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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: GI bleed COMPARISON: 4/13/2018. TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 112 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: 15/55 sec. Scan field of view: 336 mm. DLP: 1143.50 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Ill-defined groundglass opacities with craving paving type appearance is seen in the lower lung zones. There is a small amount scarring/atelectasis in the left lower lobe as well as the right middle lobe. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Bilateral nodular adrenal hyperplasia is unchanged and compatible with adenomas KIDNEYS: Minute subcentimeter hypodensities in both kidneys are technically indeterminate but unchanged. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Right hemicolectomy changes are noted. RETROPERITONEUM: Normal. VESSELS: Severe aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No acute GI bleed is identified within the abdomen or pelvis. No acute abnormality is identified within the abdomen or pelvis. 2. Bilateral airspace opacities concerning for multifocal pneumonia, in particular active or resolving COVID-19 pneumonia. 3. Additional findings above.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Ill-defined groundglass opacities with craving paving type appearance is seen in the lower lung zones. There is a small amount scarring/atelectasis in the left lower lobe as well as the right middle lobe. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Bilateral nodular adrenal hyperplasia is unchanged and compatible with adenomas KIDNEYS: Minute subcentimeter hypodensities in both kidneys are technically indeterminate but unchanged. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Right hemicolectomy changes are noted. RETROPERITONEUM: Normal. VESSELS: Severe aortoiliac atherosclerosis without aneurysmal dilatation. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Hysterectomy changes are noted. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CTA Aorta Runoff VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Patent with mild mixed atherosclerotic disease. ABDOMINAL AORTA: Postsurgical changes from prior open AAA repair CELIAC AXIS: Patent with mild ostial calcifications. Replaced left hepatic artery arising from the left gastric artery. SMA: Incidentally noted replaced right hepatic artery arising from the SMA. RIGHT RENAL: Widely patent with mild ostial calcifications. LEFT RENAL: Widely patent. Small intimal flap near the ostium appears grossly unchanged from prior. IMA: Patent. RIGHT ILIAC ARTERIES: The common iliac artery is patent and diffusely ectatic with moderate mixed calcified and noncalcified atherosclerotic plaque. Moderate narrowing at the origin of the internal iliac artery. Focal aneurysmal dilatation of the internal iliac artery with eccentric mural thrombus, measuring up to 1.6 cm in luminal caliber. The external iliac artery is widely patent with moderate scattered atherosclerotic disease. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Ectatic dilatation of the patent right common femoral artery. The patent SFA is diffusely ectatic with moderate mixed atherosclerotic disease throughout its length. Moderate multifocal luminal narrowing of the distal SFA. Fusiform popliteal artery aneurysm with eccentric mural thrombus, measuring up to 2.2 cm in luminal caliber (series 6, image 247). Mild multifocal narrowing secondary to mixed atherosclerotic disease throughout the popliteal artery. RIGHT TIBIAL AND PERONEAL ARTERIES: The anterior tibial artery is patent proximally on the delayed phase images, but not opacified within the mid-distal calf. The tibioperoneal trunk, posterior tibial, and peroneal arteries are not opacified on the arterial or delayed phase images. LEFT ILIAC ARTERIES: The common iliac artery is patent and diffusely ectatic with moderate mixed calcified and noncalcified atherosclerotic plaque. Severe focal narrowing at the origin of the internal iliac artery which remains patent and normal in caliber more distally. The external iliac artery is widely patent with moderate scattered atherosclerotic disease. LEFT FEMORAL \T\ POPLITEAL ARTERIES: Ectatic dilatation of the patent left common femoral artery. The patent SFA is diffusely ectatic with moderate mixed atherosclerotic disease throughout its length. There is aneurysmal dilatation arising from the posterior aspect of the proximal profunda femoris with the sac measuring approximately 1.6 x 0.9 cm in the neck measuring approximately 0.6 cm (series 9, image 44). Fusiform popliteal artery aneurysm with eccentric mural thrombus, measuring up to 2.1 cm in luminal caliber (series 6, image 265). Mild multifocal narrowing secondary to mixed atherosclerotic disease throughout the popliteal artery. LEFT TIBIAL AND PERONEAL ARTERIES: The anterior tibial artery is patent proximally on the delayed phase images, but not opacified within the mid-distal calf. The tibioperoneal trunk, posterior tibial, and peroneal arteries are not opacified on the arterial or delayed phase images. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Examination of the lung bases is degraded by respiratory motion artifact. There are bilateral dependent atelectatic changes. There are several scattered groundglass nodules seen throughout both lung bases and predominantly in a subpleural distribution; for example, a 7 mm subpleural groundglass nodule in the right lower lobe (series 6, image 6). No pleural effusion. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: The heart is borderline enlarged, similar to prior. No pericardial effusion. Partially visualized post median sternotomy and CABG changes and right ventricular AICD lead are noted. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There is an enhancing, predominantly exophytic left renal mass which measures approximately 7.9 x 7.1 x 6.8 cm (series 6, image 70 and series 9, image 37), new from the prior examination dated 3/8/2009. Cyst with peripheral calcifications in the right kidney appears relatively similar dating back to 2008, likely benign.. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered noninflamed colonic diverticula. Small colonic stool burden. Normal appendix. PERITONEUM / MESENTERY: No intraperitoneal free fluid or free air. RETROPERITONEUM: As above. OTHER VESSELS: Unremarkable. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Unremarkable. BODY WALL: Postsurgical changes of the midline ventral abdominal wall from prior laparotomy incision. MUSCULOSKELETAL: No focal destructive osseous lesion. There are scattered chronic degenerative changes of the thoracolumbar spine and visualized appendicular skeleton. Grade 1 anterolisthesis of L5 on S1 with associated degenerative bilateral L5 pars defects.
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3,601
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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: 223.10 mm. DLP: 1490.70 mGy cm. INDICATION: PUI for COVID Altered Mental Status COMPARISON: CT of the head without contrast dated 1/1/2022. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. There is mild some moderate diffuse cerebral volume loss. Redemonstrated hypoattenuation in the subcortical and periventricular white matter, likely sequela of advanced chronic microangiopathy. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. There is calcified atherosclerosis of bilateral cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Mild ex vacuo dilatation of the ventricular system. ORBITS: No acute orbital abnormality. Bilateral lens replacements. SINUSES: Mild mucosal thickening of the right maxillary and sphenoid sinuses and ethmoidal air cells. Tiny right maxillary sinus air-fluid level unchanged from prior. CONCLUSION: No acute intracranial process. Chronic changes, similar to prior. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. There is mild some moderate diffuse cerebral volume loss. Redemonstrated hypoattenuation in the subcortical and periventricular white matter, likely sequela of advanced chronic microangiopathy. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. There is calcified atherosclerosis of bilateral cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Mild ex vacuo dilatation of the ventricular system. ORBITS: No acute orbital abnormality. Bilateral lens replacements. SINUSES: Mild mucosal thickening of the right maxillary and sphenoid sinuses and ethmoidal air cells. Tiny right maxillary sinus air-fluid level unchanged from prior.
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FINDINGS: The quality of exam for detection of pulmonary thromboembolism is excellent. No pulmonary thromboemboli are identified. The main pulmonary artery is normal in caliber. No CT findings of right heart strain. The ET tube tip is just under 2 cm above the carina and this could be retracted a centimeter. NG tube tip is in the distal stomach. Right thyroid nodule is again partially seen. No enlarged intrathoracic lymph nodes are identified. The heart size and the mediastinum are otherwise normal. Trace left pleural effusion is seen. Diffuse groundglass opacities are seen in both lungs with slight sparing of the apices clearly increased over the prior exam. A few areas of consolidation are seen most of these are in the dependent lungs suggesting atelectasis rather than pneumonia. Elevation of the right hemidiaphragm is similar to prior. The gallbladder is surgically removed. Limited images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
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3,602
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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: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec. Scan field of view: 437 mm. (accession CT220004283), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec. Scan field of view: 437 mm. DLP: 994 mGy cm. (accession CT220004284) FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No acute abnormality. Heart size is within normal limits. The main pulmonary artery appears minimally dilated up to 3.3 cm. Aorta appears intact. 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: Colonic diverticulosis. Appendix appears normal. A mildly prominent submucosal vessel along the anterior distal rectum axial image 467 series 201 is demonstrated. PERITONEUM / MESENTERY: No pneumoperitoneum, no free fluid. The anterior abdominal wall ballistic fragment does not appear to enter the peritoneal cavity. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Metallic ballistic fragment present in the anterior abdominal wall within the left rectus sheath musculature with associated small volume surrounding soft tissue gas and anterior abdominal wall hemorrhagic stranding. The ballistic fragment does not appear to enter the peritoneal cavity. No active extravasation visualized. Small fat-containing periumbilical hernia. MUSCULOSKELETAL: No acute osseous abnormality. Mild multilevel degenerative changes in the thoracic and lumbar spine. CONCLUSION: 1. Anterior abdominal wall ballistic injury with metallic ballistic fragment present within the left rectus musculature. The ballistic fragment does not appear to enter the peritoneal cavity; no acute intrathoracic or acute intra-abdominal solid or hollow viscus organ abnormality is identified. 2. Prominent vessel in the submucosal region of the anterior distal rectum could represent a angiodysplasia for example or vascular lesion of another etiology. Consider nonemergent outpatient GI consultation. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No acute abnormality. Heart size is within normal limits. The main pulmonary artery appears minimally dilated up to 3.3 cm. Aorta appears intact. 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: Colonic diverticulosis. Appendix appears normal. A mildly prominent submucosal vessel along the anterior distal rectum axial image 467 series 201 is demonstrated. PERITONEUM / MESENTERY: No pneumoperitoneum, no free fluid. The anterior abdominal wall ballistic fragment does not appear to enter the peritoneal cavity. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Metallic ballistic fragment present in the anterior abdominal wall within the left rectus sheath musculature with associated small volume surrounding soft tissue gas and anterior abdominal wall hemorrhagic stranding. The ballistic fragment does not appear to enter the peritoneal cavity. No active extravasation visualized. Small fat-containing periumbilical hernia. MUSCULOSKELETAL: No acute osseous abnormality. Mild multilevel degenerative changes in the thoracic and lumbar spine.
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Findings: There is no evidence of acute intra- or extra-axial hemorrhage. There is no midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation appears maintained. The ventricular system are normal in configuration. The basal cisterns are clear. Scattered paranasal sinus dural thickening. Air-fluid levels in the right posterior ethmoid and sphenoid sinuses.The remainingvisualized paranasal sinuses and mastoid air cells are clear of acute process. The visualized bones of the calvarium demonstrate no acute osseous abnormality.
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3,603
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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: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec. Scan field of view: 437 mm. (accession CT220004283), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec. Scan field of view: 437 mm. DLP: 994 mGy cm. (accession CT220004284) FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No acute abnormality. Heart size is within normal limits. The main pulmonary artery appears minimally dilated up to 3.3 cm. Aorta appears intact. 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: Colonic diverticulosis. Appendix appears normal. A mildly prominent submucosal vessel along the anterior distal rectum axial image 467 series 201 is demonstrated. PERITONEUM / MESENTERY: No pneumoperitoneum, no free fluid. The anterior abdominal wall ballistic fragment does not appear to enter the peritoneal cavity. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Metallic ballistic fragment present in the anterior abdominal wall within the left rectus sheath musculature with associated small volume surrounding soft tissue gas and anterior abdominal wall hemorrhagic stranding. The ballistic fragment does not appear to enter the peritoneal cavity. No active extravasation visualized. Small fat-containing periumbilical hernia. MUSCULOSKELETAL: No acute osseous abnormality. Mild multilevel degenerative changes in the thoracic and lumbar spine. CONCLUSION: 1. Anterior abdominal wall ballistic injury with metallic ballistic fragment present within the left rectus musculature. The ballistic fragment does not appear to enter the peritoneal cavity; no acute intrathoracic or acute intra-abdominal solid or hollow viscus organ abnormality is identified. 2. Prominent vessel in the submucosal region of the anterior distal rectum could represent a angiodysplasia for example or vascular lesion of another etiology. Consider nonemergent outpatient GI consultation. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CONTRAST DISCLAIMER: Not applicable. STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No acute abnormality. Heart size is within normal limits. The main pulmonary artery appears minimally dilated up to 3.3 cm. Aorta appears intact. 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: Colonic diverticulosis. Appendix appears normal. A mildly prominent submucosal vessel along the anterior distal rectum axial image 467 series 201 is demonstrated. PERITONEUM / MESENTERY: No pneumoperitoneum, no free fluid. The anterior abdominal wall ballistic fragment does not appear to enter the peritoneal cavity. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Metallic ballistic fragment present in the anterior abdominal wall within the left rectus sheath musculature with associated small volume surrounding soft tissue gas and anterior abdominal wall hemorrhagic stranding. The ballistic fragment does not appear to enter the peritoneal cavity. No active extravasation visualized. Small fat-containing periumbilical hernia. MUSCULOSKELETAL: No acute osseous abnormality. Mild multilevel degenerative changes in the thoracic and lumbar spine.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separate CT chest report. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Unchanged bilateral simple cysts. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Postsurgical changes from distal small bowel resection. COLON / APPENDIX: Colonic diverticula without lesion. No appendicitis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Enlarged prostate. BODY WALL: Postsurgical changes from midline laparotomy. MUSCULOSKELETAL: Degenerative changes of the spine. Focal sclerosis of the left sacral ala, likely bone island. No suspicious osseous lesion.
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3,604
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: CT abdomen and pelvis December 30, 2021. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. DLP: 733.10 mGy cm. (accession CT220004290), Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. (accession CT220004291) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained. CONCLUSION: 1. Right hip soft tissue contusive changes. Otherwise, acute traumatic abnormality evident within the chest, abdomen, or pelvis. No acute fracture of the thoracic or lumbar spine. 2. Renal atrophy and there is scarring. Striated enhancement of the kidneys postcontrast is nonspecific but can be seen in acute tubular necrosis and infection for example. 3. Incidental findings as above including atherosclerotic disease with coronary artery calcifications, cholelithiasis without evidence of acute cholecystitis, colonic diverticulosis, and degenerative changes of the thoracolumbar spine. 4. Findings of CPPD arthritis involving the shoulders and symphysis pubis. Bilateral left greater than right glenohumeral joint effusions. 5. Bibasilar atelectatic changes, left greater than right and left basilar mucus plugging or aspiration related changes are not excluded. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained.
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FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: No consolidation. No suspicious pulmonary nodule. No pleural effusion. Central airways are patent. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. Redemonstrated right lateral chest wall intramuscular lipoma. Upper abdomen: Reported separately.
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3,605
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: CT abdomen and pelvis December 30, 2021. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. DLP: 733.10 mGy cm. (accession CT220004290), Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. (accession CT220004291) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained. CONCLUSION: 1. Right hip soft tissue contusive changes. Otherwise, acute traumatic abnormality evident within the chest, abdomen, or pelvis. No acute fracture of the thoracic or lumbar spine. 2. Renal atrophy and there is scarring. Striated enhancement of the kidneys postcontrast is nonspecific but can be seen in acute tubular necrosis and infection for example. 3. Incidental findings as above including atherosclerotic disease with coronary artery calcifications, cholelithiasis without evidence of acute cholecystitis, colonic diverticulosis, and degenerative changes of the thoracolumbar spine. 4. Findings of CPPD arthritis involving the shoulders and symphysis pubis. Bilateral left greater than right glenohumeral joint effusions. 5. Bibasilar atelectatic changes, left greater than right and left basilar mucus plugging or aspiration related changes are not excluded. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained.
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FINDINGS: STRUCTURED REPORT: CT Renal Mass LOWER CHEST: LUNG BASES / PLEURA: Mild bibasilar atelectasis. DISTAL ESOPHAGUS: Small sliding hiatal hernia. HEART / VESSELS: Pericardial effusion has resolved. Persistent cardiomegaly. ABDOMEN: KIDNEYS: RENAL FINDINGS: Predominantly fatty AML exophytic from the right kidney now measures 3.8 x 2.6 cm from 4.7 x 3.9 cm. There are simple cysts in both kidneys. Persistent hyperdense cyst in the upper pole of the right kidney. ADRENALS: The right adrenal is not visualized. There is a 1.5 x 1.2 cm homogeneous left adrenal nodule (series 801 image 67). LYMPH NODES: - Retroperitoneal / Pararenal lymph nodes: Not enlarged. - Other findings: None. TRANSPLANT KIDNEY: Right iliac fossa transplant kidney enhances normally. Interval removal of the peritransplant surgical drain and skin staples. The arterial and venous anastomoses are patent. LIVER: Few tiny indeterminate hepatic cysts, likely simple cysts. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without diverticulitis. The appendix is not definitively visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: Moderate calcified and noncalcified atherosclerotic disease. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. Ovaries are not seen. No adnexal abnormality. BODY WALL: Tiny fat-containing umbilical hernia. Postsurgical scarring in the abdominal wall of the right lower quadrant. MUSCULOSKELETAL: Moderate degenerative changes throughout the thoracolumbar spine. Lucent regions in the right femoral head and bilateral acetabula are unchanged and represent degenerative change.
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3,606
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: CT abdomen and pelvis December 30, 2021. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. DLP: 733.10 mGy cm. (accession CT220004290), Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. (accession CT220004291) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained. CONCLUSION: 1. Right hip soft tissue contusive changes. Otherwise, acute traumatic abnormality evident within the chest, abdomen, or pelvis. No acute fracture of the thoracic or lumbar spine. 2. Renal atrophy and there is scarring. Striated enhancement of the kidneys postcontrast is nonspecific but can be seen in acute tubular necrosis and infection for example. 3. Incidental findings as above including atherosclerotic disease with coronary artery calcifications, cholelithiasis without evidence of acute cholecystitis, colonic diverticulosis, and degenerative changes of the thoracolumbar spine. 4. Findings of CPPD arthritis involving the shoulders and symphysis pubis. Bilateral left greater than right glenohumeral joint effusions. 5. Bibasilar atelectatic changes, left greater than right and left basilar mucus plugging or aspiration related changes are not excluded. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained.
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FINDINGS: The study is mildly degraded by metallic streak artifact from multiple surgical clips extending from the level of the right maxilla into the right upper and mid neck. SOFT TISSUES: New ill-defined hyperattenuation in the right buccal space/lateral tongue margin, measuring 1.8 x 1.3 x 1.3 cm (series 5, image 14; series 603, image 36), Otherwise stable postsurgical changes from prior right neck dissection and right V3 trigeminal neurectomy. LYMPH NODES: No pathologic adenopathy by imaging size criteria. AERODIGESTIVE STRUCTURES: No asymmetric contrast enhancement or asymmetric soft tissue nodularity. PAROTID GLANDS: Normal. SUBMANDIBULAR GLANDS: The right submandibular gland is surgically absent. The left gland is normal. THYROID GLAND: Normal. VASCULAR STRUCTURES: Mild left carotid bifurcation and bilateral carotid siphon calcific atherosclerosis without flow-limiting stenosis. The bilateral internal jugular veins are partially collapsed proximally but patent. MAXILLA/MANDIBLE: Stable postsurgical changes from prior right partial maxillectomy. There is a small irregular focal area of osteolysis involving the right mandibular angle with focal medial cortical destruction which does not appear significantly changed since most recent exam dated 5/27/2021 but has progressed since exam dated 12/22/2020 and is new since 10/16/2020. Edentulous. OSSEOUS STRUCTURES: No fracture, dislocation, or destructive lesion. ORBITS: Normal. PARANASAL SINUSES AND MASTOID AIR CELLS: Mucosal thickening extending from the inferior right maxillectomy postsurgical defect into the right maxillary sinus, unchanged. New complete right mastoid effusion with aerated secretions extending into the middle ear cavity. VISUALIZED INTRACRANIAL STRUCTURES: Normal. LUNG APICES: Moderate centrilobular emphysema. Biapical pleuroparenchymal scarring.
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3,607
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: CT abdomen and pelvis December 30, 2021. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. DLP: 733.10 mGy cm. (accession CT220004290), Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 2.80 ml per sec. Scan delay: 75 secs Scan field of view: 432.50 mm. (accession CT220004291) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained. CONCLUSION: 1. Right hip soft tissue contusive changes. Otherwise, acute traumatic abnormality evident within the chest, abdomen, or pelvis. No acute fracture of the thoracic or lumbar spine. 2. Renal atrophy and there is scarring. Striated enhancement of the kidneys postcontrast is nonspecific but can be seen in acute tubular necrosis and infection for example. 3. Incidental findings as above including atherosclerotic disease with coronary artery calcifications, cholelithiasis without evidence of acute cholecystitis, colonic diverticulosis, and degenerative changes of the thoracolumbar spine. 4. Findings of CPPD arthritis involving the shoulders and symphysis pubis. Bilateral left greater than right glenohumeral joint effusions. 5. Bibasilar atelectatic changes, left greater than right and left basilar mucus plugging or aspiration related changes are not excluded. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Bilateral dependent atelectasis more pronounced in the left lower lobe the right and respiratory motion artifact limits evaluation. There is possible left lower lobe mucus plugging. No pleural effusion, or pneumothorax. HEART / VESSELS: The heart is mildly enlarged. There are mitral annular and aortic root calcifications.. Three-vessel coronary artery atherosclerosis chronic ossifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. Continued mild elevation of the left hemidiaphragm. LYMPH NODES: None enlarged. CHEST WALL: Left mastectomy changes. ABDOMEN and PELVIS: LIVER: There are multiple too small to characterize hypodensities, likely representing benign cysts. No new abnormality. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Atrophic. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Kidneys are again noted to be atrophic with areas of scarring. Striated attenuation of the renal parenchyma. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. Normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe atherosclerotic disease. URINARY BLADDER: Foley catheter in place moderately decompressing the bladder. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal masses. BODY WALL: There is stranding about the right hip soft tissues skin thickening at the right buttock. MUSCULOSKELETAL: S-shaped scoliosis of the thoracolumbar spine. Chronic appearing fracture deformities of multiple right-sided ribs. Right bipolar hip prosthesis is present. Advanced degenerative changes of the bilateral glenohumeral joints with findings of joint effusions and chondrocalcinosis which can be seen with CPPD arthritis. Additionally there is degenerative change and chondrocalcinosis at the symphysis pubis. Thoracic spine: There is a thoracolumbar scoliosis, S-shaped along with an upper thoracic levoscoliosis component. There are multilevel degenerative discogenic changes and multilevel Schmorl's nodes. Posterior vertebral alignment is maintained. There is osteopenia/demineralization. No acute fracture is evident in the thoracic spine. Lumbar spine: Severe multilevel degenerative discogenic changes with vacuum disc phenomenon and severe disc space narrowing throughout the lumbar spine. There is also multilevel disc osteophyte complex and facet DJD with bilateral foraminal stenosis demonstrated at L3-L4, L4-L5 and L5-S1 and mild spinal canal stenosis at L4-5. There is severe left foraminal stenosis at L4-L5 and severe right foraminal stenosis at L4-5. Moderate to severe right foraminal stenosis at L3-L4 or and moderate left foraminal stenosis at L3-L4 and L5-S1. No acute fracture evident in the lumbar spine. S-shaped thoracolumbar scoliosis related changes. Posterior vertebral alignment is maintained.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. No enlarged intrathoracic lymph nodes are identified. Dilated main pulmonary artery at 5 cm is redemonstrated. Within the limits of a noncontrast exam, the heart size and the mediastinum are otherwise normal. No pleural effusion. Slight linear atelectasis is seen in the lingula. A few tiny calcified nodules are seen The lungs are otherwise normal without suspicious nodules or masses. Small stones or milk of calcium is layering in the gallbladder. Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
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3,608
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EXAM: CT Enterography CLINICAL INFORMATION: Intractable diarrhea, perianal abscess/fistula, unintentional weight loss, concern for Crohn disease. COMPARISON: CT enterography 1/2/2022. TECHNIQUE: CT imaging of the abdomen and pelvis was performed with IV contrast per CT enterography protocol. CT Enterography Patient weight: 120 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Oral contrast Omnipaque: 23.66 oz. Saline flush: 85 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 80sec Scan field of view: 350 mm. DLP: 365.80 mGy cm. STRUCTURED REPORT: CT Enterography FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: STOMACH: Fluid distended, otherwise without significant abnormality. SMALL BOWEL: No abnormal bowel wall thickening or enhancement. No dilated bowel loops. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. COLORECTAL: Diffuse wall thickening and mucosal hyperenhancement of the colon extending from the hepatic flexure to the rectum, and is similar distribution to prior examination. Mild associated pericolonic stranding and mesenteric hyperemia. APPENDIX: Fluid-filled with gas noted in the appendiceal tip. No appendiceal wall thickening or mucosal hyperenhancement. Nondistended. PERIANAL TISSUES: Right posterior pararenal seton is partially visualized. Evolving soft tissue thickening in the right levator ani with focal circumscribed, peripherally enhancing hypoattenuating lesion, measuring 1.1 x 0.6 x 2.5 cm (AP by TR by CC on series 201, image 280 and series 203, image 65) and containing a small focus of gas. Mild stranding in the adjacent ischioanal fat. LIVER: Focal fatty infiltration along the falciform. Tiny calcified granuloma in the right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal in size. Tiny calcified granuloma. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Hypoattenuating lesion in the right upper pole is too small to characterize, but statistically likely represent a cyst. No radiopaque nephrolithiasis or hydroureteronephrosis. LYMPH NODES: None enlarged. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. CONCLUSION: 1. Similar appearance of diffuse wall thickening and mucosal hyperenhancement of the colon extending from the hepatic flexure through the rectum, consistent with colitis, likely infectious/inflammatory in etiology. 2. Asymmetric thickening of the right levator ani with interval development of tiny discrete gas and fluid containing collection. Associated perianal fistula is a consideration and could be further evaluated with fistula protocol MRI, as clinically indicated. 3. Interval resolution of dilatation and mucosal hyperenhancement of the appendix. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: STOMACH: Fluid distended, otherwise without significant abnormality. SMALL BOWEL: No abnormal bowel wall thickening or enhancement. No dilated bowel loops. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. COLORECTAL: Diffuse wall thickening and mucosal hyperenhancement of the colon extending from the hepatic flexure to the rectum, and is similar distribution to prior examination. Mild associated pericolonic stranding and mesenteric hyperemia. APPENDIX: Fluid-filled with gas noted in the appendiceal tip. No appendiceal wall thickening or mucosal hyperenhancement. Nondistended. PERIANAL TISSUES: Right posterior pararenal seton is partially visualized. Evolving soft tissue thickening in the right levator ani with focal circumscribed, peripherally enhancing hypoattenuating lesion, measuring 1.1 x 0.6 x 2.5 cm (AP by TR by CC on series 201, image 280 and series 203, image 65) and containing a small focus of gas. Mild stranding in the adjacent ischioanal fat. LIVER: Focal fatty infiltration along the falciform. Tiny calcified granuloma in the right hepatic lobe. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal in size. Tiny calcified granuloma. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Hypoattenuating lesion in the right upper pole is too small to characterize, but statistically likely represent a cyst. No radiopaque nephrolithiasis or hydroureteronephrosis. LYMPH NODES: None enlarged. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality is identified.
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FINDINGS: When compared to the prior exam there is worsening neuropathic changes involving the tibiotalar joint and midfoot articulations. Findings consist of marked erosions, patchy sclerosis and bone fragmentation. There is collapse of the mid arch. There is marked thickening of the synovium with complex fluid involving the tibiotalar and tarsal articulations. There is mild subcutaneous fat stranding. No definite organized fluid collection is seen; however, evaluation is limited on noncontrast exam.
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3,609
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Shortness of breath. COMPARISON: CTA chest 5/13/2021. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 203 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: 350 mm. KVP: 100 DLP: 249.10 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes. Tiny calcific granuloma in the right upper lobe. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Heart size is normal. No pericardial effusion. The main pulmonary artery and thoracic aorta are normal in caliber. Prominent contrast opacification of left chest wall venous collaterals. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: The gallbladder surgically absent. Right upper pole renal cyst. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. CONCLUSION: No acute central or segmental pulmonary thromboembolus or other acute intrathoracic abnormality. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes. Tiny calcific granuloma in the right upper lobe. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Heart size is normal. No pericardial effusion. The main pulmonary artery and thoracic aorta are normal in caliber. Prominent contrast opacification of left chest wall venous collaterals. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: The gallbladder surgically absent. Right upper pole renal cyst. MUSCULOSKELETAL: No aggressive osseous abnormality is identified.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Mild biapical pleuroparenchymal scarring. Mild upper lobe predominant emphysema with diffuse bronchial wall thickening. Bibasilar linear subsegmental atelectasis/scarring. No focal consolidation. Nodular appearance of the trachea. The trachea and main bronchi are patent. No pleural effusion. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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3,610
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EXAM: CT Head wo contrast, CT Cervical Spine wo contrast CLINICAL INFORMATION: MVC COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Cervical Spine wo contrast 3-D CT MIP images were generated in post processing. Scan field of view: 250 mm. DLP: 1096 mGy cm. (accession CT220004298), Scan field of view: 185 mm. DLP: 888 mGy cm. (accession CT220004299) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Small right maxillary sinus mucous retention cyst. Otherwise clear. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Small right maxillary sinus mucous retention cyst. Otherwise clear. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Infrarenal abdominal aortic aneurysm measures 4.5 x 3.8 cm (image 272 series 3), previously 4.2 x 3.4 cm. Aneurysm morphology is abnormal with disruption of the intimal calcifications. CELIAC AXIS: No significant abnormality. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: Main and accessory left renal arteries are patent. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Heart size is normal. Moderate coronary calcified atherosclerosis. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Persistent benign calcifications in the right adrenal. Left adrenal is normal. KIDNEYS: There are simple cysts in the right kidney. Left kidney is normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Severe colonic diverticulosis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat-containing right inguinal hernia. MUSCULOSKELETAL: There are degenerative changes of the lower lumbar spine.
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3,611
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EXAM: CT Head wo contrast, CT Cervical Spine wo contrast CLINICAL INFORMATION: MVC COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Cervical Spine wo contrast 3-D CT MIP images were generated in post processing. Scan field of view: 250 mm. DLP: 1096 mGy cm. (accession CT220004298), Scan field of view: 185 mm. DLP: 888 mGy cm. (accession CT220004299) FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Small right maxillary sinus mucous retention cyst. Otherwise clear. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: HEAD: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Small right maxillary sinus mucous retention cyst. Otherwise clear. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated CT chest. ABDOMEN and PELVIS: LIVER: Hypoattenuating lesion in the inferior right hepatic lobe on image 260 series 2 is unchanged since 2016, likely benign cyst. Additional subcentimeter foci of low attenuation throughout the liver also appears similar and likely represent cysts. No suspicious liver lesions. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Left renal cysts. Similar mildly hyperattenuating cyst in the interpolar region of the left kidney, likely proteinaceous/hemorrhagic cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Diffuse urinary bladder wall thickening and mucosal hyperenhancement. REPRODUCTIVE ORGANS: Significant prostate gland enlargement appears similar. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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3,612
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EXAM: CT Angio Abdomen and Pelvis CLINICAL INFORMATION: COVID 19 with lactic acidosis and abdominal pain. COMPARISON: CT abdomen and pelvis 8/26/2021 TECHNIQUE: CT Angio Abdomen and Pelvis. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 258 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 472.40 mm. DLP: 3434.60 mGy cm. FINDINGS: Motion limited exam. STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. Mild atherosclerotic disease. CELIAC AXIS: The left splenic artery is surgically ligated. The celiac artery is otherwise unremarkable with conventional anatomy. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Respiratory motion degradation. Bilateral groundglass opacities have developed and again demonstrated is a calcified left lower lobe granuloma. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic in morphology with surface nodularity. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Surgically absent. Nodular, enhancement residual splenic tissue in the left upper quadrant. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Enlarged periaortic, periportal, gastrohepatic, and cardiophrenic lymph nodes for example. Stable size of 1.6 cm in short axis (series 501, image 76) gastrohepatic lymph node. STOMACH / SMALL BOWEL: The stomach is unremarkable. The small bowel is normal in caliber. COLON / APPENDIX: Thickening is seen throughout the colon, most prominently in the cecum and ascending colon. Relative hypoenhancement of the ascending colon on arterial and venous phase images without bowel pneumatosis. PERITONEUM / MESENTERY: Moderate volume ascites. Diffuse mesenteric stranding is similar to prior. RETROPERITONEUM: Normal. OTHER VESSELS: Small esophageal varices and periumbilical collaterals. Nonocclusive small thrombus in the main portal vein is developed in the interval. URINARY BLADDER: Decompressed urinary bladder. REPRODUCTIVE ORGANS: The uterus is absent. BODY WALL: Moderate anasarca. Small fat-containing supraumbilical ventral and umbilical hernias. MUSCULOSKELETAL: No aggressive osseous lesions. Mild multilevel degenerative changes of the thoracolumbar spine. CONCLUSION: 1. Colonic wall thickening most prominent in the ascending colon can be seen with congestive portal hypertensive colopathy. However, relative hypoenhancement of the ascending colon is concerning for ischemia. No bowel pneumatosis evident. Consider surgical consultation. 2. Small nonocclusive main portal vein thrombus. 3. Patchy groundglass opacities in the bilateral lower lobes consistent with provided history of multifocal Covid pneumonia. 4. Cirrhosis with sequela of portal hypertension including portal vein dilatation, varices, ascites. Abdominal lymphadenopathy is similar to prior, possibly reactive but malignancy cannot be excluded. 5. Additional chronic findings as above. Preliminary findings discussed with Dr. Sharpls by Ivan Morales, M.D. on 1/8/2022 4:27 PM As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: Motion limited exam. STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. Mild atherosclerotic disease. CELIAC AXIS: The left splenic artery is surgically ligated. The celiac artery is otherwise unremarkable with conventional anatomy. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Respiratory motion degradation. Bilateral groundglass opacities have developed and again demonstrated is a calcified left lower lobe granuloma. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic in morphology with surface nodularity. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Surgically absent. Nodular, enhancement residual splenic tissue in the left upper quadrant. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Enlarged periaortic, periportal, gastrohepatic, and cardiophrenic lymph nodes for example. Stable size of 1.6 cm in short axis (series 501, image 76) gastrohepatic lymph node. STOMACH / SMALL BOWEL: The stomach is unremarkable. The small bowel is normal in caliber. COLON / APPENDIX: Thickening is seen throughout the colon, most prominently in the cecum and ascending colon. Relative hypoenhancement of the ascending colon on arterial and venous phase images without bowel pneumatosis. PERITONEUM / MESENTERY: Moderate volume ascites. Diffuse mesenteric stranding is similar to prior. RETROPERITONEUM: Normal. OTHER VESSELS: Small esophageal varices and periumbilical collaterals. Nonocclusive small thrombus in the main portal vein is developed in the interval. URINARY BLADDER: Decompressed urinary bladder. REPRODUCTIVE ORGANS: The uterus is absent. BODY WALL: Moderate anasarca. Small fat-containing supraumbilical ventral and umbilical hernias. MUSCULOSKELETAL: No aggressive osseous lesions. Mild multilevel degenerative changes of the thoracolumbar spine.
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FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Postsurgical changes from prior left lobectomy, with evolving postradiation changes in the perihilar left upper lobe. Bibasilar atelectasis in the right lower lobe. Left apical scarring, overall unchanged. No suspicious pulmonary nodule. No pleural effusion.. HEART / VESSELS: No pericardial effusion. No central PE. Mild circumflex artery coronary calcifications. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. A few small calcified mediastinal lymph nodes, new from prior study. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Will be reported separately. MUSCULOSKELETAL: No destructive osseous lesion.
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3,613
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RADIOLOGIC EXAM: CT Lumbar Spine wo contrast CLINICAL INFORMATION: Evaluate retained bullet fragment at T12-L1 COMPARISON: CT of the lumbar spine dated 12/9/2021 TECHNIQUE: CT Lumbar Spine wo contrastScan field of view: 137 mm. DLP: 880 mGy cm. Axial helical images of the lumbar spine were obtained. Coronal and sagittal reformatted images were obtained from the axial data set. FINDINGS: VERTEBRA: No fracture. Sacralization of L5 with articulation of the transverse processes with the sacrum. DISC SPACES AND FACET JOINTS: No acute injury. Redemonstrated ballistic fragment within the intervertebral disc space at T12-L1, unchanged from prior with associated subtle deformities of the adjacent endplates. PREVERTEBRAL SOFT TISSUES: Redemonstrated partially visualized simple appearing fluid collection in the left retroperitoneum, not significantly changed from prior. Several punctate ballistic fragments are noted in the left retroperitoneum, unchanged.. ALIGNMENT: Normal. CONCLUSION: 1. Unchanged ballistic fragment in the T12-L1 intervertebral disc space without acute osseous abnormality. 2. Partially visualized fluid collection in the splenectomy bed is again noted. Again, this could represent a seroma/resolving hematoma. However, further evaluation with CT abdomen is recommended as clinically 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.
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FINDINGS: VERTEBRA: No fracture. Sacralization of L5 with articulation of the transverse processes with the sacrum. DISC SPACES AND FACET JOINTS: No acute injury. Redemonstrated ballistic fragment within the intervertebral disc space at T12-L1, unchanged from prior with associated subtle deformities of the adjacent endplates. PREVERTEBRAL SOFT TISSUES: Redemonstrated partially visualized simple appearing fluid collection in the left retroperitoneum, not significantly changed from prior. Several punctate ballistic fragments are noted in the left retroperitoneum, unchanged.. ALIGNMENT: Normal.
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Findings: There is no evidence of acute intra- or extra-axial hemorrhage. There is no midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation appears maintained. The ventricular system are normal in configuration. The basal cisterns are clear. Post administration of contrast material, There is no evidence of enhancing intracranial pathology. Extracranially pansinusitis and extensive reactive osteitis is again seen. Complete opacification of the right mastoid and partial opacification of the left mastoid seen.. The visualized bones of the calvarium demonstrate no acute osseous abnormality.
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3,614
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain, dysuria COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 120 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. IV contrast injection rate: 2 ml per sec. Scan delay: 70 sec. Scan field of view: 326 mm. DLP: 376 mGy cm. FINDINGS : STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. 215V421 ABDOMEN and PELVIS: LIVER: Subcentimeter enhancing lesions within the periphery of the right hepatic lobe likely reflects a tiny flash filling hemangioma. Otherwise normal aside from focal fat adjacent to falciform. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: 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: Healed incisional scar along the anterior lower abdominal wall. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: No acute abdominal or pelvic abnormality.
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STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. 215V421 ABDOMEN and PELVIS: LIVER: Subcentimeter enhancing lesions within the periphery of the right hepatic lobe likely reflects a tiny flash filling hemangioma. Otherwise normal aside from focal fat adjacent to falciform. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: 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: Healed incisional scar along the anterior lower abdominal wall. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. The mediastinum is shifted to the left due to chronic volume loss throughout the left lung. Enlarged right paratracheal node on series 2 image 78 measures 12 x 12 mm and was only 9 mm in short axis on the prior. The lateral aortic node that was enlarged on the prior exam measures only 8 mm in short axis on the current exam on series 2 image 63. Surgical clips are seen in the left axillary region. The soft tissue density along the left internal mammary chain measures 8 x 31 mm on image 94 and was 15 x 30 mm on the prior. Additional left internal mammary nodes have also decreased in size. Small hiatal hernia is redemonstrated. Dilatation of the mid and upper esophagus is noted. Calcific atherosclerosis is present in the aorta and coronary arteries. Chronic occlusion of the distal left mainstem bronchus including the stented area is redemonstrated. Atelectasis of the left lung base secretion filled bronchi appears unchanged. A new area of increased density is seen in the right upper lobe anterior and lateral to the thoracic spine. No underlying osseous lesion is appreciated. An adjacent new small nodule measuring 5 mm is present on image 40. Previously seen lateral right apical nodule on image 39 is unchanged back to at least 2019 as is the 4 mm RUL nodule on image 76. Additional tiny subpleural nodule in the RUL on image 39 is also unchanged back to 2019. Anterior RUL subpleural nodule on image 96 is unchanged back to 2019. Opacified bronchi are again seen in the medial aspect of the right middle lobe with both tree-in-bud opacities and small peripheral consolidation. The areas of consolidation have increased from the prior. A new small RLL nodule is present on image 157. Bronchial wall thickening is throughout the right lung with additional areas of bronchial secretions centrally in the right upper lobe. Calcified granuloma are seen in the spleen. Limited noncontrast images of the upper abdomen are otherwise unremarkable. Vertebral body height loss at T8 and mild superior endplate compression at T12 are unchanged. No suspicious osseous lesions.
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3,615
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain and nausea. History of pancreatitis COMPARISON: 1/4/2022 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 155 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 80 sec Scan field of view: 356 mm. DLP: 479.50 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Peribronchial thickening and linear atelectasis in the left lower lobe. A noncalcified 9 x 9 mm nodule is present in the left lower lobe image 30, series 201, unchanged. DISTAL ESOPHAGUS: Small hiatal hernia HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. No significant peripancreatic inflammatory stranding. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach and small bowel are normal in caliber. COLON / APPENDIX: Colon is normal in caliber. Appendix appears normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild/moderate atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostatomegaly measuring up to 5.8 cm in diameter, stable. There is focal hyperattenuation in the right peripheral zone on series 201 image 238. Bilateral hydroceles BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. CONCLUSION: 1. No acute intra-abdominal abnormality. 2. There is focal hyperattenuation in the right prostate peripheral zone, recommend correlation with PSA and perhaps pelvic MRI. 3. Indeterminate stable 9 mm left lower lobe noncalcified nodule. 4. Additional chronic and incidental findings as above including atherosclerotic disease, prostatomegaly, and small hiatal hernia. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Peribronchial thickening and linear atelectasis in the left lower lobe. A noncalcified 9 x 9 mm nodule is present in the left lower lobe image 30, series 201, unchanged. DISTAL ESOPHAGUS: Small hiatal hernia HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. No significant peripancreatic inflammatory stranding. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach and small bowel are normal in caliber. COLON / APPENDIX: Colon is normal in caliber. Appendix appears normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild/moderate atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostatomegaly measuring up to 5.8 cm in diameter, stable. There is focal hyperattenuation in the right peripheral zone on series 201 image 238. Bilateral hydroceles BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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FINDINGS: STRUCTURED REPORT: CTA Lower Extremities VASCULATURE: ABDOMINAL AORTA: Patent with moderate mixed calcified and noncalcified atherosclerotic plaque without, dissection, or evidence of flow-limiting stenosis. RIGHT ILIAC ARTERIES: Patent with mild-moderate scattered atherosclerotic plaque throughout the common and internal iliac arteries without aneurysm, dissection, or evidence of flow-limiting stenosis. There is minimal scattered sclerotic disease of the widely patent external iliac artery. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Mild scattered predominantly calcified atherosclerotic plaque within the patent common femoral artery. The superficial femoral artery and profunda femoris are widely patent with minimal scattered atherosclerotic plaque. There is mild (less than 50% luminal narrowing throughout the mid popliteal artery at the level of the knee joint. The remainder of the popliteal arteries bilaterally patent without any significant atherosclerotic disease. RIGHT TIBIAL AND PERONEAL ARTERIES: Widely patent without evidence of aneurysm, dissection, or flow-limiting stenosis. There is three-vessel runoff to the right foot. RIGHT FOOT ARTERIES: No significant abnormality. LEFT ILIAC ARTERIES: Patent with mild-moderate scattered atherosclerotic plaque throughout the common and internal iliac arteries without aneurysm, dissection, or evidence of flow-limiting stenosis. There is minimal scattered sclerotic disease of the widely patent external iliac artery. LEFT FEMORAL \T\ POPLITEAL ARTERIES: Mild scattered predominantly calcified atherosclerotic plaque within the patent common femoral artery. Minimal scattered sclerotic calcifications within the widely patent superficial femoral artery and profunda femoris. There is mild scattered atherosclerotic calcifications within the patent popliteal artery without aneurysm, dissection, or evidence of flow-limiting stenosis. LEFT TIBIAL AND PERONEAL ARTERIES: Widely patent without evidence of aneurysm, dissection, or flow-limiting stenosis. There is three-vessel runoff to the left foot. LEFT FOOT ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER ABDOMEN: BOWEL: Scattered noninflamed colonic diverticula; otherwise unremarkable. PERITONEUM: No intraperitoneal free fluid or free air. OTHER: No other abnormality. PELVIS: OTHER VESSELS: No significant abnormality. Small dilated superficial (varicose) veins in the proximal medial right foreleg. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing right inguinal hernia. MUSCULOSKELETAL: No focal destructive osseous lesion. Grade 1 anterolisthesis of L5 on S1 with degenerative bilateral L5 pars defects. Right femoral intramedullary rod and nail fixation is noted.
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3,616
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Abdominal pain, altered mental status COMPARISON: 6/18/2021 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 392 mm. DLP: 630.60 mGy cm. FINDINGS: CONTRAST DISCLAIMER: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral dependent and linear subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Unremarkable for technique BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Unremarkable for technique SPLEEN: Unremarkable for technique ADRENALS: Normal. KIDNEYS: Bilateral ureteral stents are present extending from the renal pelvises to the urinary bladder. There is no hydronephrosis. Multiple nonobstructing right renal calculi are present measuring up to 5 mm on series 201 image 140. There is an exophytic lesion off the left lower pole measuring 2.7 cm in diameter and 33 Hounsfield units, overall stable compared to prior exam. Right renal caliectasis versus hydrocalyx is are unchanged. There is been interval enlargement of the left kidney with subtle asymmetric perinephric stranding. There is subtle periureteral stranding as well on the left. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Right abdomen ileostomy.. There is no evidence of obstruction. The stomach is unremarkable. COLON / APPENDIX: Subtotal colectomy changes. The residual Hartmann pouch is unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild/moderate atherosclerotic disease. URINARY BLADDER: Foley catheter in place. Bilateral ureteral stents coiled within the urinary bladder. Pericystic inflammatory stranding. REPRODUCTIVE ORGANS: Status post hysterectomy. No adnexal masses. BODY WALL: Lower anterior abdominal wall postsurgical changes and inflammatory stranding with a ill-defined fluid collection along the lower anterior abdominal wall measuring 2.8 x 1.6 cm on series 201 image 269. There is extensive subcutaneous stranding seen within the extraperitoneal tissues superior to the urinary bladder and extending up along the left paracolic gutter. There is a fluid collection seen within the subcutaneous tissues of the left pelvis measuring 5.7 x 1.7 cm on image 220, series 201. There is overlying subcutaneous stranding and a small amount of skin thickening. There is a nodular density seen in the left anterior pelvic subcutaneous tissues which is nonspecific but could be secondary to prior injection. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Postsurgical changes from subtotal colectomy and hysterectomy with ill-defined subincisional fluid collections as well as a indeterminate subcutaneous fluid collection along the left abdomen. While this could be postsurgical/seroma, superimposed infection is not excluded. 2. Extensive inflammatory changes are seen in the extraperitoneal soft tissues of the left anterior pelvis, possibly postsurgical or secondary to underlying infection. The previously seen fat-containing masses within the left lower quadrant, concerning for possible liposarcoma or fat necrosis, are not as well appreciated given the inflammatory stranding. Short-term follow-up is recommended to ensure stability, as clinically indicated. 3. Asymmetrical enlargement and perinephric stranding involving the left kidney, concerning for pyelonephritis. 4. Unchanged right renal scarring and pelviectasis. Bilateral ureteral stents without hydronephrosis. 5. Incidental nodular densities in the subcutaneous tissues, possibly due to prior injections. Subcutaneous stranding along the anterior abdomen, possibly postsurgical or infectious/inflammatory. 6. Additional findings above. Final report findings discussed with Dr. Pigott at 1/8/2022 5:01 PM by Dr. Little by telephone. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CONTRAST DISCLAIMER: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral dependent and linear subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Unremarkable for technique BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Unremarkable for technique SPLEEN: Unremarkable for technique ADRENALS: Normal. KIDNEYS: Bilateral ureteral stents are present extending from the renal pelvises to the urinary bladder. There is no hydronephrosis. Multiple nonobstructing right renal calculi are present measuring up to 5 mm on series 201 image 140. There is an exophytic lesion off the left lower pole measuring 2.7 cm in diameter and 33 Hounsfield units, overall stable compared to prior exam. Right renal caliectasis versus hydrocalyx is are unchanged. There is been interval enlargement of the left kidney with subtle asymmetric perinephric stranding. There is subtle periureteral stranding as well on the left. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Right abdomen ileostomy.. There is no evidence of obstruction. The stomach is unremarkable. COLON / APPENDIX: Subtotal colectomy changes. The residual Hartmann pouch is unremarkable. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild/moderate atherosclerotic disease. URINARY BLADDER: Foley catheter in place. Bilateral ureteral stents coiled within the urinary bladder. Pericystic inflammatory stranding. REPRODUCTIVE ORGANS: Status post hysterectomy. No adnexal masses. BODY WALL: Lower anterior abdominal wall postsurgical changes and inflammatory stranding with a ill-defined fluid collection along the lower anterior abdominal wall measuring 2.8 x 1.6 cm on series 201 image 269. There is extensive subcutaneous stranding seen within the extraperitoneal tissues superior to the urinary bladder and extending up along the left paracolic gutter. There is a fluid collection seen within the subcutaneous tissues of the left pelvis measuring 5.7 x 1.7 cm on image 220, series 201. There is overlying subcutaneous stranding and a small amount of skin thickening. There is a nodular density seen in the left anterior pelvic subcutaneous tissues which is nonspecific but could be secondary to prior injection. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis or scarring. Unchanged 6 mm left lower lobe pulmonary nodule.. DISTAL ESOPHAGUS: 5 HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Unchanged small hemangiomas in the posterior right hepatic lobe. Additional subcentimeter hypoattenuating lesions are observed, likely cysts, unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Interval ablation of the right anterior kidney lesion. There is increased density material associated with the ablation defect but no abnormal enhancement to suggest residual disease. Evolutionary changes in the ablation defect in the left kidney with decrease in size of the ablation defect. No evidence of residual or recurrent disease. Stable small renal cysts. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticula PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate aortic atherosclerotic disease without aneurysm URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: L3-L5 posterior fusion hardware is observed. Multilevel degenerative changes in the lumbar spine.
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3,617
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EXAM: CT Hip Left wo contrast CLINICAL INFORMATION: Evaluate for hardware malfunction. COMPARISON: 1/7/2022 pelvic radiograph. TECHNIQUE: CT Hip Left wo contrast Scan field of view: 280 mm. DLP: 1270 mGy cm. FINDINGS: Streak artifact from hardware limits evaluation. BONES/JOINTS: Comminuted fracture of the left pubic body extending into the left superior pubic ramus. Left hip total arthroplasty and cerclage hardware is intact without complication. SOFT TISSUES: No large hematoma or fluid collection. No acute findings visualized portions of the abdomen and pelvis. CONCLUSION: 1. Comminuted fracture of the left pubic body extending into the left superior pubic ramus. 2. Left hip arthroplasty hardware is unremarkable. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: Streak artifact from hardware limits evaluation. BONES/JOINTS: Comminuted fracture of the left pubic body extending into the left superior pubic ramus. Left hip total arthroplasty and cerclage hardware is intact without complication. SOFT TISSUES: No large hematoma or fluid collection. No acute findings visualized portions of the abdomen and pelvis.
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FINDINGS: STRUCTURED REPORT: CT Pancreatic Mass STUDY QUALITY: Satisfactory. LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small sliding hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal variant focal fatty change is at the periphery of the left hepatic lobe. Liver is otherwise normal. PERITONEUM: No abnormality. No large peritoneal nodules. PANCREAS: Pancreatic mass: - Location: Tail - Size: 2.9 x 2.5 cm, similar to MR dated 6/2021. - Composition: Cystic. Fine internal septations seen on MR are not appreciated on this exam. No mural nodularity. - Enhancement relative to pancreas: Hypoenhancing - Margins: Well defined with smooth margins. - Pancreatic duct: Not dilated - Pancreatic atrophy: No pancreatic atrophy. - Biliary ducts: Not dilated - Gallbladder: Absent. VASCULATURE: - Arterial anatomy: Accessory left hepatic artery arises from the left gastric artery. - Celiac Axis (CA): No tumor contact. - Common Hepatic Artery (CHA): No tumor contact. - Superior Mesenteric Artery (SMA): No tumor contact. - Aorta: No tumor contact. - Main Portal Vein (PV) and Superior Mesenteric Vein (SMV): No tumor contact. - IVC and Renal Veins: No tumor contact. - Vessel thrombosis: None. - Venous collaterals: None. - Other peripancreatic vessel comment: None. LYMPH NODES: None enlarged. RETROPERITONEUM: No tumor invasion. MESENTERY: No tumor invasion. ADRENALS: Normal. KIDNEYS: Normal. SPLEEN: Normal. STOMACH: No abnormality. DUODENUM: No abnormality. SMALL BOWEL: No abnormality. COLON: No abnormality. The appendix is not definitively visualized. OTHER VESSELS: No significant abnormality. BODY WALL: Postsurgical changes of the lower abdominal wall. MUSCULOSKELETAL: No aggressive osseous lesion.
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3,618
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Radiologic Exam: CT Angio Head Code Stroke, CT Angio Neck 1/8/2022 3:30 PM Clinical Information: code stroke. Comparison: None available. Technique: Helical CT images were obtained before and after the administration of contrast from the base of the skull to the vertex. Contrast enhanced images were then performed from the superior mediastinum to the vertex. 3-D CT angiographic images were generated from the axial data set under the supervision of the reporting physician. Results are reported below. "Sliding MIP" images were also generated in the sagittal, axial, and coronal planes. Patient weight: 237 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: 290 mm. DLP: 3157 mGy cm. (accession CT220004306), Patient weight: 237 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: 290 mm. (accession CT220004307) FINDINGS: CT angiogram of the brain: RIGHT CAROTID: There is moderate calcified atherosclerosis of the cavernous ICA resulting in 225% luminal narrowing. There is no evidence of occlusion or aneurysmal dilation. LEFT CAROTID: There is mild calcified atherosclerosis of the cavernous ICA without flow limitation. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation in the proximal aspects. At the region of peripheral left parietal ischemia and left frontal ischemia there is decreased flow. A left frontal developmental venous anomaly with prominent draining vessel is suggested. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild calcified atherosclerosis of the V4 segment of the left vertebral artery. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional anatomy without significant abnormality. RIGHT CAROTID: There is moderate calcified atherosclerosis of the carotid bulb with approximately 50% stenosis at the origin of the right ICA. There is no occlusion or aneurysmal dilation. LEFT CAROTID: There is moderate calcified atherosclerosis at the carotid bulb with mild luminal narrowing at the origin of the ICA and ECA. There is no evidence of flow limiting 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: A few subcentimeter thyroid nodules. In the thyroid appears mildly enlarged. CERVICAL SPINE: There is straightening of the usual cervical lordosis. Mild anterolisthesis of C4 on C5. Severe discogenic degenerative changes are noted at C5-C6 with moderate spinal canal narrowing at this level secondary to posterior disc osteophyte complex. CONCLUSION: 1. No large vessel occlusion or flow-limiting stenosis identified within the cervical or intracranial arteries. At the region of ischemia in the left frontal and left parietal lobe there is decreased flow in the peripheral left MCA territories. 2. Calcified atherosclerosis results in 50% luminal narrowing at the origin of the right ICA. 3. Thyroid goiter with a few small nodules. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT angiogram of the brain: RIGHT CAROTID: There is moderate calcified atherosclerosis of the cavernous ICA resulting in 225% luminal narrowing. There is no evidence of occlusion or aneurysmal dilation. LEFT CAROTID: There is mild calcified atherosclerosis of the cavernous ICA without flow limitation. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation in the proximal aspects. At the region of peripheral left parietal ischemia and left frontal ischemia there is decreased flow. A left frontal developmental venous anomaly with prominent draining vessel is suggested. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild calcified atherosclerosis of the V4 segment of the left vertebral artery. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional anatomy without significant abnormality. RIGHT CAROTID: There is moderate calcified atherosclerosis of the carotid bulb with approximately 50% stenosis at the origin of the right ICA. There is no occlusion or aneurysmal dilation. LEFT CAROTID: There is moderate calcified atherosclerosis at the carotid bulb with mild luminal narrowing at the origin of the ICA and ECA. There is no evidence of flow limiting 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: A few subcentimeter thyroid nodules. In the thyroid appears mildly enlarged. CERVICAL SPINE: There is straightening of the usual cervical lordosis. Mild anterolisthesis of C4 on C5. Severe discogenic degenerative changes are noted at C5-C6 with moderate spinal canal narrowing at this level secondary to posterior disc osteophyte complex.
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FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: There has been near total resolution of previously noted right middle lobe and right lower lobe nodules with residual linear scarring. A tiny 2 mm left upper lobe nodule (image 107, series 3) is unchanged. No new or enlarging suspicious pulmonary nodule. No focal consolidation. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. Lipomatous hypertrophy of the interatrial septum. Moderate coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. There is a slitlike narrowing of the left brachiocephalic vein and SVC. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Reported separately.
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3,619
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Radiologic Exam: CT Angio Head Code Stroke, CT Angio Neck 1/8/2022 3:30 PM Clinical Information: code stroke. Comparison: None available. Technique: Helical CT images were obtained before and after the administration of contrast from the base of the skull to the vertex. Contrast enhanced images were then performed from the superior mediastinum to the vertex. 3-D CT angiographic images were generated from the axial data set under the supervision of the reporting physician. Results are reported below. "Sliding MIP" images were also generated in the sagittal, axial, and coronal planes. Patient weight: 237 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: 290 mm. DLP: 3157 mGy cm. (accession CT220004306), Patient weight: 237 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: 290 mm. (accession CT220004307) FINDINGS: CT angiogram of the brain: RIGHT CAROTID: There is moderate calcified atherosclerosis of the cavernous ICA resulting in 225% luminal narrowing. There is no evidence of occlusion or aneurysmal dilation. LEFT CAROTID: There is mild calcified atherosclerosis of the cavernous ICA without flow limitation. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation in the proximal aspects. At the region of peripheral left parietal ischemia and left frontal ischemia there is decreased flow. A left frontal developmental venous anomaly with prominent draining vessel is suggested. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild calcified atherosclerosis of the V4 segment of the left vertebral artery. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional anatomy without significant abnormality. RIGHT CAROTID: There is moderate calcified atherosclerosis of the carotid bulb with approximately 50% stenosis at the origin of the right ICA. There is no occlusion or aneurysmal dilation. LEFT CAROTID: There is moderate calcified atherosclerosis at the carotid bulb with mild luminal narrowing at the origin of the ICA and ECA. There is no evidence of flow limiting 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: A few subcentimeter thyroid nodules. In the thyroid appears mildly enlarged. CERVICAL SPINE: There is straightening of the usual cervical lordosis. Mild anterolisthesis of C4 on C5. Severe discogenic degenerative changes are noted at C5-C6 with moderate spinal canal narrowing at this level secondary to posterior disc osteophyte complex. CONCLUSION: 1. No large vessel occlusion or flow-limiting stenosis identified within the cervical or intracranial arteries. At the region of ischemia in the left frontal and left parietal lobe there is decreased flow in the peripheral left MCA territories. 2. Calcified atherosclerosis results in 50% luminal narrowing at the origin of the right ICA. 3. Thyroid goiter with a few small nodules. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT angiogram of the brain: RIGHT CAROTID: There is moderate calcified atherosclerosis of the cavernous ICA resulting in 225% luminal narrowing. There is no evidence of occlusion or aneurysmal dilation. LEFT CAROTID: There is mild calcified atherosclerosis of the cavernous ICA without flow limitation. There is no evidence of flow-limiting stenosis, occlusion, or aneurysmal dilation. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation in the proximal aspects. At the region of peripheral left parietal ischemia and left frontal ischemia there is decreased flow. A left frontal developmental venous anomaly with prominent draining vessel is suggested. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild calcified atherosclerosis of the V4 segment of the left vertebral artery. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Conventional anatomy without significant abnormality. RIGHT CAROTID: There is moderate calcified atherosclerosis of the carotid bulb with approximately 50% stenosis at the origin of the right ICA. There is no occlusion or aneurysmal dilation. LEFT CAROTID: There is moderate calcified atherosclerosis at the carotid bulb with mild luminal narrowing at the origin of the ICA and ECA. There is no evidence of flow limiting 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: A few subcentimeter thyroid nodules. In the thyroid appears mildly enlarged. CERVICAL SPINE: There is straightening of the usual cervical lordosis. Mild anterolisthesis of C4 on C5. Severe discogenic degenerative changes are noted at C5-C6 with moderate spinal canal narrowing at this level secondary to posterior disc osteophyte complex.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separate CT chest report. ABDOMEN and PELVIS: LIVER: The previously noted metabolically active right hepatic dome lesions and caudate lobe lesion are not well-visualized. There are three additional subcentimeter hypoattenuating lesions too small to characterize but also appear unchanged. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: There is heterogenous lesion of the anterior limb of the left adrenal gland measuring 2.2 x 1.2 cm (series 3, image 208), previously 3.9 x 2.7. Normal right adrenal gland. KIDNEYS: Unchanged simple renal cysts bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated colonic diverticulosis. PERITONEUM / MESENTERY: No ascites or free intraperitoneal air. RETROPERITONEUM: Normal. VESSELS: Aortobiiliac graft with moderate aortic and bifemoral atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Enlarged prostate. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multilevel spinal degenerative changes. No suspicious osseous lesion.
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3,620
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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: 218 mm. DLP: 1083 mGy cm. INDICATION: expressive and receptive aphasia, right sided neglect Spec Inst: onset 2200 01.07 COMPARISON: None. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: There is loss of gray-white matter differentiation in the anterior left parietal and superior temporal lobes with effacement of the cortical sulci in this region. There is also a small area of loss of gray-white matter differentiation in the left superior frontal lobe on axial image 44 series 2 for example. There is no intracranial hemorrhage. Mild diffuse cerebral volume loss. Mild hypoattenuation in the periventricular and subcortical white matter, likely sequela of chronic microangiopathy. Chronic medial right parietal lobe infarct. In the splenium of the right corpus callosum there is a additional possible area of ischemia with slight mass effect on the posterior right lateral ventricle. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CONCLUSION: Posterior left MCA territory infarct involving Wernicke's area without intracranial hemorrhage. Additional area of acute ischemia/infarct in the left frontal lobe. Possible right corpus callosal splenial infarct/ischemia. Consider further characterization with brain MRI with contrast when appropriate. Preliminary results were discussed with Dr. Christopher Greene at 3:25 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.
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FINDINGS: BRAIN PARENCHYMA: There is loss of gray-white matter differentiation in the anterior left parietal and superior temporal lobes with effacement of the cortical sulci in this region. There is also a small area of loss of gray-white matter differentiation in the left superior frontal lobe on axial image 44 series 2 for example. There is no intracranial hemorrhage. Mild diffuse cerebral volume loss. Mild hypoattenuation in the periventricular and subcortical white matter, likely sequela of chronic microangiopathy. Chronic medial right parietal lobe infarct. In the splenium of the right corpus callosum there is a additional possible area of ischemia with slight mass effect on the posterior right lateral ventricle. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Increasing small left pleural effusion with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Pneumobilia. Mild prominence of the extrahepatic bile duct. GALLBLADDER: Absent. PANCREAS: Post surgical changes from pancreatic duodenectomy. Peripancreatic stranding and fluid appears overall similar to prior. Peripherally enhancing fluid collection arising from the cranial margin of the pancreatic body/tail is more well organized compared to the prior exam and measures 3.8 x 3.1 cm in greatest axial dimensions on image 115 series 306, previously measuring the same. Collection extending from the caudal margin of the pancreatic neck appears more organized and smaller in size compared to prior exam measuring 4.0 x 2.6 cm image 154 series 306, previously 3.9 x 3.1 cm. Collection again communicates with the precaval region. No new peripancreatic collections. SPLEEN: Normal. ADRENALS: Similar left adrenal gland thickening without discrete nodule. KIDNEYS: Right interpolar cyst. LYMPH NODES: Multiple prominent central mesenteric lymph nodes, similar to prior and likely reactive. STOMACH / SMALL BOWEL: Post surgical changes from pancreaticoduodenectomy. Small bowel is normal in caliber. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Left hemiabdomen approach surgical drain terminates in the subhepatic region, unchanged. Previously seen collection along the inferior margin left hepatic lobe has resolved. Trace pelvic ascites. RETROPERITONEUM: Normal. VESSELS: Narrowing of the portal confluence and cranial SMV appears similar to prior. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Fluid deep to the surgical incision now demonstrates increasing peripheral enhancement with the largest pocket of fluid measuring 5.7 x 3.3 cm on image 194 series 306. MUSCULOSKELETAL: Sclerosis of bilateral sacroiliac joints. Lower lumbar spine degenerative changes.
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CT Perfusion 1/8/2022 3:20 PM Clinical Information: Stroke. aphasia Comparison: None 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: 237 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: 214 mm. DLP: 1947 mGy cm. Findings: . Color parametric maps demonstrate small area of increased mean transit time and Tmax within corresponding decreased R CBF and R CBV within the left parietal lobe. Prognostic maps demonstrate small area of Tmax greater than six seconds within the left parietal lobe. Total volume is 13 mL. There is CBF less than 30% within the left parietal lobe with total volume of 7 mL. Conclusion: Acute left parietal lobe infarction with small penumbra.
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Findings: . Color parametric maps demonstrate small area of increased mean transit time and Tmax within corresponding decreased R CBF and R CBV within the left parietal lobe. Prognostic maps demonstrate small area of Tmax greater than six seconds within the left parietal lobe. Total volume is 13 mL. There is CBF less than 30% within the left parietal lobe with total volume of 7 mL.
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FINDINGS: Calcified granuloma in the left lower lobe is redemonstrated. Bilateral subpleural reticulation with reticulation along bronchovascular bundles is noted. The extensive groundglass opacities seen on the prior exam have resolved. Traction bronchiectasis is present in the lower lobes. No definitive honeycombing is seen. There is minimal apical to basilar gradient with the posterior inferior bases relatively spared. Small RLL subpleural nodule on series 2 image 130 is not clearly identified on the prior but this may be due to the groundglass opacities and motion artifact. No pleural effusion. No noncalcified nodules or masses. - Air trapping is seen bilaterally but no tracheobronchomalacia. - Calcified subcarinal lymph nodes are noted. No enlarged noncalcified intrathoracic nodes are present. Small hiatal hernia is seen. Mild calcific atherosclerosis is present in the aorta and coronary arteries. Within the limits of a noncontrast exam, the heart size and mediastinum are otherwise normal. - A 4 mm exophytic left renal cyst is partially seen. Slight nodularity in the left intrarenal suspected with linear calcification in the right adrenal. Calcified granuloma are present in the spleen. Limited noncontrast images of the upper abdomen are otherwise unremarkable. - Healing anterior right second rib fracture is new since the previous exam. No additional change or suspicious focal osseous lesions is seen. -
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 21-year-old female follow-up MVC with pain. COMPARISON: CT chest, abdomen and pelvis 1/6/2022 TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 135 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec Scan field of view: 437 mm. DLP: 546.60 mGy cm. (accession CT220004311), Patient weight: 134 lbs. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec Scan field of view: 437 mm. (accession CT220004310) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Few subtle groundglass opacities in bilateral lower lobes. No dense consolidation, pneumothorax or pleural effusion. 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: Subtle intraluminal hyperdensity, likely vicariously excreted contrast. No other significant abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. Previously seen linear hypodensity in the left upper renal pole is not well-visualized on this exam. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality. Mild colonic fecal burden. Appendix is normal. PERITONEUM / MESENTERY: Trace hemoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Small amount of intraluminal air, likely secondary to recent interpretation. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate volume fluid/edema in the preperitoneal soft tissues and along the pelvic sidewalls bilaterally. Post surgical changes in the left gluteal and anterior hip soft tissues. MUSCULOSKELETAL: Postsurgical changes from left-sided iliac wing and iliosacral screw fixation. The left iliac wing screw extends beyond the posterior margin of the cortex and closely approximates the gluteal skin. Multiple fractures involving the left ilium, sacrum and obturator ring are redemonstrated. No new traumatic osseous abnormality is identified. Lucency in the proximal sternum is redemonstrated and indeterminate. Bilateral os acromiale. CONCLUSION: 1. Trace hemoperitoneum, increased from prior exam. No definite evidence of active extravasation. No new traumatic injury in the chest, abdomen or pelvis is otherwise identified. 2. Redemonstrated fractures involving the left ilium, sacrum and obturator ring with interval iliac wing and iliosacral screw placement. Moderate volume of fluid and edema in the extra peritoneal spaces, as above, likely posttraumatic and postsurgical in etiology. 3. Additional incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Few subtle groundglass opacities in bilateral lower lobes. No dense consolidation, pneumothorax or pleural effusion. 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: Subtle intraluminal hyperdensity, likely vicariously excreted contrast. No other significant abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. Previously seen linear hypodensity in the left upper renal pole is not well-visualized on this exam. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality. Mild colonic fecal burden. Appendix is normal. PERITONEUM / MESENTERY: Trace hemoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Small amount of intraluminal air, likely secondary to recent interpretation. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate volume fluid/edema in the preperitoneal soft tissues and along the pelvic sidewalls bilaterally. Post surgical changes in the left gluteal and anterior hip soft tissues. MUSCULOSKELETAL: Postsurgical changes from left-sided iliac wing and iliosacral screw fixation. The left iliac wing screw extends beyond the posterior margin of the cortex and closely approximates the gluteal skin. Multiple fractures involving the left ilium, sacrum and obturator ring are redemonstrated. No new traumatic osseous abnormality is identified. Lucency in the proximal sternum is redemonstrated and indeterminate. Bilateral os acromiale.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Partially visualized right lower lobe and right middle lobe lower lobe collapse with diffuse endobronchial debris. Large bore right thoracostomy tube is partially visualized. Right hemopneumothorax with increasing pneumothorax component. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Large complex laceration involving the anterior right and left hepatic lobes. There are multiple areas of contrast extravasation consistent with active bleeding. No pseudoaneurysm is identified.. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Scattered foci of pneumoperitoneum. Right abdominal peritoneal drain remains in stable position. Small amount of perihepatic hemoperitoneum adjacent to the drainage catheter.. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Moderately distended REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Ventral laparotomy surgical changes MUSCULOSKELETAL: Comminuted anterior right eighth rib fracture, unchanged.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 21-year-old female follow-up MVC with pain. COMPARISON: CT chest, abdomen and pelvis 1/6/2022 TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 135 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec Scan field of view: 437 mm. DLP: 546.60 mGy cm. (accession CT220004311), Patient weight: 134 lbs. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec Scan field of view: 437 mm. (accession CT220004310) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Few subtle groundglass opacities in bilateral lower lobes. No dense consolidation, pneumothorax or pleural effusion. 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: Subtle intraluminal hyperdensity, likely vicariously excreted contrast. No other significant abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. Previously seen linear hypodensity in the left upper renal pole is not well-visualized on this exam. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality. Mild colonic fecal burden. Appendix is normal. PERITONEUM / MESENTERY: Trace hemoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Small amount of intraluminal air, likely secondary to recent interpretation. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate volume fluid/edema in the preperitoneal soft tissues and along the pelvic sidewalls bilaterally. Post surgical changes in the left gluteal and anterior hip soft tissues. MUSCULOSKELETAL: Postsurgical changes from left-sided iliac wing and iliosacral screw fixation. The left iliac wing screw extends beyond the posterior margin of the cortex and closely approximates the gluteal skin. Multiple fractures involving the left ilium, sacrum and obturator ring are redemonstrated. No new traumatic osseous abnormality is identified. Lucency in the proximal sternum is redemonstrated and indeterminate. Bilateral os acromiale. CONCLUSION: 1. Trace hemoperitoneum, increased from prior exam. No definite evidence of active extravasation. No new traumatic injury in the chest, abdomen or pelvis is otherwise identified. 2. Redemonstrated fractures involving the left ilium, sacrum and obturator ring with interval iliac wing and iliosacral screw placement. Moderate volume of fluid and edema in the extra peritoneal spaces, as above, likely posttraumatic and postsurgical in etiology. 3. Additional incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Few subtle groundglass opacities in bilateral lower lobes. No dense consolidation, pneumothorax or pleural effusion. 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: Subtle intraluminal hyperdensity, likely vicariously excreted contrast. No other significant abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. Previously seen linear hypodensity in the left upper renal pole is not well-visualized on this exam. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality. Mild colonic fecal burden. Appendix is normal. PERITONEUM / MESENTERY: Trace hemoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Small amount of intraluminal air, likely secondary to recent interpretation. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Moderate volume fluid/edema in the preperitoneal soft tissues and along the pelvic sidewalls bilaterally. Post surgical changes in the left gluteal and anterior hip soft tissues. MUSCULOSKELETAL: Postsurgical changes from left-sided iliac wing and iliosacral screw fixation. The left iliac wing screw extends beyond the posterior margin of the cortex and closely approximates the gluteal skin. Multiple fractures involving the left ilium, sacrum and obturator ring are redemonstrated. No new traumatic osseous abnormality is identified. Lucency in the proximal sternum is redemonstrated and indeterminate. Bilateral os acromiale.
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Findings: No enlarged intrathoracic nodes are present. Post CABG findings are noted with calcific atherosclerosis in the aorta, brachiocephalic arteries and native coronary arteries. Circumferential wall thickening is seen in the mid to lower esophagus. The heart size and mediastinum are otherwise normal. No pleural effusion. Bilateral calcified pleural plaques are seen. Bilateral upper lobe predominant centrilobular emphysema is present. Bronchial wall thickening is present in both lower lobes. Bilateral dependent atelectasis is noted in a few tiny calcified granuloma are present. No noncalcified nodules or masses are identified. Previous sternotomy. No focal destructive osseous lesions identified. The common bile duct is dilated into the pancreas with the distal pancreatic head and pancreaticoduodenal junction are not imaged. A right hepatic low-attenuation area seen with early peripheral globular enhancement suggesting a cavernous hemangioma. Atherosclerotic changes seen in the abdominal aorta and splenic artery.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Lower abdominal pain, guarding, tenderness COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 110 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 80 sec. Scan field of view: 369 mm. DLP: 438 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small right pleural effusion. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. No CT evidence of acute cholecystitis. PANCREAS: 4 mm pancreas body hypodensity. No acute abnormality. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild pelvocaliectasis and thickening/mild enhancement of the ureters LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: There are multiple borderline distended loops of small bowel measuring up to 3.1 cm in diameter on series 201 image 1:15 with suspected transition point in the left hemiabdomen on series 201 image 148. No bowel pneumatosis. COLON / APPENDIX: Colonic diverticulosis without diverticulitis. PERITONEUM / MESENTERY: Complex pelvic mass with fluid collections measuring 8.0 x 4.7 cm on series 201 image 245. Mass lies in close proximity to the rectum, distal sigmoid colon and posterior aspect of the bladder. There is surrounding inflammatory stranding. No pneumoperitoneum. Trace ascites. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease. URINARY BLADDER: Foley catheter in place. Pelvic mass lies in close proximity to the posterior aspect of the bladder. REPRODUCTIVE ORGANS: No normal appearing uterus is present. The pelvic mass is in the location of the uterus. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality. CONCLUSION: 1. Pelvic mass with associated fluid collections lying close proximity to the posterior aspect of the bladder and the distal sigmoid colon, rectum. Findings concerning for malignancy versus evolving pelvic abscess. Notably no normal uterine tissue is present, the lesion may be of uterine etiology if the native uterus is present. 2. Borderline distended loops of small bowel with air-fluid levels and suspected transition point in the left hemiabdomen. Findings suggestive of evolving small bowel junction. 3. Pericystic inflammatory stranding and mild hyperattenuation of the ureters may related to ascending urinary tract infection. Correlate with urinalysis. 4. Additional incidental findings as above including cholelithiasis, colonic diverticulosis and atherosclerotic disease. Note: Findings were discussed with Dr. Thompson by Dr. Perchik at 1/8/2022 5:16 PM. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small right pleural effusion. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. No CT evidence of acute cholecystitis. PANCREAS: 4 mm pancreas body hypodensity. No acute abnormality. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild pelvocaliectasis and thickening/mild enhancement of the ureters LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: There are multiple borderline distended loops of small bowel measuring up to 3.1 cm in diameter on series 201 image 1:15 with suspected transition point in the left hemiabdomen on series 201 image 148. No bowel pneumatosis. COLON / APPENDIX: Colonic diverticulosis without diverticulitis. PERITONEUM / MESENTERY: Complex pelvic mass with fluid collections measuring 8.0 x 4.7 cm on series 201 image 245. Mass lies in close proximity to the rectum, distal sigmoid colon and posterior aspect of the bladder. There is surrounding inflammatory stranding. No pneumoperitoneum. Trace ascites. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic disease. URINARY BLADDER: Foley catheter in place. Pelvic mass lies in close proximity to the posterior aspect of the bladder. REPRODUCTIVE ORGANS: No normal appearing uterus is present. The pelvic mass is in the location of the uterus. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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Findings: There are postsurgical changes following partial glossectomy and floor of mouth tumor resection. No residual recurrent tumor is identified. There are bilateral neck dissections. The nasopharynx is unremarkable and the oral cavity are otherwise unremarkable. No abnormal adenopathy is seen. The hypopharynx and larynx have normal appearance. The infraglottic visceral space appears normal. There is dilatation of the right common carotid at the bulb from prior endarterectomy. The left carotid bifurcation is obscured by streak from metal clips. The small right vertebral artery is occluded throughout most of its course as before. The remaining soft tissues of the neck are unremarkable. There are degenerative changes in cervical spine but no lytic or blastic lesion is seen. See the chest CT for pulmonary findings. --------------
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3,625
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EXAM: CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma follow-up COMPARISON: 1/7/2022 TECHNIQUE: CT Bone Pelvis w soft tissue no charge Scan field of view: 437 mm. FINDINGS/CONCLUSION: Unchanged screw fixation of the left SI joint and left zone two sacral fracture. The fracture fragments are in unchanged alignment and position. Fixation of the posterior left ilium fracture is present. The screw extends approximately 3.4 cm on the posterior cortex and terminating within the left gluteal subcutaneous soft tissues, this has been corrected on subsequent radiographs. Unchanged alignment and position of the left obturator ring fractures. The femoral heads are well-seated within their respective acetabula. There is been interval mild diastasis of the right SI joint with intra-articular gas. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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FINDINGS/CONCLUSION: Unchanged screw fixation of the left SI joint and left zone two sacral fracture. The fracture fragments are in unchanged alignment and position. Fixation of the posterior left ilium fracture is present. The screw extends approximately 3.4 cm on the posterior cortex and terminating within the left gluteal subcutaneous soft tissues, this has been corrected on subsequent radiographs. Unchanged alignment and position of the left obturator ring fractures. The femoral heads are well-seated within their respective acetabula. There is been interval mild diastasis of the right SI joint with intra-articular gas. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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FINDINGS: Large region of encephalomalacia involving the superior left frontal lobe is unchanged from prior with associated ex vacuo dilatation of left lateral ventricle. Hypodense region involving the central pons is unchanged from prior. No intraparenchymal hemorrhage, mass effect or edema. The gray white matter differentiation is maintained. No extra axial collections. The ventricles are within normal size limits and there is no midline shift. No acute displaced fracture or aggressive osseous lesion. Postsurgical changes of prior left frontoparietal craniectomy. Mild maxillary sinus mucosal thickening. The remaining paranasal sinuses, middle ears, and mastoid air cells are clear. Prominence and tortuosity of the distal optic nerves near the insertion on the globes, not significantly changed from prior. The orbits are otherwise unremarkable. The visualized soft tissues are unremarkable.
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 72-year-old female with widened mediastinum. COMPARISON: Prior same-day chest radiograph. TECHNIQUE: CT Chest wo contrast. Scan field of view: 303 mm. DLP: 270 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: Mild cardiomegaly and coronary artery calcifications. Prominent the distal fat. Mild atherosclerotic calcifications of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: Right subclavian approach chest port in place with catheter tip terminating at the cavoatrial junction. Surgical clips are seen in the left axilla. No other significant abnormality. UPPER ABDOMEN: Postsurgical changes from sleeve gastrectomy. No other significant abnormality. MUSCULOSKELETAL: Multiple chronic right-sided rib fracture deformities. Multilevel degenerative changes of the thoracic spine. CONCLUSION: 1. Mediastinal lipomatosis is responsible for widening of the mediastinum seen on chest x-ray. No acute cardiopulmonary findings. 2. Chronic and incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: Mild cardiomegaly and coronary artery calcifications. Prominent the distal fat. Mild atherosclerotic calcifications of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: Right subclavian approach chest port in place with catheter tip terminating at the cavoatrial junction. Surgical clips are seen in the left axilla. No other significant abnormality. UPPER ABDOMEN: Postsurgical changes from sleeve gastrectomy. No other significant abnormality. MUSCULOSKELETAL: Multiple chronic right-sided rib fracture deformities. Multilevel degenerative changes of the thoracic spine.
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Findings: The quality of the study is excellent. Coronary arteries: Both coronary arteries arise from their normal respective cusp and have normal proximal course. Patient has a right dominant system. The right coronary artery measures approximately 4.5 mm. Scattered eccentric calcified plaque are present in the proximal and mid RCA without luminal narrowing. The intermediate size PDA and posterior lateral LV branches are unremarkable. The left main coronary artery is normal measuring 5.3 mm. It has a trifurcation pattern with a small ramus intermedius branch. The LAD measures 4.4 mm approximately. Eccentric calcified plaque is present in the proximal and mid LAD as well as at the origin of intermediate size second diagonal branch without significant luminal narrowing. The LAD gradually tapers and wraps at the apex. The proximal circumflex vessel is normal and measures approximately 4.0 mm in diameter. It gives off an early small size OM1 and then intermediate size OM two rapidly tapers. There is no atherosclerotic disease or focal narrowing. Cardiac function: LVEF: 59% LVED volume: 136.6 mL LVES volume: 56.2 mL Stroke volume: 80.4 mL There is no regional wall motion abnormality. Cardiac chambers are normal in size. There is no myocardial hypertrophy. ASD occluder device is noted in place. The aorta and pulmonary arteries and veins are normal. No intracardiac mass or thrombus is seen. The pericardium is normal without pericardial thickening or effusion. The included portions of the lung parenchyma are normal. Visualized mediastinum and bony structures are unremarkable.
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3,627
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RADIOLOGIC EXAM: CT Cervical Spine wo contrast CLINICAL INFORMATION: Fall and altered mental status COMPARISON: CT of the cervical spine without contrast dated 12/31/2021 TECHNIQUE: CT Cervical Spine wo contrastScan field of view: 206.50 mm. DLP: 308.60 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. Advanced degenerative changes of bilateral temporomandibular joints. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. Advanced degenerative changes of bilateral temporomandibular joints. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Status bilateral lung transplant with patent central bronchial anastomoses. There has been interval near total resolution of previously noted scattered groundglass opacities in both lungs with residual biapical pleuroparenchymal scarring, mild bronchiectatic changes and subpleural reticulation. Right lower lobe 6 mm nodule (image 98, series 3) is unchanged. Interval development of tiny subcentimeter pulmonary nodules, for example in the left lower lobe at image 85 and along the left major fissure at image 51. No pleural effusion. Expiratory images demonstrate multifocal areas of air trapping bilaterally. Redemonstrated bilateral lower lobe bronchomalacia. No evidence of excessive dynamic airway collapse. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. Small hiatal hernia. The thoracic aorta is normal in caliber. Main pulmonary artery is dilated, measures 3.2 cm. The cardiac chambers are normal in size. Severe scattered three-vessel coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: Clamshell sternotomy. No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: No abnormality in the imaged upper abdomen.
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3,628
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CLINICAL HISTORY: with optic lymphoma; rule out brain lesions EXAM: CT Head wo contrast, CT Orbit or Temporal Bones with contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. In addition 0.6 mm thick thin cut images were obtained through the orbits with intravenous contrast. Sagittal and coronal reformatted views were also obtained Scan field of view: 237 mm. DLP: 12919.70 mGy cm. (accession CT220004319), Patient weight: 263 lbs. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 200 mm. DLP: 1738.60 mGy cm. (accession CT220004318) COMPARISON: 12/30/2021 FINDINGS: Head CT: There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction or remote infarction. There is no mass lesion seen on this noncontrast examination. There is no mass effect. Ventricles are normal in size. There is no extra-axial fluid collection. There is no skull fracture. Mastoid air cells are clear Orbital CT. Previously identified destructive mass involving the medial left extraconal orbits and the left ethmoid air cells is significantly decreased in size. There is mild heterogeneous enhancement of the lesion. It measures 2.0 x 1.0 cm in the axial plane, previously measured 2.4 x 2.7 cm. It measures approximately 3.7 cm in craniocaudal dimension, previously measured 4.1 cm. There is stable destruction of the left left lamina papyracea. There is decreased mass effect upon the left medial rectus muscle although there is subtle contact of the left medial rectus muscle. The inferior portion of the lesion again encroaches upon the inferior rectus muscle. There is decreased mass effect with mildly decreased lateral displacement of the globe.. There is opacification of the nasolacrimal duct which appears expanded compared to the right suggesting additional tumor involvement. There is a small area of hypoattenuation within the superior aspect of the lesion which may represent small postsurgical fluid collection. It measures 0.7 x 0.5 cm.. There is a small area of fluid attenuation anterior to the anterior wall of the left maxillary sinus It measures 0.7 x 1.0 cm on axial image 37. These may be postsurgical and represent seroma or small resolving hematoma. However small abscess could have similar configuration. Both lacrimal glands appear unremarkable There is persistent opacification of the left frontal sinus with hyperdense secretions reflecting obstructive sinusitis.. There is also mild mucosal thickening within the left sphenoid sinus and right maxillary sinus. There is no abnormal enhancement of the visualized brain. CONCLUSION: 01. Decreased size of left orbital/left ethmoid mass with mildly decreased mass effect upon adjacent structures. There is continued extension into the medial extraconal compartment of the left globe and involvement of the left nasolacrimal duct. 02. Persistent postobstructive left frontal sinusitis. 03. No acute intracranial abnormality. No evidence of intracranial metastatic involvement
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FINDINGS: Head CT: There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction or remote infarction. There is no mass lesion seen on this noncontrast examination. There is no mass effect. Ventricles are normal in size. There is no extra-axial fluid collection. There is no skull fracture. Mastoid air cells are clear Orbital CT. Previously identified destructive mass involving the medial left extraconal orbits and the left ethmoid air cells is significantly decreased in size. There is mild heterogeneous enhancement of the lesion. It measures 2.0 x 1.0 cm in the axial plane, previously measured 2.4 x 2.7 cm. It measures approximately 3.7 cm in craniocaudal dimension, previously measured 4.1 cm. There is stable destruction of the left left lamina papyracea. There is decreased mass effect upon the left medial rectus muscle although there is subtle contact of the left medial rectus muscle. The inferior portion of the lesion again encroaches upon the inferior rectus muscle. There is decreased mass effect with mildly decreased lateral displacement of the globe.. There is opacification of the nasolacrimal duct which appears expanded compared to the right suggesting additional tumor involvement. There is a small area of hypoattenuation within the superior aspect of the lesion which may represent small postsurgical fluid collection. It measures 0.7 x 0.5 cm.. There is a small area of fluid attenuation anterior to the anterior wall of the left maxillary sinus It measures 0.7 x 1.0 cm on axial image 37. These may be postsurgical and represent seroma or small resolving hematoma. However small abscess could have similar configuration. Both lacrimal glands appear unremarkable There is persistent opacification of the left frontal sinus with hyperdense secretions reflecting obstructive sinusitis.. There is also mild mucosal thickening within the left sphenoid sinus and right maxillary sinus. There is no abnormal enhancement of the visualized brain.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No mass lesion is identified on this noncontrast examination. Moderate Bilateral carotid siphon calcific atherosclerosis. EXTRA-AXIAL SPACES: Disproportionate prominence of the left greater than right sylvian fissures given degree of cerebral volume loss, unchanged.. Normal callosal angle. No extra-axial collection. SKULL AND SKULL BASE: No fracture. Incidental hyperostosis frontalis interna. VENTRICULAR SYSTEM: Stable, proportionate ex vacuo ventricular dilatation. No increased ventricular caliber or periventricular hypoattenuation to suggest hydrocephalus. ORBITS: Bilateral ocular lens replacements. SINUSES: Normal. SOFT TISSUES: Unremarkable.
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3,629
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CLINICAL HISTORY: with optic lymphoma; rule out brain lesions EXAM: CT Head wo contrast, CT Orbit or Temporal Bones with contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. In addition 0.6 mm thick thin cut images were obtained through the orbits with intravenous contrast. Sagittal and coronal reformatted views were also obtained Scan field of view: 237 mm. DLP: 12919.70 mGy cm. (accession CT220004319), Patient weight: 263 lbs. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 200 mm. DLP: 1738.60 mGy cm. (accession CT220004318) COMPARISON: 12/30/2021 FINDINGS: Head CT: There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction or remote infarction. There is no mass lesion seen on this noncontrast examination. There is no mass effect. Ventricles are normal in size. There is no extra-axial fluid collection. There is no skull fracture. Mastoid air cells are clear Orbital CT. Previously identified destructive mass involving the medial left extraconal orbits and the left ethmoid air cells is significantly decreased in size. There is mild heterogeneous enhancement of the lesion. It measures 2.0 x 1.0 cm in the axial plane, previously measured 2.4 x 2.7 cm. It measures approximately 3.7 cm in craniocaudal dimension, previously measured 4.1 cm. There is stable destruction of the left left lamina papyracea. There is decreased mass effect upon the left medial rectus muscle although there is subtle contact of the left medial rectus muscle. The inferior portion of the lesion again encroaches upon the inferior rectus muscle. There is decreased mass effect with mildly decreased lateral displacement of the globe.. There is opacification of the nasolacrimal duct which appears expanded compared to the right suggesting additional tumor involvement. There is a small area of hypoattenuation within the superior aspect of the lesion which may represent small postsurgical fluid collection. It measures 0.7 x 0.5 cm.. There is a small area of fluid attenuation anterior to the anterior wall of the left maxillary sinus It measures 0.7 x 1.0 cm on axial image 37. These may be postsurgical and represent seroma or small resolving hematoma. However small abscess could have similar configuration. Both lacrimal glands appear unremarkable There is persistent opacification of the left frontal sinus with hyperdense secretions reflecting obstructive sinusitis.. There is also mild mucosal thickening within the left sphenoid sinus and right maxillary sinus. There is no abnormal enhancement of the visualized brain. CONCLUSION: 01. Decreased size of left orbital/left ethmoid mass with mildly decreased mass effect upon adjacent structures. There is continued extension into the medial extraconal compartment of the left globe and involvement of the left nasolacrimal duct. 02. Persistent postobstructive left frontal sinusitis. 03. No acute intracranial abnormality. No evidence of intracranial metastatic involvement
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FINDINGS: Head CT: There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute infarction or remote infarction. There is no mass lesion seen on this noncontrast examination. There is no mass effect. Ventricles are normal in size. There is no extra-axial fluid collection. There is no skull fracture. Mastoid air cells are clear Orbital CT. Previously identified destructive mass involving the medial left extraconal orbits and the left ethmoid air cells is significantly decreased in size. There is mild heterogeneous enhancement of the lesion. It measures 2.0 x 1.0 cm in the axial plane, previously measured 2.4 x 2.7 cm. It measures approximately 3.7 cm in craniocaudal dimension, previously measured 4.1 cm. There is stable destruction of the left left lamina papyracea. There is decreased mass effect upon the left medial rectus muscle although there is subtle contact of the left medial rectus muscle. The inferior portion of the lesion again encroaches upon the inferior rectus muscle. There is decreased mass effect with mildly decreased lateral displacement of the globe.. There is opacification of the nasolacrimal duct which appears expanded compared to the right suggesting additional tumor involvement. There is a small area of hypoattenuation within the superior aspect of the lesion which may represent small postsurgical fluid collection. It measures 0.7 x 0.5 cm.. There is a small area of fluid attenuation anterior to the anterior wall of the left maxillary sinus It measures 0.7 x 1.0 cm on axial image 37. These may be postsurgical and represent seroma or small resolving hematoma. However small abscess could have similar configuration. Both lacrimal glands appear unremarkable There is persistent opacification of the left frontal sinus with hyperdense secretions reflecting obstructive sinusitis.. There is also mild mucosal thickening within the left sphenoid sinus and right maxillary sinus. There is no abnormal enhancement of the visualized brain.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Hypoattenuating lesion in the mid pancreatic body with irregular peripheral enhancement measures 3.3 x 2.1 cm on image 77 series 900, previously 3.4 x 2.1 cm. There is mild stranding dilation of the main pancreatic duct and atrophy of the more distal pancreatic body and tail. Pancreatic head and neck are normal. No solid pancreatic mass. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right kidney is surgically absent. No abnormal soft tissue in the nephrectomy bed. Partially calcified aneurysm at the distal portion of the ligated right renal artery. LYMPH NODES: There are borderline to mildly enlarged retroperitoneal and periportal lymph nodes. An aortocaval node measures 2.0 x 1.8 cm (image 114 series 12). STOMACH / SMALL BOWEL: No abnormality. COLON: Colonic diverticulosis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcifications of the abdominal aorta and branch vessels. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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3,630
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EXAM: CT Neck Soft Tissue w contrast CLINICAL INFORMATION: Female patient 59 years with Non-Hodgkin lymphoma, initial workup TECHNIQUE: 1.4 mm thick serial axial images were obtained through the neck after the intravenous administration of contrast. Sagittal and coronal reformatted views were also obtained. Technique: Patient weight: 263 lbs. IV contrast: Omnipaque 350, 40 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 45 sec Scan field of view: 230 mm. DLP: 1738.70 mGy cm. COMPARISON: None available. FINDINGS: Left orbital/ethmoid lesion described on CT of the orbits. The pharynx and larynx appear unremarkable. Thyroid gland is small and mildly heterogeneous without focal lesion. The submandibular glands and parotid glands appear unremarkable. There is no lymphadenopathy using CT size criteria within the submental space or within both internal jugular chains. There is no abnormal lymphadenopathy within the paratracheal region or visualized superior mediastinum. There is no destructive osseous lesion within the cervical spine. There is no significant vascular abnormality within the neck. Visualized lungs are clear. Please see CT of the head and CT of the orbits for description of intracranial findings, orbital findings and findings involving the paranasal sinuses. CONCLUSION: 01. No mass lesion within the neck and no lymphadenopathy. 02. Left orbital/left ethmoid air cells sinus aggressive lesion representing lymphoma described on CT of the orbits
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FINDINGS: Left orbital/ethmoid lesion described on CT of the orbits. The pharynx and larynx appear unremarkable. Thyroid gland is small and mildly heterogeneous without focal lesion. The submandibular glands and parotid glands appear unremarkable. There is no lymphadenopathy using CT size criteria within the submental space or within both internal jugular chains. There is no abnormal lymphadenopathy within the paratracheal region or visualized superior mediastinum. There is no destructive osseous lesion within the cervical spine. There is no significant vascular abnormality within the neck. Visualized lungs are clear. Please see CT of the head and CT of the orbits for description of intracranial findings, orbital findings and findings involving the paranasal sinuses.
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Findings: There is no mass, hemorrhage, visible infarct or extracerebral collection. The ventricles are small with normal appearance. No hypodensity seen in the white matter. Posterior fossa contents are unremarkable. No defect is seen in the calvarium and skull base. ----------------
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3,631
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EXAM: CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: Lymphoma COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Chest with contrast. Patient weight: 263 lbs. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 494 mm. (accession CT220004321), Patient weight: 263 lbs. IV contrast: Omnipaque 350, 105 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 494 mm. DLP: 1607 mGy cm. (accession CT220004322) FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. PICC line terminates in the distal SVC. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: A few calcifications are present in the pancreatic tail. The pancreas is otherwise unremarkable. SPLEEN: Normal. ADRENALS: Mild thickening of both adrenal glands. KIDNEYS: Symmetric enhancement. Subcentimeter right hypoattenuating lesion is too small to characterize, statistically a cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: A few scattered colonic diverticula are present. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Small left adnexal cyst. Otherwise, unremarkable. BODY WALL: Subcutaneous gas in the anterior abdominal wall likely represents an injection site. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No evidence of active lymphoma in the chest, abdomen, or pelvis. 2. Small left adnexal cyst can be further characterized with ultrasound, as clinically warranted. 3. Additional findings as above.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. PICC line terminates in the distal SVC. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: A few calcifications are present in the pancreatic tail. The pancreas is otherwise unremarkable. SPLEEN: Normal. ADRENALS: Mild thickening of both adrenal glands. KIDNEYS: Symmetric enhancement. Subcentimeter right hypoattenuating lesion is too small to characterize, statistically a cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: A few scattered colonic diverticula are present. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Small left adnexal cyst. Otherwise, unremarkable. BODY WALL: Subcutaneous gas in the anterior abdominal wall likely represents an injection site. MUSCULOSKELETAL: No significant abnormality.
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Findings: CTA neck: The top aortic arch and the brachiocephalic arteries have expected appearance. The common carotid arteries are unremarkable. There are calcified plaques at the bifurcations with approximately 50% stenosis on the right and 40% stenosis on the left. The cervical ICAs are normal. The right vertebral artery is sizable with no apparent defect. The left vertebral artery is small and there is thrombus with small segments filling from collaterals including retrograde filling of the terminal segment. There is ACDF of C3-4 and C5 and there is a remote partially healed fracture of the C6 spinous process. The C-spine is otherwise unremarkable. CTA head: There are calcified nonstenotic plaques in the cavernous ICAs. Supraclinoid ICAs and the proximal ACAs, MCA's and PCAs are unremarkable. The basilar artery and its branches are intact. The left vertebral artery is occluded at the plane of the foramen magnum and its distal segment is filled retrograde, including filling of the left PICA. ----------------
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3,632
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EXAM: CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: Lymphoma COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis w contrast, CT Chest with contrast. Patient weight: 263 lbs. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 494 mm. (accession CT220004321), Patient weight: 263 lbs. IV contrast: Omnipaque 350, 105 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 494 mm. DLP: 1607 mGy cm. (accession CT220004322) FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. PICC line terminates in the distal SVC. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: A few calcifications are present in the pancreatic tail. The pancreas is otherwise unremarkable. SPLEEN: Normal. ADRENALS: Mild thickening of both adrenal glands. KIDNEYS: Symmetric enhancement. Subcentimeter right hypoattenuating lesion is too small to characterize, statistically a cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: A few scattered colonic diverticula are present. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Small left adnexal cyst. Otherwise, unremarkable. BODY WALL: Subcutaneous gas in the anterior abdominal wall likely represents an injection site. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No evidence of active lymphoma in the chest, abdomen, or pelvis. 2. Small left adnexal cyst can be further characterized with ultrasound, as clinically warranted. 3. Additional findings as above.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. PICC line terminates in the distal SVC. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: A few calcifications are present in the pancreatic tail. The pancreas is otherwise unremarkable. SPLEEN: Normal. ADRENALS: Mild thickening of both adrenal glands. KIDNEYS: Symmetric enhancement. Subcentimeter right hypoattenuating lesion is too small to characterize, statistically a cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: A few scattered colonic diverticula are present. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Small left adnexal cyst. Otherwise, unremarkable. BODY WALL: Subcutaneous gas in the anterior abdominal wall likely represents an injection site. MUSCULOSKELETAL: No significant abnormality.
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Findings: CTA neck: The top aortic arch and the brachiocephalic arteries have expected appearance. The common carotid arteries are unremarkable. There are calcified plaques at the bifurcations with approximately 50% stenosis on the right and 40% stenosis on the left. The cervical ICAs are normal. The right vertebral artery is sizable with no apparent defect. The left vertebral artery is small and there is thrombus with small segments filling from collaterals including retrograde filling of the terminal segment. There is ACDF of C3-4 and C5 and there is a remote partially healed fracture of the C6 spinous process. The C-spine is otherwise unremarkable. CTA head: There are calcified nonstenotic plaques in the cavernous ICAs. Supraclinoid ICAs and the proximal ACAs, MCA's and PCAs are unremarkable. The basilar artery and its branches are intact. The left vertebral artery is occluded at the plane of the foramen magnum and its distal segment is filled retrograde, including filling of the left PICA. ----------------
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3,633
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EXAM: CT Chest High Resolution wo contrast CLINICAL INFORMATION: History of interstitial lung disease with dry cough and dyspnea on exertion. COMPARISON: CTs from 12/29/2021 and earlier. TECHNIQUE: CT Chest High Resolution wo contrast. Scan field of view: 375 mm. DLP: 407 mGy cm. High-resolution CT imaging of the chest was performed per protocol with inspiratory and expiratory technique in supine position. FINDINGS: Basilar, peripheral predominant fibrosis is again noted bilaterally associated traction bronchiectasis. Worsening patchy groundglass opacities are noted bilaterally most significant within the bilateral lower lobes. Punctate calcified nodules in association with the bilateral lower lobe fibrosis are unchanged. No new or enlarging lung nodules. On the expiratory imaging, there are a few areas of air trapping noted most significant within the left lung apex and within the bilateral lower lobes. There is significant narrowing of the trachea and bilateral main bronchi on the expiratory imaging with near complete collapse of the bronchus intermedius. No pleural effusion. There is bilateral gynecomastia. A biventricular left chest cardiac device is present with leads in similar positions. The thoracic aorta is nonaneurysmal. The main pulmonary artery is mildly dilated measuring up to 3.3 cm, as before. Multiple scattered reactive appearing lymph nodes are noted bilaterally measuring up to 10 mm in the right lower paratracheal and subaortic regions. No new or enlarging thoracic lymph nodes. The esophagus is not dilated. The gallbladder is surgically absent. There is no acute or aggressive osseous abnormality. CONCLUSION: Significant interval worsening of patchy groundglass opacities bilaterally most significant in the lower lobes. Similar extent of the basilar predominant peripheral fibrosis. Findings may represent an acute exacerbation of the patient's underlying interstitial lung disease. Superimposed infection cannot be excluded. A few scattered areas of air trapping on the expiratory imaging may be secondary to hypersensitivity. Moderate narrowing of the trachea and bilateral main bronchi on expiratory imaging compatible with tracheobronchomalacia.
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FINDINGS: Basilar, peripheral predominant fibrosis is again noted bilaterally associated traction bronchiectasis. Worsening patchy groundglass opacities are noted bilaterally most significant within the bilateral lower lobes. Punctate calcified nodules in association with the bilateral lower lobe fibrosis are unchanged. No new or enlarging lung nodules. On the expiratory imaging, there are a few areas of air trapping noted most significant within the left lung apex and within the bilateral lower lobes. There is significant narrowing of the trachea and bilateral main bronchi on the expiratory imaging with near complete collapse of the bronchus intermedius. No pleural effusion. There is bilateral gynecomastia. A biventricular left chest cardiac device is present with leads in similar positions. The thoracic aorta is nonaneurysmal. The main pulmonary artery is mildly dilated measuring up to 3.3 cm, as before. Multiple scattered reactive appearing lymph nodes are noted bilaterally measuring up to 10 mm in the right lower paratracheal and subaortic regions. No new or enlarging thoracic lymph nodes. The esophagus is not dilated. The gallbladder is surgically absent. There is no acute or aggressive osseous abnormality.
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Findings: RAPID images demonstrate CBF less than 30% volume: 0 ml and T. Max greater than 6seconds volume: 0 ml . Mismatch volume is 0 ml. There is no abnormal MTT, T max, CBV and CBF to suggest significant ischemia or infarction at the territory of the major intracranial arteries.
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3,634
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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: 250 mm. DLP: 1150 mGy cm. INDICATION: Head injury COMPARISON: CT the head without contrast dated 2/13/2015. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Persistent hypoattenuation in the subcortical and periventricular white matter, likely sequela of chronic mild microangiopathy. Unchanged moderate diffuse cerebral volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. Soft tissue density within the external auditory canals bilaterally, likely impacted cerumen. Persistent calcified atherosclerosis of the cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Ex vacuo dilatation of the ventricular system, stable. ORBITS: No acute orbital abnormality. Bilateral lens replacements, unchanged. SINUSES: Trace mucosal thickening of the maxillary sinuses.. SOFT TISSUES: Small posterior right parietal scalp hematoma and left suboccipital subcutaneous emphysema. IMPRESSION: 1. No acute intracranial process or significant interval change identified. 2. Small right posterior parietal scalp hematoma and left suboccipital subcutaneous emphysema, without underlying calvarial fracture. 3. Persistent age-appropriate brain involution and mild chronic microvascular ischemic disease. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Persistent hypoattenuation in the subcortical and periventricular white matter, likely sequela of chronic mild microangiopathy. Unchanged moderate diffuse cerebral volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. Soft tissue density within the external auditory canals bilaterally, likely impacted cerumen. Persistent calcified atherosclerosis of the cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Ex vacuo dilatation of the ventricular system, stable. ORBITS: No acute orbital abnormality. Bilateral lens replacements, unchanged. SINUSES: Trace mucosal thickening of the maxillary sinuses.. SOFT TISSUES: Small posterior right parietal scalp hematoma and left suboccipital subcutaneous emphysema.
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Findings: Conventional CT of the brain: Intracranially, there is no evidence of acute intraor extra-axial hemorrhage. There is no evidence of midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation is maintained. The ventricular system and basal cisterns are clear of acute process. Visualized osseous structures appear intact. Delayed postcontrast imaging demonstrates no pathologic parenchymal enhancement. - CT angiogram of the brain: The visualized portions of the ICAs and vertebrobasilar system appear within normal limits. The visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. - CT angiogram of the neck: There is a normal three great vessel arch. Mild calcification noncalcified atherosclerotic changes aortic arch and visualized descending aorta. Atherosclerotic plaque at the origin of the left subclavian artery. Eccentric anterior wall on calcific plaques bilateral common carotid arteries with no significant luminal narrowing. Calcific atherosclerotic plaques at both carotid bifurcation with no evidence of significant stenosis. The right vertebral artery is dominant. No evidence of flow limiting stenosis or occlusion of the neck arteries. No intraluminal thrombus identified -
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3,635
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CT Cervical Spine wo contrast 1/8/2022 5:12 PM Clinical information: 81 years Male patient with Neck injury Comparison: None available. Technique: Multiple, contiguous, axial CT images of the cervical spine were obtained from the base of the skull through the thoracic inlet without administration of intravenous contrast. Reformatted sagittal and coronal reconstructions were also performed. Scan field of view: 186 mm. DLP: 980 mGy cm. Findings: The sagittal images demonstrate mild dextrocurvature of the lower cervical spine, with preservation of the cervical lordosis, and grade 1 anterolisthesis of C6 on C7. The vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Multilevel intervertebral disc space loss, endplate sclerosis, osteophytosis and subchondral cysts, severe at C3-C4 and C4-C5. Predental space obliteration. The craniocervical junction appears unremarkable. Multilevel uncovertebral and facet hypertrophy, resulting in severe bilateral C3-C4/C4-C5 neuroforaminal narrowing, with associated moderate spinal canal stenosis. The prevertebral and paraspinal soft tissues appear normal. IMPRESSION: 1. No evidence of acute cervical spine fracture or subluxation. 2. Chronic multilevel degenerative changes as described, resulting in severe bilateral C3-C4/C4-C5 neuroforaminal narrowing, impinging upon the bilateral C4 and C5 nerve roots, with associated moderate spinal canal stenosis.
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Findings: The sagittal images demonstrate mild dextrocurvature of the lower cervical spine, with preservation of the cervical lordosis, and grade 1 anterolisthesis of C6 on C7. The vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Multilevel intervertebral disc space loss, endplate sclerosis, osteophytosis and subchondral cysts, severe at C3-C4 and C4-C5. Predental space obliteration. The craniocervical junction appears unremarkable. Multilevel uncovertebral and facet hypertrophy, resulting in severe bilateral C3-C4/C4-C5 neuroforaminal narrowing, with associated moderate spinal canal stenosis. The prevertebral and paraspinal soft tissues appear normal.
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Findings: Conventional CT of the brain: Intracranially, there is no evidence of acute intraor extra-axial hemorrhage. There is no evidence of midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation is maintained. The ventricular system and basal cisterns are clear of acute process. Visualized osseous structures appear intact. Delayed postcontrast imaging demonstrates no pathologic parenchymal enhancement. - CT angiogram of the brain: The visualized portions of the ICAs and vertebrobasilar system appear within normal limits. The visualized portions of the ACAs, MCAs, and PCAs appear within normal limits. - CT angiogram of the neck: There is a normal three great vessel arch. Mild calcification noncalcified atherosclerotic changes aortic arch and visualized descending aorta. Atherosclerotic plaque at the origin of the left subclavian artery. Eccentric anterior wall on calcific plaques bilateral common carotid arteries with no significant luminal narrowing. Calcific atherosclerotic plaques at both carotid bifurcation with no evidence of significant stenosis. The right vertebral artery is dominant. No evidence of flow limiting stenosis or occlusion of the neck arteries. No intraluminal thrombus identified -
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3,636
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CT Head wo contrast 1/8/2022 5:51 PM Clinical Information: Trauma Comparison: None. 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: 1082 mGy cm. Findings: Brain parenchyma: The brain has normal morphology and volume. The brain parenchyma has a normal appearance. The white-gray matter differentiation is preserved. Ventricular system: Normal configuration. No hydrocephalus. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Normal noncontrast appearance. 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 sphenoid sinus mucosal thickening. Otherwise, appear well aerated. IMPRESSION: No acute intracranial process identified.
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Findings: Brain parenchyma: The brain has normal morphology and volume. The brain parenchyma has a normal appearance. The white-gray matter differentiation is preserved. Ventricular system: Normal configuration. No hydrocephalus. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Normal noncontrast appearance. 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 sphenoid sinus mucosal thickening. Otherwise, appear well aerated.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Moderate atherosclerotic disease. ABDOMINAL AORTA: Aneurysmal dilatation measuring 7.1 x 6.7 cm (series 301, image 587) with peripheral thrombus of severely atherosclerotic, tortuous aorta. CELIAC AXIS: Moderate atherosclerotic disease. SMA: Moderate atherosclerotic disease. Mild stenosis at the origin. RIGHT RENAL: Moderate atherosclerotic disease. Moderate stenosis proximally. LEFT RENAL: Mild atherosclerotic disease. Moderate stenosis proximally. IMA: Not visualized RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Severe atherosclerotic disease. Evaluation of stenosis is limited due to suboptimal contrast bolus timing. Ectasia of the right common femoral artery measures 1.6 cm. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Severe atherosclerotic disease. Ectasia of the left common iliac artery measures 1.8 cm. ------------------------------------------------------------- LOWER CHEST: Please see separate CT chest report. ABDOMEN and PELVIS: LIVER: Scattered granulomatous calcifications. Otherwise normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Scattered punctate calcifications consistent with chronic pancreatitis. SPLEEN: Scattered granulomatous calcifications. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticulosis PERITONEUM / MESENTERY: No ascites or free intraperitoneal air. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Moderate degenerative changes of the spine. Decreased mineralization. No suspicious osseous lesion. Mild superior endplate pressure deformity of the L1 vertebral body, age indeterminate with no studies for comparison.
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3,637
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EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Epigastric abdominal pain, evaluate aortic repair and outside hospital finding of pneumoperitoneum. COMPARISON: CTA chest, abdomen, pelvis 12/6/2021. Outside CT chest without contrast 1/6/2022 and outside CT abdomen and pelvis without contrast 1/7/2022. 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: 200 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: 440 mm. KVP: 120 DLP: 2406 mGy cm. (accession CT220004327), Patient weight: 200 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: 440 mm. (accession CT220004328) FINDINGS: STRUCTURED REPORT: CTA CAP Stent VASCULATURE: CORONARY ARTERIES: There are severe atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. THORACIC AORTA: Redemonstration of ascending thoracic aortic replacement with endovascular stent graft repair of the ascending thoracic aorta, aortic arch, and descending thoracic aorta. No evidence of endoleak. Near complete thrombosis of the excluded false aortic lumen in the thoracic aorta, with opacification distally, similar to prior examination. Associated aneurysmal dilatation of the distal aortic arch and descending thoracic aorta. Patent brachiocephalic trunk stent. Postsurgical changes from left carotid to subclavian transposition with retroesophageal carotid to carotid bypass grafting. Embolization coils in the proximal left subclavian artery with short segment thrombosis and reconstitution distally at the level of the left vertebral artery. ABDOMINAL AORTA: The aortic dissection flap again extends through the abdominal aorta and into the left common iliac artery. No aneurysmal dilatation of the abdominal aorta. The celiac trunk, SMA, bilateral renal arteries, and IMA arise from the true aortic lumen. Mild atheromatous narrowing of the proximal SMA with maintained distal contrast opacification. Moderate calcific atherosclerosis in the abdominal aorta and its branch vessels. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Mild dependent atelectatic changes. Tiny calcific granuloma in the right middle lobe. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Mild left atrial and ventricular dilatation. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Resolving hematoma/seroma in the anterior superficial soft tissues overlying the right shoulder. Redemonstration of ballistic fragments in the right extrapleural soft tissues, as well as several additional tiny ballistic fragments embedded in the posterior aspect of the right ninth rib. Postsurgical changes from median sternotomy with unchanged fracture of the inferior most sternal wire. Unchanged nonunion of the manubrium. ABDOMEN and PELVIS: LIVER: Unchanged scattered hepatic cysts. BILIARY TRACT: Normal. GALLBLADDER: Tiny stones layering in the gallbladder neck. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Enhancing mass involving the posterior right mid kidney measures 1.8 x 1.7 cm (series 6, image 240), unchanged. Multiple bilateral renal cysts, the largest of which arising from the lower pole the left kidney containing a few thin internal calcified septations, are unchanged from prior examination. No new abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large hiatal hernia. No significant abnormality in small bowel. Enteric contrast is noted in the distal small bowel. COLON / APPENDIX: Colonic diverticulosis. Short segment wall thickening involving the proximal sigmoid colon with adjacent inflammatory stranding and edema in the left paracolic gutter, as well as a punctate focus of extraluminal gas. The appendix is normal. PERITONEUM / MESENTERY: Small volume pneumoperitoneum, primarily within the left upper abdomen and hiatal hernia sac, mildly decreased compared to outside examination of 1/7/2022. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Mild circumferential urinary bladder wall thickening and subtle perivesicular stranding. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Ballistic fragment embedded in the T12 vertebral body. Multilevel degenerative changes in the thoracolumbar spine. Moderate degenerative changes at the left hip. Partial calcification of the right acetabular labrum. Chondrocalcinosis involving the pubic symphysis. CONCLUSION: 1. Acute perforated sigmoid diverticulitis with inflammatory stranding/edema and phlegmonous changes in the left paracolic gutter. No organized/drainable fluid collection. Small volume pneumoperitoneum, decreased compared to recent outside examination. 2. Unchanged appearance of chronic aortic dissection with endovascular stent graft repair and associated aneurysmal degeneration. 3. Unchanged size of enhancing right renal mass, again concerning for renal cell carcinoma. 4. Mild urinary bladder wall thickening and perivesicular stranding, suggestive of cystitis. Recommend correlation with urinalysis. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CTA CAP Stent VASCULATURE: CORONARY ARTERIES: There are severe atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. THORACIC AORTA: Redemonstration of ascending thoracic aortic replacement with endovascular stent graft repair of the ascending thoracic aorta, aortic arch, and descending thoracic aorta. No evidence of endoleak. Near complete thrombosis of the excluded false aortic lumen in the thoracic aorta, with opacification distally, similar to prior examination. Associated aneurysmal dilatation of the distal aortic arch and descending thoracic aorta. Patent brachiocephalic trunk stent. Postsurgical changes from left carotid to subclavian transposition with retroesophageal carotid to carotid bypass grafting. Embolization coils in the proximal left subclavian artery with short segment thrombosis and reconstitution distally at the level of the left vertebral artery. ABDOMINAL AORTA: The aortic dissection flap again extends through the abdominal aorta and into the left common iliac artery. No aneurysmal dilatation of the abdominal aorta. The celiac trunk, SMA, bilateral renal arteries, and IMA arise from the true aortic lumen. Mild atheromatous narrowing of the proximal SMA with maintained distal contrast opacification. Moderate calcific atherosclerosis in the abdominal aorta and its branch vessels. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Mild dependent atelectatic changes. Tiny calcific granuloma in the right middle lobe. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Mild left atrial and ventricular dilatation. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Resolving hematoma/seroma in the anterior superficial soft tissues overlying the right shoulder. Redemonstration of ballistic fragments in the right extrapleural soft tissues, as well as several additional tiny ballistic fragments embedded in the posterior aspect of the right ninth rib. Postsurgical changes from median sternotomy with unchanged fracture of the inferior most sternal wire. Unchanged nonunion of the manubrium. ABDOMEN and PELVIS: LIVER: Unchanged scattered hepatic cysts. BILIARY TRACT: Normal. GALLBLADDER: Tiny stones layering in the gallbladder neck. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Enhancing mass involving the posterior right mid kidney measures 1.8 x 1.7 cm (series 6, image 240), unchanged. Multiple bilateral renal cysts, the largest of which arising from the lower pole the left kidney containing a few thin internal calcified septations, are unchanged from prior examination. No new abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large hiatal hernia. No significant abnormality in small bowel. Enteric contrast is noted in the distal small bowel. COLON / APPENDIX: Colonic diverticulosis. Short segment wall thickening involving the proximal sigmoid colon with adjacent inflammatory stranding and edema in the left paracolic gutter, as well as a punctate focus of extraluminal gas. The appendix is normal. PERITONEUM / MESENTERY: Small volume pneumoperitoneum, primarily within the left upper abdomen and hiatal hernia sac, mildly decreased compared to outside examination of 1/7/2022. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Mild circumferential urinary bladder wall thickening and subtle perivesicular stranding. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Ballistic fragment embedded in the T12 vertebral body. Multilevel degenerative changes in the thoracolumbar spine. Moderate degenerative changes at the left hip. Partial calcification of the right acetabular labrum. Chondrocalcinosis involving the pubic symphysis.
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FINDINGS: Vascular findings: Initial precontrast images demonstrate significant three-vessel coronary artery calcifications. Moderate atherosclerotic calcifications through the arch and descending thoracic aorta. No intramural hematoma or other acute abnormality. Normal sized cardiac chambers. No pericardial effusion. Normal caliber pulmonary artery and thoracic aorta. No central PE. Ascending thoracic aorta measures 3.3 cm on axial image 226; series 301. Arch measures up to 2.9 cm (axial image 153; series 301. Incidental note is made of direct origin of the left vertebral artery from the arch. Mixed atherosclerotic calcifications at the origin of great vessels with normal branching pattern. Descending thoracic aorta at the level of left main pulmonary artery measures up to 2.7 cm. Distal descending thoracic aorta measures up to 2.5 cm on axial image 401; series 301. Left jugular and subclavian veins, left innominate vein are widely patent. SVC is widely patent. Limited evaluation of the right central veins as visualized. Nonvascular findings: No significant abnormality in the lower neck. Central airways are patent with small volume secretions extending from the distal trachea into bilateral main bronchi and proximal segmental bronchi, especially in the lingula. Diffuse bronchial wall thickening is present. Moderate mixed emphysema, with biapical pleuroparenchymal scarring with areas of calcification. A 5 mm peripheral right upper lobe nodule on axial image 164; series 301, overall unchanged. A 7 mm nodule abutting the right major fissure on axial image 194; series 301, appears unchanged and likely represents a fissural node. No focal consolidation. Small hiatal hernia. Multiple calcified mediastinal and hilar lymph nodes. No significant abnormality in the chest wall. Abdomen and pelvis will be reported separately. Multilevel degenerative changes with compression deformities in the thoracic spine, T8 compression fracture involves up to 50% of the vertebral body height loss. Mild compression deformities in the T11 with multiple vertebral body hemangioma.
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3,638
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EXAM: CT Angio Chest wo+w contrast, CT Angio Abdomen and Pelvis CLINICAL INFORMATION: Epigastric abdominal pain, evaluate aortic repair and outside hospital finding of pneumoperitoneum. COMPARISON: CTA chest, abdomen, pelvis 12/6/2021. Outside CT chest without contrast 1/6/2022 and outside CT abdomen and pelvis without contrast 1/7/2022. 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: 200 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: 440 mm. KVP: 120 DLP: 2406 mGy cm. (accession CT220004327), Patient weight: 200 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: 440 mm. (accession CT220004328) FINDINGS: STRUCTURED REPORT: CTA CAP Stent VASCULATURE: CORONARY ARTERIES: There are severe atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. THORACIC AORTA: Redemonstration of ascending thoracic aortic replacement with endovascular stent graft repair of the ascending thoracic aorta, aortic arch, and descending thoracic aorta. No evidence of endoleak. Near complete thrombosis of the excluded false aortic lumen in the thoracic aorta, with opacification distally, similar to prior examination. Associated aneurysmal dilatation of the distal aortic arch and descending thoracic aorta. Patent brachiocephalic trunk stent. Postsurgical changes from left carotid to subclavian transposition with retroesophageal carotid to carotid bypass grafting. Embolization coils in the proximal left subclavian artery with short segment thrombosis and reconstitution distally at the level of the left vertebral artery. ABDOMINAL AORTA: The aortic dissection flap again extends through the abdominal aorta and into the left common iliac artery. No aneurysmal dilatation of the abdominal aorta. The celiac trunk, SMA, bilateral renal arteries, and IMA arise from the true aortic lumen. Mild atheromatous narrowing of the proximal SMA with maintained distal contrast opacification. Moderate calcific atherosclerosis in the abdominal aorta and its branch vessels. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Mild dependent atelectatic changes. Tiny calcific granuloma in the right middle lobe. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Mild left atrial and ventricular dilatation. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Resolving hematoma/seroma in the anterior superficial soft tissues overlying the right shoulder. Redemonstration of ballistic fragments in the right extrapleural soft tissues, as well as several additional tiny ballistic fragments embedded in the posterior aspect of the right ninth rib. Postsurgical changes from median sternotomy with unchanged fracture of the inferior most sternal wire. Unchanged nonunion of the manubrium. ABDOMEN and PELVIS: LIVER: Unchanged scattered hepatic cysts. BILIARY TRACT: Normal. GALLBLADDER: Tiny stones layering in the gallbladder neck. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Enhancing mass involving the posterior right mid kidney measures 1.8 x 1.7 cm (series 6, image 240), unchanged. Multiple bilateral renal cysts, the largest of which arising from the lower pole the left kidney containing a few thin internal calcified septations, are unchanged from prior examination. No new abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large hiatal hernia. No significant abnormality in small bowel. Enteric contrast is noted in the distal small bowel. COLON / APPENDIX: Colonic diverticulosis. Short segment wall thickening involving the proximal sigmoid colon with adjacent inflammatory stranding and edema in the left paracolic gutter, as well as a punctate focus of extraluminal gas. The appendix is normal. PERITONEUM / MESENTERY: Small volume pneumoperitoneum, primarily within the left upper abdomen and hiatal hernia sac, mildly decreased compared to outside examination of 1/7/2022. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Mild circumferential urinary bladder wall thickening and subtle perivesicular stranding. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Ballistic fragment embedded in the T12 vertebral body. Multilevel degenerative changes in the thoracolumbar spine. Moderate degenerative changes at the left hip. Partial calcification of the right acetabular labrum. Chondrocalcinosis involving the pubic symphysis. CONCLUSION: 1. Acute perforated sigmoid diverticulitis with inflammatory stranding/edema and phlegmonous changes in the left paracolic gutter. No organized/drainable fluid collection. Small volume pneumoperitoneum, decreased compared to recent outside examination. 2. Unchanged appearance of chronic aortic dissection with endovascular stent graft repair and associated aneurysmal degeneration. 3. Unchanged size of enhancing right renal mass, again concerning for renal cell carcinoma. 4. Mild urinary bladder wall thickening and perivesicular stranding, suggestive of cystitis. Recommend correlation with urinalysis. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CTA CAP Stent VASCULATURE: CORONARY ARTERIES: There are severe atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. THORACIC AORTA: Redemonstration of ascending thoracic aortic replacement with endovascular stent graft repair of the ascending thoracic aorta, aortic arch, and descending thoracic aorta. No evidence of endoleak. Near complete thrombosis of the excluded false aortic lumen in the thoracic aorta, with opacification distally, similar to prior examination. Associated aneurysmal dilatation of the distal aortic arch and descending thoracic aorta. Patent brachiocephalic trunk stent. Postsurgical changes from left carotid to subclavian transposition with retroesophageal carotid to carotid bypass grafting. Embolization coils in the proximal left subclavian artery with short segment thrombosis and reconstitution distally at the level of the left vertebral artery. ABDOMINAL AORTA: The aortic dissection flap again extends through the abdominal aorta and into the left common iliac artery. No aneurysmal dilatation of the abdominal aorta. The celiac trunk, SMA, bilateral renal arteries, and IMA arise from the true aortic lumen. Mild atheromatous narrowing of the proximal SMA with maintained distal contrast opacification. Moderate calcific atherosclerosis in the abdominal aorta and its branch vessels. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Mild dependent atelectatic changes. Tiny calcific granuloma in the right middle lobe. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Mild left atrial and ventricular dilatation. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Resolving hematoma/seroma in the anterior superficial soft tissues overlying the right shoulder. Redemonstration of ballistic fragments in the right extrapleural soft tissues, as well as several additional tiny ballistic fragments embedded in the posterior aspect of the right ninth rib. Postsurgical changes from median sternotomy with unchanged fracture of the inferior most sternal wire. Unchanged nonunion of the manubrium. ABDOMEN and PELVIS: LIVER: Unchanged scattered hepatic cysts. BILIARY TRACT: Normal. GALLBLADDER: Tiny stones layering in the gallbladder neck. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Enhancing mass involving the posterior right mid kidney measures 1.8 x 1.7 cm (series 6, image 240), unchanged. Multiple bilateral renal cysts, the largest of which arising from the lower pole the left kidney containing a few thin internal calcified septations, are unchanged from prior examination. No new abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large hiatal hernia. No significant abnormality in small bowel. Enteric contrast is noted in the distal small bowel. COLON / APPENDIX: Colonic diverticulosis. Short segment wall thickening involving the proximal sigmoid colon with adjacent inflammatory stranding and edema in the left paracolic gutter, as well as a punctate focus of extraluminal gas. The appendix is normal. PERITONEUM / MESENTERY: Small volume pneumoperitoneum, primarily within the left upper abdomen and hiatal hernia sac, mildly decreased compared to outside examination of 1/7/2022. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Mild circumferential urinary bladder wall thickening and subtle perivesicular stranding. REPRODUCTIVE ORGANS: Prostatomegaly. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Ballistic fragment embedded in the T12 vertebral body. Multilevel degenerative changes in the thoracolumbar spine. Moderate degenerative changes at the left hip. Partial calcification of the right acetabular labrum. Chondrocalcinosis involving the pubic symphysis.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LOWER NECK: Subcentimeter right lower cervical lymph node on axial image 15; series 2, overall unchanged. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. No focal consolidation or suspicious pulmonary nodule. A few calcified and noncalcified tiny pulmonary nodules are again seen. Representative 2 mm noncalcified nodule in the right lower lobe on axial image 64; series 2, was previously 2 mm. Bibasilar atelectasis. No pleural effusion. HEART / VESSELS: Normal sized cardiac chambers. Moderate LAD calcifications. Normal caliber thoracic aorta and pulmonary artery. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: A few scattered nonenlarged mediastinal and axillary lymph nodes, nonspecific. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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3,639
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Chest pain, concern for pulmonary thromboembolus. COMPARISON: Chest radiograph 1/8/2022. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 110 lbs. IV contrast: Omnipaque 350, 70 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bokus tracked Scan field of view: 317 mm. KVP: 100 DLP: 125.20 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Small bilateral pleural effusions with overlying relaxation atelectatic changes. Subtle ground glass attenuation with interlobular septal thickening in the lingula and left lower lobe may represent mild asymmetric interstitial pulmonary edema. No pneumothorax. HEART / OTHER VESSELS: Mild cardiomegaly. Main pulmonary artery and thoracic aorta are normal in caliber. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. CONCLUSION: 1. No acute central or segmental pulmonary thromboembolus. 2. Mild cardiomegaly with mild interstitial pulmonary edema and small bilateral pleural effusions. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Small bilateral pleural effusions with overlying relaxation atelectatic changes. Subtle ground glass attenuation with interlobular septal thickening in the lingula and left lower lobe may represent mild asymmetric interstitial pulmonary edema. No pneumothorax. HEART / OTHER VESSELS: Mild cardiomegaly. Main pulmonary artery and thoracic aorta are normal in caliber. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormality is identified.
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FINDINGS: There is a cyst like lesion within the anterior left mandible resulting in mild expansion. There is marked thinning of the cortex primarily laterally with questionable small amount of cortical breakthrough with soft tissue extension into the overlying soft tissues. The lesion measures approximately 2 x 0.9 cm in the axial plane. The lesion is in contact with the roots of the left mandibular bicuspid and also the left first mandibular premolar. Margins of the lesion are fairly distinct with small amount of intermediate attenuation at the periphery but no central matrix. No additional lesion identified within the mandible or maxilla. Paranasal sinuses are clear. The ostiomeatal complexes and frontal sinuses ostia are patent. There is minimal leftward deviation of the nasal septum. There is a concha bullosa involving the left middle turbinate. Orbits are unremarkable.
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3,640
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EXAM: CT Bone Pelvis wo contrast CLINICAL INFORMATION: Concern for right pelvic fracture. COMPARISON: None. TECHNIQUE: CT Bone Pelvis wo contrast Scan field of view: 400 mm. DLP: 441 mGy cm. STRUCTURED REPORT: CT Bone vDec2021 FINDINGS: BONES/JOINTS: No acute fracture or malalignment. Mild degenerative changes of the bilateral hips with marginal osteophytosis and subchondral sclerosis. Degenerative enthesopathic changes at the bilateral greater trochanters, ischial tuberosities, and iliac crests. Degenerative partial ankylosis of the left inferior sacroiliac joint. Moderate degenerative spondylosis of L5-S1 with posterior disc osteophyte complex resulting in mild spinal canal and bilateral neuroforaminal narrowing. Moderate bilateral facet arthropathy. SOFT TISSUES: No large hematoma or fluid collection. Moderate calcified atherosclerotic disease of the iliofemoral arteries. CONCLUSION: No acute 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.
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FINDINGS: BONES/JOINTS: No acute fracture or malalignment. Mild degenerative changes of the bilateral hips with marginal osteophytosis and subchondral sclerosis. Degenerative enthesopathic changes at the bilateral greater trochanters, ischial tuberosities, and iliac crests. Degenerative partial ankylosis of the left inferior sacroiliac joint. Moderate degenerative spondylosis of L5-S1 with posterior disc osteophyte complex resulting in mild spinal canal and bilateral neuroforaminal narrowing. Moderate bilateral facet arthropathy. SOFT TISSUES: No large hematoma or fluid collection. Moderate calcified atherosclerotic disease of the iliofemoral arteries.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Diffuse bilateral consolidations, groundglass opacities, and septal thickening is overall markedly worsened from prior examination with some decrease in the bilateral consolidation.. There is a "crazy paving" type pattern in the lung apices. Small bilateral pleural effusions, decreased from prior examination. No pneumothorax. Endotracheal tube is present, tip terminates 3.2 cm superior to the carina. HEART / OTHER VESSELS: Heart size is normal. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Two esophagogastric tubes are in place and both terminate below the diaphragm and outside the field-of-view. LYMPH NODES: Enlarged mediastinal and bilateral hilar lymph nodes measuring up to 1.6 x 1.7 cm and the right hilum, series 5 image 84. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Small volume ascites, partially evaluated. Otherwise normal arterial phase appearance of the imaged upper abdomen. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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RADIOLOGIC EXAM: CT Maxillofacial wo contrast, CT Head wo contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Maxillofacial wo contrast, CT Head wo contrastScan field of view: 230 mm. DLP: 1180.30 mGy cm. (accession CT220004338), Scan field of view: 265 mm. DLP: 1444 mGy cm. (accession CT220004332) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: Punctate hyperdensity within the left frontal lobe is noted without surrounding edema (series 201, image 50). There is no mass effect. , Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Mildly displaced fracture of the lateral wall of the left orbit, extending to the orbital apex there is mild asymmetric thickening of the left lateral rectus muscle. No retrobulbar stranding is seen. The globe is intact.. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Left lateral orbital wall fracture. No additional fractures evident. MANDIBLE: Normal. SINONASAL CAVITIES: Mild mucosal thickening of bilateral maxillary, sphenoid and frontal sinuses with partial opacification of the ethmoidal air cells. SOFT TISSUES: Mild soft tissue swelling and small laceration noted lateral to the left eye. CONCLUSION: 1. Punctate hyperdensity within the left frontal lobe without surrounding edema may represent tiny intraparenchymal hemorrhage. Recommend attention on follow-up. 2. Mildly displaced fracture of the lateral wall of the left orbit with mild thickening of the left lateral rectus muscle. No retrobulbar hemorrhage or globe injury. 3. Small laceration and mild soft tissue swelling lateral to the left eye. Preliminary results were discussed with Dr. Will Davis at 5:22 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.
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FINDINGS: BRAIN PARENCHYMA: Punctate hyperdensity within the left frontal lobe is noted without surrounding edema (series 201, image 50). There is no mass effect. , Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Mildly displaced fracture of the lateral wall of the left orbit, extending to the orbital apex there is mild asymmetric thickening of the left lateral rectus muscle. No retrobulbar stranding is seen. The globe is intact.. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Left lateral orbital wall fracture. No additional fractures evident. MANDIBLE: Normal. SINONASAL CAVITIES: Mild mucosal thickening of bilateral maxillary, sphenoid and frontal sinuses with partial opacification of the ethmoidal air cells. SOFT TISSUES: Mild soft tissue swelling and small laceration noted lateral to the left eye.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Stable postsurgical changes of left lower lobectomy. No evidence of residual/recurrent mass lesion. Scattered calcified granulomas. A tiny groundglass density in the right middle lobe (image 63, series 2) are unchanged. Right lower lobe subpleural nodular density adjacent to the major fissure is unchanged (image 78). No new or enlarging suspicious pulmonary nodule. Left lung base subsegmental atelectasis/scarring, similar to prior. Thoracic inlet, heart, and mediastinum: No new or enlarging thoracic lymphadenopathy. Stable subcentimeter mediastinal lymph nodes. Small hiatal hernia. The thoracic aorta and main pulmonary arteries are normal in caliber. The overall heart size normal. No pericardial effusion. Mild coronary calcification. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Postcholecystectomy. Unchanged left hepatic lobe peripheral low-attenuation lesion, probably cyst.
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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, MVC 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: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004333), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. (accession CT220004334), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004337), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004336) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar 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. Trace pelvic free fluid is nonspecific but abnormal in a male patient. This probably is related to volume resuscitation given subtle periportal edema. However, an occult injury is difficult to exclude. Final report findings discussed with Dr. Will Davis at 1/8/2022 5:43 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Few small (less than 6 mm) pulmonary nodules are seen. For reference, a 5 mm left lower lobe subpleural nodule (image 78, series 201), and 3 mm right middle lobe subpleural nodule (image 69) are noted. Clustered calcified granulomas in the superior segment right lower lobe. No focal consolidation. Minimal biapical pleuroparenchymal scarring. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: Fat interspersed thymic tissue in the anterior mediastinum. The thyroid gland is unremarkable. No supraclavicular lymphadenopathy within the field of view. No axillary lymphadenopathy. No mediastinal or hilar lymphadenopathy. Small hiatal hernia. The thoracic aorta and main pulmonary arteries are normal in caliber. The overall heart size normal. No pericardial effusion. Mild coronary calcification. Bones and soft tissues: Small focal sclerotic lesion of the left posterolateral ninth rib. No destructive bone lesion. Chest wall soft tissues are unremarkable. Upper abdomen: Left renal small nonobstructive calculus.
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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, MVC 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: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004333), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. (accession CT220004334), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004337), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004336) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar 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. Trace pelvic free fluid is nonspecific but abnormal in a male patient. This probably is related to volume resuscitation given subtle periportal edema. However, an occult injury is difficult to exclude. Final report findings discussed with Dr. Will Davis at 1/8/2022 5:43 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: A right IJ port catheter with tip at the right atrium. Lung parenchyma and pleura: Medium-sized left pleural effusion, slightly improved from prior. There is peribronchial and subpleural reticular opacities with associated focal bronchiectatic changes involving both lungs, right greater than left, new from prior. The trachea and main bronchi are patent. Thoracic inlet, heart, and mediastinum: No new or enlarging thoracic lymphadenopathy. Small hiatal hernia. Postsurgical changes of aortic valve replacement by bioprosthesis. The thoracic aorta is normal in caliber. Redemonstrated pulmonic valvular stenosis is posterior stenotic dilatation of the main pulmonary artery, measures 5.8 cm. Biatrial enlargement. Scattered three-vessel calcification/stents. Post CABG. No pericardial effusion. Blood appears hypodense relative to the interventricular septum, a finding which could be seen with anemia. Bones and soft tissues: Median sternotomy with intact sternotomy wires. Remote right rib fractures. No aggressive bone lesion. Chest wall soft tissues are unremarkable. Upper abdomen: No abnormality in the imaged upper abdomen.
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CT Cervical Spine From Reformat 1/8/2022 4:49 PM Clinical information: 142 years Unknown patient with Trauma Comparison: None available. Technique: Multiple, contiguous, axial CT images of the cervical spine were obtained from the base of the skull through the thoracic inlet without administration of intravenous contrast. Reformatted sagittal and coronal reconstructions were also performed. Findings: The sagittal images demonstrate straightening of the cervical lordosis, without subluxations. The vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Disc bulge at C5-C6 is seen, resulting in mild spinal canal stenosis, without significant neuroforaminal narrowing. The craniocervical junction appears unremarkable. The prevertebral and paraspinal soft tissues appear normal. IMPRESSION: 1. No evidence of acute cervical spine fracture or subluxation. 2. Degenerative disc disease centered at C5-C6, resulting in mild spinal canal stenosis, without significant neuroforaminal narrowing.
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Findings: The sagittal images demonstrate straightening of the cervical lordosis, without subluxations. The vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Disc bulge at C5-C6 is seen, resulting in mild spinal canal stenosis, without significant neuroforaminal narrowing. The craniocervical junction appears unremarkable. The prevertebral and paraspinal soft tissues appear normal.
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Bilateral pulmonary thromboemboli are seen. Large thrombus begins in the distal right main pulmonary artery and extends into the lobar branches for the right upper and right middle lobe and almost exclusively fills branches to the right lower lobe particularly the superior segment. A thin filling defect is seen at the bifurcation of the left lower lobe pulmonary artery extending into the lingula and proximal segmental LLL arteries. The main pulmonary artery is within normal limits in size. There is backflow contrast into the intrahepatic IVC and hepatic veins. Straightening of the intraventricular septum is seen with enlarged right atrium noted. The RV to LV ratio is 33 mm/36 mm. No additional evidence of right heart strain. Minimal calcific atherosclerosis is seen in the aorta. No coronary artery calcification is identified. No enlarged intrathoracic lymph nodes are identified. The proximal esophagus is dilated with a small air-fluid level. The heart size and the mediastinum are otherwise normal. Tiny bilateral pleural effusions are seen. Bilateral groundglass opacities with septal thickening (crazy paving) are seen in both lungs but most involvement of the right lung than the left. A few areas of peripheral consolidation are also noted. No nodules or masses are identified. Limited images of the upper abdomen are unremarkable. No focal destructive osseous abnormality.
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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, MVC 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: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004333), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. (accession CT220004334), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004337), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004336) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar 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. Trace pelvic free fluid is nonspecific but abnormal in a male patient. This probably is related to volume resuscitation given subtle periportal edema. However, an occult injury is difficult to exclude. Final report findings discussed with Dr. Will Davis at 1/8/2022 5:43 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Few small (less than 6 mm) pulmonary nodules are unchanged, for example in the left upper lobe at images 22 and 35, series 2. No new or enlarging suspicious pulmonary nodule. The posterior right lower lobe sharply marginated consolidation with associated focal bronchiectatic changes, similar to prior and likely treated to postradiation changes. There is interval mild thickening of the right paratracheal soft tissue (image 63, series 2). The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: Stable multinodular thyroid. No new or enlarging thoracic lymphadenopathy. The esophagus is nondilated. The thoracic aorta and main pulmonary arteries are normal in caliber. The overall heart size normal. Trace pericardial effusion. No coronary calcification. Bones and soft tissues: Redemonstrated right posterior chest wall scarring with no evidence of residual/recurrent mass lesion. No aggressive bone lesion. Upper abdomen: No abnormality in the imaged upper abdomen.
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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, MVC 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: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004333), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. (accession CT220004334), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004337), Patient weight: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 427 mm. DLP: 722.30 mGy cm. (accession CT220004336) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar 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. Trace pelvic free fluid is nonspecific but abnormal in a male patient. This probably is related to volume resuscitation given subtle periportal edema. However, an occult injury is difficult to exclude. Final report findings discussed with Dr. Will Davis at 1/8/2022 5:43 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. The esophagus is unremarkable. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. Focal fatty infiltration along the falciform ligament. 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: Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Circumaortic left renal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. S1 superior endplate Schmorl's node. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: Overall moderate to advanced calcified calcified atherosclerotic plaque of the abdominal aorta and branch vessels. ABDOMINAL AORTA: Normal in caliber. Continued compression and decreased size of the false lumen which extends to just below the renal artery origins. CELIAC AXIS: Accessory left hepatic artery arises from the left gastric artery. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Occlusion of the right superficial femoral artery (image 557 series 3). LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Severe narrowing of the left superficial femoral artery (image 71 series 3). ------------------------------------------------------------- LOWER CHEST: Please see separately dictated CT chest. ABDOMEN and PELVIS: LIVER: Arterially enhancing focus in the anterior segment right hepatic lobe is unchanged on image 256 series 3, likely flash filling hemangioma. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Surgical clips near the proximal stomach. Small bowel is normal in caliber. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate gland is enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Osteopenia. Lower lumbar spine degenerative changes.
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RADIOLOGIC EXAM: CT Maxillofacial wo contrast, CT Head wo contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Maxillofacial wo contrast, CT Head wo contrastScan field of view: 230 mm. DLP: 1180.30 mGy cm. (accession CT220004338), Scan field of view: 265 mm. DLP: 1444 mGy cm. (accession CT220004332) STRUCTURED REPORT: CT Head and Maxillofacial Trauma FINDINGS: BRAIN PARENCHYMA: Punctate hyperdensity within the left frontal lobe is noted without surrounding edema (series 201, image 50). There is no mass effect. , Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Mildly displaced fracture of the lateral wall of the left orbit, extending to the orbital apex there is mild asymmetric thickening of the left lateral rectus muscle. No retrobulbar stranding is seen. The globe is intact.. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Left lateral orbital wall fracture. No additional fractures evident. MANDIBLE: Normal. SINONASAL CAVITIES: Mild mucosal thickening of bilateral maxillary, sphenoid and frontal sinuses with partial opacification of the ethmoidal air cells. SOFT TISSUES: Mild soft tissue swelling and small laceration noted lateral to the left eye. CONCLUSION: 1. Punctate hyperdensity within the left frontal lobe without surrounding edema may represent tiny intraparenchymal hemorrhage. Recommend attention on follow-up. 2. Mildly displaced fracture of the lateral wall of the left orbit with mild thickening of the left lateral rectus muscle. No retrobulbar hemorrhage or globe injury. 3. Small laceration and mild soft tissue swelling lateral to the left eye. Preliminary results were discussed with Dr. Will Davis at 5:22 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.
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FINDINGS: BRAIN PARENCHYMA: Punctate hyperdensity within the left frontal lobe is noted without surrounding edema (series 201, image 50). There is no mass effect. , Gray-white matter differentiation is maintained. Cerebral cortical volume is normal. EXTRA-AXIAL SPACES: Normal. VENTRICULAR SYSTEM: Normal. ORBITS: Mildly displaced fracture of the lateral wall of the left orbit, extending to the orbital apex there is mild asymmetric thickening of the left lateral rectus muscle. No retrobulbar stranding is seen. The globe is intact.. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. FACIAL BONES: Left lateral orbital wall fracture. No additional fractures evident. MANDIBLE: Normal. SINONASAL CAVITIES: Mild mucosal thickening of bilateral maxillary, sphenoid and frontal sinuses with partial opacification of the ethmoidal air cells. SOFT TISSUES: Mild soft tissue swelling and small laceration noted lateral to the left eye.
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FINDINGS: Vascular findings: No precontrast images are available for the chest on this exam. Normal size cardiac chambers. No pericardial effusion. Significant LAD calcifications. Limited evaluation of aortic root related to cardiac motion. Redemonstrated chronic dissection extending at the level of left subclavian artery origin and extending into mid descending thoracic aorta with peripheral calcifications and completely thrombosed false lumen. No new abnormality. The aortic measurements are from series 610 by central line method are as follows: Aortic root measures 3.7 x 3.7 x 3.5 cm, previously 3.6 x 3.4 x 3.4 cm. Ascending thoracic aorta measures 4.2 x 3.8 cm, previously 3.7 x 3.5 cm. Aortic arch measures 3.9 x 3.5 cm, previously 3.4 x 3.0 cm. Proximal descending thoracic aorta, with thrombosed dissection measures 3.7 x 3.2 cm, previously 3.5 x 3.1 cm. Mid descending thoracic aorta measures 3.2 x 2.9 cm, previously 3.4 x 3.0 cm. Distal descending thoracic aorta measures 2.9 x 2.6 cm, previously 3.1 x 2.7 cm. Normal caliber pulmonary artery. No central PE. Normal pulmonary venous drainage. Central veins are patent. Nonvascular findings: Multinodular thyroid gland, overall unchanged. Central airways are patent with mild lower lobe bronchial wall thickening. Mild centrilobular emphysema. Peripheral patchy atelectasis in the right lower lobe, appears similar. No suspicious pulmonary nodule. No pleural effusion. Mild esophageal wall thickening with trace hiatal hernia. A few nonenlarged mediastinal lymph nodes. No significant abnormality in the chest wall. CTA abdomen will be reported separately. No significant abnormality in the visualized skeleton.
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CT Angio Neck 1/8/2022 4:48 PM Clinical information: 142 years Unknown patient with Trauma Comparison: None available. Technique: Intravenous iodinated contrast was then administered and multiple, contiguous, axial CT images of the neck were performed in the arterial phase using CT neck 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: 150 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: BT sec. Scan field of view: 247 mm. DLP: 1027.30 mGy cm. . FINDINGS: VASCULAR FINDINGS: Aortic arch: Patent with no hemodynamically significant stenosis. Three normal vessel aortic arch is noted. Common carotid arteries: Patent with no hemodynamically significant stenosis. Internal carotid arteries: Patent with no hemodynamically significant stenosis. Vertebral arteries: Dominant left vertebral artery. Patent with no hemodynamically significant stenosis. Aneurysm: No large aneurysm identified. NONVASCULAR 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 without focal abnormality. IMPRESSION: Patent cervical arteries, without evidence of acute vascular injury or flow-limiting stenosis.
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FINDINGS: VASCULAR FINDINGS: Aortic arch: Patent with no hemodynamically significant stenosis. Three normal vessel aortic arch is noted. Common carotid arteries: Patent with no hemodynamically significant stenosis. Internal carotid arteries: Patent with no hemodynamically significant stenosis. Vertebral arteries: Dominant left vertebral artery. Patent with no hemodynamically significant stenosis. Aneurysm: No large aneurysm identified. NONVASCULAR 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 without focal abnormality.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: No significant abnormality. Accessory left hepatic artery arises from the left gastric artery. SMA: Widely patent. Reduced aortic-SMA angle RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER CHEST: Chest findings to be dictated separately; please see separate chest CT report same day. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: 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: Effacement of the left renal vein as it passes underneath the superior mesenteric artery. There are collateral pathways observed with enlargement of the left gonadal vein. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Maxillofacial with contrast CLINICAL INFORMATION: Male patient 53 years with L gumjaw and sinus pain Spec Inst: concern for infection TECHNIQUE: 0.6 mm thick serial axial images were obtained through the maxillofacial bones with intravenous contrast. Sagittal and coronal reformatted views were also obtained. Technique: Patient weight: 255 lbs. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 226 mm. DLP: 1096.20 mGy cm. COMPARISON: None available. FINDINGS: There is large air-fluid level within the left maxillary sinus. There is also mild patchy inflammatory changes within the left ethmoid air cells and minimal mucosal thickening within the left frontal sinus. Remaining paranasal sinuses are clear. There is mild stranding of the retromaxillozygomatic space soft tissues on the left suggesting possible extension of infection. There is no obvious destruction of the posterior wall of the left maxillary sinus. There is mild periapical lucency about the roots of the left first maxillary molar. There is no definite destruction of the floor of the left maxilla however. There is mild rightward deviation of the nasal septum. There is no mass lesion within the nasal cavities. There is occlusion of the left ostiomeatal complex secondary to inflammatory changes. There is also occlusion of the left frontal sinus ostium secondary to inflammatory changes. Right ostiomeatal complex and right frontal ostium are patent. The orbits appear within normal limits. Mastoid air cells are clear. Visualized brain is within normal limits. There is small well-corticated osseous density along the inferior aspect of the anterior arch of C1 representing sequela of remote trauma. CONCLUSION: Acute left maxillary sinusitis. There is mild haziness within the left retromaxillozygomatic space soft tissues on the left raising possibility of extension of infection into the adjacent soft tissues which may be seen with atypical organisms. There is also very mild lucency about roots of the left maxillary first molar suggesting odontogenic sinusitis. There is however no significant wall destruction of the left maxillary sinus.
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FINDINGS: There is large air-fluid level within the left maxillary sinus. There is also mild patchy inflammatory changes within the left ethmoid air cells and minimal mucosal thickening within the left frontal sinus. Remaining paranasal sinuses are clear. There is mild stranding of the retromaxillozygomatic space soft tissues on the left suggesting possible extension of infection. There is no obvious destruction of the posterior wall of the left maxillary sinus. There is mild periapical lucency about the roots of the left first maxillary molar. There is no definite destruction of the floor of the left maxilla however. There is mild rightward deviation of the nasal septum. There is no mass lesion within the nasal cavities. There is occlusion of the left ostiomeatal complex secondary to inflammatory changes. There is also occlusion of the left frontal sinus ostium secondary to inflammatory changes. Right ostiomeatal complex and right frontal ostium are patent. The orbits appear within normal limits. Mastoid air cells are clear. Visualized brain is within normal limits. There is small well-corticated osseous density along the inferior aspect of the anterior arch of C1 representing sequela of remote trauma.
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FINDINGS: NONCONTRAST: No intramural hematoma is identified. No calcific atherosclerosis is seen in the aorta and coronary arteries. ANGIOGRAM: The thoracic aorta is normal in caliber. A small ductus diverticulum is seen which is a variation of normal. Some motion artifact is seen at the level of the ascending aorta. The aorta is normal in contour with no aneurysm, stenosis or dissection. Four branches are seen off the aortic arch with the left vertebral arising as an independent branch posterior to the left subclavian. No pulmonary thromboembolism is identified. The main pulmonary artery is normal in caliber. CHEST: The heart size is within normal limits with no pericardial effusion. A right-sided low-attenuation thyroid nodule is present measuring 9 mm. No enlarged intrathoracic lymph nodes are identified. Remnant thymic tissue is seen. The mediastinum is otherwise normal. No pleural effusion. Small areas of linear scarring are seen posteriorly in the RLL and laterally in the LLL. 4 mm nodule along the right accessory fissure is consistent with an intrapulmonary lymph node. Additional nodule along the right minor fissure on series 501 image 307 is also consistent with an intrapulmonary lymph node. The lungs are otherwise normal no suspicious nodules or masses. CT abdomen and pelvis will be reported separately. No focal destructive osseous lesion.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Fever, concern for infection. COMPARISON: CT chest with contrast and CT abdomen and pelvis without and with contrast 7/15/2021. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 255 lbs. IV contrast: Omnipaque 350, 145 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 474 mm. DLP: 1116.60 mGy cm. (accession CT220004342), Patient weight: 255 lbs. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 474 mm. (accession CT220004343) FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes as well as subsegmental atelectatic changes in the right lower lobe. No pleural effusions or pneumothorax. HEART / VESSELS: Heart size normal. No pericardial effusion. The thoracic aorta is normal in caliber. Right chest wall Port-A-Cath with its tip terminating in the right atrium. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Focal wall thickening in the fundus likely reflects adenomyomatosis, unchanged. PANCREAS: Normal. SPLEEN: No significant abnormality. Previously described small splenic hypodensities are not definitely identified on this examination. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Injection site granulomata in bilateral gluteal regions. Small fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Mild multilevel degenerative changes in the thoracolumbar spine. CONCLUSION: No acute abnormality in the chest, 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.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes as well as subsegmental atelectatic changes in the right lower lobe. No pleural effusions or pneumothorax. HEART / VESSELS: Heart size normal. No pericardial effusion. The thoracic aorta is normal in caliber. Right chest wall Port-A-Cath with its tip terminating in the right atrium. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Focal wall thickening in the fundus likely reflects adenomyomatosis, unchanged. PANCREAS: Normal. SPLEEN: No significant abnormality. Previously described small splenic hypodensities are not definitely identified on this examination. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Injection site granulomata in bilateral gluteal regions. Small fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Mild multilevel degenerative changes in the thoracolumbar spine.
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FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Large hiatal hernia with the majority of the stomach in the chest. HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: STOMACH: Large hiatal hernia with majority of the stomach in the chest. SMALL BOWEL: Post surgical changes from prior small bowel resections with scattered anastomoses. No abnormal bowel wall thickening or enhancement. No dilated bowel loops. PERITONEUM / MESENTERY: No fistula or abscess. Trace pelvic ascites. COLORECTAL: No abnormal bowel wall thickening or enhancement. Fluid is observed throughout the colon.. APPENDIX: Not confidently visualized PERIANAL TISSUES: No fistula or abscess. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: A portion of the pancreatic tail appears herniated into the chest. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: Prominent central mesenteric lymph nodes are likely reactive, for example measuring 1.6 x 1.1 cm on image 159 series 2. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Post surgical scarring along the anterior wall MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Fever, concern for infection. COMPARISON: CT chest with contrast and CT abdomen and pelvis without and with contrast 7/15/2021. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 255 lbs. IV contrast: Omnipaque 350, 145 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 474 mm. DLP: 1116.60 mGy cm. (accession CT220004342), Patient weight: 255 lbs. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 474 mm. (accession CT220004343) FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes as well as subsegmental atelectatic changes in the right lower lobe. No pleural effusions or pneumothorax. HEART / VESSELS: Heart size normal. No pericardial effusion. The thoracic aorta is normal in caliber. Right chest wall Port-A-Cath with its tip terminating in the right atrium. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Focal wall thickening in the fundus likely reflects adenomyomatosis, unchanged. PANCREAS: Normal. SPLEEN: No significant abnormality. Previously described small splenic hypodensities are not definitely identified on this examination. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Injection site granulomata in bilateral gluteal regions. Small fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Mild multilevel degenerative changes in the thoracolumbar spine. CONCLUSION: No acute abnormality in the chest, 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.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Dependent atelectatic changes as well as subsegmental atelectatic changes in the right lower lobe. No pleural effusions or pneumothorax. HEART / VESSELS: Heart size normal. No pericardial effusion. The thoracic aorta is normal in caliber. Right chest wall Port-A-Cath with its tip terminating in the right atrium. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Focal wall thickening in the fundus likely reflects adenomyomatosis, unchanged. PANCREAS: Normal. SPLEEN: No significant abnormality. Previously described small splenic hypodensities are not definitely identified on this examination. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Injection site granulomata in bilateral gluteal regions. Small fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Mild multilevel degenerative changes in the thoracolumbar spine.
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Findings: Small amount of remnant thymic tissue is seen. No enlarged intrathoracic nodes are present. Small hiatal hernia is seen. The heart size and mediastinum are otherwise normal. The lungs are normal without nodules or masses. No pleural effusion. No focal destructive osseous lesions identified. CT abdomen pelvis will be reported separately.
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CLINICAL HISTORY:[ 49-year-old male status post gunshot wound] EXAM: CT of the cervical spine. TECHNIQUE: 1 mm thick serial axial images were obtained throughout the cervical spine without intravenous contrast. Sagittal and coronal reformatted views were also obtained.[ Technique: Scan field of view: 180 mm. DLP: 567 mGy cm. ] COMPARISON: Neck radiographs dated 1/8/2022. FINDINGS:[ There is a small metallic pellet embedded within the left C6 transverse process. No metallic pellet is identified within the spinal canal. Scout view demonstrates multiple additional tiny metallic pellets surrounding the left shoulder. There is no acute fracture and no acute subluxation.. There are no significant degenerative changes. There is no significant prevertebral soft tissue swelling and no abnormal paraspinal soft tissue swelling within the neck soft tissues. Scout view demonstrates diffuse airspace disease within the visualized lungs which appears worse since radiographs dated 1/5/2022. Patient is intubated ] CONCLUSION [ 01. Tiny single metallic pellet embedded within the left C6 transverse process. Multiple additional tiny metallic pellets within the soft tissues about the left shoulder. However no metallic foreign body is identified within the spinal canal. No convincing contraindication] to MRI of the brain 02. Worsening bilateral airspace disease within the visualized lungs
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FINDINGS:[ There is a small metallic pellet embedded within the left C6 transverse process. No metallic pellet is identified within the spinal canal. Scout view demonstrates multiple additional tiny metallic pellets surrounding the left shoulder. There is no acute fracture and no acute subluxation.. There are no significant degenerative changes. There is no significant prevertebral soft tissue swelling and no abnormal paraspinal soft tissue swelling within the neck soft tissues. Scout view demonstrates diffuse airspace disease within the visualized lungs which appears worse since radiographs dated 1/5/2022. Patient is intubated ]
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated CT chest. ABDOMEN and PELVIS: LIVER: Posterior segment right hepatic lobe hypoattenuating lesion with discontinuous peripheral nodular enhancement on venous phase images measures 2.2 x 1.4 cm on image 87 series 301. No other liver lesions. 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.
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: PUI for COVID, AMS. COMPARISON: None. TECHNIQUE: CT Head wo contrastScan field of view: 267 mm. DLP: 1502.60 mGy cm. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. Confluent periventricular white matter hypoattenuation consistent with advanced microtraumatic change. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: Old nasal fractures. Bilateral mastoid air cells are clear. VENTRICULAR SYSTEM: Ex vacuo dilatation. ORBITS: Normal. SINUSES: Paranasal sinuses are clear. VESSELS: Moderate atherosclerosis of the bilateral cavernous ICAs. CONCLUSION: 1. No acute intracranial process. 2. Chronic findings as above As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. Confluent periventricular white matter hypoattenuation consistent with advanced microtraumatic change. Mild diffuse parenchymal volume loss. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: Old nasal fractures. Bilateral mastoid air cells are clear. VENTRICULAR SYSTEM: Ex vacuo dilatation. ORBITS: Normal. SINUSES: Paranasal sinuses are clear. VESSELS: Moderate atherosclerosis of the bilateral cavernous ICAs.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis. Tiny noncalcified pulmonary nodules throughout the lung bases appear similar to the exam dated 7/1/2016, suggesting benignity. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Dense calcifications of the aortic valve and mitral valve annulus. Additionally there are dense coronary artery calcifications. Heart size normal. ABDOMEN and PELVIS: LIVER: Hepatic dome cyst. Similar calcifications in the posterior segment right hepatic lobe. BILIARY TRACT: Mild biliary ductal dilation may be related to postcholecystectomy state. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Punctate nonobstructing left lower pole nephrolithiasis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed diverticula. Appendix is not seen. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Infrarenal abdominal aortic aneurysm sac measures 5.7 x 4.8 cm in AP by transverse dimensions on image 166 series 2, previously measuring 5.4 x 4.9 cm. Aortobiiliac stent is in place extending from the level of the renal artery origins. Similar left common iliac artery aneurysm with stent in place. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No abnormality. MUSCULOSKELETAL: Advanced lumbar spine degenerative changes. Osteopenia. Levoscoliotic curvature of thoracolumbar spine.
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 57-year-old female with history of alcoholic cirrhosis presenting with altered mental status and mild abdominal tenderness. COMPARISON: Prior same-day chest radiograph, CT abdomen and pelvis 11/7/2021, CT angiogram chest 4/11/2020 TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast. Patient weight: 170 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec Scan field of view: 389.70 mm. (accession CT220004414), Patient weight: 170 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70 sec Scan field of view: 389.70 mm. DLP: 923.90 mGy cm. (accession CT220004346) FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Subsegmental atelectatic changes in the left midlung, similar to prior exam. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Severe coronary artery calcifications. Atherosclerotic calcifications of the thoracic aorta and proximal great vessels. MEDIASTINUM / ESOPHAGUS: No significant abnormality. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic in morphology. No focal hepatic lesion. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. No gallbladder wall thickening. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: No significant abnormality. Appendix is normal. PERITONEUM / MESENTERY: Moderate volume simple ascites. RETROPERITONEUM: Normal. VESSELS: Dilated paraesophageal, perigastric and umbilical varices. Small splenorenal shunt. Mild to moderate calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Decompressed with indwelling Foley catheter. REPRODUCTIVE ORGANS: Uterus is normal in appearance. No adnexal mass. BODY WALL: Moderate lower body wall anasarca. No other significant abnormality. MUSCULOSKELETAL: Multilevel chronic degenerative changes of the spine. No aggressive osseous lesion. CONCLUSION: 1. No acute findings in the chest, abdomen or pelvis. 2. Cirrhosis with sequela of portal hypertension, including moderate volume simple ascites. 3. Uncomplicated cholelithiasis. 4. Additional chronic and incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Subsegmental atelectatic changes in the left midlung, similar to prior exam. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Severe coronary artery calcifications. Atherosclerotic calcifications of the thoracic aorta and proximal great vessels. MEDIASTINUM / ESOPHAGUS: No significant abnormality. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Cirrhotic in morphology. No focal hepatic lesion. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. No gallbladder wall thickening. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: No significant abnormality. Appendix is normal. PERITONEUM / MESENTERY: Moderate volume simple ascites. RETROPERITONEUM: Normal. VESSELS: Dilated paraesophageal, perigastric and umbilical varices. Small splenorenal shunt. Mild to moderate calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Decompressed with indwelling Foley catheter. REPRODUCTIVE ORGANS: Uterus is normal in appearance. No adnexal mass. BODY WALL: Moderate lower body wall anasarca. No other significant abnormality. MUSCULOSKELETAL: Multilevel chronic degenerative changes of the spine. No aggressive osseous lesion.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: There are several benign cysts in the liver. A 1.4 x 1.1 cm hypodense lesion in the posterior right hepatic lobe has peripheral nodular enhancement, likely representing a hemangioma (image 33 series 7). There is also a 1.4 x 1.2 cm hemangioma near the gallbladder fossa (image 87 series 7). BILIARY TRACT: Mild biliary ductal dilatation without an obstructing lesion. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: There is a 1.4 x 1.2 cm cyst in the upper pole of the left kidney with four or more thin internal septations that are best seen on the arterial phase. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Large volume of stool in the distal sigmoid and rectum. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is not seen. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrast. Scan field of view: 230 mm. DLP: 1512.60 mGy cm. FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MASTOIDS: Clear. SOFT TISSUE: Unremarkable. 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.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MASTOIDS: Clear. SOFT TISSUE: Unremarkable.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: The trachea and main bronchi are patent. Large right paratracheal diverticulum. Bibasilar subsegmental atelectasis/scarring. Scattered calcified granulomas. Focal areas of bronchiectatic changes, for example in the apical subsegmental right upper lobe bronchus. Few small (less than 5 mm) pulmonary nodules, for example a 3 mm left upper lobe subpleural nodule (image 40, series 2) and a 3 mm left lower lobe nodule (image 100). No pleural effusion. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. No coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Right hepatic lobe low-attenuation lesions the largest measures 2.5 cm, likely cysts. Splenic granuloma.
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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, kicked by horse. 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: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004349), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. DLP: 2557.50 mGy cm. (accession CT220004348), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004352), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004351) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Innumerable cystic lesions in the bilateral kidneys greater than expected for patient's age. Recommend correlation for history of familial history of polycystic kidney disease. 4. Hepatic steatosis. 5. Additional findings above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Stable wedge resection of the right upper lobe with no evidence of residual/recurrent mass lesion. Few tiny nodules are unchanged, for example in the right upper lobe at image 26 and superior segment right lower lobe at image 32, series 2. No new or enlarging suspicious pulmonary nodule. Mild upper lobe predominant emphysema with mild diffuse bronchial wall thickening and mucous plugs involving mainly the right lower lobe. No focal consolidation. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. Mild coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. A 12 mm right breast nodule (image 67), previously measured 10 mm. Upper abdomen: Hepatic granuloma.
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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, kicked by horse. 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: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004349), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. DLP: 2557.50 mGy cm. (accession CT220004348), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004352), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004351) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Innumerable cystic lesions in the bilateral kidneys greater than expected for patient's age. Recommend correlation for history of familial history of polycystic kidney disease. 4. Hepatic steatosis. 5. Additional findings above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: Redemonstrated hypoattenuation involving the superior left frontal lobe, less conspicuous on the current exam compared to prior. Multiple small infarcts involving the region of the right basal ganglia, unchanged. No intraparenchymal hemorrhage, mass effect or edema. Empty sella. Periventricular and subcortical white matter hypodensities are most consistent with chronic microangiopathic ischemic changes. No extra axial collection. Persistent ventriculomegaly, unchanged. No fracture or aggressive osseous lesion. Dentigerous cyst is noted on the right. The paranasal sinuses, middle ears, and mastoid air cells are clear. The orbits are unremarkable. The visualized soft tissues are unremarkable. -------------------
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CT Cervical Spine From Reformat 1/8/2022 5:21 PM Clinical information: 142 years Unknown patient with Trauma Comparison: None available. Technique: Multiple, contiguous, axial CT images of the cervical spine were obtained from the base of the skull through the thoracic inlet without administration of intravenous contrast. Reformatted sagittal and coronal reconstructions were also performed. Findings: The sagittal images demonstrate mild straightening of the cervical lordosis, without subluxations. The vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Multilevel intervertebral disc space loss and early anterior osteophytes, moderate at C4-C5, C6-C7 And C7-T1. The craniocervical junction appears unremarkable. The spinal canal and neuroforamina are patent. The prevertebral and paraspinal soft tissues appear normal. IMPRESSION: 1. No evidence of acute cervical spine fracture or subluxation. 2. Chronic multilevel degenerative changes as described, without significant spinal canal stenosis or neuroforaminal narrowing.
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Findings: The sagittal images demonstrate mild straightening of the cervical lordosis, without subluxations. The vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Multilevel intervertebral disc space loss and early anterior osteophytes, moderate at C4-C5, C6-C7 And C7-T1. The craniocervical junction appears unremarkable. The spinal canal and neuroforamina are patent. The prevertebral and paraspinal soft tissues appear normal.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Moderate atherosclerotic disease ABDOMINAL AORTA: Infrarenal abdominal aortic aneurysm is again observed in measures increased in size compared to the prior examination, now measuring 4.5 x 4.9 cm (series 7 image 96), previously measuring 4.0 x 4.4 cm. CELIAC AXIS: No significant abnormality SMA: Mild-moderate stenosis at the origin RIGHT RENAL: Duplication of the right renal artery LEFT RENAL: Mild stenosis at the origin IMA: Patent RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Moderate atherosclerosis. Ectasia of the right common iliac artery measuring 1.7 cm. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Moderate atherosclerosis. Ectasia of the left common iliac artery measuring 1.5 cm. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Bibasilar subsegmental atelectasis. Scattered right lower lobe tree-in-bud opacities with endobronchial debris. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Normal ABDOMEN and PELVIS: LIVER: Unchanged ill-defined hyperenhancing lesion posterior right hepatic lobe measuring about 2 cm (series 7 image 39), unchanged BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: There are a few, unchanged tiny sub-5 mm hypoattenuating pancreatic lesions, which may represent side branch type IPMN's. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Bilateral renal parenchymal scarring. 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: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: 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, kicked by horse. 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: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004349), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. DLP: 2557.50 mGy cm. (accession CT220004348), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004352), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004351) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Innumerable cystic lesions in the bilateral kidneys greater than expected for patient's age. Recommend correlation for history of familial history of polycystic kidney disease. 4. Hepatic steatosis. 5. Additional findings above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: Scouts: No additional findings. Lines and tubes: Right chest wall port catheter tip is in the right atrium as before. Lungs and pleura: Redemonstration of areas of bronchiectasis with bronchial wall thickening bilaterally, more in the lingula and right middle lobe with areas of associated atelectasis and scarring bilaterally. Mild centrilobular nodularity bilaterally is redemonstrated, overall unchanged. Mild biapical lung scarring. Scattered calcified granulomas bilaterally. Mosaic attenuation bilaterally as before. No pleural effusion. No pneumothorax. Esophagus, Mediastinum and neck: Esophagus is normal. No abnormality in the mediastinum. The thyroid gland is normal. Lymph Nodes: None enlarged. Small mediastinal lymph nodes are unchanged. Cardiovascular: No cardiomegaly or pericardial effusion. Coronary artery atherosclerotic calcification: Small amount. Abdomen: Postsurgical changes from prior cholecystectomy. Fatty replacement of the pancreatic parenchyma. Musculoskeletal/Body Wall: No soft tissue masses. Calcific foci in the right breast as before. Partially healed fracture involving the right seventh and eighth ribs laterally. Mild degenerative changes in 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, kicked by horse. 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: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004349), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. DLP: 2557.50 mGy cm. (accession CT220004348), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004352), Patient weight: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 488.50 mm. (accession CT220004351) FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No evidence of acute traumatic injury in the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Innumerable cystic lesions in the bilateral kidneys greater than expected for patient's age. Recommend correlation for history of familial history of polycystic kidney disease. 4. Hepatic steatosis. 5. Additional findings above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest, Abdomen, and Pelvis with Thoracic and Lumbar Spine LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: The central airways are patent. No focal airspace consolidation, pleural effusion, or pneumothorax. Mild dependent atelectasis. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Innumerable bilateral cortical cysts of varying sizes and additional hypoattenuating lesions that are too small to characterize. 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: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality. THORACIC AND LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel degenerative changes of the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: STRUCTURED REPORT: CT HCC Screening IMAGE QUALITY: Satisfactory LOWER CHEST: LUNG BASES / PLEURA: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Cirrhotic with moderate liver surface nodularity. No steatosis. LIVER LESIONS: None. LIVER VASCULATURE AND COLLATERALS: - Hepatic artery patency and anatomy: Patent with conventional anatomy. - Portal venous system: Intrahepatic portal venous system is small in caliber. - Hepatic veins: Patent right, middle and left hepatic veins. - Esophageal varices: Small (
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CT Angio Neck 1/8/2022 5:21 PM Clinical information: 142 years Unknown patient with Trauma Comparison: None available. Technique: Intravenous iodinated contrast was then administered and multiple, contiguous, axial CT images of the neck were performed in the arterial phase using CT neck 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: 275 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus Scan field of view: 304.80 mm. DLP: 981.20 mGy cm. . FINDINGS: VASCULAR FINDINGS: Aortic arch: Patent with no hemodynamically significant stenosis. Three normal vessel aortic arch is noted. Common carotid arteries: Patent with no hemodynamically significant stenosis. Internal carotid arteries: Patent with no hemodynamically significant stenosis. Vertebral arteries: Codominant. Patent with no hemodynamically significant stenosis. Aneurysm: No large aneurysm identified. NONVASCULAR 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 without focal abnormality. IMPRESSION: Patent cervical arteries, without evidence of acute vascular injury or flow-limiting stenosis.
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FINDINGS: VASCULAR FINDINGS: Aortic arch: Patent with no hemodynamically significant stenosis. Three normal vessel aortic arch is noted. Common carotid arteries: Patent with no hemodynamically significant stenosis. Internal carotid arteries: Patent with no hemodynamically significant stenosis. Vertebral arteries: Codominant. Patent with no hemodynamically significant stenosis. Aneurysm: No large aneurysm identified. NONVASCULAR 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 without focal abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Trace left basilar atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. Partially visualized cardiac leads. ABDOMEN and PELVIS: LIVER: Unchanged segment 4 simple hepatic cyst. No suspicious liver lesion. BILIARY TRACT: Normal. GALLBLADDER: Layering radiodensity in the gallbladder likely represents stones. PANCREAS: Fatty atrophy of the pancreatic head; otherwise normal. SPLEEN: Scattered calcified granulomas. ADRENALS: Normal. KIDNEYS: Small nonobstructing bilateral calyceal renal calculi bilaterally. Left kidney: Post ablation changes are seen off the anterior aspect of the mid left kidney. The 2.0 x 2.0 cm enhancing partially exophytic lesion from the left posterior kidney is also unchanged (image 128 series 5). Right kidney: Interval decrease in size of the exophytic right anterior kidney lesion after cryoablation, now measuring 2.3 x 2.2 cm (series 3 image 52) previously 3.1 x 3.1 cm. There is no nodular enhancement. Thin linear calcifications at the right lateral margin of the lesion are unchanged. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Tiny fat containing right inguinal hernia. MUSCULOSKELETAL: Degenerative changes of the lower thoracic spine. No aggressive osseous lesion.
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CT Cervical Spine wo contrast, CT Lumbar Spine wo contrast, CT Thoracic Spine wo contrast 1/8/2022 9:02 PM Clinical information: 72 years Male patient with cervical lesion Comparison: Same day MRI of the cervical, thoracic and lumbar spine at 01:32 hours. Technique: Multiple, contiguous, axial CT images of the cervical spine thoracic and lumbar were obtained without administration of intravenous contrast. Reformatted sagittal and coronal reconstructions were also performed. Scan field of view: 237 mm. DLP: 346 mGy cm. (accession CT220004357), Scan field of view: 151 mm. (accession CT220004355) Findings: The sagittal images demonstrate persistent preservation of the cervical lordosis, with mild retrolisthesis of C3 on C4 and ankylosis of the C5-C6 vertebral bodies. Unchanged exaggeration of the thoracic kyphosis and preservation of the lumbar lordosis, without subluxations. Unchanged mild decreased height of C7, T5, T6, T7 and T8 vertebral bodies, with severe height loss of T6 and T8 vertebral bodies. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion extending into the right lateral spinal canal and the right neural foramina. The remaining vertebral bodies are normal in height, with multiple lytic lesions extending to the visualized pelvis, without otherwise acute pathologic fractures. Unchanged prominent scattered Schmorl nodes. Persistent chronic multilevel degenerative changes manifested by intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced in the mid thoracic spine. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level. Intact sternotomy wires. Atherosclerotic calcifications of the thoracoabdominal aorta and its branches. IMPRESSION: 1. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion, extending into the right lateral spinal canal and the right neural foramina. 2. Multiple lytic lesions throughout the entire spine and visualized pelvis, consistent with history of multiple myeloma, with persistent chronic multifocal compression fractures, greatest at T6 and T8. 3. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level.
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Findings: The sagittal images demonstrate persistent preservation of the cervical lordosis, with mild retrolisthesis of C3 on C4 and ankylosis of the C5-C6 vertebral bodies. Unchanged exaggeration of the thoracic kyphosis and preservation of the lumbar lordosis, without subluxations. Unchanged mild decreased height of C7, T5, T6, T7 and T8 vertebral bodies, with severe height loss of T6 and T8 vertebral bodies. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion extending into the right lateral spinal canal and the right neural foramina. The remaining vertebral bodies are normal in height, with multiple lytic lesions extending to the visualized pelvis, without otherwise acute pathologic fractures. Unchanged prominent scattered Schmorl nodes. Persistent chronic multilevel degenerative changes manifested by intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced in the mid thoracic spine. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level. Intact sternotomy wires. Atherosclerotic calcifications of the thoracoabdominal aorta and its branches.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Patchy groundglass opacities scattered throughout both lung bases are new since prior exam. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Continued decrease in size of the hypoattenuation in the right hepatic dome, measuring 4.7 x 2.1 cm in greatest axial dimensions on image 60 series 601, previously 5.2 x 4.1 cm. Decreased size and attenuation of the pericapsular collection, which measures 3.2 x 1.5 cm on image 77 series 601, previously 4.2 x 1.6 cm. The pericapsular collection communicates with the right hepatic lobe lesion as seen on image 68 series 603. No new liver lesions. Liver is normal in morphology without steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right lower pole cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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CT Cervical Spine wo contrast, CT Lumbar Spine wo contrast, CT Thoracic Spine wo contrast 1/8/2022 9:02 PM Clinical information: 72 years Male patient with cervical lesion Comparison: Same day MRI of the cervical, thoracic and lumbar spine at 01:32 hours. Technique: Multiple, contiguous, axial CT images of the cervical spine thoracic and lumbar were obtained without administration of intravenous contrast. Reformatted sagittal and coronal reconstructions were also performed. Scan field of view: 237 mm. DLP: 346 mGy cm. (accession CT220004357), Scan field of view: 151 mm. (accession CT220004355) Findings: The sagittal images demonstrate persistent preservation of the cervical lordosis, with mild retrolisthesis of C3 on C4 and ankylosis of the C5-C6 vertebral bodies. Unchanged exaggeration of the thoracic kyphosis and preservation of the lumbar lordosis, without subluxations. Unchanged mild decreased height of C7, T5, T6, T7 and T8 vertebral bodies, with severe height loss of T6 and T8 vertebral bodies. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion extending into the right lateral spinal canal and the right neural foramina. The remaining vertebral bodies are normal in height, with multiple lytic lesions extending to the visualized pelvis, without otherwise acute pathologic fractures. Unchanged prominent scattered Schmorl nodes. Persistent chronic multilevel degenerative changes manifested by intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced in the mid thoracic spine. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level. Intact sternotomy wires. Atherosclerotic calcifications of the thoracoabdominal aorta and its branches. IMPRESSION: 1. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion, extending into the right lateral spinal canal and the right neural foramina. 2. Multiple lytic lesions throughout the entire spine and visualized pelvis, consistent with history of multiple myeloma, with persistent chronic multifocal compression fractures, greatest at T6 and T8. 3. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level.
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Findings: The sagittal images demonstrate persistent preservation of the cervical lordosis, with mild retrolisthesis of C3 on C4 and ankylosis of the C5-C6 vertebral bodies. Unchanged exaggeration of the thoracic kyphosis and preservation of the lumbar lordosis, without subluxations. Unchanged mild decreased height of C7, T5, T6, T7 and T8 vertebral bodies, with severe height loss of T6 and T8 vertebral bodies. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion extending into the right lateral spinal canal and the right neural foramina. The remaining vertebral bodies are normal in height, with multiple lytic lesions extending to the visualized pelvis, without otherwise acute pathologic fractures. Unchanged prominent scattered Schmorl nodes. Persistent chronic multilevel degenerative changes manifested by intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced in the mid thoracic spine. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level. Intact sternotomy wires. Atherosclerotic calcifications of the thoracoabdominal aorta and its branches.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. The right thoracotomy tube extends along the lateral surface of the right lung and into part of the minor fissure. The distal tube is opacified. Moderate pneumothorax is seen from the apex to the base with a small amount within the three fissures. Multiple peripheral bulla are again seen. Bibasilar fibrosis with groundglass opacities but without traction bronchiectasis is seen. Additional groundglass opacities with multiple small cysts are present in both upper lobes right greater than left. No pleural effusion. Small amount of air is seen in the azygo esophageal recess but not clearly into the mediastinum. Calcified subcarinal and left hilar nodes are seen. Enlarged noncalcified subcarinal node is 14 mm in short axis on image 37. Additional enlarged paratracheal nodes are noted as well as an enlarged node in the lateral aortic soft tissues measuring approximately 17 x 28 mm on image 24 and was 21 x 28 mm on the prior. Borderline enlarged right supraclavicular node is present on image seven. Small hiatal hernia is seen. The mediastinum is again seen shifted to the left in this patient with chronic left lung volume loss. The heart size is normal. Patient's had a previous cholecystectomy. Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
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CT Cervical Spine wo contrast, CT Lumbar Spine wo contrast, CT Thoracic Spine wo contrast 1/8/2022 9:02 PM Clinical information: 72 years Male patient with cervical lesion Comparison: Same day MRI of the cervical, thoracic and lumbar spine at 01:32 hours. Technique: Multiple, contiguous, axial CT images of the cervical spine thoracic and lumbar were obtained without administration of intravenous contrast. Reformatted sagittal and coronal reconstructions were also performed. Scan field of view: 237 mm. DLP: 346 mGy cm. (accession CT220004357), Scan field of view: 151 mm. (accession CT220004355) Findings: The sagittal images demonstrate persistent preservation of the cervical lordosis, with mild retrolisthesis of C3 on C4 and ankylosis of the C5-C6 vertebral bodies. Unchanged exaggeration of the thoracic kyphosis and preservation of the lumbar lordosis, without subluxations. Unchanged mild decreased height of C7, T5, T6, T7 and T8 vertebral bodies, with severe height loss of T6 and T8 vertebral bodies. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion extending into the right lateral spinal canal and the right neural foramina. The remaining vertebral bodies are normal in height, with multiple lytic lesions extending to the visualized pelvis, without otherwise acute pathologic fractures. Unchanged prominent scattered Schmorl nodes. Persistent chronic multilevel degenerative changes manifested by intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced in the mid thoracic spine. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level. Intact sternotomy wires. Atherosclerotic calcifications of the thoracoabdominal aorta and its branches. IMPRESSION: 1. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion, extending into the right lateral spinal canal and the right neural foramina. 2. Multiple lytic lesions throughout the entire spine and visualized pelvis, consistent with history of multiple myeloma, with persistent chronic multifocal compression fractures, greatest at T6 and T8. 3. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level.
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Findings: The sagittal images demonstrate persistent preservation of the cervical lordosis, with mild retrolisthesis of C3 on C4 and ankylosis of the C5-C6 vertebral bodies. Unchanged exaggeration of the thoracic kyphosis and preservation of the lumbar lordosis, without subluxations. Unchanged mild decreased height of C7, T5, T6, T7 and T8 vertebral bodies, with severe height loss of T6 and T8 vertebral bodies. Unchanged expansile destructive soft tissue lesion involving the C2 vertebral body, its right lamina and pedicle, with associated extradural lesion extending into the right lateral spinal canal and the right neural foramina. The remaining vertebral bodies are normal in height, with multiple lytic lesions extending to the visualized pelvis, without otherwise acute pathologic fractures. Unchanged prominent scattered Schmorl nodes. Persistent chronic multilevel degenerative changes manifested by intervertebral disc space loss, endplate sclerosis and osteophytosis, most pronounced in the mid thoracic spine. Please refer to same-day MRI of the complete spine for better characterization of spondylolysis level by level. Intact sternotomy wires. Atherosclerotic calcifications of the thoracoabdominal aorta and its branches.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. The exam is limited secondary to motion artifact. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus. The main pulmonary artery is normal in size. LUNGS / AIRWAYS / PLEURA: Diffuse bilateral airspace opacities. No pleural effusion or pneumothorax. The central airways are patent. HEART / OTHER VESSELS: Mild cardiomegaly. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Moderate diffuse anasarca. UPPER ABDOMEN: Please see separately dictated CT abdomen report. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Immobilization following lower extremity trauma, evaluate for pulmonary thromboembolus. COMPARISON: None available. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 167 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus tracked Scan field of view: 323 mm. KVP: 100 DLP: 165.70 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE 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: The central tracheobronchial tree is patent. No pulmonary consolidation, pleural effusion, or pneumothorax. Linear subsegmental atelectatic changes in the lingula and bilateral lower lobes. HEART / OTHER VESSELS: Mild left atrial and right ventricular as well as marked right atrial dilatation. Borderline flattening of the interventricular septum. Evaluation of the left atrial appendage is limited secondary to contrast bolus timing. No pericardial effusion. The main pulmonary artery and thoracic aorta are normal in caliber. Reflux of contrast into the intrahepatic IVC and hepatic veins. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Partially visualized ACDF hardware. CONCLUSION: 1. No acute central or proximal segmental pulmonary thromboembolus. 2. CT findings suggestive of right heart dysfunction. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT PE 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: The central tracheobronchial tree is patent. No pulmonary consolidation, pleural effusion, or pneumothorax. Linear subsegmental atelectatic changes in the lingula and bilateral lower lobes. HEART / OTHER VESSELS: Mild left atrial and right ventricular as well as marked right atrial dilatation. Borderline flattening of the interventricular septum. Evaluation of the left atrial appendage is limited secondary to contrast bolus timing. No pericardial effusion. The main pulmonary artery and thoracic aorta are normal in caliber. Reflux of contrast into the intrahepatic IVC and hepatic veins. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Partially visualized ACDF hardware.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: See separately reported CT chest report. ABDOMEN and PELVIS: LIVER: Cirrhotic with redemonstrated TIPS stent in place. No focal hepatic lesion. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No hydronephrosis or renal calculus bilaterally. Otherwise unremarkable appearance of the kidneys. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No significant abnormality. Moderate fecal burden. PERITONEUM / MESENTERY: No free fluid or intraperitoneal free air. RETROPERITONEUM: Normal. VESSELS: Mild scattered atherosclerotic calcifications of the abdominal aorta and its branches. URINARY BLADDER: Unremarkable. REPRODUCTIVE ORGANS: The uterus is normal in size. BODY WALL: Moderate diffuse anasarca, not significantly changed from prior. MUSCULOSKELETAL: No significant abnormality.
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Fall, abdominal pain. Evaluate for traumatic injury. COMPARISON: CT abdomen and pelvis 5/19/2019. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 160 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: 372 mm. DLP: 514 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Large subcapsular hematoma and multiple large splenic lacerations. Foci of contrast extravasation in the anterior splenic parenchyma which could be active extravasation or vessel opacification of a pseudoaneurysm. There is contrast extravasation along the perisplenic region which is associated with an adjacent perisplenic hemoperitoneum which suggest this is in the extra parenchymal/extracapsular hemorrhage. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Moderate volume hemoperitoneum. No free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Healing left 7th through 10th lateral rib fractures. Mild superior endplate compression deformity of the L1 vertebral body. CONCLUSION: 1. Grade 5 splenic laceration with suspected greater than 25% devascularization and focal active extravasation/pseudoaneurysm in the splenic parenchyma and a small amount of active extravasation layering along the posterior spleen with an associated perisplenic hemoperitoneum. 2. Subacute/chronic left lateral seventh through 10th rib fractures. 3. Age indeterminate superior endplate compression deformity of L1, possibly acute. Recommend correlation with point tenderness to assess for acuity. 4. Hepatic steatosis. Additional findings above. Preliminary findings discussed with Matt Hall CRNP by Ivan Morales, M.D. on 1/8/2022 5:04 PM report findings discussed with Dr. Beckadorf at 1/8/2022 approximately 5:10 PM by Dr. Little by telephone. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Bilateral dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Large subcapsular hematoma and multiple large splenic lacerations. Foci of contrast extravasation in the anterior splenic parenchyma which could be active extravasation or vessel opacification of a pseudoaneurysm. There is contrast extravasation along the perisplenic region which is associated with an adjacent perisplenic hemoperitoneum which suggest this is in the extra parenchymal/extracapsular hemorrhage. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Moderate volume hemoperitoneum. No free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Healing left 7th through 10th lateral rib fractures. Mild superior endplate compression deformity of the L1 vertebral body.
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FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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CLINICAL HISTORY: numbness on left side>24 hrs Spec Inst: asssess for cva EXAM: CT Head wo contrast TECHNIQUE: 5 mm thick serial axial images were obtained throughout the head without intravenous contrast. Scan field of view: 230 mm. DLP: 1444 mGy cm. COMPARISON: 7/10/2021 FINDINGS: There is a small area of hypoattenuation within the right thalamus which is new since the prior exam (axial image 35). Finding likely represents a lacunar infarction, either chronic or possibly subacute. There is also suggestion of additional tiny right thalamic lacunar infarction which may be acute or subacute (axial image 39). There is also a small area of hypoattenuation within the medial and posterior left thalamus also likely representing lacunar infarction, either acute or subacute (axial image 37).. There is also a chronic appearing left caudate head lacunar infarction There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute acute cortical. The ventricles, cisterns and sulci are unremarkable. 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. Small areas of hypoattenuation within both the right and left thalami the represent acute or subacute infarctions. MRI could be obtained for further evaluation as clinically indicated. 02. Small remote additional right thalamic and left caudate head lacunar infarctions. However these appear new since the prior exam.
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FINDINGS: There is a small area of hypoattenuation within the right thalamus which is new since the prior exam (axial image 35). Finding likely represents a lacunar infarction, either chronic or possibly subacute. There is also suggestion of additional tiny right thalamic lacunar infarction which may be acute or subacute (axial image 39). There is also a small area of hypoattenuation within the medial and posterior left thalamus also likely representing lacunar infarction, either acute or subacute (axial image 37).. There is also a chronic appearing left caudate head lacunar infarction There is no acute intracranial hemorrhage. There are no abnormal areas of hypoattenuation to suggest acute acute cortical. The ventricles, cisterns and sulci are unremarkable. There is no mass effect. The calvarium is intact. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
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FINDINGS: CT of the head with and without contrast: There is no acute infarction, hemorrhage, or cerebral edema. The gray-white matter differentiation is maintained. The cerebral cortical volume is appropriate for patient's age. There is no space occupying intracranial lesion or hydrocephalus. There is a partially empty sella. No enhancing intracranial abnormality. There is no acute osseous or orbital abnormality. Left maxillary sinus mucous retention cyst. The paranasal sinuses and mastoid air cells are otherwise clear. CT angiogram of the head: RIGHT CAROTID: Retropharyngeal in course. There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Retropharyngeal in course. 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. Major dural venous sinuses appear within normal limits.
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3,668
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Radiologic Exam: CT Angio Head Code Stroke, CT Angio Neck 1/8/2022 5:43 PM Clinical Information: stroke, sudden disorientation. Comparison: Same-day CT of the head without contrast and CT perfusion Technique: Helical CT images were obtained before and after the administration of contrast from the base of the skull to the vertex. Contrast enhanced images were then performed from the superior mediastinum to the vertex. 3-D CT angiographic images were generated from the axial data set under the supervision of the reporting physician. Results are reported below. "Sliding MIP" images were also generated in the sagittal, axial, and coronal plane . IV contrast: Omnipaque 350, 125 ml, per protocol. FINDINGS: 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. Punctate calcified atherosclerosis of the cavernous ICA. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation. Hypoplastic A1 segment of the right anterior cerebral artery. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Diffusely hypoplastic V4 segment of the right vertebral artery, likely congenital variant. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. 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: Dominant. There is no evidence of stenosis, occlusion, or aneurysmal dilation. NONVASCULAR 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 without focal abnormality. No acute fracture or malalignment. There is straightening of the usual cervical lordosis. Chronic multilevel degenerative changes, most significant at C5-6 and C6-C7, with moderate intervertebral disc space loss, endplate sclerosis, osteophytosis and subchondral cysts. IMPRESSION: No large vessel occlusion or flow-limiting stenosis within the cervical or intracranial arteries. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT 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. Punctate calcified atherosclerosis of the cavernous ICA. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation. Hypoplastic A1 segment of the right anterior cerebral artery. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Diffusely hypoplastic V4 segment of the right vertebral artery, likely congenital variant. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. 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: Dominant. There is no evidence of stenosis, occlusion, or aneurysmal dilation. NONVASCULAR 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 without focal abnormality. No acute fracture or malalignment. There is straightening of the usual cervical lordosis. Chronic multilevel degenerative changes, most significant at C5-6 and C6-C7, with moderate intervertebral disc space loss, endplate sclerosis, osteophytosis and subchondral cysts.
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Findings: Patchy bilateral cerebral white matter hypodensities likely related to chronic microvascular ischemic disease. Mild generalized age-related prominence of the extra-axial space is seen. There is no evidence of acute intra- or extra-axial hemorrhage. There is no midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation appears maintained. The ventricular system are normal in configuration. The basal cisterns are clear. Small air-fluid level in the left maxillary sinus.The remainingvisualized paranasal sinuses and mastoid air cells are clear of acute process. The visualized bones of the calvarium demonstrate no acute osseous abnormality.
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3,669
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Radiologic Exam: CT Angio Head Code Stroke, CT Angio Neck 1/8/2022 5:43 PM Clinical Information: stroke, sudden disorientation. Comparison: Same-day CT of the head without contrast and CT perfusion Technique: Helical CT images were obtained before and after the administration of contrast from the base of the skull to the vertex. Contrast enhanced images were then performed from the superior mediastinum to the vertex. 3-D CT angiographic images were generated from the axial data set under the supervision of the reporting physician. Results are reported below. "Sliding MIP" images were also generated in the sagittal, axial, and coronal plane . IV contrast: Omnipaque 350, 125 ml, per protocol. FINDINGS: 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. Punctate calcified atherosclerosis of the cavernous ICA. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation. Hypoplastic A1 segment of the right anterior cerebral artery. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Diffusely hypoplastic V4 segment of the right vertebral artery, likely congenital variant. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. 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: Dominant. There is no evidence of stenosis, occlusion, or aneurysmal dilation. NONVASCULAR 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 without focal abnormality. No acute fracture or malalignment. There is straightening of the usual cervical lordosis. Chronic multilevel degenerative changes, most significant at C5-6 and C6-C7, with moderate intervertebral disc space loss, endplate sclerosis, osteophytosis and subchondral cysts. IMPRESSION: No large vessel occlusion or flow-limiting stenosis within the cervical or intracranial arteries. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT 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. Punctate calcified atherosclerosis of the cavernous ICA. ANTERIOR, MIDDLE, AND POSTERIOR CEREBRAL ARTERIES: Patent without flow-limiting stenosis or aneurysmal dilation. Hypoplastic A1 segment of the right anterior cerebral artery. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Diffusely hypoplastic V4 segment of the right vertebral artery, likely congenital variant. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. 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: Dominant. There is no evidence of stenosis, occlusion, or aneurysmal dilation. NONVASCULAR 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 without focal abnormality. No acute fracture or malalignment. There is straightening of the usual cervical lordosis. Chronic multilevel degenerative changes, most significant at C5-6 and C6-C7, with moderate intervertebral disc space loss, endplate sclerosis, osteophytosis and subchondral cysts.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Similar geographic wedge-shaped perfusion abnormality in the right hepatic lobe. A thin linear branching hypodensity in this region may represent a chronically occluded segmental portal venous branch versus a mildly dilated biliary duct. BILIARY TRACT: Similar segmental dilation of the common bile duct at the level of the pancreatic head, measuring up to 1.5 x 1.5 x 3.6 cm in AP by transverse by craniocaudal dimensions (image 124 series 501, image 57 series 502). GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild right hydronephrosis with abrupt return to normal caliber of the ureter at the ureteropelvic junction is similar to prior exams and is likely related to chronic UPJ obstruction. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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3,670
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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: 218 mm. DLP: 1083 mGy cm. INDICATION: sudden disorientation COMPARISON: None. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. Mild frontoparietal age-appropriate brain parenchymal volume loss is seen. Bilateral physiologic basal ganglia calcifications are seen. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Hyperostosis frontalis interna is noted. There is calcified atherosclerosis of the cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Complete opacification of the left sphenoid sinus with hyperdense contents and mild chronic osteitis, likely sequela of chronic sinusitis and inspissated secretions. IMPRESSION: 1. No definitive acute intracranial process. In particular, no evidence of acute hemorrhage. 2. Suggestion of chronic left sphenoid 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.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. Mild frontoparietal age-appropriate brain parenchymal volume loss is seen. Bilateral physiologic basal ganglia calcifications are seen. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Hyperostosis frontalis interna is noted. There is calcified atherosclerosis of the cavernous ICAs and intracranial vertebral arteries. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Complete opacification of the left sphenoid sinus with hyperdense contents and mild chronic osteitis, likely sequela of chronic sinusitis and inspissated secretions.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Stable appearance of the spiculated left upper lobe pulmonary nodule today measuring 1.5 x 0.7 cm on series 2 image 19, previously 1.4 x 0.8 cm as measured by this radiologist. Stable right upper lobe pulmonary nodule measuring 5 mm in diameter on series 2 image 20, previously 5 mm. The right lower lobe mixed density spiculated nodule today measures 1.0 x 0.8 cm on series 2 image 61, previously 1.0 x 0.7 cm additional scattered areas of pleural parenchymal scarring and cystic changes as seen on series 2 image 40, 47, and 51 are overall stable in appearance. No focal consolidation, pleural effusion, or pneumothorax. HEART / VESSELS: Heart size is normal. No pericardial effusion. Moderate to severe atherosclerotic calcifications of the thoracic aorta. Moderate coronary artery, secretions. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Redemonstration of prominent mediastinal and hilar lymph nodes with pretracheal lymph node measuring up to 0.8 cm in short axis diameter. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal noncontrast appearance of the imaged upper abdomen. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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3,671
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CT Perfusion 1/8/2022 5:40 PM Clinical information: Code stroke Comparison: None available. 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: 160 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: 218 mm. DLP: 1947 mGy cm. 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. IMPRESSION: Unremarkable CT perfusion.
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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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FINDINGS: No intraparenchymal hemorrhage, mass effect or edema. The gray white matter differentiation is maintained. No extra axial collections. The ventricles are within normal size limits and there is no midline shift. No fracture or aggressive osseous lesion. The paranasal sinuses, middle ears, and mastoid air cells are clear. The orbits are unremarkable. The visualized soft tissues are unremarkable. --------------------
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3,672
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CT Maxillofacial with contrast 1/8/2022 6:33 PM Clinical information: 64 years Male patient with Sublingual/submandibular abscess Spec Inst: L sided lymphadenopathy Comparison: None available. Technique: Multiple, contiguous, thin slice, axial CT images of the face were obtained after administration of intravenous contrast. Reformatted coronal reconstructions were also obtained. Patient weight: 159 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 180 sec Scan field of view: 220 mm. DLP: 1234.50 mGy cm. FINDINGS: Soft tissues: Asymmetric enlargement and enhancement of the left sublingual and submandibular glands extending into their respective ducts, suggestive of acute sialoadenitis and sialectasis, without discrete fluid collection, sialolith or masses. Increased number of subcentimeter enhancing left levels IB and IIA lymph nodes, most likely reactive in nature. Bones: Edentulous patient with only residual right central and left lateral maxillary incisors, demonstrating multiple periapical lucencies suggestive of advanced periodontal disease. No acute facial bone fractures are identified. No suspicious osseous lesions are seen. The visualized mandible is intact and the bilateral TMJs are congruent. Orbits: The bilateral globes and optic nerves are intact. The retrobulbar soft tissues have a normal appearance. Paranasal sinuses and mastoid air cells: Tiny right maxillary sinus mucous retention cyst. Otherwise, appear well aerated. IMPRESSION: Asymmetric enlargement and enhancement of the left sublingual and submandibular glands extending into their respective ducts, suggestive of acute sialoadenitis and sialectasis, without discrete fluid collection, sialolith or masses. Increased number of subcentimeter enhancing left levels IB and IIA lymph nodes, most likely reactive in nature.
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FINDINGS: Soft tissues: Asymmetric enlargement and enhancement of the left sublingual and submandibular glands extending into their respective ducts, suggestive of acute sialoadenitis and sialectasis, without discrete fluid collection, sialolith or masses. Increased number of subcentimeter enhancing left levels IB and IIA lymph nodes, most likely reactive in nature. Bones: Edentulous patient with only residual right central and left lateral maxillary incisors, demonstrating multiple periapical lucencies suggestive of advanced periodontal disease. No acute facial bone fractures are identified. No suspicious osseous lesions are seen. The visualized mandible is intact and the bilateral TMJs are congruent. Orbits: The bilateral globes and optic nerves are intact. The retrobulbar soft tissues have a normal appearance. Paranasal sinuses and mastoid air cells: Tiny right maxillary sinus mucous retention cyst. Otherwise, appear well aerated.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Calcified granulomas in the right middle and lower lobe. No focal consolidation or pleural effusion. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. ADRENALS: Normal. KIDNEYS: Unremarkable. No hydronephrosis or renal calculus bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. The small bowel is unremarkable without dilation or obstruction. COLON / APPENDIX: Scattered colonic diverticulosis without diverticulitis. Moderate fecal burden. The appendix is not well visualized, but there are no secondary signs of appendicitis. PERITONEUM / MESENTERY: No intraperitoneal free fluid or air. RETROPERITONEUM: Normal. VESSELS: Mild scattered atherosclerotic calcifications of the abdominal aorta and its branches. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute displaced fracture. Mild multilevel discogenic degenerative changes of the lumbar spine with vacuum phenomenon at L5-S1. Lucent lesion in the left iliac bone likely represents benign lesion.
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3,673
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CT Head wo contrast 1/10/2022 1:45 AM Clinical Information: post crani, EVD wean Spec Inst: stealth Comparison: 1/7/2022 Technique: Unenhanced axial brain CT. Scan field of view: 195 mm. DLP: 1101 mGy cm. Findings: Right frontal approach ventriculostomy catheter is terminated at foramen Monro. The ventricular size and contour has been stable. There is interval decrease of the pneumocephalus within the ventricles. There is slight interval increase of the intraventricular hemorrhage, layered along the posterior horns. Left frontal pneumocephalus has slightly worsened. There is no significant change in the extra-axial fluid collection along the bifrontal regions with associated pneumocephalus. Stable bifrontal craniectomy site and postsurgical changes from the removal of the anterior frontal mass with associated adjacent small hemorrhage, significantly unchanged from the prior study. Impression: Stable shunted ventricles without hydrocephalus. Interval increase of the intraventricular hemorrhage and compared to prior study. Otherwise no significant interval change from the prior study. See comment for other findings
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Findings: Right frontal approach ventriculostomy catheter is terminated at foramen Monro. The ventricular size and contour has been stable. There is interval decrease of the pneumocephalus within the ventricles. There is slight interval increase of the intraventricular hemorrhage, layered along the posterior horns. Left frontal pneumocephalus has slightly worsened. There is no significant change in the extra-axial fluid collection along the bifrontal regions with associated pneumocephalus. Stable bifrontal craniectomy site and postsurgical changes from the removal of the anterior frontal mass with associated adjacent small hemorrhage, significantly unchanged from the prior study.
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Findings: Quality of the study is excellent. The atrial situs is solitus with levocardia. Right-sided SVC and IVC are both draining into morphologic right atrium. There is no persistent left SVC. All pulmonary veins are draining into morphologic left atrium. The atrioventricular connections are concordant. The ventricular arterial connections are concordant. The aortic arch is right-sided with mirror image 90, several branching. Slight dilatation of the RVOT with postsurgical changes from previous surgical prosthetic pulmonary valve replacement. There is incomplete coaptation of the tricuspid pulmonic leaflets suggesting presence of pulmonary insufficiency. The main pulmonary artery is 28.8 mm in diameter and right and left pulmonary arteries are 14.8 and 14.7 mm in diameter. There is a widely open stent in the proximal left pulmonary artery. Both coronary arteries arise from their respective coronary cusp and have normal proximal course. There is right coronary dominance without any atherosclerotic disease or focal narrowing in any of the visualized coronary arteries and its branches. There is no residual VSD. Both ventricles are normal in size. The right ventricular systolic function is slightly decreased with RVEF of 41%. The left ventricle systolic function is normal with LVEF of 65.3%. Both atria are normal in size without any intracardiac thrombus noted. Cardiac function: Morphologic left ventricle (Indexed): LVEF: 65.3% LVED volume: 135.6 mL (81.3 mL/sq m) LVES volume: 47.0 mL (28.2 mL/sq m) Stroke volume: 88.6 mL (stroke index: 53.1 mL/sq m) Morphologic right ventricle (Indexed): RVEF: 41% RV ED volume: 146.2 mL (88.6 mL/sq m) RVEF volume: 85.9 mL (52.1 mL/sq m) Stroke volume: 60.3 mL Aortic dimensions: Aortic root at the level of sinuses: 3.0 x 3.2 x 3.1 cm Mid ascending thoracic aorta: 2.8 x 2.7 cm Aortic arch: 2.1 x 2.4 cm Proximal descending thoracic aorta: 1.8 x 1.7 cm Mid descending thoracic aorta: 1.6 x 1.4 cm Distal descending thoracic aorta: 1.6 x 1.5 cm. Minimal scarring is present in the left lung apex. Rest of the lungs are clear without pleural or pericardial effusion. There is no focal lytic or sclerotic bone lesion.
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3,674
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CT Head wo+w contrast 1/8/2022 7:19 PM Clinical Information: chronic HA Comparison: None. Technique: Unenhanced and enhanced axial brain CT. Bone and soft tissue windows were reviewed. Sagittal and coronal images were generated from the axial data. Patient weight: 120 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 20 ml. IV contrast injection rate: 2.50 ml per sec. Scan delay: 300 sec. Scan field of view: 250 mm. DLP: 2162 mGy cm. Findings: Brain parenchyma: The brain has normal morphology and volume. The brain parenchyma has a normal appearance. The white-gray matter differentiation is preserved. No abnormal enhancement is identified. Ventricular system: Normal configuration. No hydrocephalus. 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: Normal noncontrast appearance. 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: No acute intracranial process or abnormal enhancement identified.
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Findings: Brain parenchyma: The brain has normal morphology and volume. The brain parenchyma has a normal appearance. The white-gray matter differentiation is preserved. No abnormal enhancement is identified. Ventricular system: Normal configuration. No hydrocephalus. 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: Normal noncontrast appearance. 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.
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FINDINGS: The quality of exam for evaluation of pulmonary thromboembolism is excellent. Linear thrombus is seen in the lobar branch to the left upper lobe and in the lower branch to the left lower lobe extending into left lower lobe segmental branches. Additional linear filling defects are seen in the right lower lobe pulmonary artery and its segmental branches with a large almost occlusive thrombus in the pulmonary artery to the medial RLL. Apparent thrombus in segmental branch to the RML but no RUL pulmonary emboli or large central embolus is identified. The main pulmonary artery is enlarged at 34 mm. Small amount of contrast is seen in the intrahepatic IVC and hepatic veins. The RV to LV ratio is 46/27 with flattening of the interventricular septum and hypertrophy of the left ventricular musculature seen. ET tube, NG tube and left subclavian line are in appropriate position with left subclavian line tip in the proximal SVC. No enlarged intrathoracic lymph nodes are identified. The heart size and the mediastinum are otherwise normal. No pleural effusions. Bibasilar dependent atelectasis is noted. Marked upper lobe predominant centrilobular emphysema is seen worse on the right than the left. Areas of septal thickening are seen in the right upper lobe. Mild bronchial wall thickening is also noted. CT abdomen pelvis will be dictated separately. 13 mm subcutaneous nodule in the left anterior wall fat suggests a sebaceous cyst. Collapsed implants are seen in the location of both breasts. Slight deformity of the right lateral third, six and seventh ribs are seen suggesting fractures with more acute partially displaced fractures at the right fourth and fifth ribs. Subtle deformities to the lateral anterior left fourth, fifth, sixth and seventh ribs are seen. No additional fractures identified. No focal destructive osseous lesions.
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3,675
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Localization of the long bone fractures, hypoxia. COMPARISON: CT chest with contrast 1/6/2022. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 309 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: 357 mm. KVP: 100 DLP: 304 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: ET tube terminates in the midthoracic trachea. Trace secretions layering in the thoracic trachea. Interval development of moderate volume right pneumothorax. Trace bilateral pleural effusions. Dependent areas of consolidation with air bronchograms in both lungs, similar to prior examination. HEART / OTHER VESSELS: Heart size is normal. Trace pericardial effusion. Borderline dilatation of the main pulmonary artery, measuring 30 mm in diameter. The thoracic aorta is normal in caliber. MEDIASTINUM / ESOPHAGUS: Trace pneumomediastinum abutting the pericardium overlying the right ventricle. Mild retrosternal stranding/edema. LYMPH NODES: None enlarged. CHEST WALL: Redemonstration of fractures of right ribs 2-8, segmental at ribs 4 and 5. Displaced fracture through the right fifth costal cartilage. Fracture of the left first rib at the costochondral junction. Displaced fractures of the posterior aspect of the left ribs 8 and 9. UPPER ABDOMEN: Hepatic steatosis. Esophagogastric catheter terminates in the stomach. MUSCULOSKELETAL: Bilateral rib fractures, as above. Unchanged mild anterior wedge compression fracture deformity of T1 fractures of the T6-T9 spinous processes. CONCLUSION: 1. No acute central or proximal segmental pulmonary thromboembolus. 2. New moderate volume right pneumothorax. 3. Dependent areas of consolidation in both lungs are unchanged from prior examination, and may again represent atelectasis, although considering the patchy air bronchograms, superimposed infection is a consideration.. 4. Trace pneumomediastinum. 5. Multiple bilateral rib fractures, T1 compression fracture deformity, and multiple thoracic spinous process fractures are unchanged from prior examination. Note: The new right pneumothorax was discussed with Dr. Lucy by Dr. Cook via telephone at 01:33 on 1/9/2022. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: ET tube terminates in the midthoracic trachea. Trace secretions layering in the thoracic trachea. Interval development of moderate volume right pneumothorax. Trace bilateral pleural effusions. Dependent areas of consolidation with air bronchograms in both lungs, similar to prior examination. HEART / OTHER VESSELS: Heart size is normal. Trace pericardial effusion. Borderline dilatation of the main pulmonary artery, measuring 30 mm in diameter. The thoracic aorta is normal in caliber. MEDIASTINUM / ESOPHAGUS: Trace pneumomediastinum abutting the pericardium overlying the right ventricle. Mild retrosternal stranding/edema. LYMPH NODES: None enlarged. CHEST WALL: Redemonstration of fractures of right ribs 2-8, segmental at ribs 4 and 5. Displaced fracture through the right fifth costal cartilage. Fracture of the left first rib at the costochondral junction. Displaced fractures of the posterior aspect of the left ribs 8 and 9. UPPER ABDOMEN: Hepatic steatosis. Esophagogastric catheter terminates in the stomach. MUSCULOSKELETAL: Bilateral rib fractures, as above. Unchanged mild anterior wedge compression fracture deformity of T1 fractures of the T6-T9 spinous processes.
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FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: None. Lung parenchyma and pleura: Redemonstrated multiple scattered pulmonary nodules aren't both lungs, not substantially since since the prior exam. Index lesions measured at series 3 and as follows: 1. Right lower lobe 21 x 20 mm nodule (image 54), previously measured 22 x 19 mm. 2. Left upper lobe 13 mm nodule (image 40), previously measured 14 mm. No focal consolidation. Stable postsurgical changes in the right lung base. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. The esophagus is nondilated. The thoracic aorta is normal in caliber. Main pulmonary artery is dilated, measures 3.8 cm. The cardiac chambers are normal in size. Mild to moderate coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. Small pericardial effusion, similar to prior. Bones and soft tissues: Stable tiny sclerotic focus of right posterolateral fifth rib. Stable syndesmosis and calcification of the right sternoclavicular joint and abnormal deformity of the right first rib. No aggressive bone lesion. Upper abdomen: Postcholecystectomy changes with stable minimally dilated CBD and intrahepatic biliary radicles.
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: 72-year-old male with altered mental status. COMPARISON: None. TECHNIQUE: CT Head wo contrast. Scan field of view: 250 mm. DLP: 1286 mGy cm. FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Age-appropriate diffuse parenchymal volume loss. Mild periventricular white matter hypoattenuation suggestive of mild chronic microvascular ischemic disease. EXTRA-AXIAL SPACES: No abnormal extra-axial fluid collections. Mineralization of the falx and bilateral tentorium is noted. SKULL AND SKULL BASE: No fracture. Dense atherosclerotic calcifications of the bilateral carotid siphons. Punctate atherosclerotic calcifications of the right vertebral artery. VENTRICULAR SYSTEM: Ex vacuo ventricular dilatation. ORBITS: Bilateral lens replacements. The orbits are otherwise unremarkable. SINUSES: Mucous retention cysts in bilateral maxillary sinuses and the left sphenoid sinus. The other paranasal sinuses are clear. MASTOIDS: Clear. SOFT TISSUE: Unremarkable. IMPRESSION: 1. No acute intracranial process. 2. Age-appropriate brain involution with mild chronic microvascular ischemic disease. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Age-appropriate diffuse parenchymal volume loss. Mild periventricular white matter hypoattenuation suggestive of mild chronic microvascular ischemic disease. EXTRA-AXIAL SPACES: No abnormal extra-axial fluid collections. Mineralization of the falx and bilateral tentorium is noted. SKULL AND SKULL BASE: No fracture. Dense atherosclerotic calcifications of the bilateral carotid siphons. Punctate atherosclerotic calcifications of the right vertebral artery. VENTRICULAR SYSTEM: Ex vacuo ventricular dilatation. ORBITS: Bilateral lens replacements. The orbits are otherwise unremarkable. SINUSES: Mucous retention cysts in bilateral maxillary sinuses and the left sphenoid sinus. The other paranasal sinuses are clear. MASTOIDS: Clear. SOFT TISSUE: Unremarkable.
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Findings: There is no evidence of acute intra- or extra-axial hemorrhage. Patchy hypoattenuation in bilateral frontoparietal deep and periventricular white matter, likely related to chronic microangiopathy. Generalized prominence of the extra-axial spaces is seen, likely age related. Tortuosity of both optic nerves. There is no midline shift, mass effect, or other space-occupying lesion. Gray-white differentiation appears maintained. The ventricular system are normal in configuration. The basal cisterns are clear. The visualized paranasal sinuses and mastoid air cells are clear of acute process. The visualized bones of the calvarium demonstrate no acute osseous abnormality.
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CT Angio Chest Partial Study Clinical Information: Suspected PTE cardiac arrest, sp ROSC cf PTE Comparison: None Technique: Noncontrast scout exam performed for localization. Following nonionic contrast, 2 mm axial images obtained through the chest. Additional 3D post processed MIP images were obtained and reviewed for interpretation. Reason for partial study: Extravasation Patient weight: 210 lbs. IV contrast injection rate: 4 ml per sec. Scan delay: 0 sec. Scan field of view: 500 mm. DLP: 29.70 mGy cm. Findings: The study was not performed due to extravasation of the contrast. The scout radiograph demonstrate ill-defined airspace opacity in the right lower and middle lobe as well as left upper lobe with endotracheal and nasogastric tubes appear in satisfactory position.
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Findings: The study was not performed due to extravasation of the contrast. The scout radiograph demonstrate ill-defined airspace opacity in the right lower and middle lobe as well as left upper lobe with endotracheal and nasogastric tubes appear in satisfactory position.
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FINDINGS/CONCLUSION: No acute fracture or dislocation. The femoral head is well-seated within its acetabulum. There are moderate degenerative changes of the right hip. Fatty atrophy of the gluteal and hamstring musculature.
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EXAM: CT Angio Chest wo+w contrast, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Cardiac arrest status post ROSC. COMPARISON: Chest radiograph 1/8/2022. 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: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 350 mm. KVP: 100 DLP: 311.80 mGy cm. (accession CT220004474), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 447 mm. DLP: 311.80 mGy cm. (accession CT220004382) FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: ET tube terminates in the distal thoracic trachea, approximately 2.5 cm with the carina. Mild overinflation of the ET tube cuff. Mild bronchial wall thickening throughout the right lung. Dependent atelectatic changes in both lungs. Subsegmental linear atelectasis in the right lung apex. Complete right lower lobar consolidation with associated volume loss. Patchy areas of hypoenhancement with air bronchograms in the right lower lobar consolidation adjacent to a 4.5 x 4.5 cm well-circumscribed thin-walled intraparenchymal cystic lesion containing a few locules of gas (series 401, image 74). No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Heart size is normal. No pericardial effusion. The thoracic aorta is normal in caliber. MEDIASTINUM / ESOPHAGUS: Mild rightward mediastinal shift associated with volume loss in the right hemithorax. LYMPH NODES: Prominent lower paratracheal and right hilar lymph nodes, likely reactive. CHEST WALL: Nondisplaced fracture through the mid sternal body. ABDOMEN and PELVIS: LIVER: Mild periportal edema, likely related to volume resuscitation. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: Contracted, limiting evaluation. Edema along the cystic plate is likely related to volume resuscitation. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing bilateral nephrolithiasis. Otherwise, no significant abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric catheter terminates in the proximal stomach, with its proximal side port at the GE junction. No significant abnormality in small bowel. COLON / APPENDIX: Minimal wall thickening of the distal sigmoid colon and rectum with minimal adjacent stranding. Gaseous distention of the upstream loops of large bowel. No significant abnormality in the appendix. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. OTHER VESSELS: Right common femoral approach venous catheter terminates in the intrahepatic IVC. URINARY BLADDER: Decompressed around a suprapubic catheter. Trace excreted contrast is visualized in the urinary bladder. Circumferential urinary bladder wall thickening and mild perivesicular stranding. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. Ulceration soft tissue thickening overlying the bilateral ischial tuberosities, proximal femora, and caudal sacrum with a few foci of gas in an area soft tissue thickening abutting the caudal sacrum. Partially visualized extravasated contrast material in the soft tissues of the right upper extremity from recent IV infiltration. MUSCULOSKELETAL: Chronic appearing sclerotic changes and osseous remodeling involving the bilateral ischial tuberosities. Chronic destruction of the caudal sacrum and coccyx with corticated osseous remodeling along the caudal margin of the remaining sacrum. CONCLUSION: 1. Complete right lower lobar consolidation with patchy areas of hypoenhancement and air bronchograms, concerning for atelectasis with superimposed pneumonia. 2. Gas and hyperattenuating fluid filled thin-walled cystic lesion in the right lower lobe adjacent to the suspected pneumonia. Differential considerations include fluid-filled cavitary lesion, which may be related to underlying infection (including fungal etiologies and tuberculosis), hematoma, abscess, less likely necrotizing pneumonia. Underlying mass lesion is not excluded. Recommend short-term interval follow-up evaluation with repeat chest CT. 3. Minimal wall thickening of the distal sigmoid colon and rectum may be secondary to relatively collapsed state. Correlate clinically for infectious/inflammatory proctocolitis. 4. Decubitus ulcerations overlying the sacrum and bilateral ischial tuberosities with changes of chronic osteomyelitis and osseous remodeling. A few foci of gas within an area soft tissue thickening abutting the caudal sacrum, probably tracking from an overlying ulceration. No organized/renal fluid collection. Additional ulcerations overlying the bilateral proximal femora. 5. Circumferential urinary bladder wall thickening and perivesicular stranding could be related to chronic suprapubic catheterization, although acute cystitis is a consideration. Correlation with urinalysis. 6. Proximal side-port of the esophagogastric catheter terminates at the GE junction. Recommend advancing the esophagogastric catheter by six seven 7 cm followed by dedicated abdominal radiograph to evaluate positioning. 7. Mild overinflation of the ET tube cuff. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest PE and Abdomen Pelvis OVERALL DIAGNOSTIC QUALITY: Mildly suboptimal quality with incomplete evaluation of subsegmental pulmonary arteries. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: ET tube terminates in the distal thoracic trachea, approximately 2.5 cm with the carina. Mild overinflation of the ET tube cuff. Mild bronchial wall thickening throughout the right lung. Dependent atelectatic changes in both lungs. Subsegmental linear atelectasis in the right lung apex. Complete right lower lobar consolidation with associated volume loss. Patchy areas of hypoenhancement with air bronchograms in the right lower lobar consolidation adjacent to a 4.5 x 4.5 cm well-circumscribed thin-walled intraparenchymal cystic lesion containing a few locules of gas (series 401, image 74). No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Heart size is normal. No pericardial effusion. The thoracic aorta is normal in caliber. MEDIASTINUM / ESOPHAGUS: Mild rightward mediastinal shift associated with volume loss in the right hemithorax. LYMPH NODES: Prominent lower paratracheal and right hilar lymph nodes, likely reactive. CHEST WALL: Nondisplaced fracture through the mid sternal body. ABDOMEN and PELVIS: LIVER: Mild periportal edema, likely related to volume resuscitation. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: Contracted, limiting evaluation. Edema along the cystic plate is likely related to volume resuscitation. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing bilateral nephrolithiasis. Otherwise, no significant abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric catheter terminates in the proximal stomach, with its proximal side port at the GE junction. No significant abnormality in small bowel. COLON / APPENDIX: Minimal wall thickening of the distal sigmoid colon and rectum with minimal adjacent stranding. Gaseous distention of the upstream loops of large bowel. No significant abnormality in the appendix. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. RETROPERITONEUM: Normal. OTHER VESSELS: Right common femoral approach venous catheter terminates in the intrahepatic IVC. URINARY BLADDER: Decompressed around a suprapubic catheter. Trace excreted contrast is visualized in the urinary bladder. Circumferential urinary bladder wall thickening and mild perivesicular stranding. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. Ulceration soft tissue thickening overlying the bilateral ischial tuberosities, proximal femora, and caudal sacrum with a few foci of gas in an area soft tissue thickening abutting the caudal sacrum. Partially visualized extravasated contrast material in the soft tissues of the right upper extremity from recent IV infiltration. MUSCULOSKELETAL: Chronic appearing sclerotic changes and osseous remodeling involving the bilateral ischial tuberosities. Chronic destruction of the caudal sacrum and coccyx with corticated osseous remodeling along the caudal margin of the remaining sacrum.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Normal size and configuration. Focal fatty infiltration near the falciform ligament. A few tiny cysts are unchanged in size and number. No new lesions. BILIARY TRACT: Normal. GALLBLADDER: Collapsed. PANCREAS: Distal pancreatectomy has normal unchanged appearance without focal lesion or ductal dilatation. There is no peripancreatic stranding or new lesion in the remaining pancreas parenchyma. SPLEEN: Tiny cyst at the anterior surface of the spleen is unchanged. No new lesion. ADRENALS: Normal. KIDNEYS: Punctate nonobstructing left lower pole renal stone. Small left lower pole renal cysts. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered colonic diverticula. No acute abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: Small anterior abdominal wall hernia contains fat. No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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Radiologic Exam: CT Angio Head wo+w contrast, CT Angio Neck 1/9/2022 1:20 AM Clinical Information: PUI for COVID cardiac arrest. Comparison: None available. Technique: Helical CT images were obtained before and 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: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 247 mm. DLP: 2310 mGy cm. (accession CT220004411), Patient weight: 220 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 267 mm. DLP: 2594 mGy cm. (accession CT220004384) FINDINGS: CT of the head with and without contrast: There is no acute infarction, hemorrhage, or cerebral edema. The gray-white matter differentiation is maintained. The cerebral cortical volume is appropriate for patient's age. There is no space occupying intracranial lesion or hydrocephalus. No enhancing intracranial abnormality. There is no acute osseous or orbital abnormality. The mastoid air cells are clear. Mucus retention cyst in the left maxillary sinus. Mild mucosal thickening of the bilateral maxillary sinuses. 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. Hypoplastic right A1 segment. Fetal circulation of the left PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Bovine arch. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Fusiform dilation of the distal common carotid artery measuring 10 x 9 x 8 mm (image 37, series #502 and image 174, series #504). There is no evidence of stenosis or occlusion. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: Chronic appearing occlusion from C3 to C5 with distal reconstitution. Hypoplastic. SOFT TISSUES: No soft tissue abnormality within the neck. Endotracheal tube terminates in the mid trachea. Esophagogastric tube is present in the esophagus with tip and side-port out of view. A line is coiled in the mouth, possibly a temperature probe. CERVICAL SPINE: Moderate multilevel discogenic degenerative change. Prominent Schmorl's nodes in the superior and inferior endplates of C4. Fusion of the left C3 and C4 facet joints. Moderate spinal canal stenosis at C3-C4 due to posterior disc osteophyte complex. CONCLUSION: 1. No acute intracranial process appreciated. No evidence of intracranial arterial abnormality. 2. Chronic appearing occlusion of the cervical left vertebral artery from C3 to C5 with distal reconstitution. 3. A line is coiled in the mouth, possibly temperature probe. Recommend removal/repositioning. COMMUNICATION: Stephanie Colvin, MD communicated preliminary findings by phone with Dr. Foster on 1/9/2022 1:47 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. 4. Fusiform dilation of the left distal common carotid artery measuring 10 mm in greatest dimension. COMMUNICATION: Stephanie Colvin, MD communicated preliminary findings by phone with Dr. Foster on 1/9/2022 4:40 AM. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT of the head with and without contrast: There is no acute infarction, hemorrhage, or cerebral edema. The gray-white matter differentiation is maintained. The cerebral cortical volume is appropriate for patient's age. There is no space occupying intracranial lesion or hydrocephalus. No enhancing intracranial abnormality. There is no acute osseous or orbital abnormality. The mastoid air cells are clear. Mucus retention cyst in the left maxillary sinus. Mild mucosal thickening of the bilateral maxillary sinuses. 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. Hypoplastic right A1 segment. Fetal circulation of the left PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Bovine arch. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT CAROTID: Fusiform dilation of the distal common carotid artery measuring 10 x 9 x 8 mm (image 37, series #502 and image 174, series #504). There is no evidence of stenosis or occlusion. RIGHT VERTEBRAL ARTERY: There is no evidence of stenosis, occlusion, or aneurysmal dilation. LEFT VERTEBRAL ARTERY: Chronic appearing occlusion from C3 to C5 with distal reconstitution. Hypoplastic. SOFT TISSUES: No soft tissue abnormality within the neck. Endotracheal tube terminates in the mid trachea. Esophagogastric tube is present in the esophagus with tip and side-port out of view. A line is coiled in the mouth, possibly a temperature probe. CERVICAL SPINE: Moderate multilevel discogenic degenerative change. Prominent Schmorl's nodes in the superior and inferior endplates of C4. Fusion of the left C3 and C4 facet joints. Moderate spinal canal stenosis at C3-C4 due to posterior disc osteophyte complex.
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Findings: Patient status post Onyx embolization of the right juvenile nasopharyngeal angiofibroma. Dense onyx cast is seen at the site of the tumor. Complete opacification of the right maxillary sinus. Packing material and drain in the right nasal cavity. Partial opacification of both the ethmoids. There is erosion of the sphenoid sinus floor with near complete opacification of the sphenoid sinuses. Mild deviation of the nasal septum to the left. Mild mucosal thickening in the left maxillary sinus. -
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Abdominal pain, recent ERCP complicated by perforation and pancreatitis. COMPARISON: Multiple prior examinations, most recently CT abdomen and pelvis without contrast 12/26/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 184 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 80 sec Scan field of view: 476 mm. DLP: 899.60 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Subsegmental atelectatic changes in both lung bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Unchanged simple cysts in the right hepatic lobe and additional scattered hypoattenuating lesions which are too small to characterize but are likely cysts. No new abnormality. BILIARY TRACT: Mild central intrahepatic and extrahepatic biliary ductal dilatation, with the common bile duct measuring up to 10 mm at the porta hepatis, with smooth tapering distally to the ampulla. No radio opaque choledocholithiasis. GALLBLADDER: Distended without wall thickening or pericholecystic stranding. No radiopaque cholelithiasis. PANCREAS: Ventral pancreatic ductal stent is in unchanged position with its distal loop formed within the second portion of the duodenum. Mild pancreatic ductal dilatation, measuring up to 6 mm in the pancreatic neck/proximal body and tapering distally. Moderate peripancreatic stranding/edema as well as evolving/organizing peripancreatic multilobulated collections tracking along the posterior aspect of the pancreatic head and duodenum and into the right anterior and posterior pararenal spaces, tracking caudally along the right psoas muscle. Small pancreatic small peripancreatic collection along the pancreatic tail is unchanged. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Mild right hydroureteronephrosis with transition in caliber of the proximal right ureter adjacent to the right retroperitoneal collection, as above. No left hydroureteronephrosis. No radiopaque nephrolithiasis. LYMPH NODES: Prominent hepatogastric and peripancreatic lymph nodes are similar prior examination. STOMACH / SMALL BOWEL: Postsurgical changes from fundoplication. Mild circumferential wall thickening of the second and third portions of the duodenum is likely reactive. No significant abnormality in the remainder of the small bowel. COLON / APPENDIX: Diverticulosis. Focal wall thickening involving the mid to distal ascending colon, likely reactive secondary to the adjacent retroperitoneal collection. The appendix is not definitely visualized. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. Inflammatory stranding in the root of the mesentery as well as in the ascending mesocolon and right paracolic gutter. RETROPERITONEUM: Organized multilobular, thin-walled peripancreatic fluid collections with a few thin internal septations, extending along the right anterior and posterior pararenal spaces and tracking caudally along the right psoas muscle, as above. Surrounding inflammatory stranding. The craniocaudal extent of the right-sided retroperitoneal collection is up to 20 cm. VESSELS: No evidence for splenic vein thrombosis. No definite splenic artery pseudoaneurysm is identified. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Rectus diastasis. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. CONCLUSION: 1. Ventral pancreatic stent is in similar position, although there is new mild pancreatic ductal and minimal/mild biliary ductal dilatation, which could be seen with stent dysfunction. Recommend correlation with biochemical profile. 2. Evolving sequela of pancreatitis with persistent peripancreatic inflammatory stranding and edema extending into the root of the mesentery, as well as evolving peripancreatic fluid collections/pseudocysts extending into the right retroperitoneal soft tissues, tracking caudally into the right iliac fossa along the right psoas muscle. Recurrent/residual acute pancreatitis is not excluded. 3. Wall thickening involving the second and third portions of the duodenum, as well as the mid to distal ascending colon are likely 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.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Subsegmental atelectatic changes in both lung bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Unchanged simple cysts in the right hepatic lobe and additional scattered hypoattenuating lesions which are too small to characterize but are likely cysts. No new abnormality. BILIARY TRACT: Mild central intrahepatic and extrahepatic biliary ductal dilatation, with the common bile duct measuring up to 10 mm at the porta hepatis, with smooth tapering distally to the ampulla. No radio opaque choledocholithiasis. GALLBLADDER: Distended without wall thickening or pericholecystic stranding. No radiopaque cholelithiasis. PANCREAS: Ventral pancreatic ductal stent is in unchanged position with its distal loop formed within the second portion of the duodenum. Mild pancreatic ductal dilatation, measuring up to 6 mm in the pancreatic neck/proximal body and tapering distally. Moderate peripancreatic stranding/edema as well as evolving/organizing peripancreatic multilobulated collections tracking along the posterior aspect of the pancreatic head and duodenum and into the right anterior and posterior pararenal spaces, tracking caudally along the right psoas muscle. Small pancreatic small peripancreatic collection along the pancreatic tail is unchanged. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Symmetric contrast enhancement. Mild right hydroureteronephrosis with transition in caliber of the proximal right ureter adjacent to the right retroperitoneal collection, as above. No left hydroureteronephrosis. No radiopaque nephrolithiasis. LYMPH NODES: Prominent hepatogastric and peripancreatic lymph nodes are similar prior examination. STOMACH / SMALL BOWEL: Postsurgical changes from fundoplication. Mild circumferential wall thickening of the second and third portions of the duodenum is likely reactive. No significant abnormality in the remainder of the small bowel. COLON / APPENDIX: Diverticulosis. Focal wall thickening involving the mid to distal ascending colon, likely reactive secondary to the adjacent retroperitoneal collection. The appendix is not definitely visualized. PERITONEUM / MESENTERY: No free intraperitoneal fluid. No pneumoperitoneum. Inflammatory stranding in the root of the mesentery as well as in the ascending mesocolon and right paracolic gutter. RETROPERITONEUM: Organized multilobular, thin-walled peripancreatic fluid collections with a few thin internal septations, extending along the right anterior and posterior pararenal spaces and tracking caudally along the right psoas muscle, as above. Surrounding inflammatory stranding. The craniocaudal extent of the right-sided retroperitoneal collection is up to 20 cm. VESSELS: No evidence for splenic vein thrombosis. No definite splenic artery pseudoaneurysm is identified. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Rectus diastasis. MUSCULOSKELETAL: No aggressive osseous abnormality is identified.
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FINDINGS: The left innominate vein is in contact with the posterior aspect of the first sternal wire in the muscle immediately behind the manubrium. The right innominate artery is 12 mm posterior to the manubrium. The ascending aorta/anterior arch is 4 mm posterior to the sternum just minimally distal to the manubrial sternal junction. On series 5 image 60 is unclear if it streak artifact or linear tethering 20 from the anterior ascending aorta to the posterior aspect of the second sternal wire. The ascending aorta at the level of the pledget from prior bypass touches on the posterior sternal body. The base of the main pulmonary artery at the pulmonary valve is 11 mm posterior to the left side of the manubrium. The origin of the right coronary artery bypass graft is 9 mm posterior to the mid sternum at the level of the fourth sternal wire. The native right coronary artery is 6 mm posterior to the next to the last sternal wire. Free wall of the right ventricle is adherent to the lower sternal body and xiphoid. An enlarged lower right paratracheal node is 15 mm in short axis on series 5 image 62. Right hilar node is 17 mm in short axis. Calcified left-sided mediastinal nodes are seen. No additional enlarged intrathoracic lymph nodes are identified. Calcified and noncalcified plaque is seen in the aorta and the origins of the brachiocephalic arteries. The ascending aorta is mildly ectatic at 42 mm. The thoracic aorta is otherwise normal in caliber. The heart size is the upper limits of normal. The mediastinum is otherwise normal. No pleural effusion. Upper lobe paraseptal emphysema is seen bilaterally with a few small areas of centrilobular emphysema. Bilateral bronchial wall thickening is appreciated. 5 mm noncalcified nodule is seen peripherally in the LLL on series 5 image 101 and a 5 x 6 mm nodule is seen in the LLL on image 84 and additional tiny peripheral LLL nodule is present on image 79 biapical pleural parenchymal scarring is noted. Tiny calcified nodule is also seen in the left lower lobe. A tiny subpleural nodule is present on image 43 in the RUL. Mosaic attenuation is seen bilaterally with a small area of subpleural fibrosis in the LUL best seen on image 62. A few calcified granuloma are seen in the spleen. Limited images the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: 59-year-old male with history of hypertension, depression, prior DVT presented with chest pain, cough, shortness of breath and fever for two days suspected PTE COMPARISON: June 7, 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: 340 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracking Scan field of view: 429 mm. KVP: 120 DLP: 817 mGy cm. FINDINGS: The contrast enhancement of pulmonary vasculature is suboptimal. There is no obvious filling defect in central pulmonary arteries. The peripheral vessel are not optimally opacified. The main pulmonary artery measures 32 mm in size. The thoracic aorta is unremarkable. All pulmonary veins are draining into morphologic left atrium. There are several borderline size nodes in the mediastinum and especially both hila and bronchopulmonary regions. Hypertrophied bronchial arteries are seen extending up to both hila. There is moderate size hiatal hernia. Diffuse increased peribronchial thickening and faint groundglass parenchymal opacities in the right upper and both lower lobes right more than left. A triangular subpleural opacity is again identified unchanged since prior study. There is minimal right pleural thickening without pleural or pericardial effusion. There is no focal lytic or sclerotic bone lesion. CONCLUSION: 1. Suboptimal pulmonary artery opacification though no central PTE is noted. 2. Peribronchial thickening and groundglass parenchymal changes in the right upper and both lower lobes right more than left are likely inflammatory suggesting bronchitis and bronchiolitis. 3. Indeterminate mediastinal, hilar and bronchopulmonary adenopathy possibly reactive.
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FINDINGS: The contrast enhancement of pulmonary vasculature is suboptimal. There is no obvious filling defect in central pulmonary arteries. The peripheral vessel are not optimally opacified. The main pulmonary artery measures 32 mm in size. The thoracic aorta is unremarkable. All pulmonary veins are draining into morphologic left atrium. There are several borderline size nodes in the mediastinum and especially both hila and bronchopulmonary regions. Hypertrophied bronchial arteries are seen extending up to both hila. There is moderate size hiatal hernia. Diffuse increased peribronchial thickening and faint groundglass parenchymal opacities in the right upper and both lower lobes right more than left. A triangular subpleural opacity is again identified unchanged since prior study. There is minimal right pleural thickening without pleural or pericardial effusion. There is no focal lytic or sclerotic bone lesion.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: See separate chest CT report. ABDOMEN and PELVIS: LIVER: Hepatomegaly with mild hepatic steatosis but no focal lesion within the limitations of unenhanced technique. BILIARY TRACT: Normal. GALLBLADDER: Subtle layering density may represent gallbladder sludge. No calcified gallstones or wall thickening. PANCREAS: Normal. SPLEEN: Calcified granulomas. Otherwise normal. ADRENALS: Normal. KIDNEYS: Vascular calcifications are unchanged. Otherwise normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colonic diverticula without diverticulitis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Thoracic aortic aneurysm extends into the abdomen and at the diaphragmatic hiatus the aneurysm measures 6.0 x 5.7 cm (image 186 series 2), previously 6.2 x 5.7 cm (image 195 series 2). Suprarenal abdominal aorta measures 4.0 x 4.0 cm (image 215 series 2), previously 4.1 x 3.9 cm (image 224 series 2). Caudal abdominal aorta measures 3.3 x 3.3 cm (image 311 series 2), previously 3.1 x 3.2 cm (image 320 series 2). Fusiform aneurysmal dilatation of bilateral common iliac arteries is unchanged. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: Abdominal wall mesh hernia repair is unremarkable. MUSCULOSKELETAL: Osteopenia. Lumbar degenerative changes and healed left inferior pubic ramus fracture. No acute lesion.
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma, pedestrian versus car. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast. Scan field of view: 292.50 mm. DLP: 1530.70 mGy cm. (accession CT220004387), Scan field of view: 194.30 mm. DLP: 1148.10 mGy cm. (accession CT220004393) FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild frontal brain parenchymal volume loss is seen. Multifocal encephalomalacia in the left frontal and bilateral occipital lobes, likely sequela of prior infarcts. Confluent periventricular white matter hypoattenuating areas, compatible with mild chronic microangiopathic disease. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MASTOIDS: Underpneumatized. SOFT TISSUE: Small right parietal scalp lipoma. No other significant abnormality. MAXILLOFACIAL: No maxillofacial or mandibular fracture. VESSELS: Atherosclerotic calcifications of the left vertebral artery, carotid siphons and visualized carotid bulbs IMPRESSION: 1. No acute intracranial process. 2. No evidence of acute maxillofacial fractures. 3. Multifocal encephalomalacia in the left frontal and bilateral occipital lobes, likely sequela of prior infarcts. 4. Brain involution and mild chronic microangiopathic disease. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild frontal brain parenchymal volume loss is seen. Multifocal encephalomalacia in the left frontal and bilateral occipital lobes, likely sequela of prior infarcts. Confluent periventricular white matter hypoattenuating areas, compatible with mild chronic microangiopathic disease. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MASTOIDS: Underpneumatized. SOFT TISSUE: Small right parietal scalp lipoma. No other significant abnormality. MAXILLOFACIAL: No maxillofacial or mandibular fracture. VESSELS: Atherosclerotic calcifications of the left vertebral artery, carotid siphons and visualized carotid bulbs
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. RESULT: Potential study limitations: None. VASCULAR : Mild calcification of the aortic valve leaflets. The ascending aorta and aortic arch are normal in caliber. The distal arch, proximal and mid descending aorta appear mildly ectatic, similar to prior. Fusiform aneurysmal dilatation of the distal descending aorta just above the hiatus measures 49 x 49 mm (series 2, image 155), previously 49 x 50 mm. Marked dilatation just at the hiatus is redemonstrated measuring 60 x 55 mm (image 189), previously 57 x 62 mm. Severe mixed atherosclerosis is seen in the aorta. There is biatrial enlargement. The coronary arteries have normal origins and courses. There are severe scattered three-vessel coronary calcifications identified, though this study was not optimized for coronary artery evaluation. The pulmonary artery is dilated, measures 3.5 cm. No pericardial effusion. CHEST: Lung and pleura: A 14 x 9 mm left upper lobe nodule (image 60) appear more globular from prior, previously measured 14 x 7 mm. Additional subcentimeter pulmonary nodules are unchanged, for example in the right lower lobe at image 122. Previously noted hazy opacity in the left upper lobe (image 97), is unchanged and likely infectious/inflammatory in etiology. Moderate upper lobe predominant mixed emphysema with diffuse bronchial wall thickening. Bibasilar subsegmental atelectasis/scarring. No pleural effusion. Mediastinum and lymph nodes: Stable mildly enlarged right paratracheal lymph node, measures 13 mm in short axis (image 86). No new or enlarging thoracic lymphadenopathy. Bones and chest wall: No aggressive bone lesion. Chest wall soft tissues are unremarkable. Upper abdomen: Reported separately.
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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, pedestrian versus car. 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: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004388), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. (accession CT220004389), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004392), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004391) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracolumbar spine. 3. Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. 4. Additional chronic and incidental findings, as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4.
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FINDINGS: Right parieto-occipital approach VP shunt catheter with tip coursing through the right lateral ventricle and terminating in the right frontal lobe is unchanged. There is stable decompression of the ventricular system. There is no extra-axial collection. Cerebellar tonsils are low-lying and there is crowding at the foramen magnum without interval change. There is chronic remodeling of the foramen magnum. 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.
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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, pedestrian versus car. 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: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004388), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. (accession CT220004389), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004392), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004391) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracolumbar spine. 3. Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. 4. Additional chronic and incidental findings, as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4.
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Findings: There is no mass, hemorrhage, visible infarct or extracerebral collection. Slight diffuse atrophy but the ventricles are not enlarged. There is preservation of gray-white margins. No hypodensity seen in the white matter. Posterior fossa contents appear normal. No defect is seen in the calvarium or skull base. ----------------
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RADIOLOGIC EXAM: CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Cervical Spine From Reformat Axial CT images of the cervix are obtained without IV contrast. Coronal and sagittal reformats were obtained. 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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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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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: There are multiple peripherally enhancing metastases throughout the left hepatic lobe with the largest in hepatic segment IVA measuring 2.5 x 2.2 cm on image 70 series 11. BILIARY TRACT: Ill-defined, heterogeneous enhancing mass in the porta hepatis measures 3.5 x 3.1 cm on image 89 series 11, previously 3.0 x 2.8 cm. Differences in measurement are likely technical. There is severe diffuse intrahepatic biliary duct dilation. GALLBLADDER: Irregular gallbladder wall thickening and cholelithiasis. The mass in the porta hepatis closely abuts the gallbladder wall. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Left adrenal thickening, unchanged. Right adrenal gland is unremarkable KIDNEYS: Left upper pole cyst. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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3,686
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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, pedestrian versus car. 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: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004388), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. (accession CT220004389), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004392), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004391) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracolumbar spine. 3. Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. 4. Additional chronic and incidental findings, as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4.
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FINDINGS: There is mild mucosal thickening and also mucosal cysts within the nasopharynx. There are small dystrophic calcifications within the palatine tonsils bilaterally. Hypopharynx and larynx appear unremarkable. There is heterogeneous appearance of the mildly enlarged left lobe of the thyroid gland. There appears to be heterogeneous lesion measuring nearly 4 cm x 2.5 x 4 cm within the left lobe of the thyroid gland. There is mild rightward displacement of the trachea. Isthmus is also mildly thickened. Right thyroid gland is normal in size. Submandibular glands and parotid glands are unremarkable. There are shotty lymph nodes within the upper internal jugular chains bilaterally.. There is a borderline enlarged left level III lymph node measuring 14 x 11 mm on axial image 302 and a borderline enlarged left level within the normal for lymph node measuring 12 x 10 mm on axial image 339. There is no significant vascular abnormality within the neck. No destructive osseous lesion is evident there are no significant degenerative changes There is a small subcentimeter nodule within the right upper lobe.
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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, pedestrian versus car. 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: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004388), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. (accession CT220004389), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004392), Patient weight: 250 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 430.30 mm. DLP: 1474.60 mGy cm. (accession CT220004391) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracolumbar spine. 3. Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. 4. Additional chronic and incidental findings, as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. There are few small dependent secretions in the trachea. Subsegmental atelectatic changes in the left lingula. No focal consolidation, pneumothorax or pleural effusion. HEART / VESSELS: Heart size is normal. Moderate atherosclerotic calcifications of the coronary arteries and thoracic aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Left-sided gynecomastia. No other significant abnormality. ABDOMEN and PELVIS: LIVER: Not grossly cirrhotic in morphology. Subcentimeter hypoattenuating lesion in the right hepatic lobe, likely a hepatic cyst. No other significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Prostate calcifications. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Subacute fracture of the posterior left 12th rib. Chronic fracture deformity of the right lateral 10th rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel degenerative changes, notably involving the C7 and T1 spinous processes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Postsurgical changes from L4-S1 laminectomies with posterior fusion and intervertebral disc spacer placement. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic changes and facet arthropathy, most prominent at L3-L4. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Grade 1 retrolisthesis of L3 on L4.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. Compared to 12/3/2021 the level of the previously seen enlarged right supraclavicular lymph node is only partially on this exam limiting comparison. An enlarged left subclavicular node is 12 mm in short axis on image 45 and was just at 10 on the previous exam. The enlarged lateral aortic node measures 25 x 34 mm on series 201 image 183 and was 18 x 29 mm on the prior. An additional superior lateral aortic node has also increased in size measuring 15 mm in short axis on image 160 and was 12 mm on the prior. Additional enlarged upper mediastinal nodes are present. Left axillary adenopathy has also increased with the index nodule measuring 22 x 39 mm on image 166 and this was 14 x 25 on the prior with several additional enlarged nodes in the left axilla. No additional areas of enlarged intrathoracic lymph nodes. Calcified nodes are seen in the left hilum. Mild coronary artery calcification is noted. The heart size and the mediastinum are otherwise normal for noncontrast exam. Opacification of the bronchus to the lateral RML is noted with atelectasis in the lateral segment. Diffuse tiny groundglass nodules are seen with additional areas of more geographic groundglass both peripherally and within the parenchyma such as in the right upper lung on series 201 image 24. The RUL nodular opacity measures 8 x 14 mm on image 225 and was 5 x 9 mm on the prior. The anterior RLL nodule measures 15 x 18 mm on image 276 and was 11 x 17 mm on the prior. Additional scattered tiny nodules are present such as in the RML on image 291. A new RLL nodular density measures 5 x 7 mm on image 387. Posterior consolidation and fibrosis in the left lower lobe is unchanged. A few small nodules on the left are similar to prior such as on image 387 but some new or increasing nodular opacities are seen in the left lung as on image 332. Lingular nodule previously seen on series 3 image 111 and appears to have resolved. No pleural effusion. Tiny low-attenuation area is seen in the left hepatic lobe appears unchanged but is difficult to characterize. Calcified granuloma are again seen in the spleen. Right adrenal nodule measuring less than 10 Hounsfield units is redemonstrated consistent with an adrenal adenoma. Limited noncontrast images of the upper abdomen are otherwise unremarkable. No focal destructive osseous lesions.
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3,688
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma, pedestrian versus car. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast. Scan field of view: 292.50 mm. DLP: 1530.70 mGy cm. (accession CT220004387), Scan field of view: 194.30 mm. DLP: 1148.10 mGy cm. (accession CT220004393) FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild frontal brain parenchymal volume loss is seen. Multifocal encephalomalacia in the left frontal and bilateral occipital lobes, likely sequela of prior infarcts. Confluent periventricular white matter hypoattenuating areas, compatible with mild chronic microangiopathic disease. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MASTOIDS: Underpneumatized. SOFT TISSUE: Small right parietal scalp lipoma. No other significant abnormality. MAXILLOFACIAL: No maxillofacial or mandibular fracture. VESSELS: Atherosclerotic calcifications of the left vertebral artery, carotid siphons and visualized carotid bulbs IMPRESSION: 1. No acute intracranial process. 2. No evidence of acute maxillofacial fractures. 3. Multifocal encephalomalacia in the left frontal and bilateral occipital lobes, likely sequela of prior infarcts. 4. Brain involution and mild chronic microangiopathic disease. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild frontal brain parenchymal volume loss is seen. Multifocal encephalomalacia in the left frontal and bilateral occipital lobes, likely sequela of prior infarcts. Confluent periventricular white matter hypoattenuating areas, compatible with mild chronic microangiopathic disease. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MASTOIDS: Underpneumatized. SOFT TISSUE: Small right parietal scalp lipoma. No other significant abnormality. MAXILLOFACIAL: No maxillofacial or mandibular fracture. VESSELS: Atherosclerotic calcifications of the left vertebral artery, carotid siphons and visualized carotid bulbs
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: ABDOMINAL AORTA: Moderate atherosclerosis without aneurysm CELIAC AXIS: No significant abnormality. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: Patent RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Scattered atherosclerotic disease. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Scattered atherosclerotic disease ------------------------------------------------------------- LOWER CHEST: Chest findings to be dictated separately; please see separate chest CT report same day. ABDOMEN and PELVIS: LIVER: A few small hypoattenuating lesions in the liver, likely cysts. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No hydronephrosis. 3 cm indeterminate lesion in the superior pole left kidney. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small bowel loops are fluid-filled and prominent in size with multiple air-fluid levels present. No overtly dilated loops of small bowel. No transition point. No pneumatosis. COLON / APPENDIX: Olin is distended with air-fluid level in the right colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Compressed around a Foley balloon REPRODUCTIVE ORGANS: No abnormality BODY WALL: No significant abnormality. MUSCULOSKELETAL: Postoperative screw and rod fixation of remote left femoral fracture. Multilevel degenerative changes in the lumbar spine. Grade 1 anterolisthesis of L4 on L5.
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3,689
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CT Angio Neck 1/8/2022 8:13 PM Clinical information: 142 years Unknown patient with Trauma Comparison: None available. Technique: Intravenous iodinated contrast was then administered and multiple, contiguous, axial CT images of the neck were performed in the arterial phase using CT neck 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: 250 lbs. IV contrast: Omnipaque 350, 150 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: 1007 mGy cm. . FINDINGS: VASCULAR FINDINGS: Aortic arch: Patent with no hemodynamically significant stenosis. Four vessel aortic arch is noted, with the left vertebral artery originating directly from aortic arch. Common/Internal carotid arteries: Atherosclerotic calcifications and fibrofatty plaques are noted involving the bilateral carotid bifurcations, resulting in mild luminal narrowing of the proximal right ICA. Vertebral arteries: Dominant right vertebral artery. Multifocal severe luminal narrowing involving the V4 segment of the left vertebral artery. Otherwise, remain patent with no hemodynamically significant stenosis. Aneurysm: No large aneurysm identified. NONVASCULAR FINDINGS: Punctate calcifications of the bilateral palatine tonsils, likely sequela of prior infections. The oral cavity, nasopharynx, oropharynx, and laryngopharynx have otherwise normal appearance. No intrinsic abnormality is seen within the larynx or trachea. The true and false vocal cords are without focal abnormality. The superficial soft tissues of the neck have a normal appearance with no enhancing lesion identified. No enlarged lymph nodes are seen. The parotid and submandibular glands are normal in appearance. The thyroid gland is without focal abnormality. Chronic multilevel degenerative changes of cervical spine, most significant at C6-C7, with mild retrolisthesis, moderate intervertebral disc space loss and endplate sclerosis, with early osteophytes. IMPRESSION: 1. Multifocal severe luminal narrowing involving the V4 segment of the left vertebral artery. 2. Atherosclerotic calcifications and fibrofatty plaques involving the bilateral carotid bifurcations, resulting in mild luminal narrowing of the proximal right ICA. 3. Otherwise, patent cervical arteries, without evidence of acute vascular injury or flow-limiting stenosis.
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FINDINGS: VASCULAR FINDINGS: Aortic arch: Patent with no hemodynamically significant stenosis. Four vessel aortic arch is noted, with the left vertebral artery originating directly from aortic arch. Common/Internal carotid arteries: Atherosclerotic calcifications and fibrofatty plaques are noted involving the bilateral carotid bifurcations, resulting in mild luminal narrowing of the proximal right ICA. Vertebral arteries: Dominant right vertebral artery. Multifocal severe luminal narrowing involving the V4 segment of the left vertebral artery. Otherwise, remain patent with no hemodynamically significant stenosis. Aneurysm: No large aneurysm identified. NONVASCULAR FINDINGS: Punctate calcifications of the bilateral palatine tonsils, likely sequela of prior infections. The oral cavity, nasopharynx, oropharynx, and laryngopharynx have otherwise normal appearance. No intrinsic abnormality is seen within the larynx or trachea. The true and false vocal cords are without focal abnormality. The superficial soft tissues of the neck have a normal appearance with no enhancing lesion identified. No enlarged lymph nodes are seen. The parotid and submandibular glands are normal in appearance. The thyroid gland is without focal abnormality. Chronic multilevel degenerative changes of cervical spine, most significant at C6-C7, with mild retrolisthesis, moderate intervertebral disc space loss and endplate sclerosis, with early osteophytes.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small bowel loops are displaced by the large pelvic mass. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Trace perisplenic free fluid in trace free fluid in the pelvis. No peritoneal nodules. RETROPERITONEUM: Normal. VESSELS: Severe aortoiliac calcified atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The next solid and cystic right ovarian mass has enlarged and measures 13.7 x 12.3 cm (image 238 series 2), previously 13.0 x 8.9 cm. There are large nodular enhancing components posteriorly. The mass appears to arise from the right ovary. The mass contacts and displaces the left ovary and the uterus. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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3,690
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Shortness of breath. History of COPD and ILD. COMPARISON: Multiple prior examinations, most recently CTA chest 7/20/2021 and high-resolution CT chest 7/30/2021. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 180 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: 354.10 mm. KVP: 120 DLP: 364.20 mGy cm. FINDINGS: Examination is limited by artifact from respiratory motion. STRUCTURED REPORT: CT PE 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: The central tracheobronchial tree is patent with redemonstration of bronchomalacia. Upper lobe predominant centrilobular paraseptal emphysematous changes. Diffuse bilateral groundglass attenuation with intraventricular septal thickening, as well as superimposed diffuse patchy consolidative opacities. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Mild right atrial and ventricular dilatation. No pericardial effusion. 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. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Prominent bilateral hilar and mediastinal lymph nodes are likely reactive. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormalities identified. CONCLUSION: 1. No acute central or proximal segmental pulmonary thromboembolus. 2. Diffuse patchy groundglass and consolidative opacities superimposed on a background of emphysematous and fibrotic changes in both lungs, concerning for atypical/multifocal infection. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: Examination is limited by artifact from respiratory motion. STRUCTURED REPORT: CT PE 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: The central tracheobronchial tree is patent with redemonstration of bronchomalacia. Upper lobe predominant centrilobular paraseptal emphysematous changes. Diffuse bilateral groundglass attenuation with intraventricular septal thickening, as well as superimposed diffuse patchy consolidative opacities. No pleural effusions or pneumothorax. HEART / OTHER VESSELS: Mild right atrial and ventricular dilatation. No pericardial effusion. 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. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Prominent bilateral hilar and mediastinal lymph nodes are likely reactive. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormalities identified.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated CT chest. ABDOMEN and PELVIS: LIVER: Right lobe hemangioma is unchanged. No new liver lesions. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Left adrenal gland is normal. Right adrenal gland is not well seen and may be surgically absent. KIDNEYS: Post surgical changes from right nephrectomy. No abnormal soft tissue in the nephrectomy bed. Left kidney is normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Scattered surgical clips throughout the retroperitoneum. VESSELS: No significant abnormality. URINARY BLADDER: Asymmetric hyperattenuation along the right lateral wall of the urinary bladder is likely related to actively excreted contrast. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: No significant abnormality.
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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: 269 mm. DLP: 1500.20 mGy cm. INDICATION: Confusion, assess for stroke COMPARISON: None available STRUCTURED REPORT: CT Head FINDINGS: Patient's head is tilted in the scanner. Mildly limited evaluation due to motion artifact. BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. There is mild diffuse cerebral atrophy. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. Small posterior scalp effusion/hematoma VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. CONCLUSION: 1. No acute intracranial abnormality evident. 2. Small posterior scalp hematoma/effusion. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: Patient's head is tilted in the scanner. Mildly limited evaluation due to motion artifact. BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is preserved. There is mild diffuse cerebral atrophy. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. The mastoid air cells are clear. Small posterior scalp effusion/hematoma VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
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FINDINGS: The enlarged centrally necrotic subcarinal node is slightly decreased in size. Right paratracheal nodes are similar to the prior exam and nonenlarged. No additional enlarged intrathoracic lymph nodes are identified. Mild dilatation of the esophagus is seen. Mild coronary artery calcification is present. The heart size and the mediastinum are otherwise normal. No pleural effusion. The RUL nodule on series 602 image 91 remains unchanged. Tiny LLL nodule on image 171 is unchanged back to February 2021. The lungs are otherwise normal with no new nodules or masses. CT abdomen and pelvis will be reported separately. No focal destructive osseous lesions.
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3,692
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Shortness of breath. COMPARISON: Chest radiograph 1/8/2022. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 315 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 411 mm. KVP: 120 DLP: 588.20 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: Prominent right thyroid lobe and isthmus without discrete thyroid tissue seen in the left lobe bed, which may represent changes from prior left thyroid lobectomy. CHEST: PULMONARY ARTERIES: Subtle focal eccentric filling defect in a right upper lobe distal segmental pulmonary artery branch (series 401, image 35). This is difficult to confirm with sagittal and coronal images due to the degree of noise. Otherwise, no occlusive central or segmental pulmonary thromboembolus. Dilatation of the main pulmonary artery, measuring 37 mm in diameter. LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Subsegmental atelectasis in the lingula and left lower lobe. Complete right middle lobar and subsegmental right lower lobar consolidation with associated volume loss and subtle asymmetric hypoenhancement compared to the areas of consolidation in the left lower lobe and lingula. HEART / OTHER VESSELS: Mild biatrial dilatation. No pericardial effusion. Mild calcific atherosclerosis in the coronary arteries. The thoracic aorta is normal in caliber. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Multilevel degenerative changes in the visualized thoracic spine. CONCLUSION: 1. Subtle focal eccentric filling defect in a right upper lobe distal segmental pulmonary artery is thought to be probably artifactual. No definite central pulmonary thromboembolism is identified. Evaluation of the segmental and subsegmental pulmonary arteries is limited. 2. Bibasilar consolidative changes are most likely secondary to atelectasis, although superimposed infection is difficult to exclude. 3. Dilatation of the main pulmonary artery, suggestive of chronic pulmonary arterial hypertension. 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.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. LOWER NECK: Prominent right thyroid lobe and isthmus without discrete thyroid tissue seen in the left lobe bed, which may represent changes from prior left thyroid lobectomy. CHEST: PULMONARY ARTERIES: Subtle focal eccentric filling defect in a right upper lobe distal segmental pulmonary artery branch (series 401, image 35). This is difficult to confirm with sagittal and coronal images due to the degree of noise. Otherwise, no occlusive central or segmental pulmonary thromboembolus. Dilatation of the main pulmonary artery, measuring 37 mm in diameter. LUNGS / AIRWAYS / PLEURA: The central tracheobronchial tree is patent. Subsegmental atelectasis in the lingula and left lower lobe. Complete right middle lobar and subsegmental right lower lobar consolidation with associated volume loss and subtle asymmetric hypoenhancement compared to the areas of consolidation in the left lower lobe and lingula. HEART / OTHER VESSELS: Mild biatrial dilatation. No pericardial effusion. Mild calcific atherosclerosis in the coronary arteries. The thoracic aorta is normal in caliber. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No aggressive osseous abnormality is identified. Multilevel degenerative changes in the visualized thoracic spine.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Pelvis Renal Transplant VASCULATURE: LOWER ABDOMINAL AORTA: Not included on the images. RIGHT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LOWER ABDOMEN: BOWEL: No abnormality. Normal appendix. PERITONEUM: Moderate pelvic free fluid with peritoneal dialysis catheter in the anterior midline pelvis. OTHER: No other abnormality. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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3,693
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CT Head wo contrast 1/8/2022 7:40 PM Clinical Information: Relapsed ALL patient with new blurry vision Spec Inst: PLT 52 with new blurry vision. concern for bleed Comparison: CT head without contrast dated 1/5/2022. Technique: Unenhanced axial brain CT. Bone and soft tissue windows were reviewed. Sagittal and coronal images were generated from the axial data. Scan field of view: 220 mm. DLP: 1906 mGy cm. Findings: Brain parenchyma: The brain has normal morphology and volume. 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: Slight interval enlargement of known mixed density left cerebral convexity subdural hematoma, now measuring up to 11 mm in maximum thickness (previously measured 9.5 mm), resulting in persistent mass effect upon the left lateral ventricle, with associated 7 mm rightward midline shift (previously measured 5 mm), suggestive of subfalcine herniation. Unchanged mega cisterna magna. Vascular system: Normal noncontrast appearance. 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 remain mildly underpneumatized. Paranasal sinuses: Well aerated. IMPRESSION: Slight interval enlargement of known mixed density left cerebral convexity subdural hematoma, now measuring up to 11 mm in maximum thickness (previously measured 9.5 mm), resulting in persistent mass effect upon the left lateral ventricle, with associated 7 mm rightward midline shift (previously measured 5 mm), suggestive of subfalcine herniation.
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Findings: Brain parenchyma: The brain has normal morphology and volume. 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: Slight interval enlargement of known mixed density left cerebral convexity subdural hematoma, now measuring up to 11 mm in maximum thickness (previously measured 9.5 mm), resulting in persistent mass effect upon the left lateral ventricle, with associated 7 mm rightward midline shift (previously measured 5 mm), suggestive of subfalcine herniation. Unchanged mega cisterna magna. Vascular system: Normal noncontrast appearance. 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 remain mildly underpneumatized. Paranasal sinuses: Well aerated.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: Chest findings to be dictated separately; please see separate chest CT report same day. ABDOMEN: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Mildly enlarged ADRENALS: Normal. KIDNEYS: Small cysts are observed in the right kidney. The kidneys are otherwise unremarkable. LYMPH NODES: There is persistent nodularity in the region of the gastrohepatic ligament just below the GE junction measuring 1.7 x 2.3 cm (series 2 image 222) similar in appearance to the prior examination. STOMACH / SMALL BOWEL: Thickening of the distal esophageal wall and proximal stomach with associated adjacent inflammatory stranding. COLON: No abnormality. PERITONEUM / MESENTERY: Trace ascites in the right paracolic gutter. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Multilevel degenerative changes of the lumbar spine.
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3,694
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Hematuria with retained ureteral stent. COMPARISON: CT abdomen and pelvis 8/24/2018 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 379 mm. DLP: 231 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: Severe centrilobular emphysema in the imaged lung bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Trace pericardial effusion. The heart is normal in size. ABDOMEN and PELVIS: LIVER: The liver is diffusely hyperattenuating. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: The right kidney is atrophied. Dilatation of the left renal pelvis, calyces, and proximal left ureter. Dependent calculi are seen in the proximal ureter. Two ureteral stents are present in the left ureter and terminating in the bladder in expected position. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Moderate amount of formed material throughout colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate calcified atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Ureteral stents terminate in the decompressed urinary bladder. Small dependent calculi are seen in the urinary bladder. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from right inguinal hernia repair. MUSCULOSKELETAL: Decreased osseous mineralization. Grade 1 anterolisthesis of L5 over S1. Bilateral L5 pars defects. CONCLUSION: 1. Two left ureteral stents are visualized in expected position. Dilatation of the proximal left ureter and renal pelvis with mild hydronephrosis. 2. Dependent layering nonobstructive urolithiasis in the urinary bladder and proximal left ureter. 3. Increased attenuation of the liver is nonspecific, but may be secondary to iron overload. Severe bilateral emphysema and additional chronic findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Severe centrilobular emphysema in the imaged lung bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Trace pericardial effusion. The heart is normal in size. ABDOMEN and PELVIS: LIVER: The liver is diffusely hyperattenuating. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: The right kidney is atrophied. Dilatation of the left renal pelvis, calyces, and proximal left ureter. Dependent calculi are seen in the proximal ureter. Two ureteral stents are present in the left ureter and terminating in the bladder in expected position. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Moderate amount of formed material throughout colon. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate calcified atherosclerotic disease of the abdominal aorta and its branches. URINARY BLADDER: Ureteral stents terminate in the decompressed urinary bladder. Small dependent calculi are seen in the urinary bladder. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Postsurgical changes from right inguinal hernia repair. MUSCULOSKELETAL: Decreased osseous mineralization. Grade 1 anterolisthesis of L5 over S1. Bilateral L5 pars defects.
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FINDINGS: Limitations: None. Chest: Lines, tubes, and devices: A right IJ port catheter with tip at the lower SVC. Lung parenchyma and pleura: Tiny tree-in-bud opacities in the posterior left lower lobe (image 175, series 2) is new from prior and likely infectious/inflammatory in etiology. Bilateral dependent atelectasis. Medial left lower lobe subpleural opacity, likely related to inflammation from the adjacent osteophytes. The trachea and main bronchi are patent. No pleural effusion. Thoracic inlet, heart, and mediastinum: No lymphadenopathy in the axillary, mediastinal, or hilar regions. Suspected small hiatal hernia/nondistention of the lower esophagus. The thoracic aorta and main pulmonary artery are normal in caliber. The cardiac chambers are normal in size. Moderate coronary artery atherosclerotic calcifications are noted, although the study is not optimized for coronary assessment. No pericardial effusion. Bones and soft tissues: No destructive bone lesion. Chest wall is unremarkable. Upper abdomen: Reported separately.
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3,695
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: Hematochezia. COMPARISON: CT abdomen and pelvis with contrast 4/12/2013. TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked, 70 sec venous Scan field of view: 387.60 mm. DLP: 2302 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Diffuse groundglass consolidative opacities throughout the visualized lower lungs. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Moderate four-chamber cardiomegaly. Thrombi noted in the right and left ventricles. Small pericardial effusion. ABDOMEN and PELVIS: LIVER: Tiny calcified granuloma in the right hepatic lobe. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Hypoattenuating lesions in both kidneys are too small to characterize, but are statistically likely to represent cysts. Otherwise, no significant abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. No intraluminal contrast extravasation is identified. COLON / APPENDIX: No significant abnormality in the colon. The appendix is normal. No intraluminal contrast extravasation is identified. PERITONEUM / MESENTERY: Mild mesenteric vascular congestion with trace perihepatic ascites as well as trace fluid interdigitating these of the mesentery in the lower abdomen. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: High-grade stenosis of the celiac trunk secondary to compression by the median arcuate ligament with mild poststenotic dilatation. URINARY BLADDER: Mildly distended with Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild body wall edema. MUSCULOSKELETAL: No aggressive osseous abnormalities identified. Multilevel degenerative changes in the visualized thoracolumbar spine. CONCLUSION: 1. No evidence of active gastrointestinal hemorrhage or other acute abdominopelvic abnormality. 2. Diffuse ground glass and consolidative opacities throughout the visualized lower lungs, concerning for multifocal pneumonia. 3. Cardiomegaly with sequela of volume overload, including anasarca and trace ascites. Incidental right and left intraventricular thrombi. 4. Mildly distended urinary bladder with Foley catheter in place. Recommend evaluation of catheter function. 5. High-grade stenosis of the proximal celiac trunk secondary to compression by the median arcuate ligament. Findings were discussed with Dr. Nicodemus by Dr. Cook at 5:30 AM on 1/9/2022. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Diffuse groundglass consolidative opacities throughout the visualized lower lungs. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Moderate four-chamber cardiomegaly. Thrombi noted in the right and left ventricles. Small pericardial effusion. ABDOMEN and PELVIS: LIVER: Tiny calcified granuloma in the right hepatic lobe. Otherwise, no significant abnormality. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Hypoattenuating lesions in both kidneys are too small to characterize, but are statistically likely to represent cysts. Otherwise, no significant abnormality. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. No intraluminal contrast extravasation is identified. COLON / APPENDIX: No significant abnormality in the colon. The appendix is normal. No intraluminal contrast extravasation is identified. PERITONEUM / MESENTERY: Mild mesenteric vascular congestion with trace perihepatic ascites as well as trace fluid interdigitating these of the mesentery in the lower abdomen. No pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: High-grade stenosis of the celiac trunk secondary to compression by the median arcuate ligament with mild poststenotic dilatation. URINARY BLADDER: Mildly distended with Foley catheter in place. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild body wall edema. MUSCULOSKELETAL: No aggressive osseous abnormalities identified. Multilevel degenerative changes in the visualized thoracolumbar spine.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Mild-to-moderate 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: Normal. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: There are shotty and borderline enlarged bilateral hilar and prevascular lymph nodes, presumably reactive. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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3,696
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Radiologic Exam: CT Angio Head Code Stroke, CT Angio Neck 1/8/2022 7:47 PM Clinical Information: Possible stroke. Comparison: Same day noncontrast head CT at 7:00 pm. Technique: Helical CT images were obtained before and 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: 219 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: bolus tracking Scan field of view: 311 mm. DLP: 2744 mGy cm. (accession CT220004402), Patient weight: 219 lbs. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: bolus tracking Scan field of view: 358 mm. (accession CT220004403) FINDINGS: CT of the head with and without contrast: Please see separately reported same day noncontrast head CT. No abnormal contrast enhancement within the limitations of arterial phase exam. 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. Fetal origin of the right PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. 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. NONVASCULAR 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 without focal abnormality. Scattered groundglass opacities in the left upper lobe. Moderate multilevel discogenic degenerative change of the cervical spine with multilevel uncovertebral facet hypertrophy. Moderate to severe multilevel spinal canal stenosis and neuroforaminal narrowing from C2 to C6. IMPRESSION: 1. No definitive acute intracranial process, abnormal enhancement or significant interval change identified. 2. No evidence of acute cervical or intracranial arterial abnormality. 3. Mild nonflow limiting multifocal atherosclerosis as described. 4. Groundglass opacities in left upper lobe, likely infectious versus inflammatory. 5. Advanced chronic multilevel degenerative changes of cervical spine as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT of the head with and without contrast: Please see separately reported same day noncontrast head CT. No abnormal contrast enhancement within the limitations of arterial phase exam. 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. Fetal origin of the right PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. 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. NONVASCULAR 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 without focal abnormality. Scattered groundglass opacities in the left upper lobe. Moderate multilevel discogenic degenerative change of the cervical spine with multilevel uncovertebral facet hypertrophy. Moderate to severe multilevel spinal canal stenosis and neuroforaminal narrowing from C2 to C6.
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FINDINGS: STRUCTURED REPORT: CT Urogram LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small hiatal hernia HEART / VESSELS: No significant abnormality. ABDOMEN AND PELVIS: KIDNEYS: No enhancing renal mass. UPPER URINARY TRACTS: - Calculi: No urothelial calculi. - Urothelium: Intermittent collapse of the left ureter likely related to peristalsis. No abnormal urothelial enhancement, thickening or filling defects. URINARY BLADDER: No abnormal bladder enhancement. No bladder mass. LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No ascites or free intraperitoneal air. RETROPERITONEUM: Normal. VESSELS: Mild aortic atherosclerosis without aneurysm. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: Normal. MUSCULOSKELETAL: Redemonstration of L4 butterfly vertebra and focal sclerosis of the right femoral head. No suspicious osseous lesion.
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3,697
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Radiologic Exam: CT Angio Head Code Stroke, CT Angio Neck 1/8/2022 7:47 PM Clinical Information: Possible stroke. Comparison: Same day noncontrast head CT at 7:00 pm. Technique: Helical CT images were obtained before and 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: 219 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: bolus tracking Scan field of view: 311 mm. DLP: 2744 mGy cm. (accession CT220004402), Patient weight: 219 lbs. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: bolus tracking Scan field of view: 358 mm. (accession CT220004403) FINDINGS: CT of the head with and without contrast: Please see separately reported same day noncontrast head CT. No abnormal contrast enhancement within the limitations of arterial phase exam. 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. Fetal origin of the right PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. 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. NONVASCULAR 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 without focal abnormality. Scattered groundglass opacities in the left upper lobe. Moderate multilevel discogenic degenerative change of the cervical spine with multilevel uncovertebral facet hypertrophy. Moderate to severe multilevel spinal canal stenosis and neuroforaminal narrowing from C2 to C6. IMPRESSION: 1. No definitive acute intracranial process, abnormal enhancement or significant interval change identified. 2. No evidence of acute cervical or intracranial arterial abnormality. 3. Mild nonflow limiting multifocal atherosclerosis as described. 4. Groundglass opacities in left upper lobe, likely infectious versus inflammatory. 5. Advanced chronic multilevel degenerative changes of cervical spine as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT of the head with and without contrast: Please see separately reported same day noncontrast head CT. No abnormal contrast enhancement within the limitations of arterial phase exam. 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. Fetal origin of the right PCA. VERTEBROBASILAR ARTERIES: There is no evidence of stenosis, occlusion, or aneurysmal dilation. CT angiogram of the neck: AORTIC ARCH and PROXIMAL GREAT VESSELS: Unremarkable. Three normal vessel aortic arch is noted. RIGHT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. LEFT CAROTID: There is no evidence of stenosis, occlusion, or aneurysmal dilation. Mild nonflow limiting calcified atherosclerosis of the proximal ICA. 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. NONVASCULAR 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 without focal abnormality. Scattered groundglass opacities in the left upper lobe. Moderate multilevel discogenic degenerative change of the cervical spine with multilevel uncovertebral facet hypertrophy. Moderate to severe multilevel spinal canal stenosis and neuroforaminal narrowing from C2 to C6.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Stable calcifications in the left thyroid lobe. CHEST: LUNGS / AIRWAYS / PLEURA: No focal consolidation, pleural effusion, or pneumothorax. No suspicious pulmonary nodules. Central airways are patent. HEART / VESSELS: Left ventricular enlargement. No pericardial effusion. Mild atherosclerotic disease with mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Stable surgical clips in the right axilla. UPPER ABDOMEN: Please see same day CT abdomen for abdomen findings. MUSCULOSKELETAL: No acute or aggressive appearing osseous abnormality.
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3,698
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: 24-year-old early postpartum female with pulmonary hypertension, evaluation for pulmonary embolism. COMPARISON: Prior same-day chest radiograph. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 332 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 384 mm. KVP: 120 DLP: 778 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus. Main pulmonary artery is minimally dilated. LUNGS / AIRWAYS / PLEURA: Central airways are patent. Mosaic attenuation of bilateral perihilar regions and lung bases. Some scattered more prominent groundglass opacities in both lower lobes are demonstrated. No dense focal consolidation or pneumothorax. Trace left pleural effusion. HEART / OTHER VESSELS: Heart size is normal. No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Multilevel Schmorl's nodes and upper thoracic mild levoscoliosis. No acute osseous abnormality evident. CONCLUSION: 1. No evidence of pulmonary embolism. 2. Mosaic attenuation of bilateral perihilar regions and lung bases is nonspecific but can be seen with air trapping, edema, and small airways disease. Main pulmonary artery is minimally dilated which can be seen with pulmonary arterial hypertension. Trace left effusion. 3. A few areas of more prominent groundglass in both lower lobes could represent superimposed infection. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus. Main pulmonary artery is minimally dilated. LUNGS / AIRWAYS / PLEURA: Central airways are patent. Mosaic attenuation of bilateral perihilar regions and lung bases. Some scattered more prominent groundglass opacities in both lower lobes are demonstrated. No dense focal consolidation or pneumothorax. Trace left pleural effusion. HEART / OTHER VESSELS: Heart size is normal. No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Multilevel Schmorl's nodes and upper thoracic mild levoscoliosis. No acute osseous abnormality evident.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: See separate chest CT report. ABDOMEN and PELVIS: LIVER: Normal. No arterial hyperenhancing or hypodense lesions. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. Small area of focal fat in the pancreatic body is unchanged. SPLEEN: Cyst at the margin of the spleen is slightly larger. No new lesion. ADRENALS: Right adrenal nodule measures 2.3 x 2.0 cm (image 220 series 9), previously 2.2 x 1.9 cm (image 214 series 9). The left adrenal gland measures 2.7 x 2.0 cm (image 207 series 9), previously 2.7 x 2.0 cm (image 201 series 9). KIDNEYS: Normal. LYMPH NODES: None enlarged. Small inguinal and pelvic nodes are nonspecific. STOMACH / SMALL BOWEL: Small proximal duodenal diverticulum. No significant abnormality. COLON / APPENDIX: Colonic diverticulosis without diverticulitis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered arterial wall calcifications without aneurysmal are unchanged. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Severe lumbar degenerative changes. No acute abnormality or osseous metastasis.
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3,699
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Fall from bicycle, head injury. COMPARISON: None. TECHNIQUE: CT Head wo contrastScan field of view: 250 mm. DLP: 1000 mGy cm. STRUCTURED REPORT: CT Head FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. Normal cerebral cortical volume for patient's age. Incidentally there is tonsillar ectopia. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. Left frontal scalp hematoma extending to the left periorbital region as described below. VENTRICULAR SYSTEM: Normal. ORBITS: Large left periorbital hematoma. The globes are intact. No proptosis. SINUSES: Paranasal sinuses are clear. VESSELS: Normal noncontrast appearance of the vessels. CONCLUSION: 1. No acute intracranial process. 2. Large left frontal scalp hematoma extending to the left periorbital soft tissues. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. No evidence of acute infarction. Normal cerebral cortical volume for patient's age. Incidentally there is tonsillar ectopia. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Bilateral mastoid air cells are clear. Left frontal scalp hematoma extending to the left periorbital region as described below. VENTRICULAR SYSTEM: Normal. ORBITS: Large left periorbital hematoma. The globes are intact. No proptosis. SINUSES: Paranasal sinuses are clear. VESSELS: Normal noncontrast appearance of the vessels.
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Findings: Diffuse osteopenia limits evaluation of subtle nondisplaced fractures. Burst fracture is noted involving the T12 vertebral body with approximately 50% of the vertebral body height loss and 6 mm retropulsion of fracture fragment into the spinal canal, resulting in mild T10-T11 spinal canal stenosis with mild to moderate bilateral neuroforaminal narrowing. Mild dextroscoliosis of the thoracic spine with compensatory levoscoliosis of the lumbar spine, accentuation of the thoracic kyphosis and lumbar lordosis with grade 1 anterolisthesis of L4 on L5. The remaining vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Multilevel intervertebral disc space loss, episodes and osteophytosis, severe at T6-T7, moderate at T4-T5 and T5-T6. Multilevel circumferential disc bulges and bilateral facet hypertrophy is seen, most significant at L4-5, resulting in moderate right and mild left neuroforaminal narrowing, with severe spinal canal stenosis. The prevertebral and paraspinal soft tissues appear normal. Partially visualized bilateral nonobstructive nephrolithiasis. Atherosclerotic calcifications of the thoracoabdominal aorta and its branches.
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