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Radiologic Exam: CT Angio Neck, CT Angio Head Code Stroke 1/8/2022 10:43 AM Clinical Information: Left-sided weakness and difficulty word finding.. Evaluate for CVA. Comparison: None available. Technique: Helical CT images were obtained after the administration of contrast from the base of the skull to the vertex. Contrast enhanced CT angiographic images were obtained from the superior mediastinum to the vertex during the arterial phase. 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: 111 lbs. IV contrast: Omnipaque 350, 125 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Track Scan field of view: 276 mm. (accession CT220004226), Patient weight: 111 lbs. IV contrast: Omnipaque 350, 125 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Track Scan field of view: 276 mm. DLP: 3342 mGy cm. (accession CT220004225) FINDINGS: CT of the head with and without contrast: See separately reported CT head. CT angiogram of the brain: RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: No acute displaced fracture. Vertebral body and disc space heights are maintained. Prevertebral soft tissues are within normal limits. CONCLUSION: 1. No evidence of cervical or intracranial arterial 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.
FINDINGS: CT of the head with and without contrast: See separately reported CT head. CT angiogram of the brain: RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: No acute displaced fracture. Vertebral body and disc space heights are maintained. Prevertebral soft tissues are within normal limits.
FINDINGS: CT of the head with and without contrast: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. After the administration of contrast no abnormal intracranial enhancement is evident. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal size and configuration. VESSELS: No significant vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable. CT of the 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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Radiologic Exam: CT Angio Neck, CT Angio Head Code Stroke 1/8/2022 10:43 AM Clinical Information: Left-sided weakness and difficulty word finding.. Evaluate for CVA. Comparison: None available. Technique: Helical CT images were obtained after the administration of contrast from the base of the skull to the vertex. Contrast enhanced CT angiographic images were obtained from the superior mediastinum to the vertex during the arterial phase. 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: 111 lbs. IV contrast: Omnipaque 350, 125 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Track Scan field of view: 276 mm. (accession CT220004226), Patient weight: 111 lbs. IV contrast: Omnipaque 350, 125 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Track Scan field of view: 276 mm. DLP: 3342 mGy cm. (accession CT220004225) FINDINGS: CT of the head with and without contrast: See separately reported CT head. CT angiogram of the brain: RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: No acute displaced fracture. Vertebral body and disc space heights are maintained. Prevertebral soft tissues are within normal limits. CONCLUSION: 1. No evidence of cervical or intracranial arterial 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.
FINDINGS: CT of the head with and without contrast: See separately reported CT head. CT angiogram of the brain: RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Unremarkable. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. SOFT TISSUES: No soft tissue abnormality within the neck. CERVICAL SPINE: No acute displaced fracture. Vertebral body and disc space heights are maintained. Prevertebral soft tissues are within normal limits.
FINDINGS: CT of the head with and without contrast: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. After the administration of contrast no abnormal intracranial enhancement is evident. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal size and configuration. VESSELS: No significant vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable. CT of the 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 Head wo contrast Clinical Information: Left-sided weakness and difficulty word finding. Evaluate for CVA. Comparison: None available Technique: Unenhanced axial brain CT with sagittal and coronal reformats. Scan field of view: 231 mm. DLP: 1137 mGy cm. Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. Conclusion: No acute intracranial abnormality. No intracranial hemorrhage. 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.
Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
FINDINGS: CT of the head with and without contrast: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. After the administration of contrast no abnormal intracranial enhancement is evident. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal size and configuration. VESSELS: No significant vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Well aerated. MASTOIDS: Clear. SOFT TISSUES: Unremarkable. CT of the 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 Perfusion 1/8/2022 10:44 AM Clinical Information: Stroke. CVA Spec Inst: L sided weakness and difficulty word finding Comparison: Head CT performed on the same day. Technique: A CT perfusion study was performed during single pass of 50 cc contrast bolus. Axial images were acquired at 8 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 depicting areas of ischemia (voxel values for MTT > 1.4 times mirror image voxels on the contralateral "normal side") in the color green and areas predictive of infarction (CBV values < 2.0 ml/100g) in the color red. Patient weight: 111 lbs. IV contrast: Omnipaque 350, 40 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: 0 sec. Scan field of view: 226 mm. DLP: 1947 mGy cm. Findings: Color parametric maps demonstrate no abnormal perfusion.. Prognostic maps demonstrate no reduced cerebral blood flow or increased mean transit time.. Conclusion: No perfusion abnormality.
Findings: Color parametric maps demonstrate no abnormal perfusion.. Prognostic maps demonstrate no reduced cerebral blood flow or increased mean transit time..
Findings/conclusion: Nondisplaced fracture of the posterior talar process extending into the tibiotalar joint. Nondisplaced fracture of the lateral talar process. Comminuted fracture of the sustentaculum tali. Comminuted fractures of the anterior calcaneal process involving the calcaneocuboid joint. Comminuted fracture of the navicular involving the talonavicular and naviculocuneiform joints. Displaced fracture of the plantar aspect of the cuboid involving the calcaneocuboid joint. The ankle mortise is maintained. Soft tissue swelling about the ankle and hindfoot.
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: 74-year-old male, evaluation for nephrolithiasis/fluid collections. COMPARISON: CT abdomen and pelvis 10/24/2021 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 409 mm. DLP: 558 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: Minimal bibasilar atelectatic changes. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Heart size is normal. Atherosclerotic calcifications of the coronary arteries and degenerative calcification of aortic valve. ABDOMEN and PELVIS: LIVER: Cirrhotic in morphology. Otherwise unremarkable for unenhanced technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Bilateral native kidneys are atrophic. Multiple bilateral renal cysts are similar in appearance to prior exam. Right lower quadrant transplant kidney in place. There is gas within the transplant collecting system, likely extending from the urinary bladder. Mild perinephric stranding and fluid, unchanged. A focal fluid collection along the right pelvic sidewall just posterior to the iliac vessels measures approximately 3.0 x 2.5 cm (axial image 223), previously 3.1 x 3.3 cm. No new fluid collection is identified. No focal perinephric fluid collection. No hydronephrosis or renal calculi. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is not visualized. PERITONEUM / MESENTERY: Trace free fluid. No other significant abnormality. RETROPERITONEUM: No other significant abnormality. VESSELS: Moderate to severe calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Decompressed with wall thickening and indwelling Foley catheter. Intraluminal air is likely secondary to recent instrumentation. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Injection changes in the ventral abdominal wall, similar to prior exam. Postsurgical changes in the right lower abdominal wall. No other significant abnormality. MUSCULOSKELETAL: Changes secondary to osteonecrosis of bilateral femoral heads. CONCLUSION: 1. Simple appearing fluid collection along the right pelvic sidewall posterior to the iliac vasculature measuring up to 3.0 cm, slightly decreased size from prior exam. Differential includes but is not limited to a lymphocele versus seroma. Infection is felt less likely. No new fluid collection. 2. Right lower quadrant transplant kidney with gas in the collecting system, likely extending from gas within the urinary bladder which is suspected to be secondary to instrumentation with Foley catheter. Transplant kidney is otherwise stable in appearance given the limitations of unenhanced CT without evidence of focal perinephric fluid collection, hydronephrosis or renal calculi. 3. Cirrhosis with trace ascites. 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.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Minimal bibasilar atelectatic changes. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Heart size is normal. Atherosclerotic calcifications of the coronary arteries and degenerative calcification of aortic valve. ABDOMEN and PELVIS: LIVER: Cirrhotic in morphology. Otherwise unremarkable for unenhanced technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Bilateral native kidneys are atrophic. Multiple bilateral renal cysts are similar in appearance to prior exam. Right lower quadrant transplant kidney in place. There is gas within the transplant collecting system, likely extending from the urinary bladder. Mild perinephric stranding and fluid, unchanged. A focal fluid collection along the right pelvic sidewall just posterior to the iliac vessels measures approximately 3.0 x 2.5 cm (axial image 223), previously 3.1 x 3.3 cm. No new fluid collection is identified. No focal perinephric fluid collection. No hydronephrosis or renal calculi. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is not visualized. PERITONEUM / MESENTERY: Trace free fluid. No other significant abnormality. RETROPERITONEUM: No other significant abnormality. VESSELS: Moderate to severe calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Decompressed with wall thickening and indwelling Foley catheter. Intraluminal air is likely secondary to recent instrumentation. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Injection changes in the ventral abdominal wall, similar to prior exam. Postsurgical changes in the right lower abdominal wall. No other significant abnormality. MUSCULOSKELETAL: Changes secondary to osteonecrosis of bilateral femoral heads.
FINDINGS/CONCLUSION: Fracture of the posterior aspect of the medial femoral condyle. Avulsion fracture of the posterior aspect of the proximal tibia at the tibial attachment of the PCL. Comminuted fracture of the medial aspect of the patella. Large lipohemarthrosis. Soft tissue swelling about the knee.
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CT Head wo contrast Clinical Information: Head injury Comparison: 8/1/2021. Technique: Unenhanced axial brain CT with sagittal and coronal reformats. Scan field of view: 229 mm. DLP: 1150 mGy cm. Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Periventricular hypodensities, likely representing chronic microangiopathic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Ex vacuo dilatation of the ventricles. ORBITS: Normal. SINUSES: Mild mucosal thickening and mucosal retention cyst in the sphenoid sinus. There is a small posterior scalp contusion and subgaleal hematoma. Conclusion: 1. No acute intracranial abnormality. 2. Posterior scalp contusion with small subgaleal hematoma. 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.
Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Periventricular hypodensities, likely representing chronic microangiopathic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Ex vacuo dilatation of the ventricles. ORBITS: Normal. SINUSES: Mild mucosal thickening and mucosal retention cyst in the sphenoid sinus. There is a small posterior scalp contusion and subgaleal hematoma.
FINDINGS/CONCLUSION: There is persistent posterior dislocation of the left hip. Grossly stable alignment and position of the comminuted fracture left acetabulum involving the posterior column wall. Increased displacement and apex anterior angulation of the transcervical femoral neck fracture. Impaction fracture of the anterior right femoral head is again noted. Nondisplaced fracture of the posterior left ilium with extension into the SI joint. No pubic symphyseal or SI joint diastasis. Left L4 transverse process fracture. Unchanged intra-abdominal and intrapelvic findings from prior CT abdomen/pelvis. No new acute findings.
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RADIOLOGIC EXAM: CT Cervical Spine wo contrast CLINICAL INFORMATION: Neck injury COMPARISON: None. TECHNIQUE: CT Cervical Spine wo contrastScan field of view: 201 mm. DLP: 814 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. STRUCTURED REPORT: CT Cervical Spine Trauma 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 (
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 (
FINDINGS/CONCLUSION: Fracture of the distal humeral diaphysis with posterolateral displacement of the distal fracture fragment with proximal migration. No evidence of intra-articular extension. The elbow joint is unremarkable. No joint effusion. Mild soft tissue swelling of the upper arm.
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EXAM: TEMPORARY CLINICAL INFORMATION: Right lower quadrant abdominal pain. History of chronic lymphocytic leukemia. COMPARISON: CT abdomen pelvis 1/22/2021 TECHNIQUE: TEMPORARY. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: The imaged lung bases demonstrate bilateral lobulated pleural thickening which probably represents tumor/lymphoma. There is a small left and trace right pleural effusions. Partially imaged bilateral hilar lymphadenopathy. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Fatty infiltration along the falciform ligament. Subcentimeter hypoattenuating lesion in the right hepatic lobe is too small to characterize. Small area of hypoenhancement in segment VI (series 201, image 94). BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly with small wedge-shaped areas of hypoenhancement. ADRENALS: Normal. KIDNEYS: The previously seen areas of focal hypoattenuation within the bilateral kidneys has improved and there is areas of cortical volume loss, probably represents residual scarring. There are additional subcentimeter hypodensities in both kidneys which are technically indeterminate but probably cysts. LYMPH NODES: Multiple bulky, confluent retroperitoneal adenopathy surrounding the aorta and inferior vena cava and extends into the chest. The largest component of the periaortic mass measures approximately 20.2 x 12.1 cm on image 156, series 201. Bilateral enlarged iliac and pelvic lymphadenopathy is also seen. Several enlarged mesenteric lymph nodes are also seen. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Bulky adenopathy as above. There is an additional area of soft tissue seen anterior to the urinary bladder which also probably represents lymphomatous involvement measuring approximately 10.4 x 5.1 cm on image 266, series 201.. VESSELS: The bilateral iliac veins and inferior vena cava veins are narrowed by the bulky retroperitoneal adenopathy. The aorta is lifted anteriorly off of the spine. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Small right ovarian cysts, likely physiologic. BODY WALL: Tiny fat-containing umbilical hernia. Myomatous uterus is again noted. MUSCULOSKELETAL: No aggressive osseous lesions. CONCLUSION: 1. Extensive new periaortic retroperitoneal adenopathy/nodal mass with pleural involvement concerning for disease progression of lymphoma. Left greater than right pleural effusions, probably malignant. 2. Splenomegaly with wedge-shaped areas of hypoenhancement concerning for splenic infarcts. 3. Small area of hypoenhancement in the posterior right hepatic lobe may also represent a perfusional abnormality/infarct or less likely underlying metastasis. Attention on follow-up is recommended. Otherwise, this could be further evaluated with nonemergent outpatient MRI with Eovist, if clinically indicated. 4. Improvement in the bilateral renal masses which likely represented renal lymphoma. 5. Partially imaged right bilateral lymphadenopathy. 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.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: The imaged lung bases demonstrate bilateral lobulated pleural thickening which probably represents tumor/lymphoma. There is a small left and trace right pleural effusions. Partially imaged bilateral hilar lymphadenopathy. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Fatty infiltration along the falciform ligament. Subcentimeter hypoattenuating lesion in the right hepatic lobe is too small to characterize. Small area of hypoenhancement in segment VI (series 201, image 94). BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly with small wedge-shaped areas of hypoenhancement. ADRENALS: Normal. KIDNEYS: The previously seen areas of focal hypoattenuation within the bilateral kidneys has improved and there is areas of cortical volume loss, probably represents residual scarring. There are additional subcentimeter hypodensities in both kidneys which are technically indeterminate but probably cysts. LYMPH NODES: Multiple bulky, confluent retroperitoneal adenopathy surrounding the aorta and inferior vena cava and extends into the chest. The largest component of the periaortic mass measures approximately 20.2 x 12.1 cm on image 156, series 201. Bilateral enlarged iliac and pelvic lymphadenopathy is also seen. Several enlarged mesenteric lymph nodes are also seen. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Bulky adenopathy as above. There is an additional area of soft tissue seen anterior to the urinary bladder which also probably represents lymphomatous involvement measuring approximately 10.4 x 5.1 cm on image 266, series 201.. VESSELS: The bilateral iliac veins and inferior vena cava veins are narrowed by the bulky retroperitoneal adenopathy. The aorta is lifted anteriorly off of the spine. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Small right ovarian cysts, likely physiologic. BODY WALL: Tiny fat-containing umbilical hernia. Myomatous uterus is again noted. MUSCULOSKELETAL: No aggressive osseous lesions.
Findings: There is no acute intracranial hemorrhage. There is asymmetric right frontal deep white matter hypoattenuation, nonspecific. There is no hydrocephalus. No mass effect or midline shift. No loss of gray-white matter differentiation. The orbits are maintained. Bilateral maxillary sinus mucous retention cyst, left greater than right and scattered mucus retention cysts in the sphenoid sinuses and small sphenoid sinus air-fluid level are demonstrated. The calvarium and skull base are intact.
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EXAM: CT Angio Upper Ext Right wo+w contrast CLINICAL INFORMATION: Right hand and wrist pain with concern for ischemic limb. COMPARISON: CTA upper extremity earlier same day. TECHNIQUE: CT Angio Upper Ext Right wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 290 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked: 15/60 sec Scan field of view: 403 mm. DLP: 1783.70 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Upper Extremity FINDINGS: VASCULATURE: AORTIC ARCH: No significant abnormality. PROXIMAL ASPECT OF ARCH VESSELS: Common origin of the innominate and left common carotid arteries. RIGHT SUBCLAVIAN ARTERY: No significant abnormality. RIGHT AXILLARY ARTERY: No significant abnormality. RIGHT BRACHIAL ARTERY: No significant abnormality. RIGHT RADIAL ARTERY: No significant abnormality. RIGHT ULNAR ARTERY: No significant abnormality. RIGHT HAND ARTERIES: The deep palmar arch is patent. The superficial palmar arch becomes diminutive and is not well visualized distally although this is also a normal variant. OTHER VASCULATURE: The right brachial, axillary, subclavian, and brachiocephalic veins are grossly patent. The bilateral internal jugular veins are unremarkable. PARTIALLY IMAGED HEAD AND NECK: No abnormality. PARTIALLY IMAGED CHEST: No abnormality. SUPERFICIAL SOFT TISSUES: No abnormality. MUSCULOSKELETAL: No aggressive osseous lesions. No acute fracture or malalignment. CONCLUSION: 1. Patent right upper extremity arteries without evidence of stenosis or occlusion. The superficial palmar arch is not visualized distally, but incomplete palmar arch is a normal variant. The deep palmar arch is patent. 2. The deep right upper extremity veins are grossly patent. 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.
FINDINGS: STRUCTURED REPORT: CTA Upper Extremity FINDINGS: VASCULATURE: AORTIC ARCH: No significant abnormality. PROXIMAL ASPECT OF ARCH VESSELS: Common origin of the innominate and left common carotid arteries. RIGHT SUBCLAVIAN ARTERY: No significant abnormality. RIGHT AXILLARY ARTERY: No significant abnormality. RIGHT BRACHIAL ARTERY: No significant abnormality. RIGHT RADIAL ARTERY: No significant abnormality. RIGHT ULNAR ARTERY: No significant abnormality. RIGHT HAND ARTERIES: The deep palmar arch is patent. The superficial palmar arch becomes diminutive and is not well visualized distally although this is also a normal variant. OTHER VASCULATURE: The right brachial, axillary, subclavian, and brachiocephalic veins are grossly patent. The bilateral internal jugular veins are unremarkable. PARTIALLY IMAGED HEAD AND NECK: No abnormality. PARTIALLY IMAGED CHEST: No abnormality. SUPERFICIAL SOFT TISSUES: No abnormality. MUSCULOSKELETAL: No aggressive osseous lesions. No acute fracture or malalignment.
FINDINGS: Head CT: No acute intracranial hemorrhage, hydrocephalus, brain edema, mass effect or midline shift. No abnormal intracranial enhancement evident. Orbits are maintained. Visualized paranasal sinuses and mastoid air cells are clear. The calvarium and skull base appear intact. Head angiogram: There are postintervention changes of cortical embolization of a basilar tip aneurysm without obvious recurrent/residual aneurysmal filling. There is moderate atherosclerotic calcification of the intracranial ICAs on the left and right with about 50% atherosclerotic narrowing of the bilateral ICAs at the carotid siphon and supraclinoid ICA. The ACA, MCA and PCAs appear patent. The bilateral posterior communicating arteries are patent. Cervical angiogram: The lung apices are clear. Aortic arch is patent. Common origin brachiocephalic and left common carotid. There is mild atherosclerotic calcification of the right and left carotid bulb. The left and right cervical carotid and ICAs remain patent without flow-limiting stenosis or large vessel occlusion. The bilateral vertebral arteries are patent. There is atherosclerotic calcification scattered in the cervical and intracranial vertebral arteries with a moderate left and right focal stenosis in the V2 segment at the C5-C6 level. Dental caries and right maxillary molar periapical cyst/abscess are again demonstrated with remodeling of the right maxillary sinus floor. There is mucosal thickening in the floor the right maxillary sinus. No acute osseous abnormality evident.
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EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Infrarenal aortic dissection evaluation. COMPARISON: CTA CAP 1/5/2022. CT CAP 1/3/2022. TECHNIQUE: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 177 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus track Scan field of view: 374 mm. KVP: 120 DLP: 1018 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Chest Abdomen VASCULATURE: CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Unchanged appearance of the focal short segment dissection in the distal infrarenal abdominal aorta. Dissection terminates just above the level of the bifurcation. No aneurysmal dilation. CELIAC AXIS: Unchanged focal narrowing of the proximal celiac axis with post stenotic dilation, possibly related to median arcuate ligament syndrome. SMA: No abnormality of the proximal SMA. There is occlusion of the distal mesenteric branches in the right hemiabdomen (image 244, series #6), unchanged from prior exam and likely postsurgical related to ileocecectomy. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Linear subsegmental atelectasis in the left dependent lung. Bilateral dependent atelectasis. Trace bilateral layering pleural effusions. Resolution of the small right-sided pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Normal heart size. Right IJ central venous catheter is present with tip in the right brachiocephalic vein. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast implants. Mildly displaced left 9th through 11th rib fractures, unchanged. ABDOMEN and PELVIS: LIVER: Unchanged small benign-appearing fatty lesion in the right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Interval development of mild diffuse small bowel distention without focal transition point. Normal wall enhancement. No pneumatosis. Postsurgical change from prior ileocecectomy and small bowel resection. COLON / APPENDIX: Fluid-filled colon. Stable post surgical change from prior transverse colon resection. PERITONEUM / MESENTERY: Small amount of free intraperitoneal fluid throughout the abdomen and pelvis, increased from prior exam. No free intraperitoneal air. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter is present. Trace retained contrast. Nondependent gas in the urinary bladder, likely related to instrumentation. REPRODUCTIVE ORGANS: Uterus is present with IUD in the fundus. No adnexal mass. BODY WALL: Midline surgical incision with superficial skin staples and trace gas in the abdominal wall. There is gas in the right lateral abdominal wall musculature, decreased from prior exam and likely secondary to recent surgery. Left lower quadrant abdominal drainage catheter is present with adjacent stranding and nonorganized fluid. No organizing fluid collection identified. MUSCULOSKELETAL: Unchanged compression fracture of the anterior aspect of the L4 vertebral body superior endplate. Internal fixation hardware in the right clavicle. No new osseous abnormality. CONCLUSION: 1. Unchanged focal dissection of the distal infrarenal abdominal aorta without aneurysmal dilation. 2. Interval development of mildly distended loops of small bowel without focal transition point, likely postoperative ileus. 3. Evolving postsurgical change from prior expiratory laparotomy as above. 4. Small volume ascites, increased from prior exam. 5. Trace bilateral layering pleural effusions. Resolution of the small right-sided pneumothorax. 6. Right IJ central venous catheter terminates in the right brachiocephalic vein. Recommend further advancement for more optimal positioning. 7. Other stable 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.
FINDINGS: STRUCTURED REPORT: CTA Chest Abdomen VASCULATURE: CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Unchanged appearance of the focal short segment dissection in the distal infrarenal abdominal aorta. Dissection terminates just above the level of the bifurcation. No aneurysmal dilation. CELIAC AXIS: Unchanged focal narrowing of the proximal celiac axis with post stenotic dilation, possibly related to median arcuate ligament syndrome. SMA: No abnormality of the proximal SMA. There is occlusion of the distal mesenteric branches in the right hemiabdomen (image 244, series #6), unchanged from prior exam and likely postsurgical related to ileocecectomy. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Linear subsegmental atelectasis in the left dependent lung. Bilateral dependent atelectasis. Trace bilateral layering pleural effusions. Resolution of the small right-sided pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Normal heart size. Right IJ central venous catheter is present with tip in the right brachiocephalic vein. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast implants. Mildly displaced left 9th through 11th rib fractures, unchanged. ABDOMEN and PELVIS: LIVER: Unchanged small benign-appearing fatty lesion in the right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Interval development of mild diffuse small bowel distention without focal transition point. Normal wall enhancement. No pneumatosis. Postsurgical change from prior ileocecectomy and small bowel resection. COLON / APPENDIX: Fluid-filled colon. Stable post surgical change from prior transverse colon resection. PERITONEUM / MESENTERY: Small amount of free intraperitoneal fluid throughout the abdomen and pelvis, increased from prior exam. No free intraperitoneal air. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter is present. Trace retained contrast. Nondependent gas in the urinary bladder, likely related to instrumentation. REPRODUCTIVE ORGANS: Uterus is present with IUD in the fundus. No adnexal mass. BODY WALL: Midline surgical incision with superficial skin staples and trace gas in the abdominal wall. There is gas in the right lateral abdominal wall musculature, decreased from prior exam and likely secondary to recent surgery. Left lower quadrant abdominal drainage catheter is present with adjacent stranding and nonorganized fluid. No organizing fluid collection identified. MUSCULOSKELETAL: Unchanged compression fracture of the anterior aspect of the L4 vertebral body superior endplate. Internal fixation hardware in the right clavicle. No new osseous abnormality.
FINDINGS: Head CT: No acute intracranial hemorrhage, hydrocephalus, brain edema, mass effect or midline shift. No abnormal intracranial enhancement evident. Orbits are maintained. Visualized paranasal sinuses and mastoid air cells are clear. The calvarium and skull base appear intact. Head angiogram: There are postintervention changes of cortical embolization of a basilar tip aneurysm without obvious recurrent/residual aneurysmal filling. There is moderate atherosclerotic calcification of the intracranial ICAs on the left and right with about 50% atherosclerotic narrowing of the bilateral ICAs at the carotid siphon and supraclinoid ICA. The ACA, MCA and PCAs appear patent. The bilateral posterior communicating arteries are patent. Cervical angiogram: The lung apices are clear. Aortic arch is patent. Common origin brachiocephalic and left common carotid. There is mild atherosclerotic calcification of the right and left carotid bulb. The left and right cervical carotid and ICAs remain patent without flow-limiting stenosis or large vessel occlusion. The bilateral vertebral arteries are patent. There is atherosclerotic calcification scattered in the cervical and intracranial vertebral arteries with a moderate left and right focal stenosis in the V2 segment at the C5-C6 level. Dental caries and right maxillary molar periapical cyst/abscess are again demonstrated with remodeling of the right maxillary sinus floor. There is mucosal thickening in the floor the right maxillary sinus. No acute osseous abnormality evident.
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EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Infrarenal aortic dissection evaluation. COMPARISON: CTA CAP 1/5/2022. CT CAP 1/3/2022. TECHNIQUE: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 177 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus track Scan field of view: 374 mm. KVP: 120 DLP: 1018 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Chest Abdomen VASCULATURE: CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Unchanged appearance of the focal short segment dissection in the distal infrarenal abdominal aorta. Dissection terminates just above the level of the bifurcation. No aneurysmal dilation. CELIAC AXIS: Unchanged focal narrowing of the proximal celiac axis with post stenotic dilation, possibly related to median arcuate ligament syndrome. SMA: No abnormality of the proximal SMA. There is occlusion of the distal mesenteric branches in the right hemiabdomen (image 244, series #6), unchanged from prior exam and likely postsurgical related to ileocecectomy. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Linear subsegmental atelectasis in the left dependent lung. Bilateral dependent atelectasis. Trace bilateral layering pleural effusions. Resolution of the small right-sided pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Normal heart size. Right IJ central venous catheter is present with tip in the right brachiocephalic vein. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast implants. Mildly displaced left 9th through 11th rib fractures, unchanged. ABDOMEN and PELVIS: LIVER: Unchanged small benign-appearing fatty lesion in the right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Interval development of mild diffuse small bowel distention without focal transition point. Normal wall enhancement. No pneumatosis. Postsurgical change from prior ileocecectomy and small bowel resection. COLON / APPENDIX: Fluid-filled colon. Stable post surgical change from prior transverse colon resection. PERITONEUM / MESENTERY: Small amount of free intraperitoneal fluid throughout the abdomen and pelvis, increased from prior exam. No free intraperitoneal air. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter is present. Trace retained contrast. Nondependent gas in the urinary bladder, likely related to instrumentation. REPRODUCTIVE ORGANS: Uterus is present with IUD in the fundus. No adnexal mass. BODY WALL: Midline surgical incision with superficial skin staples and trace gas in the abdominal wall. There is gas in the right lateral abdominal wall musculature, decreased from prior exam and likely secondary to recent surgery. Left lower quadrant abdominal drainage catheter is present with adjacent stranding and nonorganized fluid. No organizing fluid collection identified. MUSCULOSKELETAL: Unchanged compression fracture of the anterior aspect of the L4 vertebral body superior endplate. Internal fixation hardware in the right clavicle. No new osseous abnormality. CONCLUSION: 1. Unchanged focal dissection of the distal infrarenal abdominal aorta without aneurysmal dilation. 2. Interval development of mildly distended loops of small bowel without focal transition point, likely postoperative ileus. 3. Evolving postsurgical change from prior expiratory laparotomy as above. 4. Small volume ascites, increased from prior exam. 5. Trace bilateral layering pleural effusions. Resolution of the small right-sided pneumothorax. 6. Right IJ central venous catheter terminates in the right brachiocephalic vein. Recommend further advancement for more optimal positioning. 7. Other stable 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.
FINDINGS: STRUCTURED REPORT: CTA Chest Abdomen VASCULATURE: CORONARY ARTERIES: There are no atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Unchanged appearance of the focal short segment dissection in the distal infrarenal abdominal aorta. Dissection terminates just above the level of the bifurcation. No aneurysmal dilation. CELIAC AXIS: Unchanged focal narrowing of the proximal celiac axis with post stenotic dilation, possibly related to median arcuate ligament syndrome. SMA: No abnormality of the proximal SMA. There is occlusion of the distal mesenteric branches in the right hemiabdomen (image 244, series #6), unchanged from prior exam and likely postsurgical related to ileocecectomy. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT COMMON ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Linear subsegmental atelectasis in the left dependent lung. Bilateral dependent atelectasis. Trace bilateral layering pleural effusions. Resolution of the small right-sided pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Normal heart size. Right IJ central venous catheter is present with tip in the right brachiocephalic vein. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Bilateral breast implants. Mildly displaced left 9th through 11th rib fractures, unchanged. ABDOMEN and PELVIS: LIVER: Unchanged small benign-appearing fatty lesion in the right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating contents, likely vicarious excretion of contrast. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Interval development of mild diffuse small bowel distention without focal transition point. Normal wall enhancement. No pneumatosis. Postsurgical change from prior ileocecectomy and small bowel resection. COLON / APPENDIX: Fluid-filled colon. Stable post surgical change from prior transverse colon resection. PERITONEUM / MESENTERY: Small amount of free intraperitoneal fluid throughout the abdomen and pelvis, increased from prior exam. No free intraperitoneal air. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter is present. Trace retained contrast. Nondependent gas in the urinary bladder, likely related to instrumentation. REPRODUCTIVE ORGANS: Uterus is present with IUD in the fundus. No adnexal mass. BODY WALL: Midline surgical incision with superficial skin staples and trace gas in the abdominal wall. There is gas in the right lateral abdominal wall musculature, decreased from prior exam and likely secondary to recent surgery. Left lower quadrant abdominal drainage catheter is present with adjacent stranding and nonorganized fluid. No organizing fluid collection identified. MUSCULOSKELETAL: Unchanged compression fracture of the anterior aspect of the L4 vertebral body superior endplate. Internal fixation hardware in the right clavicle. No new osseous abnormality.
FINDINGS/CONCLUSION: Comminuted subtrochanteric fracture of the proximal right femur extending into the lesser trochanter. There is anterolateral displacement and mild proximal migration of the distal fracture fragments. No other acute displaced fracture is seen. Decreased bone mineralization. There are two sclerotic lesions, within the left ilium and right ischium which are unchanged and are most consistent with bone islands. The femoral heads are well-seated within their respective acetabula with mild bilateral degenerative changes. No pubic symphyseal or SI joint diastasis. Degenerative changes are noted within the visualized portions of the lumbar spine with mild retrolisthesis of L4 over L5 and L5 over S1. No acute intra-abdominal or intrapelvic findings. Aortic atherosclerosis. Postsurgical changes of prior colectomy. Numerous brachytherapy seeds are again noted in the region of the prostate.
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EXAM: CT Pelvis with contrast CLINICAL INFORMATION: History of recent pilonidal cyst surgery. Evaluate for infection. COMPARISON: None. TECHNIQUE: CT Pelvis with contrast. Patient weight: 224 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 100 sec. Scan field of view: 500 mm. DLP: 906 mGy cm. FINDINGS: STRUCTURED REPORT: CT Pelvis LOWER ABDOMEN: BOWEL: No abnormality. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Postsurgical changes from recent pilonodial cyst drainage/resection at the cranial intergluteal cleft with region of soft tissue attenuation and trace unorganized fluid in the subcutaneous soft tissues at this level measuring 1.5 x 4.6 cm (series 201, image 105). No drainable fluid collection identified. No significant skin thickening or subcutaneous emphysema. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Postsurgical changes of recent pilonidal cyst resection with small area of subcutaneous soft tissue attenuation and stranding at the site favored to represent represent residual small hematoma and granulation tissue. Superimposed infection can't be entirely excluded. No organized/drainable fluid collection identified. 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.
FINDINGS: STRUCTURED REPORT: CT Pelvis LOWER ABDOMEN: BOWEL: No abnormality. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Postsurgical changes from recent pilonodial cyst drainage/resection at the cranial intergluteal cleft with region of soft tissue attenuation and trace unorganized fluid in the subcutaneous soft tissues at this level measuring 1.5 x 4.6 cm (series 201, image 105). No drainable fluid collection identified. No significant skin thickening or subcutaneous emphysema. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality.
FINDINGS/CONCLUSION: Comminuted fracture of the calcaneus involving the subtalar and calcaneocuboid joints. No acute fracture of the distal tibia or fibula. Partially visualized healed posttraumatic deformity of the distal tibial diaphysis with screw fixation. Prior hardware tracks are noted within the distal fibula and tibia. Os navicularis and os peroneum. Decreased bone mineralization. Joint alignment is maintained. Soft tissue swelling of the foot and ankle.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma, evaluate for infectious source. COMPARISON: CT chest on 1/5/2022 and CT abdomen and pelvis 1/2/2022 TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 205 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 60 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 90 sec Scan field of view: 393 mm. DLP: 685.90 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in mid trachea. Postsurgical changes from left VATS. Decreased size of left pleural effusion with interval placement left thoracostomy tubes terminating in the posterior costodiaphragmatic recess and left lung apex. Small left pneumothorax. Decreased left lower lobe atelectasis. Patchy consolidative opacities in the right upper and lower lobes are increased from prior. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small retrosternal hematoma. Esophagogastric tube present. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema overlying the left chest wall and surrounding the left pectoralis muscles. Multiple skin staples in the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Moderate left perirenal hematoma is mildly increased in size compared to prior. The hematoma compresses the left renal cortex. Small laceration is seen in the interpolar left kidney. The left kidney is hypoenhancing compared to the right. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube terminates in the stomach. The small bowel is normal in caliber. COLON / APPENDIX: Rectal tube in place. The colon is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid in the pelvis. No organized fluid collection. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca. Small fat-containing umbilical hernia. MUSCULOSKELETAL: Redemonstration of sternal body, left scapular body, and L1 vertebral body fractures. Similar height loss of the L1 body burst fracture. CONCLUSION: 1. Postsurgical changes from left VATS with interval placement of two chest tubes. Decreased size of left pleural effusion. Small left pneumothorax. 2. Increased patchy consolidative opacities in the right upper and lower lobes concerning for pneumonia. 3. Evolving left pararenal hematoma with compression of the renal parenchyma by the subcapsular hematoma which is mildly enlarged since prior. Small interpolar laceration. There is hypoenhancement of the left kidney relative to the right suggesting decreased perfusion. 4. Additional traumatic injuries 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.
FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in mid trachea. Postsurgical changes from left VATS. Decreased size of left pleural effusion with interval placement left thoracostomy tubes terminating in the posterior costodiaphragmatic recess and left lung apex. Small left pneumothorax. Decreased left lower lobe atelectasis. Patchy consolidative opacities in the right upper and lower lobes are increased from prior. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small retrosternal hematoma. Esophagogastric tube present. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema overlying the left chest wall and surrounding the left pectoralis muscles. Multiple skin staples in the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Moderate left perirenal hematoma is mildly increased in size compared to prior. The hematoma compresses the left renal cortex. Small laceration is seen in the interpolar left kidney. The left kidney is hypoenhancing compared to the right. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube terminates in the stomach. The small bowel is normal in caliber. COLON / APPENDIX: Rectal tube in place. The colon is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid in the pelvis. No organized fluid collection. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca. Small fat-containing umbilical hernia. MUSCULOSKELETAL: Redemonstration of sternal body, left scapular body, and L1 vertebral body fractures. Similar height loss of the L1 body burst fracture.
FINDINGS: CT of the head with and without contrast: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: No vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Indwelling Rapid Rhino epistaxis device. Enhancing lesion within the right nasopharynx extending into the right parapharyngeal space and retromaxillary fat measures approximately 4.0 x 2.9 cm x 2.5 in maximum dimensions (series 601 image 3, series 503 image 157). There is involvement and osseous destruction of the right pterygoid plates and body of the sphenoid. Multiple nonenhancing foci within the lesion likely represent necrosis. Postsurgical changes from prior resection with right antrectomy. Right maxillary and bilateral sphenoid sinus mucosal thickening with hyperattenuating contents consistent with hemorrhage. MASTOIDS: Clear. CT angiogram of the brain: RIGHT INTRACRANIAL CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT INTRACRANIAL CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma, evaluate for infectious source. COMPARISON: CT chest on 1/5/2022 and CT abdomen and pelvis 1/2/2022 TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 205 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 60 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 90 sec Scan field of view: 393 mm. DLP: 685.90 mGy cm. FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in mid trachea. Postsurgical changes from left VATS. Decreased size of left pleural effusion with interval placement left thoracostomy tubes terminating in the posterior costodiaphragmatic recess and left lung apex. Small left pneumothorax. Decreased left lower lobe atelectasis. Patchy consolidative opacities in the right upper and lower lobes are increased from prior. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small retrosternal hematoma. Esophagogastric tube present. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema overlying the left chest wall and surrounding the left pectoralis muscles. Multiple skin staples in the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Moderate left perirenal hematoma is mildly increased in size compared to prior. The hematoma compresses the left renal cortex. Small laceration is seen in the interpolar left kidney. The left kidney is hypoenhancing compared to the right. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube terminates in the stomach. The small bowel is normal in caliber. COLON / APPENDIX: Rectal tube in place. The colon is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid in the pelvis. No organized fluid collection. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca. Small fat-containing umbilical hernia. MUSCULOSKELETAL: Redemonstration of sternal body, left scapular body, and L1 vertebral body fractures. Similar height loss of the L1 body burst fracture. CONCLUSION: 1. Postsurgical changes from left VATS with interval placement of two chest tubes. Decreased size of left pleural effusion. Small left pneumothorax. 2. Increased patchy consolidative opacities in the right upper and lower lobes concerning for pneumonia. 3. Evolving left pararenal hematoma with compression of the renal parenchyma by the subcapsular hematoma which is mildly enlarged since prior. Small interpolar laceration. There is hypoenhancement of the left kidney relative to the right suggesting decreased perfusion. 4. Additional traumatic injuries 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.
FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Endotracheal tube terminates in mid trachea. Postsurgical changes from left VATS. Decreased size of left pleural effusion with interval placement left thoracostomy tubes terminating in the posterior costodiaphragmatic recess and left lung apex. Small left pneumothorax. Decreased left lower lobe atelectasis. Patchy consolidative opacities in the right upper and lower lobes are increased from prior. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small retrosternal hematoma. Esophagogastric tube present. LYMPH NODES: None enlarged. CHEST WALL: Subcutaneous emphysema overlying the left chest wall and surrounding the left pectoralis muscles. Multiple skin staples in the left lateral chest wall. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Moderate left perirenal hematoma is mildly increased in size compared to prior. The hematoma compresses the left renal cortex. Small laceration is seen in the interpolar left kidney. The left kidney is hypoenhancing compared to the right. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube terminates in the stomach. The small bowel is normal in caliber. COLON / APPENDIX: Rectal tube in place. The colon is unremarkable. PERITONEUM / MESENTERY: Small volume free fluid in the pelvis. No organized fluid collection. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild anasarca. Small fat-containing umbilical hernia. MUSCULOSKELETAL: Redemonstration of sternal body, left scapular body, and L1 vertebral body fractures. Similar height loss of the L1 body burst fracture.
FINDINGS: BRAIN PARENCHYMA: Hyperattenuating right cerebellopontine angle mass with internal foci of hypoattenuation, measuring 3.9 x 5.2 x 3.7 cm in maximum dimensions (series 201 image 126). There is surrounding hypoattenuation consistent with edema. There is approximately 4 mm of inferior cerebellar tonsillar protrusion. Additionally there is effacement of the ambient cistern. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Dilation of the third and lateral ventricles with indwelling right frontal approach ventriculostomy catheter terminating in the third ventricle. Small foci of pneumocephalus overlying the right frontal lobe and within the anterior horn of the right lateral ventricle. VESSELS: No vascular calcifications. SKULL AND SKULL BASE: Right frontal ventriculostomy catheter postsurgical changes. ORBITS: Normal. SINUSES: Right maxillary mucus retention cysts. MASTOIDS: Clear. SOFT TISSUES: Right frontal scalp hematoma and subcutaneous emphysema.
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CT Head wo Contrast TECHNIQUE: CT of the head was performed without intravenous contrast at 2.5mm slice thickness. Scan field of view: 253 mm. DLP: 2477.20 mGy cm. INDICATION: Pontine hemorrhage COMPARISON: Outside CT of the head without contrast dated 1/8/2022 at 06:47 STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: Acute hemorrhage centered in the pons measuring 3.8 x 2.7 (series 206, image 58) with surrounding low-attenuation edema with partial effacement of the prepontine and interpeduncular cisterns. No suprapatellar tentorial parenchymal hemorrhage. There is moderate periventricular and subcortical white matter hypoattenuation, likely sequela of chronic microangiopathy. Unchanged chronic lacunar infarct within the left basal ganglia. EXTRA-AXIAL SPACES: No extra-axial fluid collection or hemorrhage. SKULL AND SKULL BASE: No fracture. Trace fluid is seen within the right mastoid air cells. The left mastoid air cells are clear. VENTRICULAR SYSTEM: The pontine hemorrhage extends into the expanded fourth ventricle as well as the third ventricle and posterior horns of the lateral ventricles. Mild to moderate hydrocephalus. Previously, the measurement across the anterior body of the lateral ventricles was 3.8 cm, now 4.7 cm. ORBITS: Normal. SINUSES: Mild mucosal thickening of the right maxillary sinus. The remaining visualized paranasal sinuses are clear. CONCLUSION: Large acute pontine hemorrhage with intraventricular extension, associated hydrocephalus, and developing inferior cerebellar tonsillar herniation Preliminary results were discussed with Dr. Jessica Edgar at 2:20 PM on 1/8/2022 by Dr. Mary Beth Oglesby. 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.
FINDINGS: BRAIN PARENCHYMA: Acute hemorrhage centered in the pons measuring 3.8 x 2.7 (series 206, image 58) with surrounding low-attenuation edema with partial effacement of the prepontine and interpeduncular cisterns. No suprapatellar tentorial parenchymal hemorrhage. There is moderate periventricular and subcortical white matter hypoattenuation, likely sequela of chronic microangiopathy. Unchanged chronic lacunar infarct within the left basal ganglia. EXTRA-AXIAL SPACES: No extra-axial fluid collection or hemorrhage. SKULL AND SKULL BASE: No fracture. Trace fluid is seen within the right mastoid air cells. The left mastoid air cells are clear. VENTRICULAR SYSTEM: The pontine hemorrhage extends into the expanded fourth ventricle as well as the third ventricle and posterior horns of the lateral ventricles. Mild to moderate hydrocephalus. Previously, the measurement across the anterior body of the lateral ventricles was 3.8 cm, now 4.7 cm. ORBITS: Normal. SINUSES: Mild mucosal thickening of the right maxillary sinus. The remaining visualized paranasal sinuses are clear.
FINDINGS: CT of the head with and without contrast: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. VESSELS: No vascular calcifications. SKULL AND SKULL BASE: No acute fracture. ORBITS: Normal. SINUSES: Indwelling Rapid Rhino epistaxis device. Enhancing lesion within the right nasopharynx extending into the right parapharyngeal space and retromaxillary fat measures approximately 4.0 x 2.9 cm x 2.5 in maximum dimensions (series 601 image 3, series 503 image 157). There is involvement and osseous destruction of the right pterygoid plates and body of the sphenoid. Multiple nonenhancing foci within the lesion likely represent necrosis. Postsurgical changes from prior resection with right antrectomy. Right maxillary and bilateral sphenoid sinus mucosal thickening with hyperattenuating contents consistent with hemorrhage. MASTOIDS: Clear. CT angiogram of the brain: RIGHT INTRACRANIAL CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT INTRACRANIAL CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation.
3,578
EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain COMPARISON: 1/2/2022 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Oral contrast Omnipaque: 16.9 oz. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 80 secs Scan field of view: 431 mm. DLP: 750.90 mGy cm. FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small right, trace left pleural effusions. Bilateral small pulmonary nodules measuring 2-3 cm in the lung bases are grossly unchanged. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Questionable cirrhotic morphology of the liver. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There are bilateral too small to characterize hypodensities, likely representing benign cysts. A stable left upper pole renal cyst is again noted. No hydronephrosis LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Multiple nondistended fluid-filled loops of small bowel, mildly more prominent compared to prior examination. There is new segmental distal small bowel thickening and edema seen in the right upper quadrant for instance on image 134, series 201. This likely extends approximately 10-15 cm in length and the segment involves the distal small bowel just proximal to the ileocolonic anastomosis. No pneumatosis is seen. COLON / APPENDIX: Post surgical changes status post right colectomy. Mixed solid and liquid stool within the colon. PERITONEUM / MESENTERY: Moderate ascites, mildly increased compared to prior examination. Similar appearance of small peritoneal nodules within the peritoneal folds in the pelvis. There is again scalloping of partially loculated ascites seen in Morison's pouch. RETROPERITONEUM: Presacral edema, similar prior examination. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Partially decompressed and poorly evaluated REPRODUCTIVE ORGANS: Prostamegaly with prostate calcifications. Prominent seminal vesicles, left greater right BODY WALL: Anterior abdominal wall posterior changes from prior colostomy, ileostomy. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. CONCLUSION: 1. New segmental small bowel edema involving the distal small bowel just proximal to the ileocolonic anastomosis, consistent with enteritis. This could be secondary to ischemia or possibly infectious/inflammatory. Biochemical correlation with lactic acidosis is recommended. No pneumatosis or free air is currently seen. 2. Mild interval increase in loculated ascites. Stable appearance of peritoneal nodularity concerning for peritoneal carcinomatosis. 3. Stable indeterminate bilateral pulmonary nodules. Metastasis is not excluded. Small right, trace left pleural effusions. 4. Stable findings as above including borderline cirrhotic morphology of liver and prostatomegaly. Note: Findings were discussed with Dr. Brown by Dr. Perchik at 1/8/2022 2:07 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.
FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small right, trace left pleural effusions. Bilateral small pulmonary nodules measuring 2-3 cm in the lung bases are grossly unchanged. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Questionable cirrhotic morphology of the liver. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There are bilateral too small to characterize hypodensities, likely representing benign cysts. A stable left upper pole renal cyst is again noted. No hydronephrosis LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Multiple nondistended fluid-filled loops of small bowel, mildly more prominent compared to prior examination. There is new segmental distal small bowel thickening and edema seen in the right upper quadrant for instance on image 134, series 201. This likely extends approximately 10-15 cm in length and the segment involves the distal small bowel just proximal to the ileocolonic anastomosis. No pneumatosis is seen. COLON / APPENDIX: Post surgical changes status post right colectomy. Mixed solid and liquid stool within the colon. PERITONEUM / MESENTERY: Moderate ascites, mildly increased compared to prior examination. Similar appearance of small peritoneal nodules within the peritoneal folds in the pelvis. There is again scalloping of partially loculated ascites seen in Morison's pouch. RETROPERITONEUM: Presacral edema, similar prior examination. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Partially decompressed and poorly evaluated REPRODUCTIVE ORGANS: Prostamegaly with prostate calcifications. Prominent seminal vesicles, left greater right BODY WALL: Anterior abdominal wall posterior changes from prior colostomy, ileostomy. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Interval increase in small bilateral pleural effusions, right larger than left. Diffuse bilateral pulmonary opacities and septal thickening appears similar. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Cardiomegaly with similar small pericardial effusion. Pacemaker noted. ABDOMEN and PELVIS: Exam markedly limited due to bilateral arm down positioning. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Sludge. PANCREAS: Similar pancreatic head calcifications, possibly sequela of chronic pancreatitis. SPLEEN: Normal. ADRENALS: Stable right adrenal nodule. KIDNEYS: No hydronephrosis or nephrolithiasis. LYMPH NODES: None enlarged. Calcified mediastinal nodes, likely sequela of prior granulomatous exposure. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Small volume ascites and diffuse mesenteric congestion. No free air. RETROPERITONEUM: Normal. VESSELS: Unchanged aortoiliac and branch vessel atherosclerotic calcifications. URINARY BLADDER: Collapsed around a Foley catheter. REPRODUCTIVE ORGANS: Fibroid uterus. BODY WALL: Similar marked anasarca. MUSCULOSKELETAL: Decreased osseous mineralization. Degenerative changes of the thoracolumbar spine.
3,579
EXAM: CT Abdomen and Pelvis wo IV contrast, CT Chest wo contrast CLINICAL INFORMATION: Status post orthotopic liver transplant. Fluid overload. COMPARISON: 1/2/2022 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast, CT Chest wo contrast. Scan field of view: 388 mm. DLP: 716.10 mGy cm FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP LOWER NECK: Right internal jugular central venous catheter, tip terminates in the SVC. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered bilateral, multi lobar groundglass opacities. Bilateral interlobular septal thickening. Small right, trace left pleural effusions. Central airways are patent. Prior tracheotomy changes are stable. HEART / VESSELS: Heart size is normal. Stable coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Stable gynecomastia. ABDOMEN and PELVIS: LIVER: Post transplant changes of the liver, overall stable in appearance. Evaluation limited without intravenous contrast. Redemonstration of perihepatic collection within the gallbladder fossa now with intermixed gas measuring 3.9 x 3.8 on series 401 image 249, previously 5.0 x 5.2 cm BILIARY TRACT: Biliary stent is stable in appearance. GALLBLADDER: Absent. PANCREAS: The peripancreatic collection appears less defined on today's examination but subjectively decreased in size compared to prior exam. Collection measures approximately 5.9 x 2.8 cm on series 401 image 254, previously 7.6 x 3.3 cm. This collection now contains internal gas. The more inferior aspect of the collection (series 401 image 297) is overall stable in appearance. SPLEEN: Stable splenomegaly. ADRENALS: Normal. KIDNEYS: Nonobstructing left renal calculus. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach and small bowel are normal in caliber. COLON / APPENDIX: Colon is normal in caliber. Appendix is not well seen. PERITONEUM / MESENTERY: Trace ascites. Perihepatic and peripancreatic collections as above. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Marked fluid within the scrotum, likely extension of ascitic fluid through the right inguinal canal, overall similar in extent to prior examination. BODY WALL: Anasarca. Stable rectus diastases. Right lateral abdominal wall fluid collection stable to mildly decreased in size. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. CONCLUSION: 1. Scattered bilateral groundglass opacities in the upper septal thickening concerning for multifocal pneumonia. 2. Small right, trace left pleural effusions. 3. Postsurgical changes status post orthotopic liver transplant with fluid collection in the gallbladder fossa. The gallbladder fossa collection is decreased in size compared to prior examination, however there has been increased gas within the collection. Correlate with history of instrumentation versus superimposed infection. 4. Decrease in size of the peripancreatic fluid collection, however with new internal gas concerning for infection or fistulization. 5. Stable to mildly decreased size of the right abdominal wall collection. 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.
FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP LOWER NECK: Right internal jugular central venous catheter, tip terminates in the SVC. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered bilateral, multi lobar groundglass opacities. Bilateral interlobular septal thickening. Small right, trace left pleural effusions. Central airways are patent. Prior tracheotomy changes are stable. HEART / VESSELS: Heart size is normal. Stable coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Stable gynecomastia. ABDOMEN and PELVIS: LIVER: Post transplant changes of the liver, overall stable in appearance. Evaluation limited without intravenous contrast. Redemonstration of perihepatic collection within the gallbladder fossa now with intermixed gas measuring 3.9 x 3.8 on series 401 image 249, previously 5.0 x 5.2 cm BILIARY TRACT: Biliary stent is stable in appearance. GALLBLADDER: Absent. PANCREAS: The peripancreatic collection appears less defined on today's examination but subjectively decreased in size compared to prior exam. Collection measures approximately 5.9 x 2.8 cm on series 401 image 254, previously 7.6 x 3.3 cm. This collection now contains internal gas. The more inferior aspect of the collection (series 401 image 297) is overall stable in appearance. SPLEEN: Stable splenomegaly. ADRENALS: Normal. KIDNEYS: Nonobstructing left renal calculus. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach and small bowel are normal in caliber. COLON / APPENDIX: Colon is normal in caliber. Appendix is not well seen. PERITONEUM / MESENTERY: Trace ascites. Perihepatic and peripancreatic collections as above. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Marked fluid within the scrotum, likely extension of ascitic fluid through the right inguinal canal, overall similar in extent to prior examination. BODY WALL: Anasarca. Stable rectus diastases. Right lateral abdominal wall fluid collection stable to mildly decreased in size. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
Findings: 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 significant hypodensity seen in the white matter. Posterior fossa contents appear normal. No defect is seen in the calvarium or skull base. There is cerumen in the right EAC. ----------------
3,580
EXAM: CT Abdomen and Pelvis wo IV contrast, CT Chest wo contrast CLINICAL INFORMATION: Status post orthotopic liver transplant. Fluid overload. COMPARISON: 1/2/2022 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast, CT Chest wo contrast. Scan field of view: 388 mm. DLP: 716.10 mGy cm FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP LOWER NECK: Right internal jugular central venous catheter, tip terminates in the SVC. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered bilateral, multi lobar groundglass opacities. Bilateral interlobular septal thickening. Small right, trace left pleural effusions. Central airways are patent. Prior tracheotomy changes are stable. HEART / VESSELS: Heart size is normal. Stable coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Stable gynecomastia. ABDOMEN and PELVIS: LIVER: Post transplant changes of the liver, overall stable in appearance. Evaluation limited without intravenous contrast. Redemonstration of perihepatic collection within the gallbladder fossa now with intermixed gas measuring 3.9 x 3.8 on series 401 image 249, previously 5.0 x 5.2 cm BILIARY TRACT: Biliary stent is stable in appearance. GALLBLADDER: Absent. PANCREAS: The peripancreatic collection appears less defined on today's examination but subjectively decreased in size compared to prior exam. Collection measures approximately 5.9 x 2.8 cm on series 401 image 254, previously 7.6 x 3.3 cm. This collection now contains internal gas. The more inferior aspect of the collection (series 401 image 297) is overall stable in appearance. SPLEEN: Stable splenomegaly. ADRENALS: Normal. KIDNEYS: Nonobstructing left renal calculus. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach and small bowel are normal in caliber. COLON / APPENDIX: Colon is normal in caliber. Appendix is not well seen. PERITONEUM / MESENTERY: Trace ascites. Perihepatic and peripancreatic collections as above. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Marked fluid within the scrotum, likely extension of ascitic fluid through the right inguinal canal, overall similar in extent to prior examination. BODY WALL: Anasarca. Stable rectus diastases. Right lateral abdominal wall fluid collection stable to mildly decreased in size. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. CONCLUSION: 1. Scattered bilateral groundglass opacities in the upper septal thickening concerning for multifocal pneumonia. 2. Small right, trace left pleural effusions. 3. Postsurgical changes status post orthotopic liver transplant with fluid collection in the gallbladder fossa. The gallbladder fossa collection is decreased in size compared to prior examination, however there has been increased gas within the collection. Correlate with history of instrumentation versus superimposed infection. 4. Decrease in size of the peripancreatic fluid collection, however with new internal gas concerning for infection or fistulization. 5. Stable to mildly decreased size of the right abdominal wall collection. 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.
FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP LOWER NECK: Right internal jugular central venous catheter, tip terminates in the SVC. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered bilateral, multi lobar groundglass opacities. Bilateral interlobular septal thickening. Small right, trace left pleural effusions. Central airways are patent. Prior tracheotomy changes are stable. HEART / VESSELS: Heart size is normal. Stable coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Stable gynecomastia. ABDOMEN and PELVIS: LIVER: Post transplant changes of the liver, overall stable in appearance. Evaluation limited without intravenous contrast. Redemonstration of perihepatic collection within the gallbladder fossa now with intermixed gas measuring 3.9 x 3.8 on series 401 image 249, previously 5.0 x 5.2 cm BILIARY TRACT: Biliary stent is stable in appearance. GALLBLADDER: Absent. PANCREAS: The peripancreatic collection appears less defined on today's examination but subjectively decreased in size compared to prior exam. Collection measures approximately 5.9 x 2.8 cm on series 401 image 254, previously 7.6 x 3.3 cm. This collection now contains internal gas. The more inferior aspect of the collection (series 401 image 297) is overall stable in appearance. SPLEEN: Stable splenomegaly. ADRENALS: Normal. KIDNEYS: Nonobstructing left renal calculus. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach and small bowel are normal in caliber. COLON / APPENDIX: Colon is normal in caliber. Appendix is not well seen. PERITONEUM / MESENTERY: Trace ascites. Perihepatic and peripancreatic collections as above. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Marked fluid within the scrotum, likely extension of ascitic fluid through the right inguinal canal, overall similar in extent to prior examination. BODY WALL: Anasarca. Stable rectus diastases. Right lateral abdominal wall fluid collection stable to mildly decreased in size. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small right pleural effusion with bilateral dependent atelectasis. No focal consolidation. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Normal in size. Redemonstrated severe three-vessel coronary artery calcifications and postsurgical changes of CABG. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. No focal lesion. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Benign cyst in the upper pole of the right kidney. Left kidney is unremarkable. No hydronephrosis or renal calculus bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Mild wall thickening and adjacent fat stranding of the gastric antrum and proximal duodenum. No small bowel dilation or obstruction. COLON / APPENDIX: No abnormality. The appendix is normal. Moderate fecal burden. PERITONEUM / MESENTERY: Trace free fluid. No intraperitoneal free air. RETROPERITONEUM: Normal. VESSELS: Mild scattered atherosclerotic calcifications of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small bilateral fat-containing inguinal hernias. MUSCULOSKELETAL: No significant abnormality. Unchanged median sternotomy wires..
3,581
RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Assault with loss of consciousness, pistol whip COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 249 mm. DLP: 1396 mGy cm. (accession CT220004248), Scan field of view: 261 mm. DLP: 1122 mGy cm. (accession CT220004249) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: No acute orbital abnormality. Mildly displaced right orbital floor fracture with associated herniation of a small amount of intraorbital fat. There is also fracture of the right lamina papyracea/medial orbital wall. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Moderate mucosal thickening of the right maxillary sinus with trace mucosal thickening of the left maxillary and right frontal sinuses . CONCLUSION: 1. No acute intracranial abnormality. 2. Fractures of the right orbital floor and right medial orbital wall/lamina papyracea, likely at least subacute fractures. 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. Right orbital floor and medial orbital wall fractures are likely recent/subacute.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: No acute orbital abnormality. Mildly displaced right orbital floor fracture with associated herniation of a small amount of intraorbital fat. There is also fracture of the right lamina papyracea/medial orbital wall. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Moderate mucosal thickening of the right maxillary sinus with trace mucosal thickening of the left maxillary and right frontal sinuses .
FINDINGS/IMPRESSION: 1. Partially healed comminuted ballistic fracture of the left distal tibia. Nonunited fracture lines communicate with the marrow cavity where sclerotic bone fragments are seen, indicating chronic osteomyelitis. 2. Periosteal reaction, involving the distal tibial diametaphysis and extending to the tibial plafond, sinus tract extending through the medial tibial cortex. The findings indicate chronic osteomyelitis with acute component distally. 3. Skin, subcutaneous, and deep soft tissue swelling, extending to bone, with foci of gas in the medial ankle soft tissues. Trace gas is seen along the anterior ankle soft tissues in absence of recent intervention gas forming infection is not excluded. MR is ordered at the time of this interpretation.
3,582
RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Assault with loss of consciousness, pistol whip COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 249 mm. DLP: 1396 mGy cm. (accession CT220004248), Scan field of view: 261 mm. DLP: 1122 mGy cm. (accession CT220004249) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: No acute orbital abnormality. Mildly displaced right orbital floor fracture with associated herniation of a small amount of intraorbital fat. There is also fracture of the right lamina papyracea/medial orbital wall. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Moderate mucosal thickening of the right maxillary sinus with trace mucosal thickening of the left maxillary and right frontal sinuses . CONCLUSION: 1. No acute intracranial abnormality. 2. Fractures of the right orbital floor and right medial orbital wall/lamina papyracea, likely at least subacute fractures. 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. Right orbital floor and medial orbital wall fractures are likely recent/subacute.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: No acute orbital abnormality. Mildly displaced right orbital floor fracture with associated herniation of a small amount of intraorbital fat. There is also fracture of the right lamina papyracea/medial orbital wall. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Normal. MANDIBLE: Normal. SINONASAL CAVITIES: Moderate mucosal thickening of the right maxillary sinus with trace mucosal thickening of the left maxillary and right frontal sinuses .
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: No focal consolidation or pleural effusion. 6 mm noncalcified nodule in the left lower lung (image 48, series 301), previously 5 mm. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: The heart is normal in size. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. No focal hepatic lesion. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing 4 mm renal calculus in the lower pole of the right kidney. No hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticula. Wall thickening of the sigmoid colon with adjacent ill-defined fat stranding. The appendix is normal. PERITONEUM / MESENTERY: No free fluid or intraperitoneal free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
3,583
CT Angio Head wo+w contrast 1/8/2022 6:03 PM Clinical information: 68 years Male patient with Occlusion of ICA on imaging MRI thought to be chronic Spec Inst: There is .br occlusion of the right petrocavernous ICA. Comparison: MRI brain with and without contrast dated 1/6/2022. 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: 288 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 3.80 ml per sec. Scan delay: bolus tracked, 300s ec Scan field of view: 238 mm. DLP: 2919 mGy cm. FINDINGS: VASCULAR FINDINGS: Intracranial internal carotid arteries: Lack of contrast opacification involving the visualized right internal carotid artery. The left ICA remains patent with no hemodynamically significant stenosis. Anterior cerebral arteries: Slightly hypoplastic right A1 segment, filling via the anterior communicating artery. 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: No large aneurysm or vascular malformation identified. Dominant right dural venous sinus system. NONVASCULAR FINDINGS: Ill-defined hypoattenuation along the right mesial temporal lobe suggestive of postictal edema, is better characterized in prior MRI of the brain. Persistent mild diffuse age-appropriate brain parenchymal volume loss, resulting in mild exvacuo dilatation of the ventricular system. Confluent periventricular and scattered subcortical white matter hypoattenuation is unchanged, suggestive of moderate chronic microvascular ischemic disease, with remote lacunar infarct in the right centrum semiovale. There is no abnormal enhancement, intracranial hemorrhage, 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. Unchanged bilateral lens replacements. The orbits are grossly normal in appearance. No acute fracture or suspicious osseous lesion is identified. The paranasal sinuses are well-developed and clear. IMPRESSION: 1. Ill-defined hypoattenuation along the right mesial temporal lobe suggestive of postictal edema, is better characterized in prior MRI of the brain. 2. Persistent age-appropriate brain involution and moderate chronic microvascular ischemic disease, with remote right corona radiata lacunar infarct. 3. Lack of contrast opacification involving the visualized right internal carotid artery, suggestive of remote occlusion. 4. Otherwise patency of the remaining intracranial arteries, without acute vascular injury or flow-limiting stenosis.
FINDINGS: VASCULAR FINDINGS: Intracranial internal carotid arteries: Lack of contrast opacification involving the visualized right internal carotid artery. The left ICA remains patent with no hemodynamically significant stenosis. Anterior cerebral arteries: Slightly hypoplastic right A1 segment, filling via the anterior communicating artery. 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: No large aneurysm or vascular malformation identified. Dominant right dural venous sinus system. NONVASCULAR FINDINGS: Ill-defined hypoattenuation along the right mesial temporal lobe suggestive of postictal edema, is better characterized in prior MRI of the brain. Persistent mild diffuse age-appropriate brain parenchymal volume loss, resulting in mild exvacuo dilatation of the ventricular system. Confluent periventricular and scattered subcortical white matter hypoattenuation is unchanged, suggestive of moderate chronic microvascular ischemic disease, with remote lacunar infarct in the right centrum semiovale. There is no abnormal enhancement, intracranial hemorrhage, 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. Unchanged bilateral lens replacements. The orbits are grossly normal in appearance. No acute fracture or suspicious osseous lesion is identified. The paranasal sinuses are well-developed and clear.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Calcified right lung base granuloma and small areas of linear atelectasis in the lung bases. DISTAL ESOPHAGUS: Small sliding hiatal hernia. Residual hyperdense contrast overlies posterior to the gastroesophageal junction, unchanged from 2020. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Moderate common bile duct dilatation without intrahepatic biliary dilatation. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Calcified granulomas. Otherwise normal spleen. ADRENALS: Normal. KIDNEYS: Simple left renal cyst. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small duodenal diverticulum. Otherwise normal stomach and small bowel. COLON / APPENDIX: No abnormality. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: No significant abnormality. No breast implant abnormality is identified. MUSCULOSKELETAL: Left iliac bone island and patchy bone demineralization is present without focal destructive lesion.
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CLINICAL HISTORY: fu swelling EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 206 mm. DLP: 1031 mGy cm. COMPARISON: 1/5/2022 FINDINGS: Large acute right frontal lobe hemorrhage is stable in size. There is large amount of edema within the right frontal lobe and extending into the right basal ganglia without interval change. There is significant mass effect resulting in significant effacement of the right lateral ventricle. There is also significant midline shift measuring 1.5 cm. Previously measured 1.5 cm when remeasured by me. There is small amount of IVH within the left occipital horn and mild enlargement of the left temporal horn suggesting partial entrapment There is no new hemorrhage or infarction. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. CONCLUSION: 01. Stable appearing large right frontal lobe hemorrhage with large amount of adjacent edema. There is stable moderate to severe right to left midline shift 02. Stable small amount of IVH within the left occipital horn. Partial entrapment of the left lateral ventricle with mild hydrocephalus.
FINDINGS: Large acute right frontal lobe hemorrhage is stable in size. There is large amount of edema within the right frontal lobe and extending into the right basal ganglia without interval change. There is significant mass effect resulting in significant effacement of the right lateral ventricle. There is also significant midline shift measuring 1.5 cm. Previously measured 1.5 cm when remeasured by me. There is small amount of IVH within the left occipital horn and mild enlargement of the left temporal horn suggesting partial entrapment There is no new hemorrhage or infarction. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
Findings: There is slight diffuse atrophy but the ventricles are not enlarged. There is no mass, hemorrhage or extracerebral collection. There is preservation of gray-white margins. No hypodensity seen in the white matter. The posterior fossa contents are unremarkable. There are retention cysts in the left maxillary sinus and there is slight mucosal thickening in the right antrum. The remainder the paranasal sinuses, mastoids and middle ears are clear. No defect is seen in the calvarium or skull base. Compared to prior scan on 6/1/2015 there is no significant change. ---------------
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CLINICAL HISTORY: thalamic lesion Spec Inst: stealth protocol EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 246 mm. DLP: 1154 mGy cm. COMPARISON: 1/8/2022 at 10:51 FINDINGS: There is again small burr hole within the right frontal bone. Acute hemorrhage associated with cystlike lesion in the right basal ganglia and insula is not significantly changed in size since exam from earlier today. The hemorrhage within the lesion measures 31 x 26 mm, previously measured 31 x 27 mm. The larger hypodense lesion measures approximately 41 x 31 mm without significant interval change. There is mild adjacent subarachnoid hemorrhage, possibly minimally increased. There is slightly decreased postprocedural gas overlying the right frontal lobe. There is stable adjacent vasogenic edema. There is stable mass effect upon the right lateral ventricle. There is stable slight right to left midline shift The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. CONCLUSION: 01. Stable acute hemorrhage within known lesion after biopsy. There is stable or minimally increased adjacent subarachnoid hemorrhage. 02. There is grossly stable hyperdense cyst like lesion within the right basal ganglia and insula with adjacent vasogenic edema resulting in mild right to left midline shift. No acute hemorrhage
FINDINGS: There is again small burr hole within the right frontal bone. Acute hemorrhage associated with cystlike lesion in the right basal ganglia and insula is not significantly changed in size since exam from earlier today. The hemorrhage within the lesion measures 31 x 26 mm, previously measured 31 x 27 mm. The larger hypodense lesion measures approximately 41 x 31 mm without significant interval change. There is mild adjacent subarachnoid hemorrhage, possibly minimally increased. There is slightly decreased postprocedural gas overlying the right frontal lobe. There is stable adjacent vasogenic edema. There is stable mass effect upon the right lateral ventricle. There is stable slight right to left midline shift The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Atelectasis involving the bilateral lung bases has improved. DISTAL ESOPHAGUS: Multiple prominent paraesophageal lymph nodes. The largest measures 2.2 x 1.2 cm, similar to prior (series 2 image 52). There are small varices. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Unchanged cyst in the left hepatic lobe. No suspicious liver lesion. Mild liver surface nodularity. See comments on portal venous system below. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Stable splenomegaly. Indeterminate subcentimeter cyst in the posterior aspect of the spleen. ADRENALS: Normal. KIDNEYS: Multiple small benign cysts in the kidneys. LYMPH NODES: Enlarged periportal lymph node is redemonstrated and appears similar, measuring 16 x 28 mm (series 11, image 134) from 16 x 25 mm. Prominent paraesophageal lymph nodes as described above. STOMACH / SMALL BOWEL: Redemonstrated small bowel-small bowel anastomosis is patent. No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Multiple prominent mesenteric lymph nodes measuring up to 12 x 11 mm, for example image 26 series 11. No ascites. RETROPERITONEUM: Normal. VESSELS: Previously identified nonocclusive thrombus involving the splenic vein and SMV has resolved. However, there is a small nonocclusive filling defect in the lower SMV (series 11 image 181). The main portal vein is patent. Previously seen thrombus in the upper right portal vein has decreased in size. No arterial abnormality. . BODY WALL: Anasarca has improved from prior. Tiny fat-containing umbilical hernia. Tiny supraumbilical ventral midline abdominal hernia containing fat. MUSCULOSKELETAL: No aggressive osseous lesion.
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EXAM: CT Tib Fib Right with contrast CLINICAL INFORMATION: History of calf sarcoma S/P resection/radiation. COMPARISON: None. TECHNIQUE: CT Tib Fib Right with contrast Patient weight: 194 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 5 min sec. Scan field of view: 250 mm. DLP: 542 mGy cm. STRUCTURED REPORT: CT Bone vDec2021 FINDINGS: BONES/JOINTS: No acute fracture or malalignment. No periostitis or erosion. No aggressive osseous lesion. SOFT TISSUES: Postsurgical changes in the proximal posterior calf with skin thickening at the level of the resection bed. There is subtle enhancement with fascial thickening of the posterior proximal calf. No discrete mass or enhancing lesion, although, CT is suboptimal for the evaluation of residual disease. CONCLUSION: Postsurgical/postradiation changes in the proximal posterior calf with cutaneous and fascial thickening and enhancement. Although no discrete mass is identified on CT, MRI is a more sensitive study for evaluation of residual/recurrent soft tissue sarcoma, and correlation with MRI with and without contrast is recommended as indicated. 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.
FINDINGS: BONES/JOINTS: No acute fracture or malalignment. No periostitis or erosion. No aggressive osseous lesion. SOFT TISSUES: Postsurgical changes in the proximal posterior calf with skin thickening at the level of the resection bed. There is subtle enhancement with fascial thickening of the posterior proximal calf. No discrete mass or enhancing lesion, although, CT is suboptimal for the evaluation of residual disease.
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: Enlarged mesenteric and right lower abdomen lymph nodes measuring up to 1.2 cm (image 171, series 201). STOMACH / SMALL BOWEL: No gastric or small bowel obstruction. COLON / APPENDIX: The appendix is dilated to 1.2 cm (image 216, series 201. There is discontinuity of the appendiceal wall with contained perforation/abscess about the appendiceal orifice and medial cecum measuring approximately 6.8 x 3.5 cm. This walled off collection contains gas. Small volume free fluid tracks into the dependent pelvis. PERITONEUM / MESENTERY: Mesenteric abscess about the cecum and appendiceal orifice, as above. Small volume dependent free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The ovaries are normal in size bilaterally. The uterus is normal in size. The walled off collection about the cecum and appendix abuts the right ovary without definite involvement. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Chest with contrast CLINICAL INFORMATION: COVID 19 with history of right calf sarcoma status post resection and radiation. Rule out local recurrence and metastatic disease. COMPARISON: CT chest 5/6/2020 TECHNIQUE: CT Chest with contrast. Patient weight: 194 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 35 sec. Scan field of view: 445 mm. DLP: 479 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Left thyroid lobe nodule measuring 1.1 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Mild bilateral peribronchial thickening. Heterogeneously enhancing right hilar and paramediastinal mass measuring 9.8 x 7.0 cm (series 201, image 67) with associated narrowing of the left upper lobe bronchus. The mass also extends within the left major fissure. Patchy peripheral groundglass opacities in the bilateral lungs. HEART / VESSELS: Severe narrowing of the left superior pulmonary vein and mild narrowing of the left inferior pulmonary vein. Mild narrowing of lingular subsegmental pulmonary arteries. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: The left hilar mass appears to involve multiple confluent hilar lymph nodes. Enlarged mediastinal lymph nodes are also seen. For example, a subcarinal lymph node measures 1.3 cm in short axis (series 201, image 61). CHEST WALL: No significant abnormality. UPPER ABDOMEN: Hepatic steatosis. MUSCULOSKELETAL: No aggressive osseous lesions. Mild multilevel degenerative changes of the thoracic spine. CONCLUSION: 1. Large left hilar and paramediastinal mass with associated mass effect on the left upper lobe bronchus and pulmonary veins as above. Mass compared to represent multiple enlarged confluent lymph nodes concerning for metastatic disease. 2. Mediastinal lymphadenopathy also concerning for metastasis. 3. Patchy groundglass opacities scattered in the bilateral lungs consistent with history of COVID 19 pneumonia. 4. Hepatic steatosis. 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.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Left thyroid lobe nodule measuring 1.1 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Mild bilateral peribronchial thickening. Heterogeneously enhancing right hilar and paramediastinal mass measuring 9.8 x 7.0 cm (series 201, image 67) with associated narrowing of the left upper lobe bronchus. The mass also extends within the left major fissure. Patchy peripheral groundglass opacities in the bilateral lungs. HEART / VESSELS: Severe narrowing of the left superior pulmonary vein and mild narrowing of the left inferior pulmonary vein. Mild narrowing of lingular subsegmental pulmonary arteries. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: The left hilar mass appears to involve multiple confluent hilar lymph nodes. Enlarged mediastinal lymph nodes are also seen. For example, a subcarinal lymph node measures 1.3 cm in short axis (series 201, image 61). CHEST WALL: No significant abnormality. UPPER ABDOMEN: Hepatic steatosis. MUSCULOSKELETAL: No aggressive osseous lesions. Mild multilevel degenerative changes of the thoracic spine.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: There is a 3 x 3 mm noncalcified nodule in the lingula (image 25 series 4). DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: There are small cysts and subcentimeter hypodensities in the liver, also likely representing small cysts. Normal liver morphology. BILIARY TRACT: Normal. GALLBLADDER: Multiple subcentimeter enhancing polyps are seen along the gallbladder wall. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Small focal area of scarring posteriorly in the mid upper right kidney. A calcification at the periphery of this seems to be in the parenchyma. Kidneys are otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate is mildly enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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CLINICAL HISTORY: Stroke EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 215 mm. DLP: 1469 mGy cm. COMPARISON: 1/2/2022 FINDINGS: Examination is degraded by motion artifact. There is a large new area of hypoattenuation involving the posterior left temporal lobe and left parietal lobe representing subacute posterior left MCA infarction. There is no hemorrhagic conversion. There is mild focal mass effect upon the left lateral ventricle and there is also focal sulcal effacement. There is however no midline shift. There is no hydrocephalus.. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. CONCLUSION: Large subacute posterior left MCA infarction. No hemorrhagic conversion. There is focal mass effect but no midline shift.
FINDINGS: Examination is degraded by motion artifact. There is a large new area of hypoattenuation involving the posterior left temporal lobe and left parietal lobe representing subacute posterior left MCA infarction. There is no hemorrhagic conversion. There is mild focal mass effect upon the left lateral ventricle and there is also focal sulcal effacement. There is however no midline shift. There is no hydrocephalus.. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
Findings: Conventional CT scan of the brain a large right CP angle mass measuring 3.9 x 5 cm, slightly hyperdense with multiple small internal cysts. There is compression and displacement of the fourth ventricle. There is a right frontal shunt tube and the third and lateral ventricles are decompressed. Postcontrast scans show slight irregular enhancement of the mass. The right porous acusticus is covered but the IAC is not enlarged. The differential includes schwannoma, atypical meningioma and hemangioblastoma CTA brain: There is slight hypervascularity of the large right CP angle tumor with multiple internal vessels. Supplies primarily from the right PICA with likely partial supply from the right AICA and right superior cerebellar artery. The carotid siphons, suprasellar ICAs and the proximal ACAs MCA's and PCAs are unremarkable. The basilar artery is also unremarkable. See the concurrent cranial MR scan. ----------------
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CT Head wo contrast 1/10/2022 1:02 AM Clinical Information: cerebellar mass Spec Inst: stealth Comparison: 1/8/2022 Technique: Unenhanced axial brain CT. Scan field of view: 216 mm. DLP: 1194 mGy cm. Findings: Stable postsurgical changes are noted in the posterior fossa. There is a hypodense nodule in the surgical bed anteroinferiorly. There is mild diffuse edema in the vermis. There is right frontal approach ventriculostomy catheter, coursing through the septum pellucidum and terminates in the left lateral ventricle. There is a small pneumocephalus in the bilateral lateral ventricles and right temporal horn. There is a trace intraventricular hemorrhage, layered in the posterior horns. There is moderate air lucencies in the posterior aspect of the neck and occipital soft tissues, likely due to the postsurgical. Impression: This study is performed as a Stealth protocol. Stable postsurgical changes in the posterior fossa with nodular hypodense lesion in the surgical bed. Stable right frontal approach ventriculostomy catheter without hydrocephalus. Small pneumocephalus and trace intraventricular hemorrhage, unchanged from the prior study.
Findings: Stable postsurgical changes are noted in the posterior fossa. There is a hypodense nodule in the surgical bed anteroinferiorly. There is mild diffuse edema in the vermis. There is right frontal approach ventriculostomy catheter, coursing through the septum pellucidum and terminates in the left lateral ventricle. There is a small pneumocephalus in the bilateral lateral ventricles and right temporal horn. There is a trace intraventricular hemorrhage, layered in the posterior horns. There is moderate air lucencies in the posterior aspect of the neck and occipital soft tissues, likely due to the postsurgical.
Findings: Brain parenchyma: Minimal residual hyperattenuation in the previously seen left frontal intraparenchymal hematoma, with surrounding maturing left frontal/pericallosal and left temporal encephalomalacia/gliosis. Ventricular system: Unchanged right frontal ventriculostomy catheter terminating in the right frontal horn, with slight interval decrease in the ventricular system caliber, measuring up to 33 mm at the level of the septum pellucidum, (previously measured 39.4 mm), with near complete resolution of dependent minimal intraventricular hemorrhage. Unchanged ex vacuo dilatation of the left lateral ventricle temporal horn. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No new intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Persistent atherosclerotic calcifications of the bilateral carotid siphons. Soft tissues: Unremarkable without discrete fluid collections. Orbits: Normal appearance. Calvarium and skull base: Unchanged bilateral frontal burr hole's. No acute fractures or suspicious osseous lesions identified. The bilateral mastoid air cell complexes are well-developed and clear. Paranasal sinuses: Well aerated.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: Persisting cough after stem cell transplant. History of pleural effusions. COMPARISON: 9/3/2021 TECHNIQUE: CT Chest wo contrast. Scan field of view: 442 mm. DLP: 308 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Interval development of a pulmonary abscess in the right lower lobe which measures approximately 4.1 cm on series 3, image 54. There is a small right pleural effusion and patchy tree-in-bud opacities in the right lung base. Additional areas of consolidation are noted in the right upper lobe, including two nodular areas of consolidation in the right lung apex that were present on prior exam. The left lung is clear. HEART / VESSELS: Port catheter terminates in the SVC. Scattered coronary artery calcifications. Small pericardial effusion. Normal heart size. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Interval development of multifocal consolidations in the right lung with a right lower lobe pulmonary abscess. Small right pleural effusion.
FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Interval development of a pulmonary abscess in the right lower lobe which measures approximately 4.1 cm on series 3, image 54. There is a small right pleural effusion and patchy tree-in-bud opacities in the right lung base. Additional areas of consolidation are noted in the right upper lobe, including two nodular areas of consolidation in the right lung apex that were present on prior exam. The left lung is clear. HEART / VESSELS: Port catheter terminates in the SVC. Scattered coronary artery calcifications. Small pericardial effusion. Normal heart size. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Mild bibasilar atelectasis or scarring. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild cardiomegaly. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: Mild irregularity of multiple renal calyces. No filling defect in the upper urinary tract. URINARY BLADDER: Urinary bladder is markedly distended with fluid and has mild urinary bladder wall trabeculation. LIVER: Normal. BILIARY TRACT: Moderate to severe bilateral intrahepatic biliary ductal dilatation, despite the presence of a common bile duct stent which appears to be directed into the parenchyma of the medial left hepatic lobe. GALLBLADDER: Collapsed. PANCREAS: Normal. SPLEEN: Atrophic and calcified. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. REPRODUCTIVE ORGANS: Prostate is mildly enlarged. BODY WALL: Normal. MUSCULOSKELETAL: Severe scoliotic deformity of the spine. Heterogeneous appearance of the bones likely due to known sickle cell disease and thalassemia.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Dyspnea with concern for pulmonary embolus. COMPARISON: CT chest 12/31/2021 TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 124 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus tracked Scan field of view: 283 mm. KVP: 100 DLP: 157.90 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: Unchanged 1.0 cm left thyroid lobe nodule. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: The lung bases are incompletely imaged. Respiratory motion degradation in the lung bases. Unchanged appearance of small right Bochdalek diaphragmatic hernia. Right middle lobe calcified granuloma. No focal airspace consolidation or pleural effusion. Biapical pleuroparenchymal scarring with calcifications. HEART / OTHER VESSELS: Moderate coronary artery atherosclerotic calcifications. The heart, pulmonary artery, and thoracic aorta are normal in size. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. MEDIASTINUM / ESOPHAGUS: Fluid in the esophagus can be seen with gastroesophageal reflux. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Mildly displaced fractures of the anterior left second-sixth ribs. Partially imaged inferior cervical ACDF hardware. Postsurgical changes from T5 to T6 laminectomies. CONCLUSION: 1. No evidence of acute pulmonary embolus. 2. Mildly displaced fractures of the left anterior second through sixth ribs. These are slightly more displaced or new from the prior exam dated 12/31/2021. No large pneumothorax. 3. Indeterminate left thyroid nodule. Nonemergent thyroid ultrasound recommended, as clinically indicated. 4. 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.
FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: Unchanged 1.0 cm left thyroid lobe nodule. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: The lung bases are incompletely imaged. Respiratory motion degradation in the lung bases. Unchanged appearance of small right Bochdalek diaphragmatic hernia. Right middle lobe calcified granuloma. No focal airspace consolidation or pleural effusion. Biapical pleuroparenchymal scarring with calcifications. HEART / OTHER VESSELS: Moderate coronary artery atherosclerotic calcifications. The heart, pulmonary artery, and thoracic aorta are normal in size. Mild atherosclerotic disease of the thoracic aorta and proximal arch vessels. MEDIASTINUM / ESOPHAGUS: Fluid in the esophagus can be seen with gastroesophageal reflux. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Mildly displaced fractures of the anterior left second-sixth ribs. Partially imaged inferior cervical ACDF hardware. Postsurgical changes from T5 to T6 laminectomies.
FINDINGS: STRUCTURED REPORT: CTA Upper Extremity FINDINGS: VASCULATURE: AORTIC ARCH: No significant abnormality. PROXIMAL ASPECT OF ARCH VESSELS: No significant abnormality. RIGHT BRACHIOCEPHALIC ARTERY: No significant abnormality. RIGHT SUBCLAVIAN ARTERY: Occlusion of the right subclavian artery about 1.5 cm distal to the take off of the right vertebral artery. There is reconstitution of the vessel which is diminutive in caliber. RIGHT AXILLARY ARTERY: Diminutive in caliber but patent RIGHT BRACHIAL ARTERY: Diminutive in caliber but patent. There is indentation of the right upper extremity the elbow. OTHER VASCULATURE: No significant abnormality. PARTIALLY IMAGED HEAD AND NECK: No abnormality. PARTIALLY IMAGED CHEST: Comminuted fracture of the right scapula involving the coracoid process, glenoid and acromion. Remote deformity of the right first rib and clavicle. Unchanged pulmonary cyst in the right lower lobe.. SUPERFICIAL SOFT TISSUES: Large right axillary hematoma, similar to the prior examination. No active extravasation of contrast is identified. Diffuse inflammatory stranding of the soft tissues of the right chest wall and axillary region. Imaging of the upper abdomen is remarkable for small hemangioma in the right hepatic dome. Stable mild intrahepatic biliary dilatation.
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CLINICAL HISTORY: subdural hematoma and thrombocytoepneic EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 203 mm. DLP: 958 mGy cm. COMPARISON: 1/7/2022 FINDINGS: There is mildly increased size of extra-axial hemorrhages overlying the right parietal lobe which measures approximately 12 mm in thickness and also right frontal lobe which measures 5 mm in thickness. The right parietal lobe lobe subdural hemorrhage previously measured 8 mm in thickness. No definite right frontal lobe subdural hemorrhage is identified on the prior exam. There are no abnormal areas of hypoattenuation to suggest acute infarction. There is a remote superior left cerebellar infarction. There is moderate generalized atrophy with proportionate enlargement of the ventricles. There are also moderate periventricular hypodensities reflecting microangiopathic changes. There are also moderate atherosclerotic calcifications of the distal ICAs bilaterally. There is no mass effect. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. CONCLUSION: 01. Mild interval enlargement of acute subdural hemorrhage overlying the right parietal lobe with slight focal mass effect. There is also new small right frontal lobe subdural hemorrhage. 02. No midline shift. 03. No acute parenchymal abnormality. Stable moderate generalized atrophy and microangiopathic changes
FINDINGS: There is mildly increased size of extra-axial hemorrhages overlying the right parietal lobe which measures approximately 12 mm in thickness and also right frontal lobe which measures 5 mm in thickness. The right parietal lobe lobe subdural hemorrhage previously measured 8 mm in thickness. No definite right frontal lobe subdural hemorrhage is identified on the prior exam. There are no abnormal areas of hypoattenuation to suggest acute infarction. There is a remote superior left cerebellar infarction. There is moderate generalized atrophy with proportionate enlargement of the ventricles. There are also moderate periventricular hypodensities reflecting microangiopathic changes. There are also moderate atherosclerotic calcifications of the distal ICAs bilaterally. There is no mass effect. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
FINDINGS: There is scattered colonic diverticulosis. No additional significant incidental finding is identified in this limited study.
3,593
CT Head wo Contrast TECHNIQUE: CT of the head was performed without intravenous contrast at 2.5mm slice thickness. Scan field of view: 251 mm. DLP: 1426 mGy cm. INDICATION: altered mental status, rule out CVA COMPARISON: MRA of the brain dated 11/1/2021; CT sinus dated 4/6/2016 STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. There is mild diffuse cerebral volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Under pneumatization of the right mastoid air cells which are clear. The left mastoid air cells are also clear. There is calcified atherosclerosis of the cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Small Septum cavum pellucidum et vergae, normal congenital variant. No hydrocephalus ORBITS: No acute orbital abnormality. Bilateral lens replacements. SINUSES: Mild mucosal thickening of the left sphenoid sinus and anterior ethmoidal air cells. Soft tissue density in the left external auditory canal likely represents impacted cerumen. CONCLUSION: 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. There is mild diffuse cerebral volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Under pneumatization of the right mastoid air cells which are clear. The left mastoid air cells are also clear. There is calcified atherosclerosis of the cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Small Septum cavum pellucidum et vergae, normal congenital variant. No hydrocephalus ORBITS: No acute orbital abnormality. Bilateral lens replacements. SINUSES: Mild mucosal thickening of the left sphenoid sinus and anterior ethmoidal air cells. Soft tissue density in the left external auditory canal likely represents impacted cerumen.
Previously noted mediastinal adenopathy is stable. Bilateral interstitial disease has worsened, without evidence of traction bronchiectasis or honey comb change The pulmonary trunk measures 30 mm, larger from 26 mm in the prior scan There is no significant pleural disease. Coronary arterial calcification: None Visualized thoracic skeleton is unremarkable. Noncontrast views of the upper abdomen are unremarkable.
3,594
EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Shortness of breath, hypoxia. History of COVID. Evaluate for pulmonary embolus COMPARISON: 5/8/2021 TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 204 lbs. IV contrast: Omnipaque 350, 62 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: Bolus Track Scan field of view: 335 mm. KVP: 100 DLP: 492 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: Bilateral peripheral groundglass opacities and interlobular septal thickening. Moderate biapical centrilobular emphysema. No pleural effusion or pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Heart size is normal. No pericardial effusion. Atherosclerotic calcifications of the left anterior descending artery. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Evolution of T11 chance fracture with progressive anterior collapse of the vertebral body, now approximately 50% height loss, and fractures of the T10 inferior facets and spinous process. Spinal simulator hardware at T8-T9. CONCLUSION: 1. No evidence of pulmonary embolus. 2. COVID pneumonia. 3. Ununited T11 fracture with progressive vertebral body height loss and developing posttraumatic degenerative change. 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.
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: Bilateral peripheral groundglass opacities and interlobular septal thickening. Moderate biapical centrilobular emphysema. No pleural effusion or pneumothorax. Central airways are patent. HEART / OTHER VESSELS: Heart size is normal. No pericardial effusion. Atherosclerotic calcifications of the left anterior descending artery. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Evolution of T11 chance fracture with progressive anterior collapse of the vertebral body, now approximately 50% height loss, and fractures of the T10 inferior facets and spinous process. Spinal simulator hardware at T8-T9.
Findings: There has been interval right parotidectomy resection of the necrotic tumor masses in the medial parotid. There is no extensive postsurgical scarring/phlegmon in the resection bed and right lateral neck dissection. No residual recurrent tumor is seen here. There is stranding in subcutaneous fat, likely related to radiation. 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 is extensive pleural and pulmonary scarring in the upper lung fields. CT scan of the chest is suggested. There are degenerative changes in cervical spine but no lytic or blastic lesion is seen. --------------
3,595
CT Head wo Contrast TECHNIQUE: CT of the head was performed without intravenous contrast at 2.5mm slice thickness. Scan field of view: 230 mm. DLP: 1356.90 mGy cm. INDICATION: Altered Mental Status COMPARISON: None. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. Mild diffuse cortical atrophy is present. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Hyperostosis frontalis interna. Trace fluid in seen layering dependently within the left mastoid air cells. The right mastoid air cells are clear. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Small mucous retention cyst seen within the left sphenoid sinus. Mild mucosal thickening of the ethmoidal air cells.. CONCLUSION: 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. Mild diffuse cortical atrophy is present. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Hyperostosis frontalis interna. Trace fluid in seen layering dependently within the left mastoid air cells. The right mastoid air cells are clear. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Small mucous retention cyst seen within the left sphenoid sinus. Mild mucosal thickening of the ethmoidal air cells..
FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: Redemonstration of a increased density lesion in the interpolar right kidney measures 1.6 cm today, slightly larger compared to prior examination (series 3 image 132). There is no enhancement within this lesion however consistent with a hyperdense cyst. Redemonstration of bilateral renal cortical parenchymal scarring. Left renal cysts are unchanged. Air in both renal collecting systems is observed, similar to prior. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: Urinary bladder is surgically absent. Right lower quadrant ileal conduit is again observed LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small bowel anastomosis in the left abdomen. No dilated loops of small bowel COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Numerous metallic fragments in the right flank soft tissues are again observed. MUSCULOSKELETAL: No significant abnormality.
3,596
CT Head wo Contrast TECHNIQUE: CT of the head was performed without intravenous contrast at 2.5mm slice thickness. Scan field of view: 235 mm. DLP: 1122 mGy cm. INDICATION: Head trauma, mod-severe COMPARISON: MRI of the brain dated 12/24/2007; CT the head without contrast dated 12/21/2007. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Well aerated. CONCLUSION: 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.
FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Well aerated.
FINDINGS: SOFT TISSUES: The masticator, parapharyngeal, retropharyngeal, carotid, sublingual, and submandibular spaces are normal. Asymmetric soft tissue swelling and stranding overlying the left mandibular region with similar-appearing stranding to a lesser extent involving the anterior and minimally the right mandibular soft tissues. No focal fluid collection is identified. Sebaceous cysts involving the right posterior neck soft tissues. LYMPH NODES: No pathologic adenopathy by imaging size criteria. AERODIGESTIVE STRUCTURES: No asymmetric contrast enhancement or asymmetric soft tissue nodularity. PAROTID GLANDS/SUBMANDIBULAR GLANDS: Unremarkable. THYROID GLAND: Diffusely enlarged, possible goiter with multiple nodules, the largest in the left measuring 12 x 12 mm.. VASCULAR STRUCTURES: No evidence of dissection, occlusion, or aneurysm. OSSEOUS STRUCTURES: No fracture, dislocation, or destructive lesion. Mild periapical lucency left mandibular first molar. No associated cortical breakthrough or adjacent abscess. ORBITS: Unremarkable. PARANASAL SINUSES AND MASTOID AIR CELLS: Clear. PARTIALLY VISUALIZED INTRACRANIAL STRUCTURES: Unremarkable. LUNG APICES: Unremarkable. -------------------
3,597
RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Headache, low platelet count COMPARISON: None. TECHNIQUE: CT Head wo contrastScan field of view: 204 mm. DLP: 1310 mGy cm. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: There is no acute intracranial hemorrhage or acute infarct. No brain edema or mass effect. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CONCLUSION: No acute intracranial process.
FINDINGS: BRAIN PARENCHYMA: There is no acute intracranial hemorrhage or acute infarct. No brain edema or mass effect. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separate CT chest report. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. No cirrhosis or focal lesion. BILIARY TRACT: Normal. GALLBLADDER: Gallstones. No gallbladder wall thickening or pericholecystic fluid. PANCREAS: Normal. SPLEEN: Unchanged well-circumscribed subcentimeter hypodensity, likely represents a cyst. ADRENALS: Normal. KIDNEYS: Unchanged well-circumscribed subcentimeter hypodensity likely represents a simple cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticula. PERITONEUM / MESENTERY: No ascites. No free intraperitoneal air. RETROPERITONEUM: Normal. VESSELS: Minimal scattered atherosclerosis of the infrarenal aorta. URINARY BLADDER: Partially collapsed. REPRODUCTIVE ORGANS: No abnormality BODY WALL: Tiny fat-containing periumbilical hernia. MUSCULOSKELETAL: Mild degenerative changes of the lumbar spine. No suspicious osseous lesion.
3,598
EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Follow-up evaluation of aortic injury. COMPARISON: CTA chest, abdomen, and pelvis 1/6/2022. TECHNIQUE: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 261 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 402 mm. KVP: 100 DLP: 980 mGy cm. (accession CT220004278), Patient weight: 261 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 402 mm. (accession CT220004279) FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: Mild calcific atherosclerosis in the thoracoabdominal aorta and its branch vessels. CORONARY ARTERIES: There are mild atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Dilated, measuring 36 mm in diameter. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: Significant interval decrease in size of the periaortic hematoma and stranding surrounding the mid to distal descending thoracic aorta, difficult to accurately measure. No active contrast extravasation. No dissection flap or intramural hematoma. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: No significant abnormality. SMA: Mild calcific atherosclerosis at this may origin without significant luminal narrowing. RIGHT RENAL: Single right renal artery. No significant abnormality. LEFT RENAL: Three left renal arteries. No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Partially calcified 9 mm right thyroid nodule. Hypoattenuating left thyroid nodule measuring 14 mm. CHEST: LUNGS / AIRWAYS / PLEURA: ET tube terminates in the midthoracic trachea. Interval increase in size of left pleural effusion (which appears high in attenuation, particularly superiorly), now large, with complete left lung atelectasis. Moderate volume right pleural effusion with overlying relaxation atelectasis. Mosaic attenuation in the aerated portions of the right lung are likely related to imaging during expiratory phase. No pneumothorax. HEART / OTHER VESSELS: Mild cardiomegaly. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Marked interval decrease in size of periaortic hematoma, as above. LYMPH NODES: None enlarged. CHEST WALL: Mild chest wall edema. Previously seen thickening surrounding the right diaphragm has improved with mild residual stranding near the hiatus and along the distal esophagus. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating material in the gallbladder, which may represent vicarious excretion of contrast versus biliary sludge. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Esophagogastric catheter terminates in the distal stomach. No significant abnormality in small bowel. COLON / APPENDIX: No significant abnormality in the colon or appendix. Enteric contrast is noted throughout the colon. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Ill-defined stranding along the left external iliac vasculature and interposed between the bilateral common iliac vasculature. No significant abnormality in the adjacent arterial vasculature. OTHER VESSELS: Left common femoral vein approach vascular catheter terminates in unchanged position in the left common iliac vein near the IVC confluence. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate body wall edema. A few foci of gas in the right lower quadrant ventral abdominal wall are likely related to recent medication injection. Posterior midline surgical skin staples from recent posterior spinal fusion. MUSCULOSKELETAL: Redemonstration of minimally displaced left 12th rib fracture. Similar appearance of posterior spinal fusion hardware spanning T9-L2. Persistent widening of the T11-12 disc space and vertebral body fragmentation. Changes from T11-T12 laminectomy. Evaluation of known T11 posterior element fractures is limited secondary to streak artifact from fusion hardware. CONCLUSION: 1. Interval decrease in volume of hematoma surrounding the distal thoracic aorta. No active extravasation is identified. No aortic dissection flap or intramural hematoma. 2. Enlarging bilateral pleural effusions with structures are complete left lung atelectasis. Intermediate attenuation within the left pleural effusion suggests a component of hemothorax. 3. Redemonstration of distracted fracture dislocation of the T11-12 disc space with involvement of the T12 superior endplate expanded by posterior thoracolumbar spinal fusion construct, similar in appearance. 4. Ill-defined stranding along the left external and common iliac vasculature without significant abnormality in the adjacent retroperitoneal vasculature. 5. Interval improvement of the hematoma near the hiatus and right diaphragmatic crus 6. Additional 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.
FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: Mild calcific atherosclerosis in the thoracoabdominal aorta and its branch vessels. CORONARY ARTERIES: There are mild atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Dilated, measuring 36 mm in diameter. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: Significant interval decrease in size of the periaortic hematoma and stranding surrounding the mid to distal descending thoracic aorta, difficult to accurately measure. No active contrast extravasation. No dissection flap or intramural hematoma. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: No significant abnormality. SMA: Mild calcific atherosclerosis at this may origin without significant luminal narrowing. RIGHT RENAL: Single right renal artery. No significant abnormality. LEFT RENAL: Three left renal arteries. No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Partially calcified 9 mm right thyroid nodule. Hypoattenuating left thyroid nodule measuring 14 mm. CHEST: LUNGS / AIRWAYS / PLEURA: ET tube terminates in the midthoracic trachea. Interval increase in size of left pleural effusion (which appears high in attenuation, particularly superiorly), now large, with complete left lung atelectasis. Moderate volume right pleural effusion with overlying relaxation atelectasis. Mosaic attenuation in the aerated portions of the right lung are likely related to imaging during expiratory phase. No pneumothorax. HEART / OTHER VESSELS: Mild cardiomegaly. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Marked interval decrease in size of periaortic hematoma, as above. LYMPH NODES: None enlarged. CHEST WALL: Mild chest wall edema. Previously seen thickening surrounding the right diaphragm has improved with mild residual stranding near the hiatus and along the distal esophagus. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating material in the gallbladder, which may represent vicarious excretion of contrast versus biliary sludge. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Esophagogastric catheter terminates in the distal stomach. No significant abnormality in small bowel. COLON / APPENDIX: No significant abnormality in the colon or appendix. Enteric contrast is noted throughout the colon. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Ill-defined stranding along the left external iliac vasculature and interposed between the bilateral common iliac vasculature. No significant abnormality in the adjacent arterial vasculature. OTHER VESSELS: Left common femoral vein approach vascular catheter terminates in unchanged position in the left common iliac vein near the IVC confluence. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate body wall edema. A few foci of gas in the right lower quadrant ventral abdominal wall are likely related to recent medication injection. Posterior midline surgical skin staples from recent posterior spinal fusion. MUSCULOSKELETAL: Redemonstration of minimally displaced left 12th rib fracture. Similar appearance of posterior spinal fusion hardware spanning T9-L2. Persistent widening of the T11-12 disc space and vertebral body fragmentation. Changes from T11-T12 laminectomy. Evaluation of known T11 posterior element fractures is limited secondary to streak artifact from fusion hardware.
FINDINGS: LOWER NECK: A few subcentimeter left lower cervical lymph nodes, appear new from prior exam. A representative 10 mm left lateral IV lymph node on axial image 31; series 2. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent with mild bronchial wall thickening. Mixed upper lobe emphysema, overall unchanged. Apical scarring in the right lung. No suspicious pulmonary nodule. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. There is left ventricular apical thinning with low-attenuation, a small left ventricular apical thrombus, appears new (axial image 167; series 2). Normal-sized pulmonary artery and thoracic aorta. Moderate coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Esophagus appears unremarkable for the technique. LYMPH NODES: A few scattered mediastinal lymph nodes are again seen. A representative 0.9 x 0.8 cm lateral aortic lymph node on axial image 89; series 2, previously measured 0.9 x 0.9 cm. A subcarinal lymph node with short axis less than 10 mm (axial image 112; series 2, overall unchanged. No new lymph nodes. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: No destructive osseous lesion.
3,599
EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Follow-up evaluation of aortic injury. COMPARISON: CTA chest, abdomen, and pelvis 1/6/2022. TECHNIQUE: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 261 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 402 mm. KVP: 100 DLP: 980 mGy cm. (accession CT220004278), Patient weight: 261 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 402 mm. (accession CT220004279) FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: Mild calcific atherosclerosis in the thoracoabdominal aorta and its branch vessels. CORONARY ARTERIES: There are mild atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Dilated, measuring 36 mm in diameter. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: Significant interval decrease in size of the periaortic hematoma and stranding surrounding the mid to distal descending thoracic aorta, difficult to accurately measure. No active contrast extravasation. No dissection flap or intramural hematoma. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: No significant abnormality. SMA: Mild calcific atherosclerosis at this may origin without significant luminal narrowing. RIGHT RENAL: Single right renal artery. No significant abnormality. LEFT RENAL: Three left renal arteries. No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Partially calcified 9 mm right thyroid nodule. Hypoattenuating left thyroid nodule measuring 14 mm. CHEST: LUNGS / AIRWAYS / PLEURA: ET tube terminates in the midthoracic trachea. Interval increase in size of left pleural effusion (which appears high in attenuation, particularly superiorly), now large, with complete left lung atelectasis. Moderate volume right pleural effusion with overlying relaxation atelectasis. Mosaic attenuation in the aerated portions of the right lung are likely related to imaging during expiratory phase. No pneumothorax. HEART / OTHER VESSELS: Mild cardiomegaly. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Marked interval decrease in size of periaortic hematoma, as above. LYMPH NODES: None enlarged. CHEST WALL: Mild chest wall edema. Previously seen thickening surrounding the right diaphragm has improved with mild residual stranding near the hiatus and along the distal esophagus. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating material in the gallbladder, which may represent vicarious excretion of contrast versus biliary sludge. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Esophagogastric catheter terminates in the distal stomach. No significant abnormality in small bowel. COLON / APPENDIX: No significant abnormality in the colon or appendix. Enteric contrast is noted throughout the colon. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Ill-defined stranding along the left external iliac vasculature and interposed between the bilateral common iliac vasculature. No significant abnormality in the adjacent arterial vasculature. OTHER VESSELS: Left common femoral vein approach vascular catheter terminates in unchanged position in the left common iliac vein near the IVC confluence. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate body wall edema. A few foci of gas in the right lower quadrant ventral abdominal wall are likely related to recent medication injection. Posterior midline surgical skin staples from recent posterior spinal fusion. MUSCULOSKELETAL: Redemonstration of minimally displaced left 12th rib fracture. Similar appearance of posterior spinal fusion hardware spanning T9-L2. Persistent widening of the T11-12 disc space and vertebral body fragmentation. Changes from T11-T12 laminectomy. Evaluation of known T11 posterior element fractures is limited secondary to streak artifact from fusion hardware. CONCLUSION: 1. Interval decrease in volume of hematoma surrounding the distal thoracic aorta. No active extravasation is identified. No aortic dissection flap or intramural hematoma. 2. Enlarging bilateral pleural effusions with structures are complete left lung atelectasis. Intermediate attenuation within the left pleural effusion suggests a component of hemothorax. 3. Redemonstration of distracted fracture dislocation of the T11-12 disc space with involvement of the T12 superior endplate expanded by posterior thoracolumbar spinal fusion construct, similar in appearance. 4. Ill-defined stranding along the left external and common iliac vasculature without significant abnormality in the adjacent retroperitoneal vasculature. 5. Interval improvement of the hematoma near the hiatus and right diaphragmatic crus 6. Additional 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.
FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: Mild calcific atherosclerosis in the thoracoabdominal aorta and its branch vessels. CORONARY ARTERIES: There are mild atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Dilated, measuring 36 mm in diameter. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. DESCENDING THORACIC AORTA: Significant interval decrease in size of the periaortic hematoma and stranding surrounding the mid to distal descending thoracic aorta, difficult to accurately measure. No active contrast extravasation. No dissection flap or intramural hematoma. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: No significant abnormality. SMA: Mild calcific atherosclerosis at this may origin without significant luminal narrowing. RIGHT RENAL: Single right renal artery. No significant abnormality. LEFT RENAL: Three left renal arteries. No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Partially calcified 9 mm right thyroid nodule. Hypoattenuating left thyroid nodule measuring 14 mm. CHEST: LUNGS / AIRWAYS / PLEURA: ET tube terminates in the midthoracic trachea. Interval increase in size of left pleural effusion (which appears high in attenuation, particularly superiorly), now large, with complete left lung atelectasis. Moderate volume right pleural effusion with overlying relaxation atelectasis. Mosaic attenuation in the aerated portions of the right lung are likely related to imaging during expiratory phase. No pneumothorax. HEART / OTHER VESSELS: Mild cardiomegaly. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Marked interval decrease in size of periaortic hematoma, as above. LYMPH NODES: None enlarged. CHEST WALL: Mild chest wall edema. Previously seen thickening surrounding the right diaphragm has improved with mild residual stranding near the hiatus and along the distal esophagus. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Layering hyperattenuating material in the gallbladder, which may represent vicarious excretion of contrast versus biliary sludge. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Esophagogastric catheter terminates in the distal stomach. No significant abnormality in small bowel. COLON / APPENDIX: No significant abnormality in the colon or appendix. Enteric contrast is noted throughout the colon. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Ill-defined stranding along the left external iliac vasculature and interposed between the bilateral common iliac vasculature. No significant abnormality in the adjacent arterial vasculature. OTHER VESSELS: Left common femoral vein approach vascular catheter terminates in unchanged position in the left common iliac vein near the IVC confluence. URINARY BLADDER: Decompressed around a Foley catheter. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate body wall edema. A few foci of gas in the right lower quadrant ventral abdominal wall are likely related to recent medication injection. Posterior midline surgical skin staples from recent posterior spinal fusion. MUSCULOSKELETAL: Redemonstration of minimally displaced left 12th rib fracture. Similar appearance of posterior spinal fusion hardware spanning T9-L2. Persistent widening of the T11-12 disc space and vertebral body fragmentation. Changes from T11-T12 laminectomy. Evaluation of known T11 posterior element fractures is limited secondary to streak artifact from fusion hardware.
Findings: The paranasal sinuses are normally formed and developed. There is a large retention cyst in the left maxillary sinus and there is slight mucosal thickening in the right, in some ethmoid cells and in the right sphenoid sinus. There is also slight mucosal thickening in the frontal sinuses. No fluid retention is seen. The maxillofacial bones, orbits and orbital contents are unremarkable. The mastoids and middle ears are clear. No defect is seen in the anterior skull base or calvarium. ---------------