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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Primary lung cancer, metastatic workup COMPARISON: CT abdomen pelvis dated 12/15/2019 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 119 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70sec Scan field of view: 355 mm. DLP: 394 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Examination is significantly degraded by motion artifact. ABDOMEN and PELVIS: LIVER: Subcentimeter hypodensity in the left hepatic lobe, possibly seen on the prior exam, likely representing a cyst. GALLBLADDER: Probable gallstones, the gallbladder is not well evaluated due to motion artifact. PANCREAS: Pancreas is difficult to evaluate given motion artifact. SPLEEN: Normal size. ADRENALS: Normal. KIDNEYS: Redemonstration of bilateral hypoattenuating lesions. Question tiny nonobstructive left nephrolithiasis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No evidence of small bowel obstruction. COLON / APPENDIX: Large fecal burden in the rectum. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Severe calcified and noncalcified atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The prostate is not enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Sclerosis of the bilateral femoral heads. CONCLUSION: 1. Examination is markedly degraded by motion artifact. No definite evidence of abdominopelvic metastatic disease is identified, however recommend repeat examination in the outpatient setting. 2. Large fecal burden in the rectum may be seen with impaction or constipation in the appropriate clinical setting. 3. Please see separately dictated CT of the chest for additional details.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Examination is significantly degraded by motion artifact. ABDOMEN and PELVIS: LIVER: Subcentimeter hypodensity in the left hepatic lobe, possibly seen on the prior exam, likely representing a cyst. GALLBLADDER: Probable gallstones, the gallbladder is not well evaluated due to motion artifact. PANCREAS: Pancreas is difficult to evaluate given motion artifact. SPLEEN: Normal size. ADRENALS: Normal. KIDNEYS: Redemonstration of bilateral hypoattenuating lesions. Question tiny nonobstructive left nephrolithiasis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No evidence of small bowel obstruction. COLON / APPENDIX: Large fecal burden in the rectum. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Severe calcified and noncalcified atherosclerosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: The prostate is not enlarged. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Sclerosis of the bilateral femoral heads.
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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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2,801
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EXAM: CT Foot Right with contrast CLINICAL INFORMATION: Evaluate right foot osteomyelitis COMPARISON: None. TECHNIQUE: CT Foot Right with contrast Patient weight: 280 lbs. IV contrast: Omnipaque 350, 99 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 180 sec Scan field of view: 364 mm. DLP: 890.90 mGy cm. Findings: There is a large soft tissue ulceration along the lateral and plantar aspects of the forefoot. Soft tissue gas tracks throughout the dorsal and plantar fascial planes, into the mid tarsal joints. There are multiple pockets of fluid in the soft tissues and plantar tendon sheaths. Fluid and gas tracks proximally within the flexor digitorum and peroneal tendon sheaths, to the level posterior to the ankle. There is gross osseous destruction of the fourth and fifth metatarsals as well as the cuboid, lateral cuneiform, and intermediate cuneiform. There is chronic periosteal reaction involving multiple bones in the second through fifth rays. There is also chronic periosteal reaction of the distal tibial and distal fibular metaphyses. Impression: 1. Acute on chronic osteomyelitis involving most of the bones of the midfoot and forefoot. 2. Large forefoot soft tissue ulceration with underlying ill-defined abscesses, infectious tenosynovitis, and septic arthritis throughout the foot. There is gas extending into Chopart's joint and the sinus tarsi. The tibiotalar and subtalar joints are grossly normal. 3. Chronic periosteal reaction of the distal tibial and fibular metaphyses probably reflects chronic osteomyelitis. The infectious tenosynovitis extends into the distal foreleg as well.
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Findings: There is a large soft tissue ulceration along the lateral and plantar aspects of the forefoot. Soft tissue gas tracks throughout the dorsal and plantar fascial planes, into the mid tarsal joints. There are multiple pockets of fluid in the soft tissues and plantar tendon sheaths. Fluid and gas tracks proximally within the flexor digitorum and peroneal tendon sheaths, to the level posterior to the ankle. There is gross osseous destruction of the fourth and fifth metatarsals as well as the cuboid, lateral cuneiform, and intermediate cuneiform. There is chronic periosteal reaction involving multiple bones in the second through fifth rays. There is also chronic periosteal reaction of the distal tibial and distal fibular metaphyses.
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Findings: No enlarged hilar or mediastinal nodes are present. The mediastinum is normal. Mild centrilobular emphysema is seen. Tiny peripheral LUL nodule series 3 image 57 has actually decreased in size from series 201 image 30 on the prior. Tiny peripheral RLL nodule on image 134 is unchanged from August 2020 and most likely benign. Linear scarring and atelectasis are seen in the left lower lobe with elevation the left hemidiaphragm again noted. The lungs are otherwise normal without suspicious nodules or masses. Coronary artery calcification: The visual score of calcification is 9.. (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: Degenerative changes in the thoracic spine otherwise unremarkable.
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2,802
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: 34-year-old male with flank pain. COMPARISON: None available. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 405 mm. DLP: 1487.17 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: Peripheral left lower lobe consolidation with air bronchogram. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Diffuse hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is normal. 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 aggressive osseous lesion. CONCLUSION: 1. No acute abnormality within the abdomen or pelvis. 2. Consolidation in the left lower lobe, suggestive of developing pneumonia and perhaps accounting for the patient's flank pain. 3. Diffuse hepatic steatosis. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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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: Peripheral left lower lobe consolidation with air bronchogram. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Diffuse hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal for technique. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: No renal calculi or hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix is normal. 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 aggressive osseous lesion.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Moderate partially loculated right-sided pleural effusion with associated atelectasis. DISTAL ESOPHAGUS: Unremarkable. HEART / VESSELS: The patient appears anemic. Cardiomegaly. Mild calcified atherosclerotic disease of the coronary arteries. ABDOMEN and PELVIS: LIVER: Cyst in left lobe of the liver and additional subcentimeter low-attenuation lesion in the right lobe of the liver, too small to characterize. BILIARY TRACT: Normal. GALLBLADDER: Unremarkable. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Bilateral renal cortical thinning. No hydronephrosis or nephrolithiasis. Multiple bilateral renal cysts and additional subcentimeter low-attenuation lesions, too small to characterize. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach appears unremarkable. The loops of small bowel are normal in caliber COLON / APPENDIX: Postoperative changes of the sigmoid colon. Colonic diverticulosis. The appendix appears unremarkable. PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Unremarkable. VESSELS: Mild to moderate calcified atherosclerotic disease of aorta and iliac arteries. Focal atherosclerotic disease of the origin of the right renal artery. There is dilation of the right common iliac artery measuring up to 1.4 cm. URINARY BLADDER: There is stranding of the urinary bladder. REPRODUCTIVE ORGANS: Trace right-sided hydrocele. BODY WALL: No significant abnormality. MUSCULOSKELETAL: There are degenerative changes of the spine.
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2,803
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: History of COPD with lung mass COMPARISON: 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: 140 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: 207 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is an irregular mass within the left lower lobe measuring up to 7.3 x 5.9 cm axially (series 401, image 82). There are consolidative changes surrounding the mass with additional groundglass and tree-in-bud opacities in the left lung base. The left posterior basal arteries remain patent as they course through the mass. Paraseptal and central lobular emphysematous changes are noted. There is a indeterminate semisolid nodule seen in the right upper lobe measuring 7 mm on image 71, series 401 HEART / OTHER VESSELS: Mild calcified atherosclerosis of the aortic arch and origin of the great vessels. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Mildly enlarged right hilar lymph node, nonspecific. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Low attenuated lesion within the right hepatic lobe, probably a cyst. MUSCULOSKELETAL: No acute abnormality or aggressive osseous lesion. There are chronic multilevel degenerative changes throughout the imaged spine. CONCLUSION: 1. No acute pulmonary embolism identified. 2. Left lower lobe mass, concerning for malignancy. Nonspecific right hilar adenopathy. 3. Indeterminate semisolid right upper lobe pulmonary nodule, possibly infectious/inflammatory. However, attention on follow-up is recommended to exclude metastasis. 4. Consolidative change surrounding the mass with groundglass and tree-in-bud opacities in the left lung base may be postobstructive infectious or inflammatory. 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 PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is an irregular mass within the left lower lobe measuring up to 7.3 x 5.9 cm axially (series 401, image 82). There are consolidative changes surrounding the mass with additional groundglass and tree-in-bud opacities in the left lung base. The left posterior basal arteries remain patent as they course through the mass. Paraseptal and central lobular emphysematous changes are noted. There is a indeterminate semisolid nodule seen in the right upper lobe measuring 7 mm on image 71, series 401 HEART / OTHER VESSELS: Mild calcified atherosclerosis of the aortic arch and origin of the great vessels. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Mildly enlarged right hilar lymph node, nonspecific. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Low attenuated lesion within the right hepatic lobe, probably a cyst. MUSCULOSKELETAL: No acute abnormality or aggressive osseous lesion. There are chronic multilevel degenerative changes throughout the imaged spine.
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FINDINGS: STRUCTURED REPORT: CTA Aorta Runoff VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Mild scattered circumferential atherosclerotic calcification of the abdominal aorta, particularly within the infrarenal region. CELIAC AXIS: Mild ostial atherosclerotic calcification. SMA: No significant abnormality. RIGHT RENAL: Mild ostial atherosclerotic calcification. LEFT RENAL: Mild ostial atherosclerotic calcification. Two left renal arteries. IMA: Patent. RIGHT ILIAC ARTERIES: Mild scattered atherosclerotic calcification. RIGHT FEMORAL \T\ POPLITEAL ARTERIES: Chronic occlusion of the right superficial femoral artery. There is multifocal atherosclerotic stenosis of the deep femoral artery which appears patent to its distal extent. There has been interval above-the-knee amputation. LEFT ILIAC ARTERIES: Mild to moderate scattered atherosclerotic ossification, particularly of the distal left internal iliac artery. LEFT FEMORAL \T\ POPLITEAL ARTERIES: Moderate to severe multifocal atherosclerotic stenosis, for example there is a critical stenosis within the superficial femoral artery on image 188, series 6 with distal patency. LEFT TIBIAL AND PERONEAL ARTERIES/LEFT FOOT ARTERIES: Multifocal atherosclerotic stenosis with possible chronic occlusion of the posterior tibial artery. There is at minimum two-vessel runoff to the foot. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Scattered atelectatic changes are seen throughout the lung bases, including round atelectasis in the inferior left upper lobe. Multiple subpleural nodules are noted, some of which contain calcification likely representing granulomas. One of these nodules may have mild spiculation in the left lower lobe measuring 9 mm in diameter (image 8, series 6). No pleural effusion or focal consolidation. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal for technique. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Heterogeneous appearance of the spleen. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Scattered diverticulosis. Normal appendix. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Normal. MUSCULOSKELETAL: Interval right above-the-knee amputation. Advanced multilevel discogenic degenerative change, particularly of the lower lumbar spine where there is posterior fusion hardware in place and laminectomy changes. Grade 1 retrolisthesis of L5 on S1. No aggressive appearing osseous lesion is identified.
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2,804
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: HCC, staging CT chest. COMPARISON: CT chest 5/16/2018. CT abdomen and pelvis 11/24/2021. MR abdomen 12/14/2021. TECHNIQUE: CT Chest wo contrast. Scan field of view: 342 mm. DLP: 286 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Noncalcified 5 mm pulmonary nodule in the right middle lobe (image 61, series #2), stable since 2018. Tiny pleural-based nodule in the right lower lobe is also stable and likely represents intrapulmonary lymph node. No new suspicious nodule or mass. No pleural effusion or pneumothorax. Central airways are patent. HEART / VESSELS: Normal heart size. No pericardial effusion. Advanced multivessel coronary artery atherosclerosis. Normal caliber thoracic aorta and pulmonary artery. Mild calcified atherosclerosis of the thoracic aorta. Dense atherosclerotic calcification in the proximal right subclavian artery, unchanged from prior exam. MEDIASTINUM / ESOPHAGUS: No abnormality. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Partially imaged lesion in segment IVb of the liver, better visualized on prior MRI. Hyperattenuating ingested contents in the stomach. MUSCULOSKELETAL: No aggressive osseous lesions. Partially imaged lower cervical spine anterior fusion hardware. Mild multilevel discogenic degenerative changes of the thoracic spine. CONCLUSION: 1. No new suspicious pulmonary nodule or lymphadenopathy. Noncalcified 5 mm right middle lobe nodule is stable since 2018, likely benign. 2. Partially imaged liver lesion, better visualized and characterized on prior MRI. 3. Other 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. LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Noncalcified 5 mm pulmonary nodule in the right middle lobe (image 61, series #2), stable since 2018. Tiny pleural-based nodule in the right lower lobe is also stable and likely represents intrapulmonary lymph node. No new suspicious nodule or mass. No pleural effusion or pneumothorax. Central airways are patent. HEART / VESSELS: Normal heart size. No pericardial effusion. Advanced multivessel coronary artery atherosclerosis. Normal caliber thoracic aorta and pulmonary artery. Mild calcified atherosclerosis of the thoracic aorta. Dense atherosclerotic calcification in the proximal right subclavian artery, unchanged from prior exam. MEDIASTINUM / ESOPHAGUS: No abnormality. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Partially imaged lesion in segment IVb of the liver, better visualized on prior MRI. Hyperattenuating ingested contents in the stomach. MUSCULOSKELETAL: No aggressive osseous lesions. Partially imaged lower cervical spine anterior fusion hardware. Mild multilevel discogenic degenerative changes of the 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: No calcified atherosclerotic disease. RIGHT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: No calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: No calcified atherosclerotic disease. LOWER ABDOMEN: BOWEL: No abnormality. PERITONEUM: Normal. 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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2,805
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Concern for aortic dissection. During chest pain extending into the abdomen. Negative cardiac workup. COMPARISON: Chest radiograph from the same day. TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 94 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 360 mm. KVP: 100 DLP: 871 mGy cm. FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: The unenhanced CT demonstrates no evidence of intramural hematoma. Scattered atherosclerotic calcification in the thoracic aorta. CORONARY ARTERIES: There are minimal atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. Normal variant common origin of the brachiocephalic and left common carotid artery. DESCENDING THORACIC AORTA: No significant abnormality. Scattered minimal atherosclerotic calcification. UPPER ABDOMINAL AORTA: Reported separately. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There are mild dependent atelectatic changes in the small amount of lingular atelectasis. The lungs are otherwise clear. No effusion or pneumothorax evident. The airways are patent. HEART / OTHER VESSELS: The heart size is within normal limits. There is a small amount of pericardial fluid and small amount of simple appearing fluid in the superior pericardial recess. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: No acute osseous abnormality evident. CONCLUSION: No evidence of thoracic aortic dissection or aneurysm. Small pericardial fluid.
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FINDINGS: STRUCTURED REPORT: CTA Chest VASCULATURE: The unenhanced CT demonstrates no evidence of intramural hematoma. Scattered atherosclerotic calcification in the thoracic aorta. CORONARY ARTERIES: There are minimal atherosclerotic calcifications of the native coronary arteries. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: No significant abnormality. Normal variant common origin of the brachiocephalic and left common carotid artery. DESCENDING THORACIC AORTA: No significant abnormality. Scattered minimal atherosclerotic calcification. UPPER ABDOMINAL AORTA: Reported separately. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: There are mild dependent atelectatic changes in the small amount of lingular atelectasis. The lungs are otherwise clear. No effusion or pneumothorax evident. The airways are patent. HEART / OTHER VESSELS: The heart size is within normal limits. There is a small amount of pericardial fluid and small amount of simple appearing fluid in the superior pericardial recess. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Reported separately. MUSCULOSKELETAL: No acute osseous abnormality evident.
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FINDINGS/IMPRESSION: No stress fracture or acute osseous injury is detected. However, MR is more sensitive for detection of early stress reaction. Mild degenerative changes at the anterior right SI joint. There is no free pelvic fluid, iliac or inguinal lymphadenopathy.
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2,806
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EXAM: CT Angio Abdomen wo+w contrast CLINICAL INFORMATION: Concern for dissection. COMPARISON: None. TECHNIQUE: CT Angio Abdomen wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 94 ml, per protocol. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 360 mm. FINDINGS: STRUCTURED REPORT: CTA Abdomen VASCULATURE: Unenhanced CT images demonstrate no evidence of intramural hematoma. There are scattered mild to moderate atherosclerotic calcification in the aorta. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Mild atherosclerotic narrowing at the origin without poststenotic dilatation. The left gastric supplies the left hepatic artery. SMA: No significant abnormality. RIGHT RENAL: Moderate to high-grade stenosis of the right renal artery origin and the setting of atherosclerotic calcific and noncalcific plaque. LEFT RENAL: There are two left renal arteries with the upper renal artery supplying the left upper pole and the more inferiorly originated artery supplying the mid and inferior kidney. Both are patent. IMA: No significant abnormality. RIGHT ILIAC/FEMORAL: Mild to moderate atherosclerotic calcification without significant stenosis evident. LEFT ILIAC/FEMORAL: Mild atherosclerotic calcification without significant stenosis. ------------------------------------------------------------- LOWER CHEST: Reported separately. ABDOMEN and pelvis: LIVER: Several cysts are demonstrated in the liver. A few subcentimeter hypodensities are indeterminate due to small size. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: The right kidney is mildly atrophic. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Small bowel is nondilated. COLON: The appendix appears normal. There is diverticulosis without acute diverticulitis evident. PERITONEUM / MESENTERY: No free fluid or free air. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BLADDER: No abnormality. REPRODUCTIVE: The uterus is absent. No adnexal mass evident. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Degenerative changes of the SI joints and symphysis pubis and lumbar spine. No acute osseous abnormality evident. CONCLUSION: 1. No evidence of aortic aneurysm or dissection. 2. No acute intra-abdominal or pelvic abnormality evident. Incidental findings are discussed above. 3. Mild right renal atrophy in the setting of a moderate to high-grade stenosis of the right renal artery origin appearing secondary to atherosclerotic disease.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen VASCULATURE: Unenhanced CT images demonstrate no evidence of intramural hematoma. There are scattered mild to moderate atherosclerotic calcification in the aorta. DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: Mild atherosclerotic narrowing at the origin without poststenotic dilatation. The left gastric supplies the left hepatic artery. SMA: No significant abnormality. RIGHT RENAL: Moderate to high-grade stenosis of the right renal artery origin and the setting of atherosclerotic calcific and noncalcific plaque. LEFT RENAL: There are two left renal arteries with the upper renal artery supplying the left upper pole and the more inferiorly originated artery supplying the mid and inferior kidney. Both are patent. IMA: No significant abnormality. RIGHT ILIAC/FEMORAL: Mild to moderate atherosclerotic calcification without significant stenosis evident. LEFT ILIAC/FEMORAL: Mild atherosclerotic calcification without significant stenosis. ------------------------------------------------------------- LOWER CHEST: Reported separately. ABDOMEN and pelvis: LIVER: Several cysts are demonstrated in the liver. A few subcentimeter hypodensities are indeterminate due to small size. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: The right kidney is mildly atrophic. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. Small bowel is nondilated. COLON: The appendix appears normal. There is diverticulosis without acute diverticulitis evident. PERITONEUM / MESENTERY: No free fluid or free air. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. BLADDER: No abnormality. REPRODUCTIVE: The uterus is absent. No adnexal mass evident. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Degenerative changes of the SI joints and symphysis pubis and lumbar spine. No acute osseous abnormality evident.
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FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: There is a markedly comminuted fracture of the parasymphyseal mandible and left mandibular body/ramus with associated ballistic fragments and large soft tissue defect. There is a tract of osseous fragments extending into the oral cavity with extensive hemorrhage and soft tissue gas. There is a comminuted fracture of the hyoid bone. The temporal mandibular joints are appropriately aligned. There is minimal mucosal thickening in the ethmoid sinuses. There is a trace right mastoid effusion. The globes appear intact. There is no retrobulbar hemorrhage. There is hemorrhage and numerous ballistic and/or osseous fragments in the common and adjacent oral cavity. There is gas within the right submandibular gland. 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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2,807
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EXAM: Dual-energy CT Hand Bilateral wo contrast CLINICAL INFORMATION: Hand pain, possible gout COMPARISON: None. TECHNIQUE: Dual-energy CT was performed of bilateral hands using protocol for monosodium urate crystal analysis. Additional 3-D postprocessing was done with MIP and volume rendered images which were reviewed for interpretation and concurrent supervision. Scan field of view: 303 mm. DLP: 107 mGy cm. Findings: Calcifications from crystal deposition are present throughout the carpal bones bilaterally. The majority of calcifications show no significant anterior monosodium urate, with only a few punctate "positive" foci in the left wrist. There are a few punctate monosodium urate crystals around the left long finger PIP joint. There are a few small carpal lucencies bilaterally suspicious for erosions. Severe narrowing on the right thumb CMC joint appears degenerative. Impression: Extensive CPPD crystal deposition throughout both wrists with a few small erosions. Minimal monosodium urate deposition, mostly seen at the left long finger PIP.
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Findings: Calcifications from crystal deposition are present throughout the carpal bones bilaterally. The majority of calcifications show no significant anterior monosodium urate, with only a few punctate "positive" foci in the left wrist. There are a few punctate monosodium urate crystals around the left long finger PIP joint. There are a few small carpal lucencies bilaterally suspicious for erosions. Severe narrowing on the right thumb CMC joint appears degenerative.
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FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: There is a markedly comminuted fracture of the parasymphyseal mandible and left mandibular body/ramus with associated ballistic fragments and large soft tissue defect. There is a tract of osseous fragments extending into the oral cavity with extensive hemorrhage and soft tissue gas. There is a comminuted fracture of the hyoid bone. The temporal mandibular joints are appropriately aligned. There is minimal mucosal thickening in the ethmoid sinuses. There is a trace right mastoid effusion. The globes appear intact. There is no retrobulbar hemorrhage. There is hemorrhage and numerous ballistic and/or osseous fragments in the common and adjacent oral cavity. There is gas within the right submandibular gland. 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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2,808
|
EXAM: CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma. COMPARISON: 1/6/2022 radiograph. TECHNIQUE: CT Bone Pelvis w soft tissue no charge Scan field of view: 304 mm. STRUCTURED REPORT: CT Bone vDec2021 FINDINGS: BONES/JOINTS: Left iliac wing fracture which extends into the sacroiliac joint which is slightly widened. Zone II left sacral fracture with involvement of the left S1, S2 and likely S3 neuroforamen. Moderately displaced mildly comminuted fractures of the left superior pubic ramus and left ischiopubic ramus. No pubic symphysis diastasis. SOFT TISSUES: No large hematoma or fluid collection. CONCLUSION: 1. Intra-articular left iliac wing fracture with slight associated left SI joint diastasis. 2. Zone II left sacral fracture. 3. Moderately displaced left obturator ring comminuted fractures. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: BONES/JOINTS: Left iliac wing fracture which extends into the sacroiliac joint which is slightly widened. Zone II left sacral fracture with involvement of the left S1, S2 and likely S3 neuroforamen. Moderately displaced mildly comminuted fractures of the left superior pubic ramus and left ischiopubic ramus. No pubic symphysis diastasis. SOFT TISSUES: No large hematoma or fluid collection.
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FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: There is a markedly comminuted fracture of the parasymphyseal mandible and left mandibular body/ramus with associated ballistic fragments and large soft tissue defect. There is a tract of osseous fragments extending into the oral cavity with extensive hemorrhage and soft tissue gas. There is a comminuted fracture of the hyoid bone. The temporal mandibular joints are appropriately aligned. There is minimal mucosal thickening in the ethmoid sinuses. There is a trace right mastoid effusion. The globes appear intact. There is no retrobulbar hemorrhage. There is hemorrhage and numerous ballistic and/or osseous fragments in the common and adjacent oral cavity. There is gas within the right submandibular gland. 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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2,809
|
EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Acute kidney injury and bilateral flank pain radiating to the midline, rule out kidney stone COMPARISON: None. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 329 mm. DLP: 270 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Minimal dependent atelectasis seen in the lung bases bilaterally. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal with small accessory spleen noted. ADRENALS: Normal. KIDNEYS: Normal. No calculi identified. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. Nuvaring is in place. BODY WALL: Small fat-containing umbilical hernia is noted. MUSCULOSKELETAL: Nonaggressive appearing sclerotic lesion within T10 vertebral body is likely a bone island. No destructive osseous lesion. No acute abnormality. CONCLUSION: No acute abnormality within the abdomen or pelvis. No renal calculi are identified. No evidence of hydronephrosis. 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: Minimal dependent atelectasis seen in the lung bases bilaterally. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal with small accessory spleen noted. ADRENALS: Normal. KIDNEYS: Normal. No calculi identified. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. Nuvaring is in place. BODY WALL: Small fat-containing umbilical hernia is noted. MUSCULOSKELETAL: Nonaggressive appearing sclerotic lesion within T10 vertebral body is likely a bone island. No destructive osseous lesion. No acute abnormality.
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FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: There is a markedly comminuted fracture of the parasymphyseal mandible and left mandibular body/ramus with associated ballistic fragments and large soft tissue defect. There is a tract of osseous fragments extending into the oral cavity with extensive hemorrhage and soft tissue gas. There is a comminuted fracture of the hyoid bone. The temporal mandibular joints are appropriately aligned. There is minimal mucosal thickening in the ethmoid sinuses. There is a trace right mastoid effusion. The globes appear intact. There is no retrobulbar hemorrhage. There is hemorrhage and numerous ballistic and/or osseous fragments in the common and adjacent oral cavity. There is gas within the right submandibular gland. 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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2,810
|
EXAM: CT Sinus wo contrast CLINICAL INFORMATION: Female patient 37 years with Sinusitis, chronic or recurrent, J32.9 Chronic sinusitis, unspecified Spec Inst: sinus stealth protocol TECHNIQUE: 0.6 mm thick serial axial images were obtained through the paranasal sinuses without intravenous contrast. Sagittal and coronal reformatted views were also obtained. Technique: Scan field of view: 230 mm. DLP: 1380.89 mGy cm. COMPARISON: None available. FINDINGS: The frontal, ethmoid, sphenoid and maxillary sinuses are clear. No air-fluid levels are present. The walls of the paranasal sinuses are intact. The ostiomeatal complexes are patent bilaterally. The frontal sinuses outflow tracts are patent bilaterally. There is moderate rightward deviation of the nasal septum. No mass lesion is identified within the nasal cavities. There is no acute abnormality of the orbits. Mastoid air cells are clear bilaterally. Visualized brain is unremarkable. CONCLUSION: 01. No acute sinusitis or obstructive outflow lesion. No findings to suggest chronic sinusitis 02. Moderate rightward deviation of the nasal septum
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FINDINGS: The frontal, ethmoid, sphenoid and maxillary sinuses are clear. No air-fluid levels are present. The walls of the paranasal sinuses are intact. The ostiomeatal complexes are patent bilaterally. The frontal sinuses outflow tracts are patent bilaterally. There is moderate rightward deviation of the nasal septum. No mass lesion is identified within the nasal cavities. There is no acute abnormality of the orbits. Mastoid air cells are clear bilaterally. Visualized brain is unremarkable.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary calcifications. No pericardial effusion. ABDOMEN and PELVIS: LIVER: Normal aside from small focal fat adjacent to the gallbladder fossa. Otherwise normal BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. Small splenule. ADRENALS: Normal. KIDNEYS: Small left upper pole renal cyst. Otherwise normal aside from mild nonspecific perinephric stranding bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Few distended small bowel segments in the mid abdomen without transition point. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free air or ascites. RETROPERITONEUM: Normal. VESSELS: Moderate aortoiliac atherosclerotic disease without aneurysm or flow-limiting stenosis. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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2,811
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 239.70 mm. DLP: 1433.90 mGy cm. (accession CT220003345), Scan field of view: 206.10 mm. DLP: 1244.40 mGy cm. (accession CT220003351), Patient weight: 230 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: 887.50 mGy cm. (accession CT220003352) FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. 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: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. 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: BRAIN PARENCHYMA and ventricles: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Diffuse age-appropriate brain parenchymal volume loss is again seen, resulting in ex vacuo dilatation of the ventricular system. Scattered periventricular and subcortical white matter hypoattenuation is unchanged, suggestive of moderate chronic microvascular ischemic disease. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. SKULL AND SKULL BASE: No acute fracture. Unchanged atherosclerotic calcifications of the bilateral carotid siphons and the right vertebral artery. ORBITS: Normal. Unchanged bilateral lens replacements. SINUSES: Mastoid air cells and paranasal sinuses are well aerated.
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2,812
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EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003346), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003350), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003349), Patient weight: 230 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: 415.40 mm. (accession CT220003347) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic injury is identified within the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Suspected intrauterine gestation. Indeterminate 5 cm right ovarian cystic lesion. Ultrasound recommended for further evaluation. 4. Small pelvic free fluid, probably physiologic. Although an occult traumatic injury is difficult to exclude. 5. Additional findings above. Final report findings discussed with Dr. Marquez at 1/6/2022 4:47 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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Findings: Bilateral cerebral white matter hypoattenuation likely related to chronic microvascular ischemic disease. Mild generalized prominence of the extra-axial spaces is seen, likely age related. 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. 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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2,813
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EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003346), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003350), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003349), Patient weight: 230 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: 415.40 mm. (accession CT220003347) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic injury is identified within the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Suspected intrauterine gestation. Indeterminate 5 cm right ovarian cystic lesion. Ultrasound recommended for further evaluation. 4. Small pelvic free fluid, probably physiologic. Although an occult traumatic injury is difficult to exclude. 5. Additional findings above. Final report findings discussed with Dr. Marquez at 1/6/2022 4:47 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: Scouts: No additional findings. Lines and tubes: None. Lungs and pleura: 8 mm nodule in the right lower lobe along the hemidiaphragm (series 2 image 80, series 601 image 82). No pulmonary consolidation. No central endobronchial masses. No pleural effusion. No pneumothorax. Esophagus, Mediastinum and neck: Small hiatal hernia. No abnormality in the mediastinum. The thyroid gland is normal. Lymph Nodes: Enlarged paraesophageal lymph node is new from prior measuring 40 mm in short axis. Unchanged small mediastinal lymph nodes. Cardiovascular: No cardiomegaly or pericardial effusion. Coronary artery atherosclerotic calcification: Large amount. Abdomen: Please refer to same day CT abdomen report for detailed findings below the diaphragm. Musculoskeletal/Body Wall: No soft tissue masses. No aggressive appearing skeletal lesions. Degenerative changes in spine.
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2,814
|
EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 239.70 mm. DLP: 1433.90 mGy cm. (accession CT220003345), Scan field of view: 206.10 mm. DLP: 1244.40 mGy cm. (accession CT220003351), Patient weight: 230 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: 887.50 mGy cm. (accession CT220003352) FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. 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: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. 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: Multiple new metastases in and adjacent to the liver. The largest metastasis in the inferior right hepatic lobe measures 5.8 x 3.1 cm on image 88 series 3. BILIARY TRACT: Mild extrahepatic ductal dilation, unchanged. GALLBLADDER: No abnormality. PANCREAS: Similar pancreatic lipoma versus interdigitating fat. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypodensity lower pole left kidney is statistically a cyst but too small to characterize. LYMPH NODES: Epigastric lymph node versus peritoneal metastasis measures 1.8 x 1.8 cm on image 97 series 3. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Ill-defined pelvic mass involves the rectum, for example on image 269 series 3. Right perineal metastases about the ascending colon. PERITONEUM / MESENTERY: Multiple new peritoneal metastases throughout the abdomen and pelvis, for example mixed attenuating metastasis adjacent to the ascending colon measures 4.6 x 3.0 cm on image 175 series 3. Pelvic mass along the cranial margin of the vaginal cuff measures 4.2 x 3.7 cm on image 268 series 3. RETROPERITONEUM: Normal. VESSELS: Moderate atherosclerotic calcifications of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. Pelvic mass along the cranial margin of the vaginal cuff. BODY WALL: Ventral hernia contains loops of nonobstructed small bowel and mesenteric fat. MUSCULOSKELETAL: No destructive osseous lesions seen.
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2,815
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EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003346), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003350), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003349), Patient weight: 230 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: 415.40 mm. (accession CT220003347) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic injury is identified within the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Suspected intrauterine gestation. Indeterminate 5 cm right ovarian cystic lesion. Ultrasound recommended for further evaluation. 4. Small pelvic free fluid, probably physiologic. Although an occult traumatic injury is difficult to exclude. 5. Additional findings above. Final report findings discussed with Dr. Marquez at 1/6/2022 4:47 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: New patchy groundglass parenchymal opacities are now seen in the transplanted right lung. The previously noted linear subpleural parenchymal changes in the right middle lobe are stable. There is persistent minimal narrowing of the right bronchial anastomosis. The native left lung also shows patchy groundglass opacities superimposed on underlying extensive honeycombing. No mediastinal adenopathy is seen. There is no pleural or pericardial effusion. Visualized bones are unremarkable.
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2,816
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EXAM: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003346), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003350), Patient weight: 230 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: 415.40 mm. DLP: 1656.90 mGy cm. (accession CT220003349), Patient weight: 230 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: 415.40 mm. (accession CT220003347) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic injury is identified within the chest, abdomen, or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Suspected intrauterine gestation. Indeterminate 5 cm right ovarian cystic lesion. Ultrasound recommended for further evaluation. 4. Small pelvic free fluid, probably physiologic. Although an occult traumatic injury is difficult to exclude. 5. Additional findings above. Final report findings discussed with Dr. Marquez at 1/6/2022 4:47 PM by Dr. Little by telephone.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Normal. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue. Small hiatal hernia. 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: Minute subcentimeter hypodensity within the bilateral kidneys are technically indeterminate but statistically likely cysts. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: There is a small amount of pelvic free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: There is a enhancing fluid collection seen within the uterus which is suspicious for a gestational sac. There is a 5.4 cm right adnexal cystic lesion. The left ovary is grossly unremarkable. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. No fracture. THORACIC SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: SOFT TISSUES: Bilateral tonsilloliths. Otherwise normal. 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: Normal. THYROID GLAND: Normal. VASCULAR STRUCTURES: Normal. OSSEOUS STRUCTURES: No fracture, dislocation, or destructive lesion. ORBITS: Normal. PARANASAL SINUSES AND MASTOID AIR CELLS: Clear. VISUALIZED INTRACRANIAL STRUCTURES: Normal. Please see separately dictated CT chest report for dedicated intrathoracic findings.
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2,817
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 239.70 mm. DLP: 1433.90 mGy cm. (accession CT220003345), Scan field of view: 206.10 mm. DLP: 1244.40 mGy cm. (accession CT220003351), Patient weight: 230 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: 887.50 mGy cm. (accession CT220003352) FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. 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: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. 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: Scouts: No additional findings. Lines and tubes: None. Lungs and pleura: No pulmonary consolidation. No central endobronchial masses. No pleural effusion. No pneumothorax. Esophagus, Mediastinum and neck: Fluid distended distal esophagus. Anterior mediastinal soft tissue likely residual thymus. The thyroid gland is normal. Lymph Nodes: None enlarged. Cardiovascular: Borderline left ventricular dilation. No pericardial effusion. Coronary artery atherosclerotic calcification: None detected. Abdomen: Please refer to same day CT abdomen report for detailed findings below the diaphragm. Musculoskeletal/Body Wall: No soft tissue masses. No aggressive appearing skeletal lesions.
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2,818
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EXAM: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast, CT Angio Neck, CT Cervical Spine From Reformat 3-D CT MIP images were generated in post processing. Scan field of view: 239.70 mm. DLP: 1433.90 mGy cm. (accession CT220003345), Scan field of view: 206.10 mm. DLP: 1244.40 mGy cm. (accession CT220003351), Patient weight: 230 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: 887.50 mGy cm. (accession CT220003352) FINDINGS: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. 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: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Small subgaleal scalp hematoma at the cranial vertex. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. MAXILLOFACIAL: Open-mouth position of the TMJs at the time of imaging. There are no acute maxillofacial or mandibular fractures. The orbits appear intact. There are several dental caries. CERVICAL SPINE: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis CHEST: Please see separately dictated report for CT chest. ABDOMEN and PELVIS: LIVER: Noncirrhotic. Few scattered subcentimeter hypoattenuating foci in the liver, likely simple cysts. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal in size. Multiple round soft tissue nodules near the anterior aspect of the spleen likely representing small splenules. ADRENALS: Normal. KIDNEYS: Right renal cyst. Otherwise, bilateral kidneys are normal without hydronephrosis. 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: No significant abnormality. MUSCULOSKELETAL: No osseous abnormality.
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2,819
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EXAM: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast 3-D CT MIP images were generated in post processing. Scan field of view: 289.80 mm. DLP: 1502.60 mGy cm. (accession CT220003353), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 953.90 mGy cm. (accession CT220003360), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003355), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 917.60 mGy cm. (accession CT220003354) FINDINGS: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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/CONCLUSION: Comminuted, displaced fracture of the medial malleolus. Comminuted, displaced fracture of the posterior malleolus. Comminuted fractures of the distal fibula. Multiple osseous fragments are noted within the tibiotalar joint as well as at the distal tibiofibular syndesmosis. There is slight lateral translation of the talus in relation to the tibia. Gas is noted within the tibiotalar joint and within the soft tissues about the ankle consistent with open fracture. Extensive soft tissue edema about the ankle.
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2,820
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EXAM: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast 3-D CT MIP images were generated in post processing. Scan field of view: 289.80 mm. DLP: 1502.60 mGy cm. (accession CT220003353), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 953.90 mGy cm. (accession CT220003360), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003355), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 917.60 mGy cm. (accession CT220003354) FINDINGS: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: LUNG BASES / PLEURA: Redemonstration of large right pleural effusion with minimal pleural thickening and associated partial right middle and complete right lower lobe atelectasis. Small left-sided pleural effusion is also present DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Partially imaged Mediport catheter with tip terminating at the cavoatrial junction. A lead less pacemaker tip is in the RV apex. Advanced coronary artery atherosclerosis. Moderate calcified atherosclerosis of the descending thoracic aorta. The left lower lobe and lingula pulmonary emboli are not well visualized on today's exam, possibly secondary to contrast timing. Small pericardial effusion is again noted. ABDOMEN and PELVIS: LIVER: Enlarged areas of hypoattenuation in the right and left hepatic lobes corresponding to previously ablated metastasis. These lesions now demonstrate a thin hyperattenuating rim which likely represents post ablation change. The right hepatic lobe lesion measures 4.1 x 2.9 cm (image 78, series #202), previously 1.4 x 2.0 cm (remeasured on prior exam). The left hepatic lobe lesion measures 4.4 x 3.7 cm (image 87, series #202), previously 1.3 x 1.1 cm (remeasured on prior exam). BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Calcified granulomas. ADRENALS: Normal. KIDNEYS: Unchanged bilateral subcentimeter hypoattenuating lesions, likely renal cysts. Punctate nonobstructing right nephrolithiasis, unchanged. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Hyperattenuating material in the stomach, likely ingested contents. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Unchanged left peritoneal nodule measuring 0.9 x 0.7 cm (image 138, series #202). Trace free fluid in the pelvis. RETROPERITONEUM: Normal. VESSELS: Advanced calcified atherosclerosis of the abdominal aorta and branch vessels. URINARY BLADDER: Uterus is absent. No adnexal mass. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Midline surgical scar. Mild rectus diastasis, unchanged. MUSCULOSKELETAL: Right hip arthroplasty and left femur intramedullary nail, unchanged. L2-L4 posterior spinal fusion hardware, unchanged. Transitional S1 vertebrae. Unchanged grade 1 anterolisthesis of L5 on S1. No aggressive osseous lesions. Unchanged deflated left breast implant.
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2,821
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EXAM: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast 3-D CT MIP images were generated in post processing. Scan field of view: 289.80 mm. DLP: 1502.60 mGy cm. (accession CT220003353), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 953.90 mGy cm. (accession CT220003360), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003355), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 917.60 mGy cm. (accession CT220003354) FINDINGS: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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 Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal left apical pleural parenchymal scarring, otherwise normal. No evidence of interstitial lung disease. No air trapping. No significant dynamic airway collapse. HEART / 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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2,822
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EXAM: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast 3-D CT MIP images were generated in post processing. Scan field of view: 289.80 mm. DLP: 1502.60 mGy cm. (accession CT220003353), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 953.90 mGy cm. (accession CT220003360), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003355), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 917.60 mGy cm. (accession CT220003354) FINDINGS: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: Scouts: No additional findings. Lines and tubes: None. Lungs and pleura: Interval increase in size of lobulated mass in the left upper lobe now measuring 71 x 54 mm (series 2 image 70), previously 40 x 37 mm. It again abuts the mediastinum medially with loss of fat planes, and is in close proximity with the aortic arch. Anteriorly focally abuts the anterior chest wall. There is associated atelectasis, likely secondary to left upper lobe segmental bronchial occlusion (series 2 image 90). Mild surrounding nodularity is new from prior (series 2 image 60 for example). Moderate centrilobular emphysema bilaterally with bronchial wall thickening. Scattered noncalcified pulmonary nodules bilaterally measuring up to 3 to 4 mm (series 2 image 54 for example). Bronchial wall thickening bilaterally. Linear atelectasis/scarring in the right middle lobe. Focal scarring in the right upper lobe anteriorly is new from prior (series 2 image 108). Endobronchial nodularity/secretions in the bronchus intermedius are redemonstrated (series 2 image 101) annual bronchial secretions in the lingular bronchi are unchanged (series 2 image 118). Scattered calcified granulomas. No pleural effusion. No pneumothorax. Esophagus, Mediastinum and neck: Esophagus is normal. No abnormality in the mediastinum. The thyroid gland is normal. Lymph Nodes: Borderline enlarged mediastinal lymph nodes are unchanged. Evaluation for hilar lymph nodes is limited due to lack of IV contrast. Cardiovascular: Left atrial dilation. Trace anterior pericardial effusion. Mild mitral annular, aortic valvular calcifications. Atherosclerotic calcifications involving the thoracic aorta, aortic arch sidebranches. Mild dilation of the distal aortic arch is unchanged measuring up to 36 mm in diameter. Coronary artery atherosclerotic calcification: Moderate amount. Abdomen: No upper abdominal abnormality identified. Musculoskeletal/Body Wall: Surgical anchors in the left humeral head. Mild bilateral gynecomastia. No aggressive appearing skeletal lesions. Mild degenerative changes in spine.
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2,823
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EXAM: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast 3-D CT MIP images were generated in post processing. Scan field of view: 289.80 mm. DLP: 1502.60 mGy cm. (accession CT220003353), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 953.90 mGy cm. (accession CT220003360), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003355), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 917.60 mGy cm. (accession CT220003354) FINDINGS: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: There are postsurgical changes from left frontal parietal craniotomy with resection of underlying meningioma. There is underlying extra-axial collection with gas in small and of hemorrhage. Small amount of hemorrhage is also seen in the resection cavity. Extensive left frontal edema is again noted with mass effect on the left frontal horn and rightward midline shift which appear unchanged. Overlying scalp drainage catheter is present. The visualized paranasal sinuses and mastoid air cells are clear.
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2,824
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EXAM: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast 3-D CT MIP images were generated in post processing. Scan field of view: 289.80 mm. DLP: 1502.60 mGy cm. (accession CT220003353), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 953.90 mGy cm. (accession CT220003360), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003355), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 917.60 mGy cm. (accession CT220003354) FINDINGS: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No hemorrhage, mass effect or edema. Mild frontoparietal age-appropriate brain parenchymal volume loss is again seen, resulting in mild exvacuo dilatation of the lateral ventricles. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Mild under pneumatization of the left mastoid tip. Punctate atherosclerotic calcifications of the bilateral carotid siphons. ORBITS: Normal. SINUSES: Mild mucosal thickening at the bilateral ethmoid and inferior maxillary sinuses.
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2,825
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EXAM: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast CLINICAL INFORMATION: COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Thoracic Spine from Reformat, CT Lumbar Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast 3-D CT MIP images were generated in post processing. Scan field of view: 289.80 mm. DLP: 1502.60 mGy cm. (accession CT220003353), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 953.90 mGy cm. (accession CT220003360), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003355), Patient weight: 160 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 917.60 mGy cm. (accession CT220003354) FINDINGS: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: BRAIN PARENCHYMA: No acute hemorrhage, mass effect or edema. Bilateral posterior PCA chronic infarcts in the bilateral parieto-occipital territories. Superimposed mild diffuse cortical atrophic changes. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. Posterior scalp contusive changes. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left maxillary sinus mucosal thickening and small left maxillary sinus air-fluid level. Bilateral mild ethmoid air cell mucosal thickening. Small right sphenoid sinus mucous retention cyst. Mastoid air cells are 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: LUNG BASES / PLEURA: Small bilateral pleural effusions. Bilateral dependent atelectasis. DISTAL ESOPHAGUS: Small hiatal hernia. Small amount of fluid in the distal esophagus, likely secondary to reflux. Periesophageal varices present. HEART / VESSELS: Pacemaker leads terminate in the right atrium and ventricle. Mildly enlarged heart size. Small pericardial effusion. Suspected enlarged nodes in the precarinal and right middle lobe bronchopulmonary region. ABDOMEN and PELVIS: LIVER: Cirrhosis. BILIARY TRACT: Normal. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Subcentimeter hypoattenuating lesion in the right upper pole, likely a renal cyst. Left renal cortical scarring. No hydronephrosis. LYMPH NODES: Small supradiaphragmatic cardiophrenic angle lymph nodes, unchanged. STOMACH / SMALL BOWEL: Diffuse small bowel wall edema, likely secondary to fluid overload. COLON / APPENDIX: Mild diffuse colon wall thickening, likely secondary to fluid overload. Normal appendix. PERITONEUM / MESENTERY: Large volume ascites. No significant peritoneal enhancement. No free intraperitoneal air. RETROPERITONEUM: Normal. VESSELS: Advanced calcified atherosclerosis of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is present. No adnexal mass. BODY WALL: Diffuse body wall anasarca. Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: Unchanged grade 1 anterolisthesis of L4 on L5. Mild multilevel discogenic degenerative change.
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2,826
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: 78-year-old man with history of prostate cancer. COMPARISON: There are no prior abdominal or pelvic CTs performed at UAB for comparison. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 474 mm. DLP: 2437.90 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. No intravenous contrast was administered secondary to patient's creatinine of 3.1 and GFR of 20 . STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: No nodules are seen in the bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary artery calcifications. No abnormalities otherwise. ABDOMEN and PELVIS: LIVER: No abnormalities for unenhanced technique. BILIARY TRACT: Normal. GALLBLADDER: The gallbladder is contracted around several gas-containing gallstones. PANCREAS: No abnormalities for unenhanced technique. SPLEEN: No abnormalities for unenhanced technique. ADRENALS: Mild bilateral thickening. No nodules are seen. KIDNEYS: The right kidney contains a few contour altering fluid density structures most likely representing cysts but incompletely characterized without intravenous contrast. There is mild diffuse cortical thinning. The left kidney contains a complex cystic lesion in the left upper pole measuring approximately 8.8 x 5.7 cm (image 106 series 4) and containing calcifications along several internal septations. No nodules are discernible given limitations of unenhanced images. No hydronephrosis is seen bilaterally. LYMPH NODES: No pathologically enlarged lymph nodes are seen in the abdomen or pelvis. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: A few scattered diverticula are present, without inflammation. The appendix appears normal. PERITONEUM / MESENTERY: There is no free fluid or extraluminal collection. RETROPERITONEUM: Normal. VESSELS: Scattered calcified atherosclerotic plaque is seen throughout the abdominal aorta. A fusiform infrarenal abdominal aortic aneurysm is present with maximum AP dimension of 3.3 cm and a length of approximately 7 cm, ending 2 cm above the bifurcation. URINARY BLADDER: Partially collapsed likely accentuating diffuse wall thickening. REPRODUCTIVE ORGANS: The prostate is enlarged at 6.8 x 6.8 cm. BODY WALL: There is a small fat-containing left inguinal hernia. MUSCULOSKELETAL: Degenerative changes seen throughout the lumbar spine. No aggressive osseous lesions are identified. CONCLUSION: 1. No evidence of metastatic prostate cancer in the abdomen and pelvis on unenhanced CT. 2. Diminished renal function detected on screening creatinine obtained in anticipation of IV contrast injection. 3. Large complex cyst in the left upper renal pole contains mural/septal calcifications and is incompletely characterized without contrast. When clinically feasible, multiphasic renal MRI is recommended to further characterize and exclude cystic renal neoplasm though the lesion more likely represents a complex cyst. 4. Fusiform infrarenal AAA, cholelithiasis, and other incidental findings as above.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. No intravenous contrast was administered secondary to patient's creatinine of 3.1 and GFR of 20 . STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: No nodules are seen in the bases. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary artery calcifications. No abnormalities otherwise. ABDOMEN and PELVIS: LIVER: No abnormalities for unenhanced technique. BILIARY TRACT: Normal. GALLBLADDER: The gallbladder is contracted around several gas-containing gallstones. PANCREAS: No abnormalities for unenhanced technique. SPLEEN: No abnormalities for unenhanced technique. ADRENALS: Mild bilateral thickening. No nodules are seen. KIDNEYS: The right kidney contains a few contour altering fluid density structures most likely representing cysts but incompletely characterized without intravenous contrast. There is mild diffuse cortical thinning. The left kidney contains a complex cystic lesion in the left upper pole measuring approximately 8.8 x 5.7 cm (image 106 series 4) and containing calcifications along several internal septations. No nodules are discernible given limitations of unenhanced images. No hydronephrosis is seen bilaterally. LYMPH NODES: No pathologically enlarged lymph nodes are seen in the abdomen or pelvis. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: A few scattered diverticula are present, without inflammation. The appendix appears normal. PERITONEUM / MESENTERY: There is no free fluid or extraluminal collection. RETROPERITONEUM: Normal. VESSELS: Scattered calcified atherosclerotic plaque is seen throughout the abdominal aorta. A fusiform infrarenal abdominal aortic aneurysm is present with maximum AP dimension of 3.3 cm and a length of approximately 7 cm, ending 2 cm above the bifurcation. URINARY BLADDER: Partially collapsed likely accentuating diffuse wall thickening. REPRODUCTIVE ORGANS: The prostate is enlarged at 6.8 x 6.8 cm. BODY WALL: There is a small fat-containing left inguinal hernia. MUSCULOSKELETAL: Degenerative changes seen throughout the lumbar spine. No aggressive osseous lesions are identified.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Small right pleural effusion with adjacent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary artery calcifications. Normal heart size. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Mild splenomegaly, measuring 13 cm craniocaudally. ADRENALS: Normal. KIDNEYS: Nonspecific bilateral perinephric stranding has a chronic appearance. No hydronephrosis. Mild stranding/fluid around the right mid ureter (image 25 series 201). LYMPH NODES: Mildly prominent mesenteric nodes, none of which are pathologically enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Sigmoid diverticulitis. Trace fluid tracks along the descending colon into the pelvis. PERITONEUM / MESENTERY: Trace free fluid. RETROPERITONEUM: Mild right periureteral stranding/fluid. VESSELS: Moderate to severe aortoiliac and branch vessel calcific atherosclerosis. URINARY BLADDER: Underdistended, with wall thickening. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Intermediate-attenuating left lower abdominal rectus sheath collection measures 7.9 x 2.9 x 9.6 cm (image 150 series 201, image 16 series 203). Tiny hyperdensity within the collection (image 149 series 201) is nonspecific and may represent a small clot or calcification, although active extravasation is not excluded. MUSCULOSKELETAL: Scoliosis. Degenerative changes of the spine with grade 2 anterolisthesis of L5 on S1
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2,827
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EXAM: CT Chest with contrast CLINICAL INFORMATION: Lung nodule. Emphysema. COMPARISON: 9/29/2021 TECHNIQUE: CT Chest with contrast. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 55 sec. Scan field of view: 362 mm. DLP: 320 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Hazy bilateral scattered groundglass nodules are again seen, may represent infectious or inflammatory changes. A few tiny less than 0.4 cm pulmonary nodules are seen. The previously seen approximately 0.8 cm groundglass nodule in the right lower lobe is not definitely visualized and likely represents infectious or inflammatory changes. HEART / VESSELS: Moderate to severe coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: Scattered areas of patchy groundglass opacities are again seen, may represent infectious or inflammatory changes. Several small less than 0.4 cm groundglass nodules are unchanged. The larger groundglass nodule measuring up to 0.8 cm in the right lower lobe appears to have resolved. Mild upper lung predominant centrilobular emphysema is again seen. Moderate to severe coronary artery calcifications.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Hazy bilateral scattered groundglass nodules are again seen, may represent infectious or inflammatory changes. A few tiny less than 0.4 cm pulmonary nodules are seen. The previously seen approximately 0.8 cm groundglass nodule in the right lower lobe is not definitely visualized and likely represents infectious or inflammatory changes. HEART / VESSELS: Moderate to severe coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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Findings: Enlarged heterogenous enhancing right palatine tonsil with tonsillar abscess measuring up to 1.4 cm in maximal dimension and resulting in leftward deviation of the uvula Enlarged right submandibular lymph nodes as well as mildly enlarged submental nodes nodes. The parotid, submandibular, and thyroid glands are normal. Larynx and subglottic trachea are normal. Additional neck soft tissues are also normal. No acute fracture or suspicious osseous lesions.
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2,828
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CT Head wo contrast Clinical Information: Head trauma, minor Comparison: 6/29/2005 Technique: Unenhanced axial brain CT with sagittal and coronal reformats. Scan field of view: 230 mm. DLP: 1381 mGy cm. Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Mildly worsened periventricular white matter hypodensities which are nonspecific but likely represent microangiopathy. There is mild age-related atrophy with proportionate enlargement and ventricles and subarachnoid CSF spaces. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Ex vacuo ventriculomegaly. No hydrocephalus. ORBITS: Lens replacements bilaterally. Otherwise, unremarkable. SINUSES: The sinuses and mastoid air cells are clear. Conclusion: No acute intracranial abnormality. Chronic changes as outlined 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 head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Mildly worsened periventricular white matter hypodensities which are nonspecific but likely represent microangiopathy. There is mild age-related atrophy with proportionate enlargement and ventricles and subarachnoid CSF spaces. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Ex vacuo ventriculomegaly. No hydrocephalus. ORBITS: Lens replacements bilaterally. Otherwise, unremarkable. SINUSES: The sinuses and mastoid air cells are clear.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Unremarkable CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. Mild mosaic attenuation. Minimal linear bandlike atelectasis versus scarring in the right upper lobe. No focal consolidation, nodule, pneumothorax, or effusion. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Lymph nodes are not well evaluated due to technique. Enlarged paratracheal lymph node measures up to 12 mm, likely unchanged. Previously noted subcarinal lymph node is not well characterized. An AP window node measures up to 8 mm in short axis. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: No significant abnormality.
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2,829
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EXAM: CT Wrist Right wo contrast, CT Forearm Right wo contrast CLINICAL INFORMATION: Trauma follow-up COMPARISON: 12/20/2021 TECHNIQUE: CT Wrist Right wo contrast, CT Forearm Right wo contrast Scan field of view: 160 mm. DLP: 668.67 mGy cm. FINDINGS/CONCLUSION: Significant metallic streak artifact limits evaluation of the study. Progressive interval healing of the distal fracture status post sideplate and screw fixation. There is partial osseous bridging of the fracture fragments. No hardware complication. Again noted is a fracture deformity of the distal ulnar diaphysis status post sideplate and screw fixation. No significant bridging osseous callus formation is seen. No hardware complication. Progressive interval healing of the distal humeral fracture status post sideplate and screw fixation. No hardware complication. Unchanged fixation hardware of the olecranon. Decreased bone mineralization. The joint spaces are maintained. The soft tissues are unremarkable.
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FINDINGS/CONCLUSION: Significant metallic streak artifact limits evaluation of the study. Progressive interval healing of the distal fracture status post sideplate and screw fixation. There is partial osseous bridging of the fracture fragments. No hardware complication. Again noted is a fracture deformity of the distal ulnar diaphysis status post sideplate and screw fixation. No significant bridging osseous callus formation is seen. No hardware complication. Progressive interval healing of the distal humeral fracture status post sideplate and screw fixation. No hardware complication. Unchanged fixation hardware of the olecranon. Decreased bone mineralization. The joint spaces are maintained. The soft tissues are unremarkable.
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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: Mild asymmetric enlargement of the left lateral ventricle, most likely developmental in nature. 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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2,830
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EXAM: CT Wrist Right wo contrast, CT Forearm Right wo contrast CLINICAL INFORMATION: Trauma follow-up COMPARISON: 12/20/2021 TECHNIQUE: CT Wrist Right wo contrast, CT Forearm Right wo contrast Scan field of view: 160 mm. DLP: 668.67 mGy cm. FINDINGS/CONCLUSION: Significant metallic streak artifact limits evaluation of the study. Progressive interval healing of the distal fracture status post sideplate and screw fixation. There is partial osseous bridging of the fracture fragments. No hardware complication. Again noted is a fracture deformity of the distal ulnar diaphysis status post sideplate and screw fixation. No significant bridging osseous callus formation is seen. No hardware complication. Progressive interval healing of the distal humeral fracture status post sideplate and screw fixation. No hardware complication. Unchanged fixation hardware of the olecranon. Decreased bone mineralization. The joint spaces are maintained. The soft tissues are unremarkable.
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FINDINGS/CONCLUSION: Significant metallic streak artifact limits evaluation of the study. Progressive interval healing of the distal fracture status post sideplate and screw fixation. There is partial osseous bridging of the fracture fragments. No hardware complication. Again noted is a fracture deformity of the distal ulnar diaphysis status post sideplate and screw fixation. No significant bridging osseous callus formation is seen. No hardware complication. Progressive interval healing of the distal humeral fracture status post sideplate and screw fixation. No hardware complication. Unchanged fixation hardware of the olecranon. Decreased bone mineralization. The joint spaces are maintained. The soft tissues are unremarkable.
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FINDINGS: Mosaic attenuation of the lung parenchyma with partial atelectasis in the right middle lobe. An indeterminate 4 mm nodule is noted in the right lower lobe in image 59, series 2. Bilateral lower lobe bronchiectasis and linear atelectasis. The main pulmonary artery is dilated measuring 43 mm in diameter in image 39, series 2. Cardiac chambers are dilated without associated pericardial effusion. Three vessel atherosclerotic coronary artery disease changes are present. There is moderate hiatal hernia with evidence of prior fundoplication subcentimeter size nodes are seen in the mediastinum. Several collateral vessels are seen in the chest wall.
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2,831
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RADIOLOGIC EXAM: CT Head wo contrast CLINICAL INFORMATION: Encephalopathy. COMPARISON: None. TECHNIQUE: CT of the head without intravenous contrast. Scan field of view: 235 mm. DLP: 1033 mGy cm. FINDINGS: BRAIN PARENCHYMA: No hemorrhage, acute infarct, or cerebral edema. No midline shift or mass effect. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left greater than right maxillary mucosal thickening. SOFT TISSUES: Partially visualized endotracheal and orogastric tubes. 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, acute infarct, or cerebral edema. No midline shift or mass effect. EXTRA-AXIAL SPACES: Normal. SKULL AND SKULL BASE: No fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild left greater than right maxillary mucosal thickening. SOFT TISSUES: Partially visualized endotracheal and orogastric tubes.
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indings: Postsurgical changes from right thalamic lesion debulking are again noted with heterogeneous density and hemorrhage within the lesion. Intraventricular hemorrhage extension is unchanged. The ventricles are stable in size and configuration with left frontal approach ventricular shunt catheter in place. Additional scattered lesions in the bilateral cerebral hemispheres, most prominent in the left parietal lobe are also noted. There is hemorrhage along a prior catheter tract in the right frontal lobe. There is mild leftward midline shift, unchanged. The visualized paranasal sinuses and mastoid air cells are clear.
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2,832
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EXAM: CT Chest wo contrast, CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: 49-year-old female with evaluation for septic shock, lactic acidosis, and respiratory failure. History of lymphoma. Patient is on pressors. COMPARISON: CT chest dated 12/1/2021. PET/CT dated 10/21/2021. TECHNIQUE: CT Chest wo contrast, CT Abdomen and Pelvis wo+w contrast. Scan field of view: 350 mm. DLP: 475 mGy cm. (accession CT220003369), Patient weight: 254 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 450 mm. DLP: 3166 mGy cm. (accession CT220003332) FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Secretions are seen in the trachea. Endotracheal tube tip seen approximately 3.8 centimeters above the carina. Upper lobe and interlobular septal thickening. Consolidations with air bronchograms in the dependent portions of the lower lobes are new. Small effusions. HEART / VESSELS: Left chest port catheter tip in right IJ central venous catheter tip are seen in the right atrium. Enlarged main pulmonary artery measures 4.1 cm compared to 3.0 cm on prior. MEDIASTINUM / ESOPHAGUS: Focus of gas is again seen in the mediastinum and along the right trachea. Esophogastric tube in place with the tip in the stomach body. LYMPH NODES: Interval decrease in size of the enlarged right axillary lymph node measuring 2.9 x 2.0 cm (series 3, image 59) compared to 3.6 x 2.6 cm on prior. Other enlarged right axillary lymph nodes are seen and are similar to slightly increased in size compared to prior exam. For example right adnexa measures 1.8 cm in short axis (series 3, image 32) compared to 1.5 cm on prior exam (series 2, image 36). CHEST WALL: VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No aneurysm, dissection, or significant stenosis. ABDOMINAL AORTA: No aneurysm, dissection, or significant stenosis. CELIAC AXIS: No aneurysm, dissection, or significant stenosis. Replaced right hepatic artery off the SMA. SMA: No aneurysm, dissection, or significant stenosis. RIGHT RENAL: No aneurysm, dissection, or significant stenosis. LEFT RENAL: No aneurysm, dissection, or significant stenosis. IMA: No aneurysm, dissection, or significant stenosis. RIGHT ILIAC AND FEMORAL ARTERIES: No aneurysm, dissection, or significant stenosis. LEFT ILIAC AND FEMORAL ARTERIES: No aneurysm, dissection, or significant stenosis. ABDOMEN and PELVIS: LIVER: Similar renal cysts. Other subcentimeter hypoattenuating lesions are too small characterize. Periportal edema. BILIARY TRACT: Normal. GALLBLADDER: Wall thickening and surrounding edema/stranding. PANCREAS: Peripancreatic stranding along the pancreatic head and uncinate process. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right renal cysts. No hydronephrosis or suspicious lesion. Nonspecific perinephric stranding. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach is normal. A short segment of small bowel in the left pelvis demonstrates wall thickening with inflammatory stranding (series 10, image 276). COLON / APPENDIX: Wall thickening of the ascending hepatic flexure with surrounding inflammatory changes. The hepatic flexure appears to be hypoenhancing to the remaining bowel. No pneumatosis intestinalis. PERITONEUM / MESENTERY: Small volume ascites. No free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Collapsed with Foley catheter in place. Wall thickening. Intraluminal gas likely secondary to catheterization. REPRODUCTIVE ORGANS: Status post hysterectomy. No suspicious adnexal lesion. BODY WALL: Subcutaneous gas of the anterior abdominal wall likely secondary to post injection changes. Mild anasarca. MUSCULOSKELETAL: Mild spondylosis of the visualized spine without destructive osseous lesion. CONCLUSION: 1. Wall thickening and inflammatory changes of the hepatic flexure watershed region and short segment of small bowel are suspicious for ischemic bowel. Recommend correlation with lactic acid acid levels and surgical consultation. 2. New consolidations in the lower lobes may represent aspiration, infection, or atelectasis. 3. Cardiomegaly with pulmonary edema small effusions concerning for heart failure. 4. Pathologically enlarged axillary lymph nodes are again seen, some increased in size and others decreased and compatible with diagnosis of lymphoma. 5. Wall thickening and plantar changes of the gallbladder may be reactive versus cholecystitis. 6. Inflammatory changes along the pancreatic head and uncinate process may be reactive versus pancreatitis. Ancillary findings above. The findings were discussed with Dr. Chad Lynch by Dr. Jason Davis via telephone on 1/6/2022 11:01 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: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT CAP LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Secretions are seen in the trachea. Endotracheal tube tip seen approximately 3.8 centimeters above the carina. Upper lobe and interlobular septal thickening. Consolidations with air bronchograms in the dependent portions of the lower lobes are new. Small effusions. HEART / VESSELS: Left chest port catheter tip in right IJ central venous catheter tip are seen in the right atrium. Enlarged main pulmonary artery measures 4.1 cm compared to 3.0 cm on prior. MEDIASTINUM / ESOPHAGUS: Focus of gas is again seen in the mediastinum and along the right trachea. Esophogastric tube in place with the tip in the stomach body. LYMPH NODES: Interval decrease in size of the enlarged right axillary lymph node measuring 2.9 x 2.0 cm (series 3, image 59) compared to 3.6 x 2.6 cm on prior. Other enlarged right axillary lymph nodes are seen and are similar to slightly increased in size compared to prior exam. For example right adnexa measures 1.8 cm in short axis (series 3, image 32) compared to 1.5 cm on prior exam (series 2, image 36). CHEST WALL: VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No aneurysm, dissection, or significant stenosis. ABDOMINAL AORTA: No aneurysm, dissection, or significant stenosis. CELIAC AXIS: No aneurysm, dissection, or significant stenosis. Replaced right hepatic artery off the SMA. SMA: No aneurysm, dissection, or significant stenosis. RIGHT RENAL: No aneurysm, dissection, or significant stenosis. LEFT RENAL: No aneurysm, dissection, or significant stenosis. IMA: No aneurysm, dissection, or significant stenosis. RIGHT ILIAC AND FEMORAL ARTERIES: No aneurysm, dissection, or significant stenosis. LEFT ILIAC AND FEMORAL ARTERIES: No aneurysm, dissection, or significant stenosis. ABDOMEN and PELVIS: LIVER: Similar renal cysts. Other subcentimeter hypoattenuating lesions are too small characterize. Periportal edema. BILIARY TRACT: Normal. GALLBLADDER: Wall thickening and surrounding edema/stranding. PANCREAS: Peripancreatic stranding along the pancreatic head and uncinate process. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right renal cysts. No hydronephrosis or suspicious lesion. Nonspecific perinephric stranding. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach is normal. A short segment of small bowel in the left pelvis demonstrates wall thickening with inflammatory stranding (series 10, image 276). COLON / APPENDIX: Wall thickening of the ascending hepatic flexure with surrounding inflammatory changes. The hepatic flexure appears to be hypoenhancing to the remaining bowel. No pneumatosis intestinalis. PERITONEUM / MESENTERY: Small volume ascites. No free air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Collapsed with Foley catheter in place. Wall thickening. Intraluminal gas likely secondary to catheterization. REPRODUCTIVE ORGANS: Status post hysterectomy. No suspicious adnexal lesion. BODY WALL: Subcutaneous gas of the anterior abdominal wall likely secondary to post injection changes. Mild anasarca. MUSCULOSKELETAL: Mild spondylosis of the visualized spine without destructive osseous lesion.
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FINDINGS: STRUCTURED REPORT: CT Abdomen LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Persistent mild thickening. HEART / VESSELS: No significant abnormality. ABDOMEN: LIVER: Unchanged appearance of nonenhancing lesion with central hyperattenuation in segment VII measures 1.3 x 1.0 cm (series 2, image 60), previously 1.2 x 1.0 cm (series 2, image 200). This lesion did not enhance on most recent MR. Similar appearance of multiple additional hypoattenuating foci throughout the liver. No new suspicious lesion. BILIARY TRACT: Mild intra and moderate extrahepatic biliary ductal dilatation. No obstructing mass. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Redemonstration of perisplenic calcification. ADRENALS: Normal. KIDNEYS: Unchanged appearance of the subcentimeter hypodensity in the left kidney, which likely represents a simple cyst. Otherwise normal. LYMPH NODES: None enlarged. Visualized STOMACH / SMALL BOWEL: Postsurgical changes from gastrectomy and esophagojejunostomy. No abnormal mural thickening. Visualized COLON: No abnormality. Portion of appendix seen appears unremarkable. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Mild multilevel degenerative change of the thoracic spine. No destructive osseous lesion.
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2,833
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CT of cervical, thoracic and lumbar spine with contrast. INDICATION: Female aged 70 years with Lower extremity weakness, ro leukemic involvement v. other causes COMPARISON: CT of the abdomen and pelvis 10/8/2021. TECHNIQUE: CT examination of the cervical, thoracic and lumbar spine was performed without contrast and thin cut multiplanar reformats were generated by the technologist and sent to the workstation for review. Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 60 sec Scan field of view: 195 mm. DLP: 440.80 mGy cm. (accession CT220003370), Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 201 mm. DLP: 1284.60 mGy cm. (accession CT220003371), Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 201 mm. DLP: 1227.30 mGy cm. (accession CT220003372) FINDINGS: Cervical spine: Extensive heterogenous attenuation of visualized osseous structures suggesting myelodysplastic/mild proliferative process. Vertebral body heights and alignment are maintained. Craniovertebral junction is within normal limits. No acute or pathologic fractures. Multilevel discogenic, facet related and uncovertebral degenerative changes. Prominent posterior disc osteophyte complexes at C6-C7 with mild spinal canal stenosis. Left facet joint fusion at C3-C4. Chronic grade 1 anterolisthesis of C3 on C4. Mild left C3-C4, bilateral mild C5-C6 and moderate left C6-C7 neural foraminal stenosis. No evidence of abnormal enhancement associated with the cervical spine or the cervical spinal cord. Multiple enlarged cervical lymph nodes index left level 1B cervical lymph node measures approximately 1 cm in short axis (image 99, series 5). Index left level three lymph node measures approximately 1.1 cm in short axis (image 141, series 5). Scattered atherosclerotic calcifications. Otherwise soft tissues of the neck are unremarkable. Visualized portions of the intracranial structures are unremarkable. Thoracic spine: Extensive heterogenous attenuation of osseous structures similar to the cervical spine as described above concerning for myelodysplastic/myeloproliferative process. Otherwise thoracic vertebral body heights and alignment are within normal limits. No acute or pathologic fractures. Multilevel degenerative changes including discogenic and facet related changes. Diffuse idiopathic skeletal hyperostosis involving the mid and lower thoracic spine. No significant spinal canal stenosis or neural foraminal narrowing. No abnormal enhancement within the thoracic spine or thoracic spinal cord. Multiple enlarged mediastinal lymph nodes with index in the subcarinal region measuring 1.2 cm in short axis. Additional enlarged lymph nodes in bilateral axilla and bilateral hila. Trace pericardial fluid. Left subclavian approach venous infusion catheter. Groundglass opacities in bilateral upper lungs. Dependent atelectatic changes at bilateral lung bases. Septal thickening in bilateral upper lungs may suggest fluid overload or pulmonary edema. Coronary atherosclerosis. Lumbar spine: Similar to rest of the visualized osseous structures, visualized lumbosacral and other pelvic osseous structures demonstrate heterogenous attenuation suggesting myelodysplastic/myeloproliferative process. Otherwise lumbar vertebral body heights and alignment are within normal limits. No acute alignment abnormality or acute fractures. Mild multilevel degenerative changes without significant spinal canal stenosis. Mild bilateral neural foraminal narrowing at L4-L5 and L5-S1. Right sacral neural stimulator lead in place. No abnormal osseous or soft tissue enhancement. No abnormal enhancement of the conus medullaris and cauda equina nerve roots. Postcholecystectomy changes. Prominent CBD likely related to postcholecystectomy change. Scattered atherosclerosis. Mild presacral edema. Excreted contrast in bilateral renal collecting systems. Multiple enlarged abdominal and pelvic lymph nodes. Index left para-aortic lymph node just below the level of left renal vein measures approximately 2 cm in short axis (image 127, series 5). CONCLUSION: 1. Extensive heterogenous attenuation involving all the visualized osseous structures including cervical, thoracic and lumbosacral spine suggesting myelodysplastic/myeloproliferative process. This appearance is worsened from prior study dated 10/8/2021. 2. No abnormal osseous enhancement or enhancement of the visualized spinal cord and cauda equina nerve roots as described above. 3. No acute fracture or alignment abnormality or pathologic fractures involving the cervical, thoracic and lumbar spine. 4. Cervical, thoracic and abdominopelvic lymphadenopathy. 4. Additional chronic and incidental findings as described above.
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FINDINGS: Cervical spine: Extensive heterogenous attenuation of visualized osseous structures suggesting myelodysplastic/mild proliferative process. Vertebral body heights and alignment are maintained. Craniovertebral junction is within normal limits. No acute or pathologic fractures. Multilevel discogenic, facet related and uncovertebral degenerative changes. Prominent posterior disc osteophyte complexes at C6-C7 with mild spinal canal stenosis. Left facet joint fusion at C3-C4. Chronic grade 1 anterolisthesis of C3 on C4. Mild left C3-C4, bilateral mild C5-C6 and moderate left C6-C7 neural foraminal stenosis. No evidence of abnormal enhancement associated with the cervical spine or the cervical spinal cord. Multiple enlarged cervical lymph nodes index left level 1B cervical lymph node measures approximately 1 cm in short axis (image 99, series 5). Index left level three lymph node measures approximately 1.1 cm in short axis (image 141, series 5). Scattered atherosclerotic calcifications. Otherwise soft tissues of the neck are unremarkable. Visualized portions of the intracranial structures are unremarkable. Thoracic spine: Extensive heterogenous attenuation of osseous structures similar to the cervical spine as described above concerning for myelodysplastic/myeloproliferative process. Otherwise thoracic vertebral body heights and alignment are within normal limits. No acute or pathologic fractures. Multilevel degenerative changes including discogenic and facet related changes. Diffuse idiopathic skeletal hyperostosis involving the mid and lower thoracic spine. No significant spinal canal stenosis or neural foraminal narrowing. No abnormal enhancement within the thoracic spine or thoracic spinal cord. Multiple enlarged mediastinal lymph nodes with index in the subcarinal region measuring 1.2 cm in short axis. Additional enlarged lymph nodes in bilateral axilla and bilateral hila. Trace pericardial fluid. Left subclavian approach venous infusion catheter. Groundglass opacities in bilateral upper lungs. Dependent atelectatic changes at bilateral lung bases. Septal thickening in bilateral upper lungs may suggest fluid overload or pulmonary edema. Coronary atherosclerosis. Lumbar spine: Similar to rest of the visualized osseous structures, visualized lumbosacral and other pelvic osseous structures demonstrate heterogenous attenuation suggesting myelodysplastic/myeloproliferative process. Otherwise lumbar vertebral body heights and alignment are within normal limits. No acute alignment abnormality or acute fractures. Mild multilevel degenerative changes without significant spinal canal stenosis. Mild bilateral neural foraminal narrowing at L4-L5 and L5-S1. Right sacral neural stimulator lead in place. No abnormal osseous or soft tissue enhancement. No abnormal enhancement of the conus medullaris and cauda equina nerve roots. Postcholecystectomy changes. Prominent CBD likely related to postcholecystectomy change. Scattered atherosclerosis. Mild presacral edema. Excreted contrast in bilateral renal collecting systems. Multiple enlarged abdominal and pelvic lymph nodes. Index left para-aortic lymph node just below the level of left renal vein measures approximately 2 cm in short axis (image 127, series 5).
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SOFT TISSUES: Mild right frontal scalp hematoma, without underlying calvarial fracture. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. SINONASAL CAVITIES: Moderate opacification of the right maxillary sinus, with superimposed mucous retention cyst and bubbly secretions. Mild left frontal sinus and scattered anterior ethmoid air cell mucosal thickening. Mastoid air cells and remaining paranasal sinuses are well aerated.
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2,834
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CT of cervical, thoracic and lumbar spine with contrast. INDICATION: Female aged 70 years with Lower extremity weakness, ro leukemic involvement v. other causes COMPARISON: CT of the abdomen and pelvis 10/8/2021. TECHNIQUE: CT examination of the cervical, thoracic and lumbar spine was performed without contrast and thin cut multiplanar reformats were generated by the technologist and sent to the workstation for review. Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 60 sec Scan field of view: 195 mm. DLP: 440.80 mGy cm. (accession CT220003370), Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 201 mm. DLP: 1284.60 mGy cm. (accession CT220003371), Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 201 mm. DLP: 1227.30 mGy cm. (accession CT220003372) FINDINGS: Cervical spine: Extensive heterogenous attenuation of visualized osseous structures suggesting myelodysplastic/mild proliferative process. Vertebral body heights and alignment are maintained. Craniovertebral junction is within normal limits. No acute or pathologic fractures. Multilevel discogenic, facet related and uncovertebral degenerative changes. Prominent posterior disc osteophyte complexes at C6-C7 with mild spinal canal stenosis. Left facet joint fusion at C3-C4. Chronic grade 1 anterolisthesis of C3 on C4. Mild left C3-C4, bilateral mild C5-C6 and moderate left C6-C7 neural foraminal stenosis. No evidence of abnormal enhancement associated with the cervical spine or the cervical spinal cord. Multiple enlarged cervical lymph nodes index left level 1B cervical lymph node measures approximately 1 cm in short axis (image 99, series 5). Index left level three lymph node measures approximately 1.1 cm in short axis (image 141, series 5). Scattered atherosclerotic calcifications. Otherwise soft tissues of the neck are unremarkable. Visualized portions of the intracranial structures are unremarkable. Thoracic spine: Extensive heterogenous attenuation of osseous structures similar to the cervical spine as described above concerning for myelodysplastic/myeloproliferative process. Otherwise thoracic vertebral body heights and alignment are within normal limits. No acute or pathologic fractures. Multilevel degenerative changes including discogenic and facet related changes. Diffuse idiopathic skeletal hyperostosis involving the mid and lower thoracic spine. No significant spinal canal stenosis or neural foraminal narrowing. No abnormal enhancement within the thoracic spine or thoracic spinal cord. Multiple enlarged mediastinal lymph nodes with index in the subcarinal region measuring 1.2 cm in short axis. Additional enlarged lymph nodes in bilateral axilla and bilateral hila. Trace pericardial fluid. Left subclavian approach venous infusion catheter. Groundglass opacities in bilateral upper lungs. Dependent atelectatic changes at bilateral lung bases. Septal thickening in bilateral upper lungs may suggest fluid overload or pulmonary edema. Coronary atherosclerosis. Lumbar spine: Similar to rest of the visualized osseous structures, visualized lumbosacral and other pelvic osseous structures demonstrate heterogenous attenuation suggesting myelodysplastic/myeloproliferative process. Otherwise lumbar vertebral body heights and alignment are within normal limits. No acute alignment abnormality or acute fractures. Mild multilevel degenerative changes without significant spinal canal stenosis. Mild bilateral neural foraminal narrowing at L4-L5 and L5-S1. Right sacral neural stimulator lead in place. No abnormal osseous or soft tissue enhancement. No abnormal enhancement of the conus medullaris and cauda equina nerve roots. Postcholecystectomy changes. Prominent CBD likely related to postcholecystectomy change. Scattered atherosclerosis. Mild presacral edema. Excreted contrast in bilateral renal collecting systems. Multiple enlarged abdominal and pelvic lymph nodes. Index left para-aortic lymph node just below the level of left renal vein measures approximately 2 cm in short axis (image 127, series 5). CONCLUSION: 1. Extensive heterogenous attenuation involving all the visualized osseous structures including cervical, thoracic and lumbosacral spine suggesting myelodysplastic/myeloproliferative process. This appearance is worsened from prior study dated 10/8/2021. 2. No abnormal osseous enhancement or enhancement of the visualized spinal cord and cauda equina nerve roots as described above. 3. No acute fracture or alignment abnormality or pathologic fractures involving the cervical, thoracic and lumbar spine. 4. Cervical, thoracic and abdominopelvic lymphadenopathy. 4. Additional chronic and incidental findings as described above.
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FINDINGS: Cervical spine: Extensive heterogenous attenuation of visualized osseous structures suggesting myelodysplastic/mild proliferative process. Vertebral body heights and alignment are maintained. Craniovertebral junction is within normal limits. No acute or pathologic fractures. Multilevel discogenic, facet related and uncovertebral degenerative changes. Prominent posterior disc osteophyte complexes at C6-C7 with mild spinal canal stenosis. Left facet joint fusion at C3-C4. Chronic grade 1 anterolisthesis of C3 on C4. Mild left C3-C4, bilateral mild C5-C6 and moderate left C6-C7 neural foraminal stenosis. No evidence of abnormal enhancement associated with the cervical spine or the cervical spinal cord. Multiple enlarged cervical lymph nodes index left level 1B cervical lymph node measures approximately 1 cm in short axis (image 99, series 5). Index left level three lymph node measures approximately 1.1 cm in short axis (image 141, series 5). Scattered atherosclerotic calcifications. Otherwise soft tissues of the neck are unremarkable. Visualized portions of the intracranial structures are unremarkable. Thoracic spine: Extensive heterogenous attenuation of osseous structures similar to the cervical spine as described above concerning for myelodysplastic/myeloproliferative process. Otherwise thoracic vertebral body heights and alignment are within normal limits. No acute or pathologic fractures. Multilevel degenerative changes including discogenic and facet related changes. Diffuse idiopathic skeletal hyperostosis involving the mid and lower thoracic spine. No significant spinal canal stenosis or neural foraminal narrowing. No abnormal enhancement within the thoracic spine or thoracic spinal cord. Multiple enlarged mediastinal lymph nodes with index in the subcarinal region measuring 1.2 cm in short axis. Additional enlarged lymph nodes in bilateral axilla and bilateral hila. Trace pericardial fluid. Left subclavian approach venous infusion catheter. Groundglass opacities in bilateral upper lungs. Dependent atelectatic changes at bilateral lung bases. Septal thickening in bilateral upper lungs may suggest fluid overload or pulmonary edema. Coronary atherosclerosis. Lumbar spine: Similar to rest of the visualized osseous structures, visualized lumbosacral and other pelvic osseous structures demonstrate heterogenous attenuation suggesting myelodysplastic/myeloproliferative process. Otherwise lumbar vertebral body heights and alignment are within normal limits. No acute alignment abnormality or acute fractures. Mild multilevel degenerative changes without significant spinal canal stenosis. Mild bilateral neural foraminal narrowing at L4-L5 and L5-S1. Right sacral neural stimulator lead in place. No abnormal osseous or soft tissue enhancement. No abnormal enhancement of the conus medullaris and cauda equina nerve roots. Postcholecystectomy changes. Prominent CBD likely related to postcholecystectomy change. Scattered atherosclerosis. Mild presacral edema. Excreted contrast in bilateral renal collecting systems. Multiple enlarged abdominal and pelvic lymph nodes. Index left para-aortic lymph node just below the level of left renal vein measures approximately 2 cm in short axis (image 127, series 5).
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Findings: There is a small (1 cm) apparent meningioma along the upper aspect of the right tentorial leaf near its insertion into the petrous bones laterally. The parenchyma appears normal with no other mass and there is no hemorrhage or extracerebral collection. There is preservation of gray-white margins. There is no significant atrophy and ventricles are small with normal appearance. The posterior fossa contents are unremarkable. No defect is seen in the calvarium and skull base. ---------------
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2,835
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CT of cervical, thoracic and lumbar spine with contrast. INDICATION: Female aged 70 years with Lower extremity weakness, ro leukemic involvement v. other causes COMPARISON: CT of the abdomen and pelvis 10/8/2021. TECHNIQUE: CT examination of the cervical, thoracic and lumbar spine was performed without contrast and thin cut multiplanar reformats were generated by the technologist and sent to the workstation for review. Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 60 sec Scan field of view: 195 mm. DLP: 440.80 mGy cm. (accession CT220003370), Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 201 mm. DLP: 1284.60 mGy cm. (accession CT220003371), Patient weight: 182 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 87 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 300 sec Scan field of view: 201 mm. DLP: 1227.30 mGy cm. (accession CT220003372) FINDINGS: Cervical spine: Extensive heterogenous attenuation of visualized osseous structures suggesting myelodysplastic/mild proliferative process. Vertebral body heights and alignment are maintained. Craniovertebral junction is within normal limits. No acute or pathologic fractures. Multilevel discogenic, facet related and uncovertebral degenerative changes. Prominent posterior disc osteophyte complexes at C6-C7 with mild spinal canal stenosis. Left facet joint fusion at C3-C4. Chronic grade 1 anterolisthesis of C3 on C4. Mild left C3-C4, bilateral mild C5-C6 and moderate left C6-C7 neural foraminal stenosis. No evidence of abnormal enhancement associated with the cervical spine or the cervical spinal cord. Multiple enlarged cervical lymph nodes index left level 1B cervical lymph node measures approximately 1 cm in short axis (image 99, series 5). Index left level three lymph node measures approximately 1.1 cm in short axis (image 141, series 5). Scattered atherosclerotic calcifications. Otherwise soft tissues of the neck are unremarkable. Visualized portions of the intracranial structures are unremarkable. Thoracic spine: Extensive heterogenous attenuation of osseous structures similar to the cervical spine as described above concerning for myelodysplastic/myeloproliferative process. Otherwise thoracic vertebral body heights and alignment are within normal limits. No acute or pathologic fractures. Multilevel degenerative changes including discogenic and facet related changes. Diffuse idiopathic skeletal hyperostosis involving the mid and lower thoracic spine. No significant spinal canal stenosis or neural foraminal narrowing. No abnormal enhancement within the thoracic spine or thoracic spinal cord. Multiple enlarged mediastinal lymph nodes with index in the subcarinal region measuring 1.2 cm in short axis. Additional enlarged lymph nodes in bilateral axilla and bilateral hila. Trace pericardial fluid. Left subclavian approach venous infusion catheter. Groundglass opacities in bilateral upper lungs. Dependent atelectatic changes at bilateral lung bases. Septal thickening in bilateral upper lungs may suggest fluid overload or pulmonary edema. Coronary atherosclerosis. Lumbar spine: Similar to rest of the visualized osseous structures, visualized lumbosacral and other pelvic osseous structures demonstrate heterogenous attenuation suggesting myelodysplastic/myeloproliferative process. Otherwise lumbar vertebral body heights and alignment are within normal limits. No acute alignment abnormality or acute fractures. Mild multilevel degenerative changes without significant spinal canal stenosis. Mild bilateral neural foraminal narrowing at L4-L5 and L5-S1. Right sacral neural stimulator lead in place. No abnormal osseous or soft tissue enhancement. No abnormal enhancement of the conus medullaris and cauda equina nerve roots. Postcholecystectomy changes. Prominent CBD likely related to postcholecystectomy change. Scattered atherosclerosis. Mild presacral edema. Excreted contrast in bilateral renal collecting systems. Multiple enlarged abdominal and pelvic lymph nodes. Index left para-aortic lymph node just below the level of left renal vein measures approximately 2 cm in short axis (image 127, series 5). CONCLUSION: 1. Extensive heterogenous attenuation involving all the visualized osseous structures including cervical, thoracic and lumbosacral spine suggesting myelodysplastic/myeloproliferative process. This appearance is worsened from prior study dated 10/8/2021. 2. No abnormal osseous enhancement or enhancement of the visualized spinal cord and cauda equina nerve roots as described above. 3. No acute fracture or alignment abnormality or pathologic fractures involving the cervical, thoracic and lumbar spine. 4. Cervical, thoracic and abdominopelvic lymphadenopathy. 4. Additional chronic and incidental findings as described above.
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FINDINGS: Cervical spine: Extensive heterogenous attenuation of visualized osseous structures suggesting myelodysplastic/mild proliferative process. Vertebral body heights and alignment are maintained. Craniovertebral junction is within normal limits. No acute or pathologic fractures. Multilevel discogenic, facet related and uncovertebral degenerative changes. Prominent posterior disc osteophyte complexes at C6-C7 with mild spinal canal stenosis. Left facet joint fusion at C3-C4. Chronic grade 1 anterolisthesis of C3 on C4. Mild left C3-C4, bilateral mild C5-C6 and moderate left C6-C7 neural foraminal stenosis. No evidence of abnormal enhancement associated with the cervical spine or the cervical spinal cord. Multiple enlarged cervical lymph nodes index left level 1B cervical lymph node measures approximately 1 cm in short axis (image 99, series 5). Index left level three lymph node measures approximately 1.1 cm in short axis (image 141, series 5). Scattered atherosclerotic calcifications. Otherwise soft tissues of the neck are unremarkable. Visualized portions of the intracranial structures are unremarkable. Thoracic spine: Extensive heterogenous attenuation of osseous structures similar to the cervical spine as described above concerning for myelodysplastic/myeloproliferative process. Otherwise thoracic vertebral body heights and alignment are within normal limits. No acute or pathologic fractures. Multilevel degenerative changes including discogenic and facet related changes. Diffuse idiopathic skeletal hyperostosis involving the mid and lower thoracic spine. No significant spinal canal stenosis or neural foraminal narrowing. No abnormal enhancement within the thoracic spine or thoracic spinal cord. Multiple enlarged mediastinal lymph nodes with index in the subcarinal region measuring 1.2 cm in short axis. Additional enlarged lymph nodes in bilateral axilla and bilateral hila. Trace pericardial fluid. Left subclavian approach venous infusion catheter. Groundglass opacities in bilateral upper lungs. Dependent atelectatic changes at bilateral lung bases. Septal thickening in bilateral upper lungs may suggest fluid overload or pulmonary edema. Coronary atherosclerosis. Lumbar spine: Similar to rest of the visualized osseous structures, visualized lumbosacral and other pelvic osseous structures demonstrate heterogenous attenuation suggesting myelodysplastic/myeloproliferative process. Otherwise lumbar vertebral body heights and alignment are within normal limits. No acute alignment abnormality or acute fractures. Mild multilevel degenerative changes without significant spinal canal stenosis. Mild bilateral neural foraminal narrowing at L4-L5 and L5-S1. Right sacral neural stimulator lead in place. No abnormal osseous or soft tissue enhancement. No abnormal enhancement of the conus medullaris and cauda equina nerve roots. Postcholecystectomy changes. Prominent CBD likely related to postcholecystectomy change. Scattered atherosclerosis. Mild presacral edema. Excreted contrast in bilateral renal collecting systems. Multiple enlarged abdominal and pelvic lymph nodes. Index left para-aortic lymph node just below the level of left renal vein measures approximately 2 cm in short axis (image 127, series 5).
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Findings: Lines and Tubes: None. Body Wall and Abdomen: No destructive osseous lesions. Small-moderate hiatal hernia. CT of abdomen and pelvis will be reported separately. Lymph Nodes, Mediastinum and Neck: No axillary adenopathy. No mediastinal adenopathy. A few shotty hilar and right lower lobe bronchial lymph nodes are present. Lungs and Pleura: No pleural effusion. No suspicious appearing pulmonary nodules. Cardiovascular: No central PTE. Moderate-dense coronary artery atherosclerotic calcifications are present. Heart size is normal. No pericardial effusion.
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2,836
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EXAM: CT Chest with contrast CLINICAL INFORMATION: 95-year-old male with left upper lung opacity on chest radiograph. COMPARISON: Chest radiograph 1/4/2022 TECHNIQUE: CT Chest with contrast. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 60 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 2 ml per sec. Scan delay: 65 sec. Scan field of view: 350 mm. DLP: 222.60 mGy cm. FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Right thyroid nodule measuring up to 3.0 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Postsurgical changes from right upper lobectomy. Left upper lobe consolidation with multifocal narrowing and occlusion of the left upper lobe apical segmental bronchi. Atelectatic changes and diffuse bronchial wall thickening and tiny pleural calcifications in the right posterior lung base with areas of subpleural cystic change.. Few scattered calcified granulomas and tree-in-bud opacities. Trace left pleural effusion. No pneumothorax. HEART / VESSELS: Heart size is normal. Atherosclerotic calcifications of the coronary arteries, thoracic aorta and proximal great vessels. MEDIASTINUM / ESOPHAGUS: Surgical clips in the right hilum/mediastinum. No other significant abnormality. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Partially visualized renal cysts bilaterally. Multiple splenic granulomas. Scattered hepatic hypoattenuating lesions too small to accurately characterize. MUSCULOSKELETAL: Chronic degenerative changes of the spine. No aggressive osseous lesion. Hypoplastic/diminutive appearance of the right fifth rib, uncertain significance or etiology. CONCLUSION: 1. Masslike left upper lobe consolidation may represent pneumonia in the appropriate clinical setting, however the imaging appearance is also concerning for primary lung malignancy. Recommend correlation with prior imaging, if available, versus follow-up chest CT in 6-8 weeks after antibiotic treatment (if pursued). Further evaluation with bronchoscopy would be helpful if clinically indicated. 2. Postsurgical changes from right upper lobectomy. 3. Diffuse bronchial wall thickening in the right lower lobe with areas of subpleural cystic change, groundglass opacities, hand punctate calcifications, possibly representing sequela from chronic infection/inflammation or aspiration. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Right thyroid nodule measuring up to 3.0 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Postsurgical changes from right upper lobectomy. Left upper lobe consolidation with multifocal narrowing and occlusion of the left upper lobe apical segmental bronchi. Atelectatic changes and diffuse bronchial wall thickening and tiny pleural calcifications in the right posterior lung base with areas of subpleural cystic change.. Few scattered calcified granulomas and tree-in-bud opacities. Trace left pleural effusion. No pneumothorax. HEART / VESSELS: Heart size is normal. Atherosclerotic calcifications of the coronary arteries, thoracic aorta and proximal great vessels. MEDIASTINUM / ESOPHAGUS: Surgical clips in the right hilum/mediastinum. No other significant abnormality. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Partially visualized renal cysts bilaterally. Multiple splenic granulomas. Scattered hepatic hypoattenuating lesions too small to accurately characterize. MUSCULOSKELETAL: Chronic degenerative changes of the spine. No aggressive osseous lesion. Hypoplastic/diminutive appearance of the right fifth rib, uncertain significance or etiology.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: Please see separately dictated CT chest. ABDOMEN and PELVIS: LIVER: Lateral segment left hepatic lobe cyst. No suspicious liver lesions. Geographic steatosis in the right lobe of BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Right lower pole simple cyst. Additional subcentimeter focus of hypoattenuation in the right upper pole is too small for accurate characterization. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Moderate hiatal hernia. Small bowel is normal in caliber. COLON / APPENDIX: Focal area of wall thickening in the distal transverse colon, for example on image 56 series 2, with subtle soft tissue stranding adjacent. Normal appendix. PERITONEUM / MESENTERY: No ascites. RETROPERITONEUM: Normal. VESSELS: Mild atherosclerotic calcifications of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Lower lumbar spine degenerative changes. No destructive osseous lesions.
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2,837
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EXAM: CT Sinus wo contrast CLINICAL INFORMATION: Male patient 76 years with Sinusitis, chronic or recurrent, J32.9 Chronic sinusitis, unspecified TECHNIQUE: 0.6 mm thick serial axial images of the paranasal sinuses were obtained without intravenous contrast. Sagittal and coronal reformatted views were also obtained. Technique: Scan field of view: 190 mm. DLP: 719 mGy cm. COMPARISON: None available. FINDINGS: There is moderate mucosal thickening within the left frontal sinus and very mild mucosal thickening within the right frontal sinus. There is mild scattered mucosal thickening within both ethmoid air cells. There is very mild mucosal thickening within the left sphenoid sinus and minimal mucosal thickening within the right sphenoid sinus. No air-fluid levels are identified within the sinuses. However within both maxillary sinuses there is circumferential mucosal thickening with small superimposed air-fluid levels, right greater than left. The walls of the paranasal sinuses are intact. There is narrowing with focal occlusion of both ostiomeatal complexes secondary to focal mucosal thickening on inflammatory basis. There is also focal mucosal thickening resulting in occlusion of the ostia of the frontal sinuses. There is mild to moderate rightward deviation of the nasal septum. There is a large right bony spur. However no mass lesion is identified within the nasal cavities. There is no acute abnormality of the orbits. Mastoid air cells are clear bilaterally. There is cerumen within both ear canals. Multiple surgical clips are noted in the region of the right parotid gland suggesting partial right parotidectomy. No acute intracranial abnormality is identified. There is mild generalized atrophy. CONCLUSION: 01. Acute bilateral maxillary sinusitis. There is occlusion of bilateral ostiomeatal complexes secondary to inflammatory changes. 02. Occlusion of bilateral frontal sinus outflow tracts secondary to inflammatory mucosal thickening. However no discrete air-fluid levels are identified within the frontal sinuses.
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FINDINGS: There is moderate mucosal thickening within the left frontal sinus and very mild mucosal thickening within the right frontal sinus. There is mild scattered mucosal thickening within both ethmoid air cells. There is very mild mucosal thickening within the left sphenoid sinus and minimal mucosal thickening within the right sphenoid sinus. No air-fluid levels are identified within the sinuses. However within both maxillary sinuses there is circumferential mucosal thickening with small superimposed air-fluid levels, right greater than left. The walls of the paranasal sinuses are intact. There is narrowing with focal occlusion of both ostiomeatal complexes secondary to focal mucosal thickening on inflammatory basis. There is also focal mucosal thickening resulting in occlusion of the ostia of the frontal sinuses. There is mild to moderate rightward deviation of the nasal septum. There is a large right bony spur. However no mass lesion is identified within the nasal cavities. There is no acute abnormality of the orbits. Mastoid air cells are clear bilaterally. There is cerumen within both ear canals. Multiple surgical clips are noted in the region of the right parotid gland suggesting partial right parotidectomy. No acute intracranial abnormality is identified. There is mild generalized atrophy.
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FINDINGS: STRUCTURED REPORT: CT Adrenal Washout LOWER CHEST: LUNG BASES / PLEURA: Bibasilar scattered subsegmental atelectasis. No focal lung consolidation or pleural effusion.. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN: ADRENALS: There is no discrete adrenal nodule. Dotatate uptake in the left adrenal gland on recent PET is probably physiological. Similar mild uptake is seen in the right adrenal gland. LIVER: Borderline cirrhotic liver morphology. Simple hepatic cysts. No suspicious enhancing solid hepatic lesions. Anomalous segment IV a and segment 2 draining veins are seen, draining into the anterior pericardiac/anterior mediastinal vein. An additional portal venous collaterals seen communicating with this anterior mediastinal vein. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent PANCREAS: Normal. SPLEEN: Normal. KIDNEYS: Kidneys demonstrate symmetric enhancement. Simple right lower pole renal cyst. Small focal cortical defect/scarring in the right renal interpolar region. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach is partially distended. There is no abnormal dilatation of small bowel loops. COLON: No abnormality. PERITONEUM / MESENTERY: No ascites or pneumoperitoneum. RETROPERITONEUM: Normal. VESSELS: Aorta is nonaneurysmal. Aorta, IVC portal, splenic and super mesenteric veins and hepatic veins are patent. Multiple large dilated retroperitoneal portosystemic venous collaterals are seen in the right hemiabdomen. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No acute osseous findings.
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2,838
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CT Angio Head Code Stroke, CT Angio Neck 1/6/2022 4:56 PM Clinical information: blurred vision, LUE weakness Comparison: None available. Technique: 5 mm axial images of the head were obtained without contrast. After the administration of IV contrast bolus, 2.5 mm images were obtained from below the level of the clavicles to the vertex and reformatted in the 1.4 mm overlapping images. Delayed contrast enhanced axial images were then performed from the base of the skull to the vertex. 3-D CT MIP and Volume rendered angiographic images were generated In postprocessing from the axial data set. "Sliding MIP" images were also generated in the sagittal, axial, and coronal planes. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 245.60 mm. DLP: 2519.20 mGy cm. (accession CT220003375), (accession CT220003376) Findings: CTA head: There is a small 3 mm inferiorly directed saccular aneurysm in the ophthalmic segment of right ICA best seen on axial image #658, series 401 and sagittal image #61, series 410. Otherwise bilateral intracranial ICAs, MCAs, ACAs and their proximal branches show no flow-limiting stenosis. Intradural vertebral arteries, basilar artery and both PCAs appear normal. No malformations. CTA Neck: No significant stenosis at the origin of great vessels from the arch of aorta. Bilateral carotid and vertebral arteries show no flow-limiting stenosis or dissection. Impression: 1. 3 mm saccular aneurysm arising from the ophthalmic segment of right ICA. 2. No flow-limiting cervical or intracranial arterial stenosis.
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Findings: CTA head: There is a small 3 mm inferiorly directed saccular aneurysm in the ophthalmic segment of right ICA best seen on axial image #658, series 401 and sagittal image #61, series 410. Otherwise bilateral intracranial ICAs, MCAs, ACAs and their proximal branches show no flow-limiting stenosis. Intradural vertebral arteries, basilar artery and both PCAs appear normal. No malformations. CTA Neck: No significant stenosis at the origin of great vessels from the arch of aorta. Bilateral carotid and vertebral arteries show no flow-limiting stenosis or dissection.
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Findings: The gray-white matter differentiation is intact. There is bilateral basal ganglia and cerebellar mineralization. There is no evidence of acute infarct, hemorrhage, mass or mass effect. The ventricular system and extra-axial spaces appear normal. The visualized paranasal sinuses and mastoid air cells are aerated. Note is made of hyperostosis frontalis interna. No calvarial fracture is identified.
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2,839
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CT Angio Head Code Stroke, CT Angio Neck 1/6/2022 4:56 PM Clinical information: blurred vision, LUE weakness Comparison: None available. Technique: 5 mm axial images of the head were obtained without contrast. After the administration of IV contrast bolus, 2.5 mm images were obtained from below the level of the clavicles to the vertex and reformatted in the 1.4 mm overlapping images. Delayed contrast enhanced axial images were then performed from the base of the skull to the vertex. 3-D CT MIP and Volume rendered angiographic images were generated In postprocessing from the axial data set. "Sliding MIP" images were also generated in the sagittal, axial, and coronal planes. Patient weight: 230 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 245.60 mm. DLP: 2519.20 mGy cm. (accession CT220003375), (accession CT220003376) Findings: CTA head: There is a small 3 mm inferiorly directed saccular aneurysm in the ophthalmic segment of right ICA best seen on axial image #658, series 401 and sagittal image #61, series 410. Otherwise bilateral intracranial ICAs, MCAs, ACAs and their proximal branches show no flow-limiting stenosis. Intradural vertebral arteries, basilar artery and both PCAs appear normal. No malformations. CTA Neck: No significant stenosis at the origin of great vessels from the arch of aorta. Bilateral carotid and vertebral arteries show no flow-limiting stenosis or dissection. Impression: 1. 3 mm saccular aneurysm arising from the ophthalmic segment of right ICA. 2. No flow-limiting cervical or intracranial arterial stenosis.
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Findings: CTA head: There is a small 3 mm inferiorly directed saccular aneurysm in the ophthalmic segment of right ICA best seen on axial image #658, series 401 and sagittal image #61, series 410. Otherwise bilateral intracranial ICAs, MCAs, ACAs and their proximal branches show no flow-limiting stenosis. Intradural vertebral arteries, basilar artery and both PCAs appear normal. No malformations. CTA Neck: No significant stenosis at the origin of great vessels from the arch of aorta. Bilateral carotid and vertebral arteries show no flow-limiting stenosis or dissection.
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Findings: Lines and Tubes: No central line. PFO closure device is present. Body Wall and Abdomen: No destructive osseous lesions. The CT of the abdomen and pelvis will be reported separately. Small hiatal hernia. Lymph Nodes, Mediastinum and Neck: Bilateral breast implants. No axillary adenopathy. No asymmetric axillary skin thickening included. No mediastinal adenopathy. Lungs and Pleura: No pleural effusion. Groundglass density subpleural nodules in both lung bases have a similar appearance. There are a few new tiny calcifications at the lung bases as well. No suspicious appearing pulmonary nodules. Cardiovascular: No central PTE, pericardial effusion, or dense coronary artery atherosclerotic calcifications.
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2,840
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CT Head wo No Charge 1/6/2022 4:38 PM Clinical Information: Blurred vision, LUE weakness Comparison: None available Technique: Unenhanced axial brain CT with coronal and sagittal reconstructions. Scan field of view: 247.50 mm. DLP: 1446 mGy cm. Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality. Impression: No CT evidence of acute intracranial abnormality.
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Findings: There is no evidence of acute infarction, hemorrhage or hydrocephalus. There is no vasogenic edema or mass effect. The visualized paranasal sinuses and mastoid air cells are clear. There is no acute osseous abnormality.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis CHEST: Chest findings will be reported separately. ABDOMEN and PELVIS: LIVER: Normal. No suspicious hepatic lesion. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: No abnormal parenchymal enhancement. The main duct is normal in caliber. The simple cystic lesion inferior to the pancreatic head/body junction measures 1.1 cm (series 9, image 264), unchanged in size compared to 2018, likely sidebranch IPMN. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. 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: Uterus is surgically absent. BODY WALL: Tiny fat-containing umbilical hernia. MUSCULOSKELETAL: No aggressive osseous lesion.
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2,841
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CT Perfusion 1/6/2022 4:43 PM Clinical Information: Blurred vision, LUE weakness Comparison: No prior perfusion studies are available for comparison. Technique: A CT perfusion study was performed during single pass of 40 cc contrast bolus. Axial images were acquired at 16 axial locations and time-attenuation curves generated from this dataset were utilized to calculate cerebral blood flow, mean transit time, time to peak, and cerebral blood volume maps as well as region of interest specific quantitative data. "Prognostic" color maps were also generated using RAPID processing software Patient weight: 230 lbs. IV contrast: Omnipaque 350, 40 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 0 sec Scan field of view: 232.60 mm. DLP: 1440 mGy cm. Findings: RAPID images demonstrate CBF less than 30% volume: 0 ml and T. Max greater than 6seconds volume: 0 ml . Mismatch volume is 0 ml. There is no abnormal MTT, T max, CBV and CBF to suggest significant ischemia or infarction at the territory of the major intracranial arteries. Conclusion: No significant ischemia or infarction at the territory of major intracranial arteries.
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Findings: RAPID images demonstrate CBF less than 30% volume: 0 ml and T. Max greater than 6seconds volume: 0 ml . Mismatch volume is 0 ml. There is no abnormal MTT, T max, CBV and CBF to suggest significant ischemia or infarction at the territory of the major intracranial arteries.
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FINDINGS: STRUCTURED REPORT: CT Chest LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Left basilar subsegmental atelectasis. Diffuse increased peribronchial thickening is present. There is no pleural effusion or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. Tiny air in the anterior mediastinum noted previously is not identified. The thoracic esophagus appears normal without any extraluminal contrast noted. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Cholelithiasis. MUSCULOSKELETAL: Unchanged appearance of left scapular and clavicular fractures with associated subclavicular hematoma. Minimally displaced left lateral second through sixth rib fractures.
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2,842
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CT Head wo contrast Clinical Information: visual hallucinations Comparison: 1/5/2022 Technique: Unenhanced axial brain CT with sagittal and coronal reformats. Scan field of view: 212 mm. DLP: 1032 mGy cm. Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Mild periventricular hypoattenuation, consistent with chronic microangiopathic change. Mild global cerebral volume loss. EXTRA-AXIAL SPACES: There is a small area of hyperattenuation within a frontal lobe sulcus, best seen on series 2 image 38. No mass effect is seen. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal. Conclusion: 1. New small volume subarachnoid hemorrhage along right frontal sulcus. 2. Chronic changes as outlined above. Ordering physician could not be contacted to convey the findings. 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 head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. Mild periventricular hypoattenuation, consistent with chronic microangiopathic change. Mild global cerebral volume loss. EXTRA-AXIAL SPACES: There is a small area of hyperattenuation within a frontal lobe sulcus, best seen on series 2 image 38. No mass effect is seen. SKULL AND SKULL BASE: No acute fracture. No aggressive osseous lesion. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Normal.
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FINDINGS/CONCLUSION: Nondisplaced fracture of the cuboid extending into the calcaneocuboid joint. Numerous small osseous fragments are present inferior to the medial malleolus possibly representing avulsion fractures of indeterminate age. Well-corticated ossific fragments are present adjacent to the posterior medial navicular, possibly representing a variant os navicularis. The ankle mortise is maintained. Os peroneum. Dorsal and plantar calcaneal enthesopathy. Soft tissue swelling of the ankle and dorsum of the foot.
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2,843
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EXAM: CT Chest wo contrast CLINICAL INFORMATION: 60-year-old female with dyspnea on exertion, flu positive. Patient has a history of multiple myeloma with known mediastinal mass. COMPARISON: PET/CT dated 10/26/2021. TECHNIQUE: CT Chest wo contrast. Scan field of view: 345 mm. DLP: 365 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. The posterior mediastinal mass measures 8 x 10.4 cm and series 3 image 34 [10.8 cm on coronal series 4 image 56] and was 7.5 x 10.5 cm on the previous PET/CT. The mass compresses the trachea in the proximal portions of both right main stem bronchi splaying the carina. Mass also markedly compresses the esophagus with dilatation of the upper esophagus with an air-fluid level present. The mass encases the proximal descending thoracic aorta. Additional lower left paraspinal mass is 5.6 x 7.7 cm on image 55 and was 5 x 7.9 cm on the prior excluding the partially encased mid descending thoracic aorta. An additional small mass is seen to the right of the distal descending aorta just above the hiatus measuring 2.1 x 3.1 cm on image 77 increased from the prior exam where it was 1.6 x 2.4 cm. No additional adenopathy is identified on this noncontrast exam. The heart size and the mediastinum are otherwise normal within the limits of a noncontrast exam. Large loculated left pleural effusion has increased in size and extends into the major fissure. Atelectasis is seen in most of the left lower lobe. Peripheral pleural-based nodule is present in the left upper lobe measuring approximately 1.1 x 1.9 cm on image 31. A few tiny nodules are also seen in the left lung apex such as on images 20 and 26. Focal opacity is also seen dependently in the right lung base most suggestive of atelectasis. Mild bilateral mosaic attenuation is noted. Limited noncontrast images of the upper abdomen are unremarkable. Tip of the left-sided PICC line projects proximal SVC. The innominate vein is compressed and venous collaterals are seen in both sides of the anterior chest wall. An old healed left rib fracture is again seen. Focal lytic lesion with sclerosis is seen in the right side of the sternum. This is present on the previous PET/CT. No additional lytic or blastic lesions are identified. CONCLUSION: 1. Large posterior mediastinal mass with mass effect on the esophagus and trachea is redemonstrated with no significant change in size. 2. Left paraspinal mass is also not significantly changed in size. Smaller mass adjacent to the aorta at the hiatus has increased in size. 3. Marked increase in left pleural effusion which is now large and extending over the apex with compressive atelectasis of most of the left lower lobe. 4. Pleural-based left upper lobe nodule just beneath the lateral left second rib corresponds to an area of slightly increased FDG activity on the previous exam 5. Incidental findings as above.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. The posterior mediastinal mass measures 8 x 10.4 cm and series 3 image 34 [10.8 cm on coronal series 4 image 56] and was 7.5 x 10.5 cm on the previous PET/CT. The mass compresses the trachea in the proximal portions of both right main stem bronchi splaying the carina. Mass also markedly compresses the esophagus with dilatation of the upper esophagus with an air-fluid level present. The mass encases the proximal descending thoracic aorta. Additional lower left paraspinal mass is 5.6 x 7.7 cm on image 55 and was 5 x 7.9 cm on the prior excluding the partially encased mid descending thoracic aorta. An additional small mass is seen to the right of the distal descending aorta just above the hiatus measuring 2.1 x 3.1 cm on image 77 increased from the prior exam where it was 1.6 x 2.4 cm. No additional adenopathy is identified on this noncontrast exam. The heart size and the mediastinum are otherwise normal within the limits of a noncontrast exam. Large loculated left pleural effusion has increased in size and extends into the major fissure. Atelectasis is seen in most of the left lower lobe. Peripheral pleural-based nodule is present in the left upper lobe measuring approximately 1.1 x 1.9 cm on image 31. A few tiny nodules are also seen in the left lung apex such as on images 20 and 26. Focal opacity is also seen dependently in the right lung base most suggestive of atelectasis. Mild bilateral mosaic attenuation is noted. Limited noncontrast images of the upper abdomen are unremarkable. Tip of the left-sided PICC line projects proximal SVC. The innominate vein is compressed and venous collaterals are seen in both sides of the anterior chest wall. An old healed left rib fracture is again seen. Focal lytic lesion with sclerosis is seen in the right side of the sternum. This is present on the previous PET/CT. No additional lytic or blastic lesions are identified.
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Findings: CTA neck: The top of the aortic arch and the brachiocephalic arteries have have expected appearance. No aneurysm, AVM or intrinsic vascular lesion expected appearance. The common carotid arteries and bifurcations are essentially negative. The cervical ICAs are normal. Both vertebral arteries are sizable with no apparent defect. CTA head: The precavernous and cavernous ICAs appear normal. The supraclinoid ICAs and the proximal ACAs, MCA's and PCAs also appear normal. The basilar artery and its branches have expected appearance. No aneurysm, AVM or intrinsic vascular lesion is seen. ----------------
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2,844
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CT angiography of the pulmonary arteries to exclude PTE Indication:Tachycardia, abnormal EKG, high probability PE suspected Technique: A scout image was obtained for localization, before injection of contrast medium. 1.5 mm axial images were obtained. Coronal reformatted images were also reconstructed and reviewed. Additional 3D post processing was done with MIP images generated and reviewed for interpretation. Contrast:Patient weight: 180 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 10 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 353 mm. KVP: 110 DLP: 342 mGy cm. KVP:110 The quality of the examination is good with some streak artifact over both main pulmonary arteries. No pulmonary thromboembolism is identified. The main pulmonary artery is normal in caliber. No CT evidence of right heart strain. No enlarged intrathoracic lymph nodes are identified. Minimal coronary artery calcification is seen. The heart size and the mediastinum are otherwise normal. No pleural effusion. 5 mm peripheral RML nodule is seen on series 7 image 114. A 5 x 6 mm nodule is present along the right major fissure on image 86. The lungs are otherwise normal. Limited images of the upper abdomen are unremarkable. No focal destructive osseous abnormality. Impression: 1. No evidence of pulmonary thromboembolism. 2. 5 mm peripheral RML nodule is present in a 5 x 6 mm nodule is present along the right major fissure which is most consistent with intrapulmonary lymph node. For a peripheral less than 6 mm nodule if patient is at low risk no additional follow-up is needed. If patient is at high risk for lung cancer an optional CT at 12 months should be considered.
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The quality of the examination is good with some streak artifact over both main pulmonary arteries. No pulmonary thromboembolism is identified. The main pulmonary artery is normal in caliber. No CT evidence of right heart strain. No enlarged intrathoracic lymph nodes are identified. Minimal coronary artery calcification is seen. The heart size and the mediastinum are otherwise normal. No pleural effusion. 5 mm peripheral RML nodule is seen on series 7 image 114. A 5 x 6 mm nodule is present along the right major fissure on image 86. The lungs are otherwise normal. Limited images of the upper abdomen are unremarkable. No focal destructive osseous abnormality.
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Findings: CTA neck: The top of the aortic arch and the brachiocephalic arteries have have expected appearance. No aneurysm, AVM or intrinsic vascular lesion expected appearance. The common carotid arteries and bifurcations are essentially negative. The cervical ICAs are normal. Both vertebral arteries are sizable with no apparent defect. CTA head: The precavernous and cavernous ICAs appear normal. The supraclinoid ICAs and the proximal ACAs, MCA's and PCAs also appear normal. The basilar artery and its branches have expected appearance. No aneurysm, AVM or intrinsic vascular lesion is seen. ----------------
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2,845
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CT Head wo contrast 1/7/2022 1:48 AM Clinical Information: SP craniotomy Comparison: CT head 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: 200 mm. DLP: 537.20 mGy cm. Findings: Interval postsurgical changes of anterior frontal intracranial mass resection with surgical packing material within the resection cavity. Extra-axial gas and fluid collections in the anterior frontal region. Changes related to bifrontal craniotomy. Scattered blood product in the postsurgical region. Right frontal approach EVD in place with tip terminating at the roof of third ventricle/foramen of Munro. Stable appearance of bifrontal vasogenic edema. Stable ventriculomegaly. Gas in the ventricles and other scattered pneumocephalus in the intracranial compartment. No unexpected findings in the intracranial compartment. Stable appearance of left intraconal orbital mass. Stable calcifications within the left globe. Partially visualized left maxillary/nasal passage mass seen on prior study. Otherwise visualized paranasal sinuses, mastoid air cells and middle ear cavities are unremarkable. Right orbit is unremarkable. Surgical drain in the left frontal scalp with adjacent multiple pockets of gas and scattered scalp hemorrhage. Conclusion: 1. Postsurgical changes related to anterior frontal mass resection with extensive changes in frontal region, not unexpected for recent postsurgical changes. Bifrontal vasogenic edema is stable. 2. Interval placement of right transverse frontal EVD with tip terminating at the level of foramen Monro/roof of third ventricle with stable ventriculomegaly. 3. Stable appearance of left orbital intraconal mass. Partially visualized left maxillary/nasal passage mass.
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Findings: Interval postsurgical changes of anterior frontal intracranial mass resection with surgical packing material within the resection cavity. Extra-axial gas and fluid collections in the anterior frontal region. Changes related to bifrontal craniotomy. Scattered blood product in the postsurgical region. Right frontal approach EVD in place with tip terminating at the roof of third ventricle/foramen of Munro. Stable appearance of bifrontal vasogenic edema. Stable ventriculomegaly. Gas in the ventricles and other scattered pneumocephalus in the intracranial compartment. No unexpected findings in the intracranial compartment. Stable appearance of left intraconal orbital mass. Stable calcifications within the left globe. Partially visualized left maxillary/nasal passage mass seen on prior study. Otherwise visualized paranasal sinuses, mastoid air cells and middle ear cavities are unremarkable. Right orbit is unremarkable. Surgical drain in the left frontal scalp with adjacent multiple pockets of gas and scattered scalp hemorrhage.
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Findings: The parenchyma appears normal with no mass, hemorrhage, visible infarct or extracerebral collection. There is preservation of gray-white margins. This is seen in the white matter. There are features of Chiari I malformation. The posterior fossa contents are otherwise unremarkable ---------------
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2,846
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CT Head wo contrast 1/6/2022 4:54 PM Clinical information: HA Comparison: CT head 1/6/2004. Technique: 5 mm axial images were obtained without contrast from the base of the skull to the vertex with sagittal and coronal reformats. Scan field of view: 231 mm. DLP: 1136 mGy cm. Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. There is white matter hypoattenuation in right frontal lobe, along previous biopsy tract. Small hypodensity in the left frontal lobe, likely microangiopathy or sequela of old traumatic brain injury. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal. Impression: No CT evidence of acute intracranial abnormality.
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Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. There is white matter hypoattenuation in right frontal lobe, along previous biopsy tract. Small hypodensity in the left frontal lobe, likely microangiopathy or sequela of old traumatic brain injury. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal.
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Findings: There is normal CBV and CBF and Tmax times are normal. Color parametric maps show no ischemia or area predicted infarction. ---------------
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2,847
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Right lower quadrant pain COMPARISON: CT of the abdomen and pelvis without contrast dated 9/4/2019 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 140 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 330 mm. DLP: 396 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Stable lingular pulmonary nodule measuring 5 mm, grossly unchanged dating back to 8/29/2019. 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: Bilateral inguinal adenopathy and left external iliac lymph nodes are not significantly changed. STOMACH / SMALL BOWEL: No focal abnormality. The appendix is normal. COLON / APPENDIX: There is a round fat density structure adjacent to the sigmoid colon in the right lower quadrant measuring 1 cm in diameter with an high density rim with minimal adjacent fat stranding (series 301, image 258). There is no adjacent colonic wall thickening. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Peripherally enhancing round fat density adjacent to the sigmoid colon with minimal adjacent stranding may represent epiploic appendigitis in this patient with right lower quadrant pain. 2. Nonspecific bilateral inguinal adenopathy is not significantly changed. 3. Additional findings above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Stable lingular pulmonary nodule measuring 5 mm, grossly unchanged dating back to 8/29/2019. 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: Bilateral inguinal adenopathy and left external iliac lymph nodes are not significantly changed. STOMACH / SMALL BOWEL: No focal abnormality. The appendix is normal. COLON / APPENDIX: There is a round fat density structure adjacent to the sigmoid colon in the right lower quadrant measuring 1 cm in diameter with an high density rim with minimal adjacent fat stranding (series 301, image 258). There is no adjacent colonic wall thickening. 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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FINDINGS: The previously seen right extra-axial hemorrhages now form a confluent chronic right cranial convexity subdural hematoma measuring up to 9 mm (series 2, image 41) likely secondary to redistribution or mild interval progression. No midline shift or hydrocephalus. Unchanged ex vacuo ventriculomegaly. The previously seen left frontal convexity extra-axial hemorrhage has resolved. No new infarct, hemorrhage, or mass. Chronic lacunar infarcts bilaterally. Mild patchy white matter hypodensities seen in the bilateral cerebral white matter, reflecting chronic microangiopathic changes. Paranasal sinuses are well-aerated. Bilateral mastoid air cells are clear. Normal soft tissues. No acute fractures or suspicious osseous lesions. Normal orbits.
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2,848
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EXAM: CT Pelvis wo IV contrast CLINICAL INFORMATION: Renal transplant evaluation. COMPARISON: None. TECHNIQUE: CT Pelvis wo IV contrast. Scan delay: 0 sec. Scan field of view: 400 mm. DLP: 485.20 mGy cm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Pelvis Renal Transplant VASCULATURE: LOWER ABDOMINAL AORTA: Moderate calcified atherosclerotic disease. RIGHT COMMON / INTERNAL ILIAC ARTERIES: Mild calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: Mild calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: Moderate calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: Mild calcified atherosclerotic disease. LOWER ABDOMEN: BOWEL: Large amount of stool in the rectum, which can be seen with constipation/impaction. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Not fully distended. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild body wall edema. MUSCULOSKELETAL: Multilevel degenerative disc disease. CONCLUSION: 1. Mild calcific atherosclerotic disease of the bilateral external iliac arteries. 2. Large volume stool in the rectum, which could represent impaction/constipation the appropriate clinical setting.
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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: Moderate calcified atherosclerotic disease. RIGHT COMMON / INTERNAL ILIAC ARTERIES: Mild calcified atherosclerotic disease. RIGHT EXTERNAL ILIAC ARTERY: Mild calcified atherosclerotic disease. LEFT COMMON / INTERNAL ILIAC ARTERIES: Moderate calcified atherosclerotic disease. LEFT EXTERNAL ILIAC ARTERY: Mild calcified atherosclerotic disease. LOWER ABDOMEN: BOWEL: Large amount of stool in the rectum, which can be seen with constipation/impaction. PERITONEUM: Normal. OTHER: No other abnormality. PELVIS: LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Not fully distended. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Mild body wall edema. MUSCULOSKELETAL: Multilevel degenerative disc disease.
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Findings: Hypoattenuation associated with the large left MCA distribution infarct is again noted. There is no significant superimposed hemorrhagic transformation. There is localized mass effect with a 3 mm rightward midline shift. There is minimal effacement of the left lateral ventricle. There is no hydrocephalus. The visualized paranasal sinuses and mastoid air cells are clear.
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2,849
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Worsening shortness of breath and hypoxia, evaluate for pulmonary embolism. COMPARISON: Chest CT dated 5/12/2021 TECHNIQUE: CT Angio Chest wo+w contrast. Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 83 lbs. IV contrast: Omnipaque 350, 50 ml, per protocol. Saline flush: 90 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: bolus tracked Scan field of view: 264 mm. KVP: 90.15 DLP: 103 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: Trachea and central airways are patent. Redemonstration of diffuse centrilobular emphysema with paraseptal emphysema at the lung apices.. There is interval development of bilateral bronchial wall thickening, more prominently affecting the bilateral lower lobes.. Diffuse areas of tree-in-bud nodularity, particularly at the bilateral lower lobes. HEART / OTHER VESSELS: Right internal jugular implantable venous access device with tip in the lower SVC. Left internal jugular central venous line also with tip in the lower SVC. MEDIASTINUM / ESOPHAGUS: Calcified mediastinal lymph nodes. LYMPH NODES: None enlarged. CHEST WALL: Mild body wall edema. UPPER ABDOMEN: Calcified granulomas in the spleen. MUSCULOSKELETAL: Osseous demineralization. Chronic moderate compression deformity of the T9 vertebral body with approximately 50% height loss. CONCLUSION: 1. No evidence of pulmonary thromboembolism. 2. Bronchial wall thickening and bilateral tree in bud opacities, concerning for atypical or viral respiratory infection on a background of emphysematous changes.
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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: Trachea and central airways are patent. Redemonstration of diffuse centrilobular emphysema with paraseptal emphysema at the lung apices.. There is interval development of bilateral bronchial wall thickening, more prominently affecting the bilateral lower lobes.. Diffuse areas of tree-in-bud nodularity, particularly at the bilateral lower lobes. HEART / OTHER VESSELS: Right internal jugular implantable venous access device with tip in the lower SVC. Left internal jugular central venous line also with tip in the lower SVC. MEDIASTINUM / ESOPHAGUS: Calcified mediastinal lymph nodes. LYMPH NODES: None enlarged. CHEST WALL: Mild body wall edema. UPPER ABDOMEN: Calcified granulomas in the spleen. MUSCULOSKELETAL: Osseous demineralization. Chronic moderate compression deformity of the T9 vertebral body with approximately 50% height loss.
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Findings: Lines and Tubes: None. Body Wall and Abdomen: No destructive osseous lesions. Cirrhotic liver, splenomegaly, varices, and ascites are present within the included portions of the upper abdomen, also seen on CT 1/19/2022. Lymph Nodes, Mediastinum and Neck: Mild symmetric gynecomastia. No axillary or mediastinal adenopathy. Lungs and Pleura: No pleural effusion. Right lower lobe nodule measures 3.0 x 2.1 cm image 79 series 201. Cardiovascular: Heart size is normal. Moderate coronary artery atherosclerotic calcifications. No large pericardial effusion.
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2,850
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: assault COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 230 mm. DLP: 1306.90 mGy cm. (accession CT220003388), Scan field of view: 184 mm. DLP: 1071.30 mGy cm. (accession CT220003389) STRUCTURED REPORT: CT Head Trauma 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. CT maxillofacial: There is irregularity of the left nasal bone, likely old fracture There is no acute maxillofacial or mandibular fracture. There is no evidence of orbital soft tissue injury. The paranasal sinuses, middle ears, mastoid antra and mastoid air cells are clear. There is left infraorbital soft tissue contusion. CONCLUSION: No acute intracranial process. No acute maxillofacial fracture. Left infraorbital soft tissue contusion.
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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. CT maxillofacial: There is irregularity of the left nasal bone, likely old fracture There is no acute maxillofacial or mandibular fracture. There is no evidence of orbital soft tissue injury. The paranasal sinuses, middle ears, mastoid antra and mastoid air cells are clear. There is left infraorbital soft tissue contusion.
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FINDINGS: Straightening of normal cervical lordosis which could be positional. Mild retrolisthesis of C4 on C5 and C7 on T1. Anterior cervical discectomy and fusion hardware at C5-C7. The left C7 screw head is not flush with the plate, as seen on prior radiograph. No other hardware complication is identified. Soft tissues are unremarkable. Craniocervical junction: Normal atlantodental interval. The occipital condyles are well-seated on the lateral masses. The basion-dens interval is maintained. Mild multilevel uncovertebral hypertrophy most prominent at C4-C5. Multilevel facet arthropathy most prominent at C2-C5.
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2,851
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: assault COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrastScan field of view: 230 mm. DLP: 1306.90 mGy cm. (accession CT220003388), Scan field of view: 184 mm. DLP: 1071.30 mGy cm. (accession CT220003389) STRUCTURED REPORT: CT Head Trauma 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. CT maxillofacial: There is irregularity of the left nasal bone, likely old fracture There is no acute maxillofacial or mandibular fracture. There is no evidence of orbital soft tissue injury. The paranasal sinuses, middle ears, mastoid antra and mastoid air cells are clear. There is left infraorbital soft tissue contusion. CONCLUSION: No acute intracranial process. No acute maxillofacial fracture. Left infraorbital soft tissue contusion.
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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. CT maxillofacial: There is irregularity of the left nasal bone, likely old fracture There is no acute maxillofacial or mandibular fracture. There is no evidence of orbital soft tissue injury. The paranasal sinuses, middle ears, mastoid antra and mastoid air cells are clear. There is left infraorbital soft tissue contusion.
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Findings: A borderline enlarged right paratracheal node is present on series 3 image 69. Calcified nodes are seen in the subcarinal and left hilar regions. No additional enlarged hilar or mediastinal nodes are present. The mediastinum is otherwise normal. A few calcified granuloma are present. A noncalcified 5.8 x 5.8 mm nodule is present in the RML on series 3 image 91. A small nodule is seen along the left major fissure on image 134, consistent with benign intrapulmonary lymph node. The lungs are otherwise normal. Coronary artery calcification: The visual score of calcification is 9. (Based on a publication by Kirsch et al (Detection of Coronary calcium During Standard Chest Computed Tomography Correlates With Multi-Detector Computed Tomography Coronary Artery Calcium score, Int J Cardiovasc Imaging (2012) 28:1249-1256), visual score >7 is associated with an Agatston score > 400 and independently validated increased incidence of cardiovascular mortality). The visualized liver, spleen, adrenals, and bowel are unremarkable. Bones: No significant osseous abnormality.
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2,852
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EXAM: CT Pelvis with contrast CLINICAL INFORMATION: 55-year-old female with abnormal finding on bilateral lower extremity venous ultrasound. COMPARISON: Prior same-day bilateral lower extremity venous ultrasound. TECHNIQUE: CT Pelvis with contrast. Patient weight: 220 lbs. IV contrast: Omnipaque 350, 145 ml, per protocol. Saline flush: 80 ml. IV contrast injection rate: 3.50 ml per sec. Scan delay: 100 sec Scan field of view: 380 mm. DLP: 467.80 mGy cm. FINDINGS: STRUCTURED REPORT: CT Pelvis LOWER ABDOMEN: BOWEL: No abnormality. Appendix is normal. PERITONEUM: Trace free fluid in the pelvis. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. Visualized portions of bilateral common femoral veins are normal in appearance. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Foley catheter in place. Foley balloon appears hypoinflated. Small volume intraluminal air is likely secondary to instrumentation. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: No acute findings in the 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 Pelvis LOWER ABDOMEN: BOWEL: No abnormality. Appendix is normal. PERITONEUM: Trace free fluid in the pelvis. OTHER: No other abnormality. PELVIS: VESSELS: No significant abnormality. Visualized portions of bilateral common femoral veins are normal in appearance. LYMPH NODES: None enlarged. PERIRECTAL / PERIANAL REGION: Normal. URINARY BLADDER: Foley catheter in place. Foley balloon appears hypoinflated. Small volume intraluminal air is likely secondary to instrumentation. REPRODUCTIVE ORGANS: Uterus is surgically absent. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: LINES AND TUBES: None. LOWER NECK: A hypodense right thyroid nodule measures up to 22 mm. CHEST: LUNGS / AIRWAYS / PLEURA: Patchy peripheral groundglass opacities with tree-in-bud nodularity is most pronounced in the posterior segment of the right upper lobe with scattered involvement of the periphery of the posterior right lower lobe. No effusions or pneumothorax. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: Enlarged partially calcified right infrahilar lymph node measuring 2.3 x 2.3 x 3.7 cm best seen on image #67. CHEST WALL: No significant abnormality. Additional small scattered hilar lymph nodes. UPPER ABDOMEN: No acute abnormalities. MUSCULOSKELETAL: No significant abnormality. No focal destructive lesions.
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2,853
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EXAM: CT Head wo contrast CLINICAL INFORMATION: CT Head wo contrast 1/6/2022 5:30 PM Clinical information: AMS Comparison: None available. Technique: 5 mm axial images were obtained without contrast from the base of the skull to the vertex with sagittal and coronal reformats. Scan field of view: 238 mm. DLP: 1179.20 mGy cm. Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Small hypodensities in the left cerebellum. The hypoattenuation in the superior cerebellum appears continuous with the cerebellar sulcus. Hypoattenuation in the left inferior cerebellum may represent a chronic lacunar infarct. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal. Impression: No CT evidence of acute intracranial abnormality. Small hypoattenuation in the left inferior cerebellum may represent a chronic lacunar infarct.
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Findings: There is no evidence of acute intracranial hemorrhage, infarction, brain edema, mass effect or hydrocephalus. Small hypodensities in the left cerebellum. The hypoattenuation in the superior cerebellum appears continuous with the cerebellar sulcus. Hypoattenuation in the left inferior cerebellum may represent a chronic lacunar infarct. The visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Normal in size without pericardial effusion. Moderate coronary artery atherosclerotic calcification. ABDOMEN and PELVIS: LIVER: Noncirrhotic. No evidence of steatosis. Hypoattenuating lesion in the right hepatic dome measures 1.5 x 1.3 cm (series 3, image 10), and demonstrates internal enhancement. Evaluation is limited due to single post contrast phase. Multiple subcentimeter peripheral hepatic cysts are seen. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Numerous bilateral renal cysts, consistent with history of ESRD. Evaluation of subcentimeter lesions is somewhat limited. However, no suspicious renal parenchymal enhancement is visualized. There is no hydronephrosis bilaterally. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. The appendix appears surgically absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Collapsed but otherwise normal. REPRODUCTIVE ORGANS: Borderline prostatomegaly. BODY WALL: Fat-containing periumbilical hernia. Subcutaneous cyst along the left upper quadrant anterior abdominal wall. MUSCULOSKELETAL: Osseous changes consistent with renal osteodystrophy. No aggressive osseous lesions.
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2,854
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 35-year-old male with diarrhea and abdominal pain, sepsis. COMPARISON: CT abdomen pelvis dated 12/17/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 124 lbs. IV contrast: Omnipaque 350, 80 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70sec Scan field of view: 384 mm. DLP: 306 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Consolidation with air bronchogram in the lingula. Filling defects in the bronchioles of the lingula. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Partially collapsed limiting evaluation. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach is normal. Duodenal diverticulum is seen again. The small bowel is normal in caliber. COLON / APPENDIX: The colon is normal. Appendix is not seen. PERITONEUM / MESENTERY: Moderate volume ascites, increased from prior. No free air. RETROPERITONEUM: Normal. VESSELS: Aberrant common hepatic artery arising from the aorta. URINARY BLADDER: Circumferential wall thickening is increased from prior. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Anasarca. MUSCULOSKELETAL: Acute displaced fractures of the right iliac bone including the iliac crest. Chronic healed left eighth rib deformity. CONCLUSION: 1. New wall thickening of the urinary bladder may reflect cystitis in the proper clinical setting. 2. Acute displaced fractures of the right iliac bone. 3. Consolidation with air bronchogram in the lingula likely represents atelectasis from mucous plugging or aspiration. 4. Moderate volume ascites is increased from prior. Similar anasarca. The findings were discussed with NP Brittney Machowicz by Dr. Jason Davis via telephone on 1/7/2022 5:45 AM. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Consolidation with air bronchogram in the lingula. Filling defects in the bronchioles of the lingula. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Partially collapsed limiting evaluation. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Stomach is normal. Duodenal diverticulum is seen again. The small bowel is normal in caliber. COLON / APPENDIX: The colon is normal. Appendix is not seen. PERITONEUM / MESENTERY: Moderate volume ascites, increased from prior. No free air. RETROPERITONEUM: Normal. VESSELS: Aberrant common hepatic artery arising from the aorta. URINARY BLADDER: Circumferential wall thickening is increased from prior. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Anasarca. MUSCULOSKELETAL: Acute displaced fractures of the right iliac bone including the iliac crest. Chronic healed left eighth rib deformity.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis Chest findings to be dictated separately. ABDOMEN and PELVIS: LIVER: Mild focal fat is seen along the falciform ligament. No suspicious hepatic 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: Mostly collapsed but otherwise normal. REPRODUCTIVE ORGANS: Uterus is normal. No adnexal mass lesions. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No aggressive osseous lesions.
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2,855
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Covid confirmed dyspnea. Right greater than left lower extremity edema. COMPARISON: Chest radiograph from the same day. 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: 350 mm. KVP: 100 DLP: 329.30 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. There is respiratory motion artifact. Bolus timing is optimal. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is extensive bilateral groundglass and consolidative opacities which are slightly worse on the right than the left. No effusion or pneumothorax. The airways are patent. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: There is mild mediastinal lymphadenopathy. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Multilevel degenerative changes in the thoracic spine. No acute osseous abnormality evident. CONCLUSION: 1. Exam is degraded due to respiratory motion artifact. No PTE is visualized. 2. Extensive bilateral groundglass and some consolidative opacities compatible with multifocal Covid pneumonia. Mild mediastinal lymphadenopathy may be reactive.
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FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Moderately suboptimal quality with incomplete evaluation of segmental and subsegmental pulmonary arteries. There is respiratory motion artifact. Bolus timing is optimal. LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus LUNGS / AIRWAYS / PLEURA: There is extensive bilateral groundglass and consolidative opacities which are slightly worse on the right than the left. No effusion or pneumothorax. The airways are patent. HEART / OTHER VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Small hiatal hernia. LYMPH NODES: There is mild mediastinal lymphadenopathy. CHEST WALL: No significant abnormality. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Multilevel degenerative changes in the thoracic spine. No acute osseous abnormality evident.
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FINDINGS: Scouts: No additional findings. Lines and tubes: None. Lungs and pleura: Areas of reticulation and associated atelectasis in the left upper lobe subpleural region anteriorly is unchanged consistent with postradiation changes. No pulmonary consolidation. Scattered noncalcified pulmonary nodules bilaterally (series 11 image 99, 146, 90, 125). No new pulmonary nodules. 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. Cardiovascular: No cardiomegaly or pericardial effusion. Coronary artery atherosclerotic calcification: None detected. Abdomen: Please refer to same day CT abdomen report for detailed findings below the diaphragm. Musculoskeletal/Body Wall: Surgical staples in the left breast laterally with surrounding soft tissue thickening, unchanged. Sclerosis involving the left fifth rib laterally is unchanged.
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2,856
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CT Head wo contrast 1/6/2022 5:48 PM Clinical information: EVD troubleshooting Comparison: CT head 1/2/2022 Technique: 5 mm axial images were obtained without contrast from the base of the skull to the vertex with sagittal and coronal reformats. Scan field of view: 250 mm. DLP: 1955 mGy cm. Findings: Image quality is degraded due to motion artifacts. There is a right frontal approach EVD catheter terminating in the frontal horn of right lateral ventricle. Ventricles are slightly larger in size compared to prior head CT from 1/22/2022. There is decrease in size of the right parietal convexity epidural hematoma. Evaluation of the previously seen dense by convexity subdural hemorrhages is limited due to motion artifacts. Evolving hemorrhagic contusions in the left temporal and parietal lobes with slight worsening edema in the left parietal lobe. Left temporal hemorrhagic contusion is not well evaluated. Scalp hematomas show interval decrease in size. Redemonstration of multiple calvarial fractures and persistent opacification of the mastoid and middle ear cavities bilaterally. Air-fluid levels in the sphenoid sinus. The remaining visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal. Impression: Motion degraded exam. 1. Right frontal approach EVD catheter terminating the frontal horn of right lateral ventricle. Ventricular size is slightly larger compared to prior. 2. Interval decrease in size of the right convexity epidural hemorrhage. Evaluation of the biconvexity subdural hemorrhages and left temporal lobe hemorrhagic contusion is limited due to motion artifacts. 3. Evolving hemorrhagic contusions in left parietal lobe with interval mild increase in extent of edema.
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Findings: Image quality is degraded due to motion artifacts. There is a right frontal approach EVD catheter terminating in the frontal horn of right lateral ventricle. Ventricles are slightly larger in size compared to prior head CT from 1/22/2022. There is decrease in size of the right parietal convexity epidural hematoma. Evaluation of the previously seen dense by convexity subdural hemorrhages is limited due to motion artifacts. Evolving hemorrhagic contusions in the left temporal and parietal lobes with slight worsening edema in the left parietal lobe. Left temporal hemorrhagic contusion is not well evaluated. Scalp hematomas show interval decrease in size. Redemonstration of multiple calvarial fractures and persistent opacification of the mastoid and middle ear cavities bilaterally. Air-fluid levels in the sphenoid sinus. The remaining visualized paranasal sinuses, mastoid air cells and middle ear cavities are clear. Both orbits appear normal.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: Moderate atherosclerosis. ABDOMINAL AORTA: Unchanged severe calcific atherosclerosis. A few areas of ulcerated plaque appear similar. Unchanged mild stenosis just proximal to the bifurcation. No dissection or aneurysm. CELIAC AXIS: Similar mild ostial stenosis. SMA: Similar mild ostial stenosis. RIGHT RENAL: Similar moderate ostial stenosis. LEFT RENAL: Similar severe ostial stenosis. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Severe atherosclerosis with multifocal mild narrowing. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Severe atherosclerosis with multifocal mild narrowing. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Persistent nodular opacities in the right middle lobe, increased from prior. Similar nodular opacities in the medial right lower lobe. Nodular opacities in the left lower lobe are new from prior. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Coronary artery calcifications. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Unchanged mild nodular thickening of the left adrenal gland. Unchanged right adrenal nodule, characterizes a lipid rich adenoma on 5/29/2021. KIDNEYS: Punctate nonobstructing bilateral renal calculi. No hydronephrosis. LYMPH NODES: Grossly unchanged prominent mesenteric retroperitoneal and periportal nodes. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis without evidence of diverticulitis. Appendix is not seen, however there is no inflammatory stranding in the right lower quadrant or pelvis. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. OTHER VESSELS: No significant abnormality. URINARY BLADDER: Moderately distended. Otherwise unremarkable. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Unchanged nonspecific mild superficial soft tissue stranding in the left lower quadrant abdominal wall. Postsurgical changes from ventral hernia repair with mesh. MUSCULOSKELETAL: Unchanged chronic anterior wedge deformities of T10 and T12 vertebral bodies.
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2,857
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CT Head wo contrast 1/7/2022 12:30 AM Clinical Information: Concern for brain bleed in setting of thrombocytopenia Comparison: CT head 10/15/2011. Technique: Unenhanced axial brain CT. Bone and soft tissue windows were reviewed. Sagittal and coronal images were generated from the axial data. Scan field of view: 234 mm. DLP: 2575 mGy cm. Findings:Mild motion and streak artifacts limit evaluation. Bilateral cerebral hemispheres are symmetric in appearance. Gray and white matter attenuation differentiation is maintained. No acute intracranial hemorrhage, intracranial mass, mass effect or midline shift. No abnormal extra-axial fluid collections. Ventricles are normal in configuration. No hydrocephalus. Basal cisterns are patent. Posterior fossa structures are unremarkable. Bilateral orbits are within normal limits. Pan paranasal sinus mucosal thickening and air-fluid levels in bilateral maxillary sinuses suggesting acute on chronic sinusitis. Right mastoid effusion. Otherwise left mastoid air cells and middle ear cavities are unremarkable. No acute skull fractures. Conclusion: 1. No acute intracranial abnormality. 2. Pan paranasal sinus mucosal inflammatory changes, acute on chronic.
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Findings:Mild motion and streak artifacts limit evaluation. Bilateral cerebral hemispheres are symmetric in appearance. Gray and white matter attenuation differentiation is maintained. No acute intracranial hemorrhage, intracranial mass, mass effect or midline shift. No abnormal extra-axial fluid collections. Ventricles are normal in configuration. No hydrocephalus. Basal cisterns are patent. Posterior fossa structures are unremarkable. Bilateral orbits are within normal limits. Pan paranasal sinus mucosal thickening and air-fluid levels in bilateral maxillary sinuses suggesting acute on chronic sinusitis. Right mastoid effusion. Otherwise left mastoid air cells and middle ear cavities are unremarkable. No acute skull fractures.
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect, or edema. Gray-white matter differentiation is maintained. Mild frontal brain parenchymal volume loss is seen. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. SINONASAL CAVITIES: Mild scattered anterior ethmoid air cell mucosal thickening. Mastoid air cells and paranasal sinuses are otherwise well aerated.
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2,858
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: Small bowel obstruction COMPARISON: CT of the abdomen and pelvis dated 12/7/2021 TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 436.90 mm. DLP: 1483 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: Subsegmental atelectasis seen within the right lung base. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild cardiomegaly is unchanged. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No pathologically enlarged lymph nodes. Redemonstrated mildly prominent bilateral inguinal lymph nodes, likely reactive. STOMACH / SMALL BOWEL: Stable wall thickening of the gastric antrum and pylorus. No additional significant abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is not visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Stranding in the subcutaneous tissues around bilateral hips, left greater than right is similar to prior. No focal fluid collection. MUSCULOSKELETAL: Redemonstrated bilateral femoral head osteonecrosis without definite subchondral collapse. Thoracolumbar discogenic degenerative changes and severe lumbar facet arthropathy are similar. CONCLUSION: 1. No acute abnormality within the abdomen or pelvis. No evidence of small bowel obstruction. 2. Nonspecific stranding in the soft tissues about bilateral hips is similar to prior. 3. Similar bilateral femoral head osteonecrosis without subchondral collapse. 4. Cholelithiasis, diverticulosis and additional stable incidental findings, as described. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Subsegmental atelectasis seen within the right lung base. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Mild cardiomegaly is unchanged. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: No pathologically enlarged lymph nodes. Redemonstrated mildly prominent bilateral inguinal lymph nodes, likely reactive. STOMACH / SMALL BOWEL: Stable wall thickening of the gastric antrum and pylorus. No additional significant abnormality. COLON / APPENDIX: Colonic diverticulosis. The appendix is not visualized. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Stranding in the subcutaneous tissues around bilateral hips, left greater than right is similar to prior. No focal fluid collection. MUSCULOSKELETAL: Redemonstrated bilateral femoral head osteonecrosis without definite subchondral collapse. Thoracolumbar discogenic degenerative changes and severe lumbar facet arthropathy are similar.
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FINDINGS: LOWER NECK: Unremarkable. CHEST: LUNGS / AIRWAYS / PLEURA: Small left hemopneumothorax and small right hemothorax. There is bilateral dependent airspace disease.. Endotracheal tube tip 5.8 cm above carina. HEART / VESSELS: The heart is normal in size. MEDIASTINUM / ESOPHAGUS: There is pneumomediastinum and pericardium. There is an esophagogastric tube in place. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Comminuted lower manubrial fracture extending to the angle and second sternocostal joints/cartilages bilaterally. Overlying subcutaneous gas. Mildly displaced right first through seventh rib fractures and left first through 11th rib fractures. Additional disruption of the bilateral third, sixth, and seventh sternocostal cartilages. Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: No suspicious lesion; there is a slightly nodular contour of the liver. BILIARY TRACT: Normal. GALLBLADDER: Unremarkable. PANCREAS: Normal. SPLEEN: Enlarged measuring 15 cm in AP dimension. ADRENALS: Normal. KIDNEYS: No hydronephrosis, suspicious mass or laceration. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube tip coiled in gastric fundus. The loops of small bowel are normal in caliber. COLON / APPENDIX: No acute colonic pathology. The appendix appears unremarkable PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Left extraperitoneal perivesicular hematoma measures 10.0 x 9.5 cm (series 501 image 460). This hematoma exerts mass effect on the urinary bladder. VESSELS: Trace calcified atherosclerosis without aneurysm. Right femoral arterial line and CVL. URINARY BLADDER: Distended. Note is made that there is mass effect on the left aspect of the bladder by the adjacent hematoma. REPRODUCTIVE ORGANS: Unremarkable. BODY WALL: Right inguinal subcutaneous gas, iatrogenic versus post traumatic. Subcutaneous stranding along the flanks, likely contusive. MUSCULOSKELETAL: Partially visualized bilateral C6 inferior articular facet fractures extending to the spinous process. Comminuted fracture of the left iliac wing/sciatic buttress extending to the sacroiliac joint, with sacroiliac widening measuring up to 9 mm anteriorly. Minimally displaced comminuted left superior pubic ramus, inferior pubic ramus, and pubic body fractures. Comminuted right transverse acetabular fracture with posterior femoral head dislocation. Small associated hematoma with subcutaneous gas. THORACIC SPINE: VERTEBRA: Nondisplaced right T5 and T6 transverse process fractures. Minimally displaced T9 spinous process fracture. 10% anterior wedging of T11 and T12, with fracture lines through the left T10 and T11 vertebral bodies extending to the superior and inferior T10 and superior T11 endplates. No retropulsion. Minimally displaced bilateral T10 inferior articular facet fractures extending to the spinous process. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Minimally displaced right L1 and L3 and left L5 transverse process fractures, questionable at L2 and L3 on the left. DISC SPACES AND FACET JOINTS: Mild widening of the right L4-L5 facet. ALIGNMENT: Mild retrolisthesis of L1 on L2, L2 on L3, L3 on L4, L4-L5, and L5 on S1.
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2,859
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RADIOLOGIC EXAM: CT Lumbar Spine wo contrast, CT Thoracic Spine wo contrast CLINICAL INFORMATION: Trauma. COMPARISON: None. TECHNIQUE: CT Lumbar Spine wo contrast, CT Thoracic Spine wo contrastScan field of view: 208 mm. DLP: 3780.70 mGy cm. (accession CT220003402), Scan field of view: 223 mm. (accession CT220003401) Following CT of the abdomen, reformatted images were produced to optimize visualization of the osseous structures of the thoracic and lumbar spine. FINDINGS: There is diffuse osteopenia throughout the thoracolumbar spine Thoracic: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. There are mild to moderate multilevel degenerative changes involving the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. Lumbar: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild degenerative changes involving the lumbar spine. There is a small Schmorl's node involving the superior endplate of L3 vertebral body. Moderate bilateral neural foramen narrowing at T8-T9 and T9-T10. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. The visualized lungs and soft tissues are unremarkable. CONCLUSION: No acute fracture or malalignment of the thoracic or lumbar spine. Diffuse osteopenia. Mild to moderate thoracolumbar degenerative changes. 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: There is diffuse osteopenia throughout the thoracolumbar spine Thoracic: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. There are mild to moderate multilevel degenerative changes involving the thoracic spine. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. Lumbar: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild degenerative changes involving the lumbar spine. There is a small Schmorl's node involving the superior endplate of L3 vertebral body. Moderate bilateral neural foramen narrowing at T8-T9 and T9-T10. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. The visualized lungs and soft tissues are unremarkable.
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FINDINGS: LOWER NECK: Unremarkable. CHEST: LUNGS / AIRWAYS / PLEURA: Small left hemopneumothorax and small right hemothorax. There is bilateral dependent airspace disease.. Endotracheal tube tip 5.8 cm above carina. HEART / VESSELS: The heart is normal in size. MEDIASTINUM / ESOPHAGUS: There is pneumomediastinum and pericardium. There is an esophagogastric tube in place. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Comminuted lower manubrial fracture extending to the angle and second sternocostal joints/cartilages bilaterally. Overlying subcutaneous gas. Mildly displaced right first through seventh rib fractures and left first through 11th rib fractures. Additional disruption of the bilateral third, sixth, and seventh sternocostal cartilages. Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: No suspicious lesion; there is a slightly nodular contour of the liver. BILIARY TRACT: Normal. GALLBLADDER: Unremarkable. PANCREAS: Normal. SPLEEN: Enlarged measuring 15 cm in AP dimension. ADRENALS: Normal. KIDNEYS: No hydronephrosis, suspicious mass or laceration. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube tip coiled in gastric fundus. The loops of small bowel are normal in caliber. COLON / APPENDIX: No acute colonic pathology. The appendix appears unremarkable PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Left extraperitoneal perivesicular hematoma measures 10.0 x 9.5 cm (series 501 image 460). This hematoma exerts mass effect on the urinary bladder. VESSELS: Trace calcified atherosclerosis without aneurysm. Right femoral arterial line and CVL. URINARY BLADDER: Distended. Note is made that there is mass effect on the left aspect of the bladder by the adjacent hematoma. REPRODUCTIVE ORGANS: Unremarkable. BODY WALL: Right inguinal subcutaneous gas, iatrogenic versus post traumatic. Subcutaneous stranding along the flanks, likely contusive. MUSCULOSKELETAL: Partially visualized bilateral C6 inferior articular facet fractures extending to the spinous process. Comminuted fracture of the left iliac wing/sciatic buttress extending to the sacroiliac joint, with sacroiliac widening measuring up to 9 mm anteriorly. Minimally displaced comminuted left superior pubic ramus, inferior pubic ramus, and pubic body fractures. Comminuted right transverse acetabular fracture with posterior femoral head dislocation. Small associated hematoma with subcutaneous gas. THORACIC SPINE: VERTEBRA: Nondisplaced right T5 and T6 transverse process fractures. Minimally displaced T9 spinous process fracture. 10% anterior wedging of T11 and T12, with fracture lines through the left T10 and T11 vertebral bodies extending to the superior and inferior T10 and superior T11 endplates. No retropulsion. Minimally displaced bilateral T10 inferior articular facet fractures extending to the spinous process. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Minimally displaced right L1 and L3 and left L5 transverse process fractures, questionable at L2 and L3 on the left. DISC SPACES AND FACET JOINTS: Mild widening of the right L4-L5 facet. ALIGNMENT: Mild retrolisthesis of L1 on L2, L2 on L3, L3 on L4, L4-L5, and L5 on S1.
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2,860
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CT Maxillofacial wo contrast, CT Head wo contrast Clinical Information: Facial trauma Comparison: None. Technique: Unenhanced axial brain and maxillofacial CT. Scan field of view: 200 mm. DLP: 2300 mGy cm. (accession CT220003406), Scan field of view: 230 mm. DLP: 1237 mGy cm. (accession CT220003405) Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. There is a hypoattenuating focus adjacent to the body of the left lateral ventricle and left basal ganglia, likely representing remote infarction. Chronic lacunar infarcts in bilateral thalami. Hypoattenuation in left middle cerebral peduncle likely wallerian degeneration. Mild periventricular hypoattenuation, consistent with chronic microangiopathic change. EXTRA-AXIAL SPACES: Normal. SKULL and MAXILLOFACIAL BONES: There are minimally displaced fractures involving the bilateral nasal bones and frontal maxillary processes. No other fracture identified. No aggressive osseous lesion. VENTRICLES: Moderate ex vacuo ventriculomegaly. Mild dilation of the left lateral ventricular body, related to volume loss related to adjacent chronic lacunar infarct. No hydrocephalus. ORBITS: Normal. SINUSES: Mild wall thickening of the ethmoid air cells. Small mucous retention cysts of the right maxillary sinus. The remaining paranasal sinuses are clear. Mastoid air cells are clear. SOFT TISSUES: There is a subcutaneous hematoma overlying the left frontal bone that measures up to 1.5 cm (series 201, image 33). Conclusion: 1. No acute intracranial abnormality. Chronic findings as above. 2. Minimally displaced bilateral nasal bone fractures. 3. Left frontal scalp hematoma without underlying frontal bone 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: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. There is a hypoattenuating focus adjacent to the body of the left lateral ventricle and left basal ganglia, likely representing remote infarction. Chronic lacunar infarcts in bilateral thalami. Hypoattenuation in left middle cerebral peduncle likely wallerian degeneration. Mild periventricular hypoattenuation, consistent with chronic microangiopathic change. EXTRA-AXIAL SPACES: Normal. SKULL and MAXILLOFACIAL BONES: There are minimally displaced fractures involving the bilateral nasal bones and frontal maxillary processes. No other fracture identified. No aggressive osseous lesion. VENTRICLES: Moderate ex vacuo ventriculomegaly. Mild dilation of the left lateral ventricular body, related to volume loss related to adjacent chronic lacunar infarct. No hydrocephalus. ORBITS: Normal. SINUSES: Mild wall thickening of the ethmoid air cells. Small mucous retention cysts of the right maxillary sinus. The remaining paranasal sinuses are clear. Mastoid air cells are clear. SOFT TISSUES: There is a subcutaneous hematoma overlying the left frontal bone that measures up to 1.5 cm (series 201, image 33).
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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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2,861
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CT Maxillofacial wo contrast, CT Head wo contrast Clinical Information: Facial trauma Comparison: None. Technique: Unenhanced axial brain and maxillofacial CT. Scan field of view: 200 mm. DLP: 2300 mGy cm. (accession CT220003406), Scan field of view: 230 mm. DLP: 1237 mGy cm. (accession CT220003405) Findings: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. There is a hypoattenuating focus adjacent to the body of the left lateral ventricle and left basal ganglia, likely representing remote infarction. Chronic lacunar infarcts in bilateral thalami. Hypoattenuation in left middle cerebral peduncle likely wallerian degeneration. Mild periventricular hypoattenuation, consistent with chronic microangiopathic change. EXTRA-AXIAL SPACES: Normal. SKULL and MAXILLOFACIAL BONES: There are minimally displaced fractures involving the bilateral nasal bones and frontal maxillary processes. No other fracture identified. No aggressive osseous lesion. VENTRICLES: Moderate ex vacuo ventriculomegaly. Mild dilation of the left lateral ventricular body, related to volume loss related to adjacent chronic lacunar infarct. No hydrocephalus. ORBITS: Normal. SINUSES: Mild wall thickening of the ethmoid air cells. Small mucous retention cysts of the right maxillary sinus. The remaining paranasal sinuses are clear. Mastoid air cells are clear. SOFT TISSUES: There is a subcutaneous hematoma overlying the left frontal bone that measures up to 1.5 cm (series 201, image 33). Conclusion: 1. No acute intracranial abnormality. Chronic findings as above. 2. Minimally displaced bilateral nasal bone fractures. 3. Left frontal scalp hematoma without underlying frontal bone 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: CT head: BRAIN PARENCHYMA: No hemorrhage, intracranial mass, large territory infarct, or edema. Gray-white matter differentiation maintained. There is a hypoattenuating focus adjacent to the body of the left lateral ventricle and left basal ganglia, likely representing remote infarction. Chronic lacunar infarcts in bilateral thalami. Hypoattenuation in left middle cerebral peduncle likely wallerian degeneration. Mild periventricular hypoattenuation, consistent with chronic microangiopathic change. EXTRA-AXIAL SPACES: Normal. SKULL and MAXILLOFACIAL BONES: There are minimally displaced fractures involving the bilateral nasal bones and frontal maxillary processes. No other fracture identified. No aggressive osseous lesion. VENTRICLES: Moderate ex vacuo ventriculomegaly. Mild dilation of the left lateral ventricular body, related to volume loss related to adjacent chronic lacunar infarct. No hydrocephalus. ORBITS: Normal. SINUSES: Mild wall thickening of the ethmoid air cells. Small mucous retention cysts of the right maxillary sinus. The remaining paranasal sinuses are clear. Mastoid air cells are clear. SOFT TISSUES: There is a subcutaneous hematoma overlying the left frontal bone that measures up to 1.5 cm (series 201, image 33).
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FINDINGS: LOWER NECK: Unremarkable. CHEST: LUNGS / AIRWAYS / PLEURA: Small left hemopneumothorax and small right hemothorax. There is bilateral dependent airspace disease.. Endotracheal tube tip 5.8 cm above carina. HEART / VESSELS: The heart is normal in size. MEDIASTINUM / ESOPHAGUS: There is pneumomediastinum and pericardium. There is an esophagogastric tube in place. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Comminuted lower manubrial fracture extending to the angle and second sternocostal joints/cartilages bilaterally. Overlying subcutaneous gas. Mildly displaced right first through seventh rib fractures and left first through 11th rib fractures. Additional disruption of the bilateral third, sixth, and seventh sternocostal cartilages. Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: No suspicious lesion; there is a slightly nodular contour of the liver. BILIARY TRACT: Normal. GALLBLADDER: Unremarkable. PANCREAS: Normal. SPLEEN: Enlarged measuring 15 cm in AP dimension. ADRENALS: Normal. KIDNEYS: No hydronephrosis, suspicious mass or laceration. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube tip coiled in gastric fundus. The loops of small bowel are normal in caliber. COLON / APPENDIX: No acute colonic pathology. The appendix appears unremarkable PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Left extraperitoneal perivesicular hematoma measures 10.0 x 9.5 cm (series 501 image 460). This hematoma exerts mass effect on the urinary bladder. VESSELS: Trace calcified atherosclerosis without aneurysm. Right femoral arterial line and CVL. URINARY BLADDER: Distended. Note is made that there is mass effect on the left aspect of the bladder by the adjacent hematoma. REPRODUCTIVE ORGANS: Unremarkable. BODY WALL: Right inguinal subcutaneous gas, iatrogenic versus post traumatic. Subcutaneous stranding along the flanks, likely contusive. MUSCULOSKELETAL: Partially visualized bilateral C6 inferior articular facet fractures extending to the spinous process. Comminuted fracture of the left iliac wing/sciatic buttress extending to the sacroiliac joint, with sacroiliac widening measuring up to 9 mm anteriorly. Minimally displaced comminuted left superior pubic ramus, inferior pubic ramus, and pubic body fractures. Comminuted right transverse acetabular fracture with posterior femoral head dislocation. Small associated hematoma with subcutaneous gas. THORACIC SPINE: VERTEBRA: Nondisplaced right T5 and T6 transverse process fractures. Minimally displaced T9 spinous process fracture. 10% anterior wedging of T11 and T12, with fracture lines through the left T10 and T11 vertebral bodies extending to the superior and inferior T10 and superior T11 endplates. No retropulsion. Minimally displaced bilateral T10 inferior articular facet fractures extending to the spinous process. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Minimally displaced right L1 and L3 and left L5 transverse process fractures, questionable at L2 and L3 on the left. DISC SPACES AND FACET JOINTS: Mild widening of the right L4-L5 facet. ALIGNMENT: Mild retrolisthesis of L1 on L2, L2 on L3, L3 on L4, L4-L5, and L5 on S1.
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2,862
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RADIOLOGIC EXAM: CT Cervical Spine wo contrast CLINICAL INFORMATION: Neck trauma COMPARISON: None available TECHNIQUE: CT Cervical Spine wo contrastScan field of view: 240 mm. DLP: 340 mGy cm. Unenhanced axial CT of the cervical spine with sagittal and coronal reformats. STRUCTURED REPORT: CT Cervical Spine Trauma FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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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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FINDINGS: LOWER NECK: Unremarkable. CHEST: LUNGS / AIRWAYS / PLEURA: Small left hemopneumothorax and small right hemothorax. There is bilateral dependent airspace disease.. Endotracheal tube tip 5.8 cm above carina. HEART / VESSELS: The heart is normal in size. MEDIASTINUM / ESOPHAGUS: There is pneumomediastinum and pericardium. There is an esophagogastric tube in place. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Comminuted lower manubrial fracture extending to the angle and second sternocostal joints/cartilages bilaterally. Overlying subcutaneous gas. Mildly displaced right first through seventh rib fractures and left first through 11th rib fractures. Additional disruption of the bilateral third, sixth, and seventh sternocostal cartilages. Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: No suspicious lesion; there is a slightly nodular contour of the liver. BILIARY TRACT: Normal. GALLBLADDER: Unremarkable. PANCREAS: Normal. SPLEEN: Enlarged measuring 15 cm in AP dimension. ADRENALS: Normal. KIDNEYS: No hydronephrosis, suspicious mass or laceration. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Esophagogastric tube tip coiled in gastric fundus. The loops of small bowel are normal in caliber. COLON / APPENDIX: No acute colonic pathology. The appendix appears unremarkable PERITONEUM / MESENTERY: No free air or free fluid. RETROPERITONEUM: Left extraperitoneal perivesicular hematoma measures 10.0 x 9.5 cm (series 501 image 460). This hematoma exerts mass effect on the urinary bladder. VESSELS: Trace calcified atherosclerosis without aneurysm. Right femoral arterial line and CVL. URINARY BLADDER: Distended. Note is made that there is mass effect on the left aspect of the bladder by the adjacent hematoma. REPRODUCTIVE ORGANS: Unremarkable. BODY WALL: Right inguinal subcutaneous gas, iatrogenic versus post traumatic. Subcutaneous stranding along the flanks, likely contusive. MUSCULOSKELETAL: Partially visualized bilateral C6 inferior articular facet fractures extending to the spinous process. Comminuted fracture of the left iliac wing/sciatic buttress extending to the sacroiliac joint, with sacroiliac widening measuring up to 9 mm anteriorly. Minimally displaced comminuted left superior pubic ramus, inferior pubic ramus, and pubic body fractures. Comminuted right transverse acetabular fracture with posterior femoral head dislocation. Small associated hematoma with subcutaneous gas. THORACIC SPINE: VERTEBRA: Nondisplaced right T5 and T6 transverse process fractures. Minimally displaced T9 spinous process fracture. 10% anterior wedging of T11 and T12, with fracture lines through the left T10 and T11 vertebral bodies extending to the superior and inferior T10 and superior T11 endplates. No retropulsion. Minimally displaced bilateral T10 inferior articular facet fractures extending to the spinous process. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Minimally displaced right L1 and L3 and left L5 transverse process fractures, questionable at L2 and L3 on the left. DISC SPACES AND FACET JOINTS: Mild widening of the right L4-L5 facet. ALIGNMENT: Mild retrolisthesis of L1 on L2, L2 on L3, L3 on L4, L4-L5, and L5 on S1.
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2,863
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma, MVC. COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 1328.10 mGy cm. (accession CT220003409), per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003410) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Erosive changes to the left sternoclavicular joint, indeterminate. This could be remote post traumatic/degenerative or secondary to infectious/inflammatory etiologies. Clinical correlation recommended. 4. Hepatosplenomegaly and hepatic steatosis. Nonspecific periportal/gastrohepatic adenopathy, possibly reactive. Biochemical correlation with hepatitis serologies recommended. 5. Bilateral gynecomastia. 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. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect, or edema. Gray-white matter differentiation is maintained. Mild frontal brain parenchymal volume loss is seen. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. SINONASAL CAVITIES: Mild scattered anterior ethmoid air cell mucosal thickening. Mastoid air cells and paranasal sinuses are otherwise well aerated.
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2,864
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma, MVC. COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 1328.10 mGy cm. (accession CT220003409), per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003410) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Erosive changes to the left sternoclavicular joint, indeterminate. This could be remote post traumatic/degenerative or secondary to infectious/inflammatory etiologies. Clinical correlation recommended. 4. Hepatosplenomegaly and hepatic steatosis. Nonspecific periportal/gastrohepatic adenopathy, possibly reactive. Biochemical correlation with hepatitis serologies recommended. 5. Bilateral gynecomastia. 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. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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2,865
|
EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma, MVC. COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 1328.10 mGy cm. (accession CT220003409), per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003410) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Erosive changes to the left sternoclavicular joint, indeterminate. This could be remote post traumatic/degenerative or secondary to infectious/inflammatory etiologies. Clinical correlation recommended. 4. Hepatosplenomegaly and hepatic steatosis. Nonspecific periportal/gastrohepatic adenopathy, possibly reactive. Biochemical correlation with hepatitis serologies recommended. 5. Bilateral gynecomastia. 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. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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Findings: The gray-white matter differentiation is intact. There is subdural hemorrhage tracking along the falx and left tentorial leaflet. This measures to 4 mm in thickness. There is otherwise no evidence of acute infarct, hemorrhage, mass or mass effect. The ventricular system appears unremarkable. There is a slight prominence of the extra-axial spaces. There is mucosal thickening in the right maxillary sinus. The mastoid air cells are aerated. No calvarial fracture is identified. There is bilateral pseudophakia. There is a left frontal scalp hematoma. There is calcified atherosclerotic disease the cavernous carotid arteries.
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2,866
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma, MVC. COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. DLP: 1328.10 mGy cm. (accession CT220003409), per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: 70 sec Scan field of view: 415.40 mm. (accession CT220003410) FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Central airways are patent. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. No acute traumatic findings in the chest, abdomen or pelvis. 2. No acute fracture or malalignment of the thoracic or lumbar spine. 3. Erosive changes to the left sternoclavicular joint, indeterminate. This could be remote post traumatic/degenerative or secondary to infectious/inflammatory etiologies. Clinical correlation recommended. 4. Hepatosplenomegaly and hepatic steatosis. Nonspecific periportal/gastrohepatic adenopathy, possibly reactive. Biochemical correlation with hepatitis serologies recommended. 5. Bilateral gynecomastia. 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. No focal airspace opacities, pleural effusion or pneumothorax. HEART / VESSELS: Heart size is normal. Mild coronary artery calcifications. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis. Hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Splenomegaly. Small accessory splenule. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: There are shotty and borderline enlarged gastrohepatic and periportal lymph nodes. Shotty periaortic lymph nodes are also noted. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild calcific atherosclerosis of bilateral iliac arteries and their branch vessels. URINARY BLADDER: Distended, otherwise unremarkable. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Calcified granuloma in the right gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Left posterior acetabular fixation hardware in place. Erosive/degenerative changes of the left sternoclavicular joint. Chronic fracture deformity of the lateral right fifth rib. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. Partial fusion of L2-L3. DISC SPACES AND FACET JOINTS: No acute injury. Multilevel discogenic degenerative changes and bilateral facet arthropathy. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Bilateral subcentimeter hypoattenuating thyroid nodules. CHEST: LUNGS / AIRWAYS / PLEURA: No focal consolidation, pneumothorax, or pleural effusion. Diffuse mosaic attenuation, likely air trapping. HEART / VESSELS: Normal heart size. No pericardial effusion. Scattered calcified atherosclerosis of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: No evidence of diaphragmatic injury. Mild left hemidiaphragm elevation. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Enlarged. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Nodular thickening of the left adrenal gland. No focal adrenal nodule. KIDNEYS: Bilateral subcentimeter hypoattenuating lesions, likely renal cysts. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Appendix is not visualized. No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Scattered calcified atherosclerosis of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Right reverse shoulder arthroplasty is present. Old healed right posterior rib fractures. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative change with flowing ossification of the anterior longitudinal ligament consistent with DISH. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Questionable nondisplaced right L1 transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. Advanced multilevel discogenic degenerative change of the lumbar spine with multilevel facet hypertrophy. Severe T12-L1, L1-L2, L2-L3 spinal canal narrowing due to ligamentum flavum ossification and degenerative disc disease. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,867
|
EXAM: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma. MVC. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1165 mGy cm. (accession CT220003416), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 200 mm. DLP: 992 mGy cm. (accession CT220003423), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. (accession CT220003418), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. DLP: 820 mGy cm. (accession CT220003417), Scan field of view: 200 mm. DLP: 1016 mGy cm. (accession CT220003422), Scan field of view: 325 mm. (accession CT220003442) FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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 CAP Trauma LOWER NECK: Bilateral subcentimeter hypoattenuating thyroid nodules. CHEST: LUNGS / AIRWAYS / PLEURA: No focal consolidation, pneumothorax, or pleural effusion. Diffuse mosaic attenuation, likely air trapping. HEART / VESSELS: Normal heart size. No pericardial effusion. Scattered calcified atherosclerosis of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: No evidence of diaphragmatic injury. Mild left hemidiaphragm elevation. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Enlarged. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Nodular thickening of the left adrenal gland. No focal adrenal nodule. KIDNEYS: Bilateral subcentimeter hypoattenuating lesions, likely renal cysts. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Appendix is not visualized. No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Scattered calcified atherosclerosis of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Right reverse shoulder arthroplasty is present. Old healed right posterior rib fractures. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative change with flowing ossification of the anterior longitudinal ligament consistent with DISH. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Questionable nondisplaced right L1 transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. Advanced multilevel discogenic degenerative change of the lumbar spine with multilevel facet hypertrophy. Severe T12-L1, L1-L2, L2-L3 spinal canal narrowing due to ligamentum flavum ossification and degenerative disc disease. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,868
|
EXAM: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma. MVC. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1165 mGy cm. (accession CT220003416), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 200 mm. DLP: 992 mGy cm. (accession CT220003423), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. (accession CT220003418), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. DLP: 820 mGy cm. (accession CT220003417), Scan field of view: 200 mm. DLP: 1016 mGy cm. (accession CT220003422), Scan field of view: 325 mm. (accession CT220003442) FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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: The sagittal images demonstrate physiologic cervical lordosis, without subluxations. Postsurgical anterior spinal fusion at C3-C4, with solid bony callus formation, without perihardware lucencies, malpositioning or hardware fractures. Acute mildly displaced fracture of the C5 superior endplate, extending into its anterior bridging osteophyte, left transverse process and left transverse foramen, without retropulsion into the spinal canal. The remaining vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. Ossification of the posterior longitudinal ligament at C2. Predental space narrowing, spurring and mineralization with fragmentation, and ankylosis of the distal clivus with the anterior arch of C1. The craniocervical junction appears otherwise unremarkable. Multilevel prominent bridging anterior osteophytes are noted suggestive of diffuse idiopathic skeletal hyperostosis. Moderate intervertebral disc space loss, endplate sclerosis and osteophytosis centered at C7-T1. Multilevel uncovertebral and facet hypertrophy, resulting in moderate left C2-C3/right C4-C5, and mild left C6-C7 neuroforaminal narrowing with effacement of the left C5-6 lateral recess. The prevertebral and paraspinal soft tissues appear normal.
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2,869
|
EXAM: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma. MVC. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1165 mGy cm. (accession CT220003416), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 200 mm. DLP: 992 mGy cm. (accession CT220003423), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. (accession CT220003418), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. DLP: 820 mGy cm. (accession CT220003417), Scan field of view: 200 mm. DLP: 1016 mGy cm. (accession CT220003422), Scan field of view: 325 mm. (accession CT220003442) FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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 CAP Trauma LOWER NECK: Bilateral subcentimeter hypoattenuating thyroid nodules. CHEST: LUNGS / AIRWAYS / PLEURA: No focal consolidation, pneumothorax, or pleural effusion. Diffuse mosaic attenuation, likely air trapping. HEART / VESSELS: Normal heart size. No pericardial effusion. Scattered calcified atherosclerosis of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: No evidence of diaphragmatic injury. Mild left hemidiaphragm elevation. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Enlarged. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Nodular thickening of the left adrenal gland. No focal adrenal nodule. KIDNEYS: Bilateral subcentimeter hypoattenuating lesions, likely renal cysts. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Appendix is not visualized. No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Scattered calcified atherosclerosis of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Right reverse shoulder arthroplasty is present. Old healed right posterior rib fractures. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative change with flowing ossification of the anterior longitudinal ligament consistent with DISH. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Questionable nondisplaced right L1 transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. Advanced multilevel discogenic degenerative change of the lumbar spine with multilevel facet hypertrophy. Severe T12-L1, L1-L2, L2-L3 spinal canal narrowing due to ligamentum flavum ossification and degenerative disc disease. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,870
|
EXAM: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma. MVC. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1165 mGy cm. (accession CT220003416), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 200 mm. DLP: 992 mGy cm. (accession CT220003423), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. (accession CT220003418), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. DLP: 820 mGy cm. (accession CT220003417), Scan field of view: 200 mm. DLP: 1016 mGy cm. (accession CT220003422), Scan field of view: 325 mm. (accession CT220003442) FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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 CAP Trauma LOWER NECK: Bilateral subcentimeter hypoattenuating thyroid nodules. CHEST: LUNGS / AIRWAYS / PLEURA: No focal consolidation, pneumothorax, or pleural effusion. Diffuse mosaic attenuation, likely air trapping. HEART / VESSELS: Normal heart size. No pericardial effusion. Scattered calcified atherosclerosis of the thoracic aorta. MEDIASTINUM / ESOPHAGUS: No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: No evidence of diaphragmatic injury. Mild left hemidiaphragm elevation. LYMPH NODES: None enlarged. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Enlarged. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Nodular thickening of the left adrenal gland. No focal adrenal nodule. KIDNEYS: Bilateral subcentimeter hypoattenuating lesions, likely renal cysts. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Appendix is not visualized. No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: Scattered calcified atherosclerosis of the abdominal aorta and branch vessels. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Right reverse shoulder arthroplasty is present. Old healed right posterior rib fractures. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Mild multilevel discogenic degenerative change with flowing ossification of the anterior longitudinal ligament consistent with DISH. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: Questionable nondisplaced right L1 transverse process fracture. DISC SPACES AND FACET JOINTS: No acute injury. Advanced multilevel discogenic degenerative change of the lumbar spine with multilevel facet hypertrophy. Severe T12-L1, L1-L2, L2-L3 spinal canal narrowing due to ligamentum flavum ossification and degenerative disc disease. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,871
|
EXAM: CT Ankle Right wo contrast CLINICAL INFORMATION: Fracture COMPARISON: 1/6/2022 TECHNIQUE: CT Ankle Right wo contrast Scan field of view: 200 mm. DLP: 528 mGy cm. The scan was repeated secondary to motion artifact. FINDINGS/CONCLUSION: Acute comminuted fracture of the medial malleolus. Acute, nondisplaced fracture of the posterior malleolus. Comminuted, mildly displaced fracture of the lateral malleolus at the level of the tibiofibular syndesmosis. Multiple osseous fragments are present adjacent to the posterior talar process likely representing an os trigonum with associated degenerative changes. Nondisplaced fracture of the lateral talar process. Fracture of the anterior aspect of the talar dome. Minimally displaced fracture of the dorsal aspect of the dorsal talar head likely representing avulsion of the dorsal talonavicular ligament. Scattered degenerative changes of the midfoot. Gas is noted within the soft tissues of the distal foreleg and ankle and within the tibiotalar joint concerning for open fracture. Diffuse soft tissue edema about the ankle and hindfoot.
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FINDINGS/CONCLUSION: Acute comminuted fracture of the medial malleolus. Acute, nondisplaced fracture of the posterior malleolus. Comminuted, mildly displaced fracture of the lateral malleolus at the level of the tibiofibular syndesmosis. Multiple osseous fragments are present adjacent to the posterior talar process likely representing an os trigonum with associated degenerative changes. Nondisplaced fracture of the lateral talar process. Fracture of the anterior aspect of the talar dome. Minimally displaced fracture of the dorsal aspect of the dorsal talar head likely representing avulsion of the dorsal talonavicular ligament. Scattered degenerative changes of the midfoot. Gas is noted within the soft tissues of the distal foreleg and ankle and within the tibiotalar joint concerning for open fracture. Diffuse soft tissue edema about the ankle and hindfoot.
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Findings: The gray-white matter differentiation is intact. There is subdural hemorrhage tracking along the falx and left tentorial leaflet. This measures to 4 mm in thickness. There is otherwise no evidence of acute infarct, hemorrhage, mass or mass effect. The ventricular system appears unremarkable. There is a slight prominence of the extra-axial spaces. There is mucosal thickening in the right maxillary sinus. The mastoid air cells are aerated. No calvarial fracture is identified. There is bilateral pseudophakia. There is a left frontal scalp hematoma. There is calcified atherosclerotic disease the cavernous carotid arteries.
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2,872
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EXAM: CT Abdomen and Pelvis wo+w contrast CLINICAL INFORMATION: 22-year-old female, evaluation for nephrolithiasis. COMPARISON: CT chest 1/5/2022 TECHNIQUE: CT Abdomen and Pelvis wo+w contrast. Patient weight: 150 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 80 sec Scan field of view: 367.90 mm. DLP: 1030 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Partially visualized consolidation in the posterior medial right lower lobe. No other significant abnormality. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal BILIARY TRACT: Normal. GALLBLADDER: Decompressed. Internal hyperdensity, likely vicariously excreted contrast. No gallbladder wall thickening or pericholecystic fluid. PANCREAS: Normal SPLEEN: Normal ADRENALS: Normal. KIDNEYS: There are a few subcentimeter hypodensities in both kidneys which are technically indeterminant but statistically likely cysts. There appears to be bilateral caliectasis but no hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed colonic diverticula.. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: There is a duplicated infrarenal left-sided IVC/double IVC. URINARY BLADDER: Slightly thick-walled. No urinary calculi. REPRODUCTIVE ORGANS: Uterus is unremarkable. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. Subtle bladder wall thickening could suggest cystitis/UTI. Bilateral renal caliectasis without hydronephrosis. No convincing CT evidence of pyelonephritis. Clinical correlation recommended. 2. Partially visualized consolidation in the posterior medial right lower lobe, concerning for pneumonia. 3. Double infrarenal IVC. Additional findings above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Partially visualized consolidation in the posterior medial right lower lobe. No other significant abnormality. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal BILIARY TRACT: Normal. GALLBLADDER: Decompressed. Internal hyperdensity, likely vicariously excreted contrast. No gallbladder wall thickening or pericholecystic fluid. PANCREAS: Normal SPLEEN: Normal ADRENALS: Normal. KIDNEYS: There are a few subcentimeter hypodensities in both kidneys which are technically indeterminant but statistically likely cysts. There appears to be bilateral caliectasis but no hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Noninflamed colonic diverticula.. Appendix is normal. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: There is a duplicated infrarenal left-sided IVC/double IVC. URINARY BLADDER: Slightly thick-walled. No urinary calculi. REPRODUCTIVE ORGANS: Uterus is unremarkable. No adnexal mass. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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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: Punctate nonflow limiting atherosclerotic calcifications of the proximal right ICA. 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 heterogeneous, with multiple internal subcentimeter nodules, likely colloid cysts.
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2,873
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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, fall from standing COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. IV contrast: Omnipaque 350, 100 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal. CONCLUSION: 1. Comminuted right superior and inferior pubic rami fractures and mildly displaced right S1 and S2 sacral alae fractures. Moderate size pelvic hematoma. Indeterminate hyperdensities within the pubic symphysis fracture site could be bone fragments or small foci of active extravasation. Clinical correlation recommended. 2. Perivesicular hematoma could be secondary to pelvic fractures. However, there is concern for bladder injury, CT cystogram recommended. 3. No additional acute traumatic injury within the chest, abdomen or pelvis. 4. Indeterminate bilateral postmenopausal adnexal cysts. The right adnexal cyst may be mildly complex. Nonemergent sonographic follow-up recommended. 5. Indeterminate left thyroid nodules. Nonemergent thyroid ultrasound recommended for further evaluation, as clinically indicated.1 6. Cholelithiasis, diverticulosis, and other chronic and incidental findings, as detailed above. Final report findings discussed with Dr. Marquez at 1/6/2022 8:18 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 CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal.
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FINDINGS: Scouts: No additional findings. Lines and tubes: None. Lungs and pleura: Redemonstration of irregular left upper lobe nodule measuring approximately 40 x 12 mm, previously 15 x 30 mm. Previously new clustered nodularity in the right lower lobe is somewhat increased (series 2 image 206). Tree-in-bud nodularity is mildly increased bilaterally, for example in the right middle lobe (series 2 image 99, 145). Linear atelectasis/scarring in the right upper lobe anteriorly, right middle lobe and lingula with mild lingular and lower lobe bronchiectasis, unchanged. No pleural effusion. No pneumothorax. Esophagus, Mediastinum and neck: Esophagus is normal. No abnormality in the mediastinum. The thyroid gland is normal. Lymph Nodes: Small mediastinal and bilateral hilar lymph nodes are unchanged. Mild interval increase in size of right supraclavicular lymph nodes, one no measuring 9 mm in short axis, previously 6 mm. Cardiovascular: Left atrial and ventricular dilation. Mild mitral and aortic valvular calcifications.. Mild atherosclerotic calcifications involving the thoracic aorta, aortic arch sidebranches. Coronary artery atherosclerotic calcification: Moderate amount. Abdomen: Mild diffuse hepatic steatosis. Musculoskeletal/Body Wall: Bilateral breast implants in place. No aggressive appearing skeletal lesions. Mild degenerative changes in spine.
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2,874
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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, fall from standing COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. IV contrast: Omnipaque 350, 100 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal. CONCLUSION: 1. Comminuted right superior and inferior pubic rami fractures and mildly displaced right S1 and S2 sacral alae fractures. Moderate size pelvic hematoma. Indeterminate hyperdensities within the pubic symphysis fracture site could be bone fragments or small foci of active extravasation. Clinical correlation recommended. 2. Perivesicular hematoma could be secondary to pelvic fractures. However, there is concern for bladder injury, CT cystogram recommended. 3. No additional acute traumatic injury within the chest, abdomen or pelvis. 4. Indeterminate bilateral postmenopausal adnexal cysts. The right adnexal cyst may be mildly complex. Nonemergent sonographic follow-up recommended. 5. Indeterminate left thyroid nodules. Nonemergent thyroid ultrasound recommended for further evaluation, as clinically indicated.1 6. Cholelithiasis, diverticulosis, and other chronic and incidental findings, as detailed above. Final report findings discussed with Dr. Marquez at 1/6/2022 8:18 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 CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal.
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Findings: There is a heterogeneous mass centered in the region of the left ethmoid air cells which is destroying the fovea ethmoidalis and cribriform plate on both sides but more extensive on the left side. There is extension of abnormal soft tissue into the medial wall of the orbit abutting the superior oblique muscle. There is also heterogeneous soft tissue extending into the cranial maxillary sinus. The mass extends anteriorly to destroy partially the middle turbinate and the partitions of the left ethmoid air cells. The nasal septum appears eroded superiorly with extension into the contralateral right nasal cavity. Posteriorly the mass extends into the orbit including orbital apex. There is likely close contact with the optic nerve. There is extension of soft tissue into the pterygopalatine fossa, left sphenoid sinus with destruction of the greater wing of the sphenoid on the left side and likely involvement of the region of the foramen rotundum. Within the upper neck no significant lymphadenopathy is identified. Brain parenchyma appears unremarkable.
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2,875
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Craniocervical CT angiogram 1/6/2022 7:15 PM Indication: Trauma Comparison: Cervical spine CT, same date Technique: 1.4 mm axial images were obtained during the early arterial phase of a rapid IV infusion of contrast, from the thoracic inlet through the circle of Willis. 3-D CT angiographic images were generated from axial data set. "Sliding slab MIP" images were also generated. Patient weight: 125 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 237.10 mm. DLP: 842 mGy cm. Findings: CTA neck: The visualized aortic arch appears normal. There is no evidence of traumatic aortic arch injury. There are no great vessel origin stenoses. There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. The included major intracranial arteries appear normal. Intradural right vertebral artery is hypoplastic. C-spine: Cervical intervertebral alignment is normal. Craniocervical junction is maintained. There is acute fracture through the base of odontoid process without significant displacement. There is no prevertebral edema or other soft tissue abnormality. Multilevel discogenic, facet uncovertebral degenerative changes throughout the cervical spine. Moderate to severe left neural foramen narrowing from C3 to C5. Impression: 1. No CT angiographic evidence of cervical arterial injury or flow-limiting stenoses. 2. Acute Type II odontoid fracture without significant displacement.
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Findings: CTA neck: The visualized aortic arch appears normal. There is no evidence of traumatic aortic arch injury. There are no great vessel origin stenoses. There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. The included major intracranial arteries appear normal. Intradural right vertebral artery is hypoplastic. C-spine: Cervical intervertebral alignment is normal. Craniocervical junction is maintained. There is acute fracture through the base of odontoid process without significant displacement. There is no prevertebral edema or other soft tissue abnormality. Multilevel discogenic, facet uncovertebral degenerative changes throughout the cervical spine. Moderate to severe left neural foramen narrowing from C3 to C5.
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FINDINGS: Scouts: No additional findings. Lines and tubes: None. Lungs: Redemonstration of reticulations in the right lower lobe subpleural region with honeycombing and mild bronchiectasis. Mosaic attenuation in both lungs is unchanged with mild groundglass densities also seen. Nodular density along the fissure on the left (series 2 image 120). Scattered calcified granulomas bilaterally. Pleura: No pleural effusion. No pneumothorax. Esophagus, Mediastinum and neck: Esophagus is normal. Mediastinum is normal. The thyroid gland is normal. Lymph Nodes: Multiple mildly enlarged mediastinal and bilateral hilar lymph nodes are unchanged. Calcified right hilar, mediastinal lymph nodes are again seen. Cardiovascular: Biatrial and left ventricular dilation. Trace pericardial effusion. Dilated main pulmonary artery measuring 41 mm in diameter. Coronary artery atherosclerotic calcification: Moderate amount. Abdomen: No upper abdominal abnormality identified. Musculoskeletal/Body Wall: No soft tissue masses. No aggressive appearing skeletal lesions. Degenerative changes in spine.
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2,876
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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, fall from standing COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. IV contrast: Omnipaque 350, 100 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal. CONCLUSION: 1. Comminuted right superior and inferior pubic rami fractures and mildly displaced right S1 and S2 sacral alae fractures. Moderate size pelvic hematoma. Indeterminate hyperdensities within the pubic symphysis fracture site could be bone fragments or small foci of active extravasation. Clinical correlation recommended. 2. Perivesicular hematoma could be secondary to pelvic fractures. However, there is concern for bladder injury, CT cystogram recommended. 3. No additional acute traumatic injury within the chest, abdomen or pelvis. 4. Indeterminate bilateral postmenopausal adnexal cysts. The right adnexal cyst may be mildly complex. Nonemergent sonographic follow-up recommended. 5. Indeterminate left thyroid nodules. Nonemergent thyroid ultrasound recommended for further evaluation, as clinically indicated.1 6. Cholelithiasis, diverticulosis, and other chronic and incidental findings, as detailed above. Final report findings discussed with Dr. Marquez at 1/6/2022 8:18 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 CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal.
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FINDINGS: Small dependent bilateral pleural effusions are noted with linear atelectasis in the left lower lobe due to elevated left hemidiaphragm. Spleen is enlarged with multiple hypodense subcapsular lesions with small perisplenic fluid. The spleen is approximately 10.3 cm in craniocaudal extent but overall appears slightly prominent. Liver is slightly enlarged measuring 19.6 cm in craniocaudal extent. There is no focal lesion in the liver. The gallbladder, both adrenal glands and kidneys are unremarkable. The pancreatic head is prominent with subtle area of low-attenuation without pancreatic ductal dilatation. Visualized bowel loops are normal in caliber without wall thickening or pneumatosis. Only small size nodes are present in the retroperitoneum. The urinary bladder, uterus and both adnexa are unremarkable for patient's age. There is small fluid in the cul-de-sac with low CT attenuation value. No focal lytic or sclerotic bone lesion is seen.
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2,877
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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, fall from standing COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Abdomen and Pelvis w contrast. IV contrast: Omnipaque 350, 100 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal. CONCLUSION: 1. Comminuted right superior and inferior pubic rami fractures and mildly displaced right S1 and S2 sacral alae fractures. Moderate size pelvic hematoma. Indeterminate hyperdensities within the pubic symphysis fracture site could be bone fragments or small foci of active extravasation. Clinical correlation recommended. 2. Perivesicular hematoma could be secondary to pelvic fractures. However, there is concern for bladder injury, CT cystogram recommended. 3. No additional acute traumatic injury within the chest, abdomen or pelvis. 4. Indeterminate bilateral postmenopausal adnexal cysts. The right adnexal cyst may be mildly complex. Nonemergent sonographic follow-up recommended. 5. Indeterminate left thyroid nodules. Nonemergent thyroid ultrasound recommended for further evaluation, as clinically indicated.1 6. Cholelithiasis, diverticulosis, and other chronic and incidental findings, as detailed above. Final report findings discussed with Dr. Marquez at 1/6/2022 8:18 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 CAP Trauma LOWER NECK: Multiple left thyroid nodules the largest measuring approximately 1.6 cm. CHEST: LUNGS / AIRWAYS / PLEURA: Minimal bilateral dependent atelectasis. HEART / VESSELS: There is mild calcified atherosclerosis of the aortic arch and origin of great vessels. MEDIASTINUM / ESOPHAGUS: Large sliding type hiatal hernia. DIAPHRAGM: Intact. LYMPH NODES: None pathologically enlarged. Subcentimeter paratracheal lymph nodes are noted, likely reactive. CHEST WALL: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Cholelithiasis. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Mild symmetric cortical atrophy. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Large sliding-type hiatal hernia, as above. Small bowel is normal in appearance. COLON / APPENDIX: Colonic diverticulosis. The appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: There is a mild to moderate extraperitoneal hematoma seen within the pelvis adjacent to the urinary bladder and right pelvic sidewall. VESSELS: Moderate calcified atherosclerosis of the normal caliber abdominal aorta and its branching vessels. URINARY BLADDER: A perivesicular hematoma is seen REPRODUCTIVE ORGANS: Uterus is present. Bilateral adnexal cysts are seen within the largest on the right measures 4.1 cm and is higher in attenuation than simple fluid. The left cystic lesion measures approximately 3.6 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Diffusely decreased bone mineralization. Mildly displaced, comminuted fracture of the right superior and inferior pubic rami without pubic symphyseal diastasis. There is an associated right pelvic sidewall hematoma. There are small foci of hyperdensity within the fracture site which could represent small bone fragments although a small amount of contrast extravasation is difficult to exclude. Mildly displaced right S1 and S2 sacral alae which may extend into the right SI joint. No definite right SI joint diastases. Mild rightward curvature of the lumbar spine centered at L1-L2. THORACIC SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Moderate multilevel discogenic degenerative changes are noted. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Chronic multilevel discogenic degenerative changes are noted, most significant at L1-L2 and L5-S1. Posterior disc osteophyte complex at L1-L2 results in moderate spinal canal narrowing. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Posterior alignment is normal.
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Predominantly frontotemporal age-appropriate brain parenchymal volume loss is again seen, resulting in ex vacuo dilatation of the supratentorial ventricular system. Periventricular white matter hypoattenuation consistent with chronic mild microangiopathy. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. ORBITS: Interval development of bilateral pseudophakia. SKULL AND SKULL BASE: No acute fracture. Atherosclerotic calcifications of the bilateral carotid siphons and vertebral arteries. FACIAL BONES: Interval resection of previously described left maxillary gingival fornix mass and the adjacent maxillary sinus alveolar recess, with associated left radical lymph node dissection, fatty packing material and drain placement, without discrete residual enhancing masses. Fracture of the left lateral pterygoid plate, likely postsurgical. MANDIBLE: Intact. SINUSES: Surgical packing is present within the left maxillary resection bed extending into the left maxillary sinus. Bilateral maxillary sinus mucosal thickening. MASTOIDS: Clear.
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2,878
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Craniocervical CT angiogram 1/6/2022 7:15 PM Indication: Trauma Comparison: Cervical spine CT, same date Technique: 1.4 mm axial images were obtained during the early arterial phase of a rapid IV infusion of contrast, from the thoracic inlet through the circle of Willis. 3-D CT angiographic images were generated from axial data set. "Sliding slab MIP" images were also generated. Patient weight: 125 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 237.10 mm. DLP: 842 mGy cm. Findings: CTA neck: The visualized aortic arch appears normal. There is no evidence of traumatic aortic arch injury. There are no great vessel origin stenoses. There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. The included major intracranial arteries appear normal. Intradural right vertebral artery is hypoplastic. C-spine: Cervical intervertebral alignment is normal. Craniocervical junction is maintained. There is acute fracture through the base of odontoid process without significant displacement. There is no prevertebral edema or other soft tissue abnormality. Multilevel discogenic, facet uncovertebral degenerative changes throughout the cervical spine. Moderate to severe left neural foramen narrowing from C3 to C5. Impression: 1. No CT angiographic evidence of cervical arterial injury or flow-limiting stenoses. 2. Acute Type II odontoid fracture without significant displacement.
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Findings: CTA neck: The visualized aortic arch appears normal. There is no evidence of traumatic aortic arch injury. There are no great vessel origin stenoses. There is no evidence of irregularity, narrowing, occlusion or flap to indicate acute arterial injury or dissection. The included major intracranial arteries appear normal. Intradural right vertebral artery is hypoplastic. C-spine: Cervical intervertebral alignment is normal. Craniocervical junction is maintained. There is acute fracture through the base of odontoid process without significant displacement. There is no prevertebral edema or other soft tissue abnormality. Multilevel discogenic, facet uncovertebral degenerative changes throughout the cervical spine. Moderate to severe left neural foramen narrowing from C3 to C5.
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FINDINGS: STRUCTURED REPORT: CTA Abdomen Pelvis VASCULATURE: DISTAL DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: Moderate calcified and noncalcified atherosclerosis. CELIAC AXIS: No significant abnormality. Replaced left hepatic artery arising 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: Scattered mild calcified atherosclerosis. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: Scattered mild calcified atherosclerosis. ------------------------------------------------------------- LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Focal fatty infiltration along the falciform ligament. Hepatic steatosis. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Calcified granuloma. ADRENALS: Small right adrenal calcification unchanged, possibly from remote hemorrhage. KIDNEYS: Bilateral subcentimeter hypoattenuating lesions, likely renal cysts. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. OTHER VESSELS: No evidence of DVT. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Unchanged prominent Schmorl's nodes of the superior endplates L3 and L4 with associated mild anterior wedging. No aggressive osseous lesions. Mild multilevel discogenic degenerative change of the lumbar spine, most prominent at L5-S1 where there is a prominent calcified disc protrusion with associated mild spinal canal narrowing.
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2,879
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RADIOLOGIC EXAM: CT Cervical Spine wo contrast CLINICAL INFORMATION: fall COMPARISON: 11/12/2021 TECHNIQUE: CT Cervical Spine wo contrastScan field of view: 223 mm. DLP: 250 mGy cm. Following CT of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. STRUCTURED REPORT: CT Cervical Spine Trauma FINDINGS: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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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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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Minimal bibasilar atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Minimal coronary artery calcification. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Bilateral renal calculi, largest in the right upper pole is nearly 6 mm and largest in the left lower pole is 5 mm. There is mild right hydroureteronephrosis with extensive perinephric and periureteral fat stranding leading to a 4 x 4 x 6 mm (AP, TV, CC) calculus near the pelvic brim. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: As above. VESSELS: Minimal atherosclerosis. URINARY BLADDER: Punctate calcification along the posterior right bladder wall. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: Fat-containing umbilical and inguinal hernias. MUSCULOSKELETAL: Mild, multilevel discogenic degenerative changes.
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2,880
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EXAM: CT Abdomen and Pelvis wo IV contrast CLINICAL INFORMATION: 102-year-old female, evaluation after fall. COMPARISON: CT pelvis 11/12/2021; CT abdomen and pelvis 12/26/2017. TECHNIQUE: CT Abdomen and Pelvis wo IV contrast. Scan field of view: 380 mm. FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Severe coronary artery calcifications. The descending thoracic aorta is borderline dilated measuring 3 cm. ABDOMEN and PELVIS: LIVER: Normal unenhanced appearance. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Bilateral adrenal thickening, similar to prior exam. KIDNEYS: Bilateral renal cysts, multiple of which have enlarged in the interim. Hyperdense lesion in the right medial interpolar kidney, likely a proteinaceous versus hemorrhagic cyst. No hydronephrosis or renal calculi. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach is thick-walled which may be due to lack distention. The small bowel is normal in caliber. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Distended, otherwise normal. REPRODUCTIVE ORGANS: Uterus is absent. Right adnexal cystic lesion measuring 3.8 x 2.8 cm (axial series 201, image 158), previously 3.4 x 2.1 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic degenerative changes of the visualized thoracolumbar spine and bilateral hips. No aggressive osseous lesion. CONCLUSION: 1. No acute traumatic findings in the abdomen or pelvis, given limitations of noncontrast CT. 2. Postmenopausal right adnexal cyst measuring up to 3.8 cm only minimally increased in size since 2017. 3. Additional chronic and incidental findings as above. As the attending physician, I have personally reviewed the images, interpreted and/or supervised the study or procedure, and agree with the wording of the above report.
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FINDINGS: CT imaging was performed without IV contrast, which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Severe coronary artery calcifications. The descending thoracic aorta is borderline dilated measuring 3 cm. ABDOMEN and PELVIS: LIVER: Normal unenhanced appearance. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Bilateral adrenal thickening, similar to prior exam. KIDNEYS: Bilateral renal cysts, multiple of which have enlarged in the interim. Hyperdense lesion in the right medial interpolar kidney, likely a proteinaceous versus hemorrhagic cyst. No hydronephrosis or renal calculi. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: The stomach is thick-walled which may be due to lack distention. The small bowel is normal in caliber. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Moderate to severe calcific atherosclerosis of the abdominal aorta and its branch vessels. URINARY BLADDER: Distended, otherwise normal. REPRODUCTIVE ORGANS: Uterus is absent. Right adnexal cystic lesion measuring 3.8 x 2.8 cm (axial series 201, image 158), previously 3.4 x 2.1 cm. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Chronic degenerative changes of the visualized thoracolumbar spine and bilateral hips. No aggressive osseous lesion.
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Findings: Brain parenchyma: Diffuse age-appropriate brain parenchymal volume loss is seen, resulting in ex vacuo dilatation of the ventricular system. Mild periventricular white matter hypoattenuation is noted, suggestive of mild chronic microvascular ischemic disease. The white-gray matter differentiation is preserved. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Punctate atherosclerotic calcifications of the bilateral carotid siphons and the left vertebral artery. 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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2,881
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 64-year-old male with drain evaluation for COMPARISON: CT abdomen dated 9/15/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 165 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. Saline flush: 50 ml. IV contrast injection rate: 2.90 ml per sec. Scan delay: 80 sec. Scan field of view: 400 mm. DLP: 735 mGy cm. FINDINGS: Evaluation is limited by motion artifact which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Consolidation with air bronchogram in the left lower lobe. Dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Radiodensities are seen along the aortic valve and coronary vessels. ABDOMEN and PELVIS: LIVER: Postsurgical changes of transhepatic cholecystostomy tube placement are seen with the tube traverses the right hepatic lobe similar to prior exam. No suspicious lesion. BILIARY TRACT: Normal. GALLBLADDER: Percutaneous transhepatic cholecystostomy tube and appears to coil with the tip in lumen of the gallbladder, although the tip is not well-visualized secondary to motion artifact. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Left renal caliectasis. No hydronephrosis or suspicious lesion. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered mild/moderate atherosclerosis. Infrarenal IVC filter in place with similar strut penetration. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Small left fat-containing inguinal hernia. MUSCULOSKELETAL: Mild spondylosis and Schmorl's nodes of the visualized spine. No destructive osseous lesion. Chronic wedging of the vertebral bodies is similar. CONCLUSION: 1. Percutaneous transhepatic cholecystostomy tube appears to be coiled in the lumen of the gallbladder, although motion artifact limits visualization of the distal tip and gallbladder walls. 2. Diverticulosis, IVC filter in place, and other chronic 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: Evaluation is limited by motion artifact which can reduce diagnostic accuracy. STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Consolidation with air bronchogram in the left lower lobe. Dependent atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Radiodensities are seen along the aortic valve and coronary vessels. ABDOMEN and PELVIS: LIVER: Postsurgical changes of transhepatic cholecystostomy tube placement are seen with the tube traverses the right hepatic lobe similar to prior exam. No suspicious lesion. BILIARY TRACT: Normal. GALLBLADDER: Percutaneous transhepatic cholecystostomy tube and appears to coil with the tip in lumen of the gallbladder, although the tip is not well-visualized secondary to motion artifact. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Left renal caliectasis. No hydronephrosis or suspicious lesion. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Diverticulosis. Appendix is normal. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Scattered mild/moderate atherosclerosis. Infrarenal IVC filter in place with similar strut penetration. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Small left fat-containing inguinal hernia. MUSCULOSKELETAL: Mild spondylosis and Schmorl's nodes of the visualized spine. No destructive osseous lesion. Chronic wedging of the vertebral bodies is similar.
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FINDINGS: Diffuse osteopenia limits evaluation of subtle nondisplaced fractures. 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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2,882
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EXAM: CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: 102-year-old female with left hip pain after fall. COMPARISON: Same day CT abdomen and pelvis without contrast; CT bone pelvis 11/12/2021 TECHNIQUE: CT Bone Pelvis w soft tissue no charge Scan field of view: 380 mm. DLP: 370.90 mGy cm. FINDINGS: BONES/JOINTS: No acute fracture or malalignment. Mild degenerative arthrosis of bilateral hips and the pubic symphysis. Chronic degenerative changes of the lumbar spine. SOFT TISSUES: No large hematoma or fluid collection. OTHER: Uncomplicated diverticulosis. Moderate two severe calcified atherosclerotic disease of the abdominal aorta and its branch vessels. Simple appearing right adnexal cyst is unchanged. CONCLUSION: 1. No acute fracture or malalignment. 2. 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: BONES/JOINTS: No acute fracture or malalignment. Mild degenerative arthrosis of bilateral hips and the pubic symphysis. Chronic degenerative changes of the lumbar spine. SOFT TISSUES: No large hematoma or fluid collection. OTHER: Uncomplicated diverticulosis. Moderate two severe calcified atherosclerotic disease of the abdominal aorta and its branch vessels. Simple appearing right adnexal cyst is unchanged.
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FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered subsegmental atelectasis. Small right posterolateral tracheal diverticulum at the thoracic inlet. HEART / VESSELS: Mild calcified atherosclerosis, including three vessel coronary atherosclerosis. Mild tortuosity of the descending aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Minimally displaced left anterior fourth rib fracture. Healed right midclavicular and posterior right 10th and left 10th and 11th rib fractures. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing right nephrolithiasis, the largest stone measuring 6 mm. Mild right periureteral stranding, most prominent at the hilum, with mild hydroureter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: Diverticula without inflammation. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild scattered calcified atherosclerosis without aneurysm. URINARY BLADDER: Mild diffuse wall thickening and perivesicular stranding. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Right iliac wing screw without hardware complication. Healed right obturator ring fractures. Diffuse demineralization. Left femoral head and intertrochanteric enchondromas. THORACIC SPINE: VERTEBRA: Mild anterior wedging of T7 and T8, age indeterminant. Unchanged 50% vertebral body height loss of T10. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild levocurvature. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Facet predominant degenerative changes. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative. Mild levocurvature.
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2,883
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EXAM: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma. MVC. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat, CT Angio Neck, CT Cervical Spine From Reformat, CT Abdomen and Pelvis w contrast, CT Chest with contrast, CT Maxillofacial wo contrast, CT Bone Pelvis w soft tissue no charge 3-D CT MIP images were generated in post processing. Scan field of view: 230 mm. DLP: 1165 mGy cm. (accession CT220003416), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 200 mm. DLP: 992 mGy cm. (accession CT220003423), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. (accession CT220003418), Patient weight: 120 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bt sec. Scan field of view: 415 mm. DLP: 820 mGy cm. (accession CT220003417), Scan field of view: 200 mm. DLP: 1016 mGy cm. (accession CT220003422), Scan field of view: 325 mm. (accession CT220003442) FINDINGS: HEAD: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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: The gray-white matter differentiation is intact. There is no evidence of acute infarct, hemorrhage, mass or mass effect. Right choroidal fissural cyst is incidentally noted. The ventricular system and extra-axial spaces appear normal. No calvarial fracture is identified. MAXILLOFACIAL: Multiple dental caries. The mandible appears intact. The TMJs are appropriately aligned. The orbits appear within normal limits and the globes are intact. No acute maxillofacial fractures evident. There is minimal bilateral ethmoid air cell mucosal thickening. The visualized skull base and calvarium appear intact. 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: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered subsegmental atelectasis. Small right posterolateral tracheal diverticulum at the thoracic inlet. HEART / VESSELS: Mild calcified atherosclerosis, including three vessel coronary atherosclerosis. Mild tortuosity of the descending aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Minimally displaced left anterior fourth rib fracture. Healed right midclavicular and posterior right 10th and left 10th and 11th rib fractures. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing right nephrolithiasis, the largest stone measuring 6 mm. Mild right periureteral stranding, most prominent at the hilum, with mild hydroureter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: Diverticula without inflammation. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild scattered calcified atherosclerosis without aneurysm. URINARY BLADDER: Mild diffuse wall thickening and perivesicular stranding. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Right iliac wing screw without hardware complication. Healed right obturator ring fractures. Diffuse demineralization. Left femoral head and intertrochanteric enchondromas. THORACIC SPINE: VERTEBRA: Mild anterior wedging of T7 and T8, age indeterminant. Unchanged 50% vertebral body height loss of T10. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild levocurvature. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Facet predominant degenerative changes. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative. Mild levocurvature.
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2,884
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EXAM: CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Fall. COMPARISON: Earlier same day pelvic radiograph. TECHNIQUE: CT Bone Pelvis w soft tissue no charge Scan field of view: 346 mm. FINDINGS: BONES/JOINTS: Mildly displaced comminuted fractures of the right superior and inferior pubic rami with extension into the pubic body. Right zone I sacral fracture with extension to the right SI joint. No SI joint or pubic symphysis diastasis. Diffuse decreased bone mineralization. SOFT TISSUES: Left pelvic sidewall hematoma. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings. CONCLUSION: 1. Right superior and inferior comminuted pubic rami fractures with extension to the pubic body and associated pelvic sidewall hematoma. 2. Right zone I sacral fractures with extension to the right SI joint. 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: Mildly displaced comminuted fractures of the right superior and inferior pubic rami with extension into the pubic body. Right zone I sacral fracture with extension to the right SI joint. No SI joint or pubic symphysis diastasis. Diffuse decreased bone mineralization. SOFT TISSUES: Left pelvic sidewall hematoma. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered subsegmental atelectasis. Small right posterolateral tracheal diverticulum at the thoracic inlet. HEART / VESSELS: Mild calcified atherosclerosis, including three vessel coronary atherosclerosis. Mild tortuosity of the descending aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Minimally displaced left anterior fourth rib fracture. Healed right midclavicular and posterior right 10th and left 10th and 11th rib fractures. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing right nephrolithiasis, the largest stone measuring 6 mm. Mild right periureteral stranding, most prominent at the hilum, with mild hydroureter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: Diverticula without inflammation. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild scattered calcified atherosclerosis without aneurysm. URINARY BLADDER: Mild diffuse wall thickening and perivesicular stranding. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Right iliac wing screw without hardware complication. Healed right obturator ring fractures. Diffuse demineralization. Left femoral head and intertrochanteric enchondromas. THORACIC SPINE: VERTEBRA: Mild anterior wedging of T7 and T8, age indeterminant. Unchanged 50% vertebral body height loss of T10. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild levocurvature. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Facet predominant degenerative changes. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative. Mild levocurvature.
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2,885
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EXAM: CT Angio Chest wo+w contrast CLINICAL INFORMATION: Shortness of breath, hemoptysis, chest pain COMPARISON: None. TECHNIQUE: CT Angio Chest wo+w contrast Additional 3D image post-processing was performed to generate MIP and/or volume-rendered images. Patient weight: 140 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: 318.50 mm. KVP: 100 DLP: 162.70 mGy cm. FINDINGS: STRUCTURED REPORT: CT PE OVERALL DIAGNOSTIC QUALITY: Full diagnostic quality LOWER NECK: No abnormality. CHEST: PULMONARY ARTERIES: Negative for pulmonary embolus. Pulmonary artery is enlarged. LUNGS / AIRWAYS / PLEURA: Left basilar airspace consolidation. Right middle lobe and bilateral upper lobe patchy groundglass opacities. Additional masslike consolidation in the left upper lobe measuring 3 x 2 cm. HEART / OTHER VESSELS: Cardiomegaly. Dense annular mitral calcification. Aortic valve prosthesis. Scattered coronary artery calcification. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Somewhat spiculated left breast lesion with central fat lucency. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Chronic T3 superior endplate compression deformity. CONCLUSION: 1. Negative for pulmonary embolus. 2. Multifocal pneumonia with left basilar predominant consolidation. 3. Masslike consolidation in the left upper lobe could feasibly reflect malignancy. Short-term follow-up CT and/or PET scan recommended once pneumonia has resolved. 4. Spiculated left breast lesion with central fat lucency probably reflects fat necrosis. Mammographic correlation recommended, however. 5. Feature suggestive of pulmonary arterial hypertension and additional findings detailed above.
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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. Pulmonary artery is enlarged. LUNGS / AIRWAYS / PLEURA: Left basilar airspace consolidation. Right middle lobe and bilateral upper lobe patchy groundglass opacities. Additional masslike consolidation in the left upper lobe measuring 3 x 2 cm. HEART / OTHER VESSELS: Cardiomegaly. Dense annular mitral calcification. Aortic valve prosthesis. Scattered coronary artery calcification. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None enlarged. CHEST WALL: Somewhat spiculated left breast lesion with central fat lucency. UPPER ABDOMEN: Normal. MUSCULOSKELETAL: Chronic T3 superior endplate compression deformity.
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FINDINGS: LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered subsegmental atelectasis. Small right posterolateral tracheal diverticulum at the thoracic inlet. HEART / VESSELS: Mild calcified atherosclerosis, including three vessel coronary atherosclerosis. Mild tortuosity of the descending aorta. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Minimally displaced left anterior fourth rib fracture. Healed right midclavicular and posterior right 10th and left 10th and 11th rib fractures. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Nonobstructing right nephrolithiasis, the largest stone measuring 6 mm. Mild right periureteral stranding, most prominent at the hilum, with mild hydroureter. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: Small hiatal hernia. COLON / APPENDIX: Diverticula without inflammation. Appendix is absent. PERITONEUM / MESENTERY: Normal. RETROPERITONEUM: Normal. VESSELS: Mild scattered calcified atherosclerosis without aneurysm. URINARY BLADDER: Mild diffuse wall thickening and perivesicular stranding. REPRODUCTIVE ORGANS: Uterus is absent. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Right iliac wing screw without hardware complication. Healed right obturator ring fractures. Diffuse demineralization. Left femoral head and intertrochanteric enchondromas. THORACIC SPINE: VERTEBRA: Mild anterior wedging of T7 and T8, age indeterminant. Unchanged 50% vertebral body height loss of T10. DISC SPACES AND FACET JOINTS: No acute injury. ALIGNMENT: Mild levocurvature. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. Facet predominant degenerative changes. ALIGNMENT: Grade 1 anterolisthesis of L4 on L5, likely degenerative. Mild levocurvature.
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2,886
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EXAM: CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Trauma. COMPARISON: Earlier same day pelvic radiograph. TECHNIQUE: CT Bone Pelvis w soft tissue no charge Scan field of view: 394 mm. FINDINGS: BONES/JOINTS: Right mildly comminuted intratrochanteric fracture. Right zone I sacral fracture. No pubic symphysis diastasis or significant SI joint widening. Partially imaged left femoral fixation hardware appears intact. Bilateral L5 pars defects with grade 1 anterolisthesis of L5 over S1. Partially visualized proximal left femur fixation hardware. SOFT TISSUES: No large hematoma or fluid collection. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings. CONCLUSION: 1. Mildly comminuted right intertrochanteric fracture. 2. Right zone I sacral 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: Right mildly comminuted intratrochanteric fracture. Right zone I sacral fracture. No pubic symphysis diastasis or significant SI joint widening. Partially imaged left femoral fixation hardware appears intact. Bilateral L5 pars defects with grade 1 anterolisthesis of L5 over S1. Partially visualized proximal left femur fixation hardware. SOFT TISSUES: No large hematoma or fluid collection. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. SKULL AND SKULL BASE: No acute fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild maxillary sinus mucosal thickening. MASTOIDS: Clear. SOFT TISSUES: Calcified atherosclerotic disease of the cavernous carotid arteries. CERVICOCRANIAL JUNCTION: The occipital condyles are normal. ATLANTODENTAL INTERVAL: Normal (
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2,887
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EXAM: CT Bone Pelvis w soft tissue no charge CLINICAL INFORMATION: Concern for femoral neck fracture COMPARISON: None. TECHNIQUE: CT Bone Pelvis w soft tissue no charge Scan field of view: 346 mm. FINDINGS/CONCLUSION: No acute fracture or dislocation. The femoral heads are well-seated within their respective acetabula. No pubic symphyseal or SI joint diastasis. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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FINDINGS/CONCLUSION: No acute fracture or dislocation. The femoral heads are well-seated within their respective acetabula. No pubic symphyseal or SI joint diastasis. Please see separately dictated and concurrently obtained CT chest abdomen and pelvis for intra-abdominal findings.
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral cortical volume is appropriate for patient's age. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. SKULL AND SKULL BASE: No acute fracture. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SINUSES: Mild maxillary sinus mucosal thickening. MASTOIDS: Clear. SOFT TISSUES: Calcified atherosclerotic disease of the cavernous carotid arteries. CERVICOCRANIAL JUNCTION: The occipital condyles are normal. ATLANTODENTAL INTERVAL: Normal (
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2,888
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: 33-year-old female with right-sided abdominal pain. COMPARISON: CT abdomen and pelvis 8/9/2020 TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 200 lbs. IV contrast: Omnipaque 350, 115 ml, per protocol. IV contrast injection rate: 3 ml per sec. Scan delay: 78 sec. Scan field of view: 392 mm. DLP: 1066 mGy cm. FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Normal. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: 2-3 mm nonobstructing renal calculi bilaterally. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No other significant abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is surgically absent. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Mostly decompressed, otherwise unremarkable. REPRODUCTIVE ORGANS: Uterus is surgically absent. BODY WALL: Calcified granulomas in the left gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Transitional lumbosacral anatomy. CONCLUSION: 1. No acute imaging findings in the abdomen or pelvis. 2. Bilateral nonobstructing nephrolithiasis, similar to prior exam. 3. 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: Normal. DISTAL ESOPHAGUS: Small hiatal hernia. HEART / VESSELS: No significant abnormality. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: Surgically absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: 2-3 mm nonobstructing renal calculi bilaterally. No hydronephrosis. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No other significant abnormality. COLON / APPENDIX: Uncomplicated diverticulosis. Appendix is surgically absent. PERITONEUM / MESENTERY: Normal. No free fluid. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Mostly decompressed, otherwise unremarkable. REPRODUCTIVE ORGANS: Uterus is surgically absent. BODY WALL: Calcified granulomas in the left gluteal soft tissues. No other significant abnormality. MUSCULOSKELETAL: Transitional lumbosacral anatomy.
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FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: CORONARY ARTERIES: There is moderate atherosclerotic calcification within the LAD. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: Conventional three vessel branching. DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: No significant abnormality. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Minimal calcific atherosclerosis within the internal iliac artery. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered subcentimeter solid pulmonary nodules the largest of which measures 7 mm in maximum axial diameter within the anterior right lower lobe (series 501 image 73) . HEART / OTHER VESSELS: As above. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None pathologically enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis with hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: Collapsed. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Nodular thickening of the left adrenal gland. KIDNEYS: Bilateral simple renal cysts with the largest measuring 6 cm in maximum axial diameter on the right. LYMPH NODES: Prominent lymph nodes within the jejunal mesentery (series 501 image 165). STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colon is unremarkable. Normal appendix. PERITONEUM / MESENTERY: Mild stranding within the jejunal mesentery. RETROPERITONEUM: Normal. OTHER VESSELS: As above. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Small fat-containing periumbilical hernia. MUSCULOSKELETAL: Mild discogenic degenerative changes.
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2,889
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CT Angio Head wo+w contrast, CT Angio Neck 1/6/2022 11:26 PM Indication: anisocoria with fixed dilated left pupil Spec Inst: anisocoria with fixed dilated left pupil, rule out aneurysm. Comparison: No prior similar studies are presented for comparison at this time. Technique: Axial noncontrast images from the level of the skull base to the vertex. After the administration of IV contrast bolus, helical axial images were obtained from the clavicles to the vertex and reformatted in multiple planes. Delayed contrast enhanced axial images were then performed from the base of the skull to the vertex. 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: 209 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 272 mm. DLP: 1310 mGy cm. (accession CT220003448), Patient weight: 209 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 272 mm. DLP: 1310 mGy cm. (accession CT220003449) Findings: Conventional CT of the brain: Dual based extra-axial enhancing lesion in the right anterior temporal region likely represents metastatic disease measuring 1.7 x 1.7 cm (image 34, series 26). In addition, there are multiple areas of nodular likely pachymeningeal enhancement with index lesion measuring approximately 1 x 0.9 cm in the right frontal opercular region (image 44, series 26). Additional enhancing nodularity along the right MCA cistern and sylvian fissure. There is thickening and encasement of the intracranial part of the right optic nerve and optic chiasm is along with bilateral optic tracts concerning for involvement with metastatic tumor. Further evaluation with MRI of brain with orbit protocol is suggested. Otherwise gray and white matter attenuation differentiation bilateral cerebral hemispheres is maintained. Extensive periventricular white matter hypoattenuation in a pattern compatible with severe small vessel ischemic disease. Ventriculomegaly with crowding of sulcal spaces at the vertex suggests normal pressure hydrocephalus. No intracranial hemorrhage or midline shift. Otherwise bilateral orbits are unremarkable. Mucosal thickening in the left maxillary sinus. No acute calvarial fractures. CT angiogram of the brain: Medially directed small left cavernous ICA aneurysm measuring 3 mm in size (image 304, series 19). Minimal atherosclerotic changes in intracranial vasculature. Fetal origin of left PCA. Hypoplasia V4 segment of the right vertebral artery. Otherwise, the visualized portions of the ICAs and vertebrobasilar system appear within normal limits. Bilateral ophthalmic arteries are patent. CT angiogram of the neck: Large vascular enhancing mass measuring 3.8 x 4.6 cm (image 224, series 6) with stippled calcification in the carotid space encasing the left internal carotid artery without definite narrowing or occlusion suggesting a paraganglioma. The mass appears to extend into the carotico-jugular space at the skull base on the left. Otherwise, visualized portions of the aortic arch and arch vessels are unremarkable. Splaying of the left internal carotid artery and external carotid artery branches. Otherwise, the common, as well as cervical portions of the right internal, and right external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. Miscellaneous: Partially visualized bilateral pulmonary embolism in bilateral lower lobar and right upper lobar pulmonary artery. Degenerative changes in the cervical spine. IMPRESSION: 1. Multiple extra-axial enhancing lesions in the right temporal and right frontal regions concerning for meningeal metastasis. 2. In addition there is encasement of enhancing soft tissue along the optic chiasm, right intracranial portion of the optic nerve and bilateral optic tracts likely related to metastatic disease. 3. Ventriculomegaly with crowding of sulcal spaces towards the vertex, may suggest normal pressure hydrocephalus in the appropriate clinical setting. 4. Extensive periventricular white matter hypoattenuation in a pattern compatible with severe small vessel ischemic disease. 5. Small 3 mm medially directed aneurysm in the cavernous left ICA. There is mild encasement without occlusion of metastatic soft tissue along the right M1 segment in the MCA cistern. Otherwise no significant abnormality in the intracranial vasculature. 6. Large left carotid space mass with extension towards the skull base suggesting paraganglioma, encasing the left internal carotid artery in the neck and extending into the left caroticojugular space at the skull base. 7. No other significant vascular abnormality in the neck. 8. Bilateral pulmonary emboli. 9. Other findings as described above. The above results were discussed with Dr. Aubery Young on 1/7/2022 8:32 AM, over phone by Dr. Gopi Sirineni.
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Findings: Conventional CT of the brain: Dual based extra-axial enhancing lesion in the right anterior temporal region likely represents metastatic disease measuring 1.7 x 1.7 cm (image 34, series 26). In addition, there are multiple areas of nodular likely pachymeningeal enhancement with index lesion measuring approximately 1 x 0.9 cm in the right frontal opercular region (image 44, series 26). Additional enhancing nodularity along the right MCA cistern and sylvian fissure. There is thickening and encasement of the intracranial part of the right optic nerve and optic chiasm is along with bilateral optic tracts concerning for involvement with metastatic tumor. Further evaluation with MRI of brain with orbit protocol is suggested. Otherwise gray and white matter attenuation differentiation bilateral cerebral hemispheres is maintained. Extensive periventricular white matter hypoattenuation in a pattern compatible with severe small vessel ischemic disease. Ventriculomegaly with crowding of sulcal spaces at the vertex suggests normal pressure hydrocephalus. No intracranial hemorrhage or midline shift. Otherwise bilateral orbits are unremarkable. Mucosal thickening in the left maxillary sinus. No acute calvarial fractures. CT angiogram of the brain: Medially directed small left cavernous ICA aneurysm measuring 3 mm in size (image 304, series 19). Minimal atherosclerotic changes in intracranial vasculature. Fetal origin of left PCA. Hypoplasia V4 segment of the right vertebral artery. Otherwise, the visualized portions of the ICAs and vertebrobasilar system appear within normal limits. Bilateral ophthalmic arteries are patent. CT angiogram of the neck: Large vascular enhancing mass measuring 3.8 x 4.6 cm (image 224, series 6) with stippled calcification in the carotid space encasing the left internal carotid artery without definite narrowing or occlusion suggesting a paraganglioma. The mass appears to extend into the carotico-jugular space at the skull base on the left. Otherwise, visualized portions of the aortic arch and arch vessels are unremarkable. Splaying of the left internal carotid artery and external carotid artery branches. Otherwise, the common, as well as cervical portions of the right internal, and right external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. Miscellaneous: Partially visualized bilateral pulmonary embolism in bilateral lower lobar and right upper lobar pulmonary artery. Degenerative changes in the cervical spine.
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FINDINGS: STRUCTURED REPORT: CTA CAP VASCULATURE: CORONARY ARTERIES: There is moderate atherosclerotic calcification within the LAD. PULMONARY ARTERIES: No central pulmonary embolus. Normal size. ASCENDING THORACIC AORTA: No significant abnormality. AORTIC ARCH: No significant abnormality. ARCH VESSELS: Conventional three vessel branching. DESCENDING THORACIC AORTA: No significant abnormality. ABDOMINAL AORTA: No significant abnormality. CELIAC AXIS: No significant abnormality. SMA: No significant abnormality. RIGHT RENAL: No significant abnormality. LEFT RENAL: No significant abnormality. IMA: No significant abnormality. RIGHT ILIAC / PROXIMAL FEMORAL ARTERIES: Minimal calcific atherosclerosis within the internal iliac artery. LEFT ILIAC / PROXIMAL FEMORAL ARTERIES: No significant abnormality. ------------------------------------------------------------- LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Scattered subcentimeter solid pulmonary nodules the largest of which measures 7 mm in maximum axial diameter within the anterior right lower lobe (series 501 image 73) . HEART / OTHER VESSELS: As above. MEDIASTINUM / ESOPHAGUS: Normal. LYMPH NODES: None pathologically enlarged. CHEST WALL: Bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Hepatic steatosis with hepatomegaly. BILIARY TRACT: Normal. GALLBLADDER: Collapsed. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Nodular thickening of the left adrenal gland. KIDNEYS: Bilateral simple renal cysts with the largest measuring 6 cm in maximum axial diameter on the right. LYMPH NODES: Prominent lymph nodes within the jejunal mesentery (series 501 image 165). STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: Colon is unremarkable. Normal appendix. PERITONEUM / MESENTERY: Mild stranding within the jejunal mesentery. RETROPERITONEUM: Normal. OTHER VESSELS: As above. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Mild prostatomegaly. BODY WALL: Small fat-containing periumbilical hernia. MUSCULOSKELETAL: Mild discogenic degenerative changes.
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2,890
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CT Angio Head wo+w contrast, CT Angio Neck 1/6/2022 11:26 PM Indication: anisocoria with fixed dilated left pupil Spec Inst: anisocoria with fixed dilated left pupil, rule out aneurysm. Comparison: No prior similar studies are presented for comparison at this time. Technique: Axial noncontrast images from the level of the skull base to the vertex. After the administration of IV contrast bolus, helical axial images were obtained from the clavicles to the vertex and reformatted in multiple planes. Delayed contrast enhanced axial images were then performed from the base of the skull to the vertex. 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: 209 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 272 mm. DLP: 1310 mGy cm. (accession CT220003448), Patient weight: 209 lbs. IV contrast: Omnipaque 350, 100 ml, per protocol. Saline flush: 75 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 272 mm. DLP: 1310 mGy cm. (accession CT220003449) Findings: Conventional CT of the brain: Dual based extra-axial enhancing lesion in the right anterior temporal region likely represents metastatic disease measuring 1.7 x 1.7 cm (image 34, series 26). In addition, there are multiple areas of nodular likely pachymeningeal enhancement with index lesion measuring approximately 1 x 0.9 cm in the right frontal opercular region (image 44, series 26). Additional enhancing nodularity along the right MCA cistern and sylvian fissure. There is thickening and encasement of the intracranial part of the right optic nerve and optic chiasm is along with bilateral optic tracts concerning for involvement with metastatic tumor. Further evaluation with MRI of brain with orbit protocol is suggested. Otherwise gray and white matter attenuation differentiation bilateral cerebral hemispheres is maintained. Extensive periventricular white matter hypoattenuation in a pattern compatible with severe small vessel ischemic disease. Ventriculomegaly with crowding of sulcal spaces at the vertex suggests normal pressure hydrocephalus. No intracranial hemorrhage or midline shift. Otherwise bilateral orbits are unremarkable. Mucosal thickening in the left maxillary sinus. No acute calvarial fractures. CT angiogram of the brain: Medially directed small left cavernous ICA aneurysm measuring 3 mm in size (image 304, series 19). Minimal atherosclerotic changes in intracranial vasculature. Fetal origin of left PCA. Hypoplasia V4 segment of the right vertebral artery. Otherwise, the visualized portions of the ICAs and vertebrobasilar system appear within normal limits. Bilateral ophthalmic arteries are patent. CT angiogram of the neck: Large vascular enhancing mass measuring 3.8 x 4.6 cm (image 224, series 6) with stippled calcification in the carotid space encasing the left internal carotid artery without definite narrowing or occlusion suggesting a paraganglioma. The mass appears to extend into the carotico-jugular space at the skull base on the left. Otherwise, visualized portions of the aortic arch and arch vessels are unremarkable. Splaying of the left internal carotid artery and external carotid artery branches. Otherwise, the common, as well as cervical portions of the right internal, and right external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. Miscellaneous: Partially visualized bilateral pulmonary embolism in bilateral lower lobar and right upper lobar pulmonary artery. Degenerative changes in the cervical spine. IMPRESSION: 1. Multiple extra-axial enhancing lesions in the right temporal and right frontal regions concerning for meningeal metastasis. 2. In addition there is encasement of enhancing soft tissue along the optic chiasm, right intracranial portion of the optic nerve and bilateral optic tracts likely related to metastatic disease. 3. Ventriculomegaly with crowding of sulcal spaces towards the vertex, may suggest normal pressure hydrocephalus in the appropriate clinical setting. 4. Extensive periventricular white matter hypoattenuation in a pattern compatible with severe small vessel ischemic disease. 5. Small 3 mm medially directed aneurysm in the cavernous left ICA. There is mild encasement without occlusion of metastatic soft tissue along the right M1 segment in the MCA cistern. Otherwise no significant abnormality in the intracranial vasculature. 6. Large left carotid space mass with extension towards the skull base suggesting paraganglioma, encasing the left internal carotid artery in the neck and extending into the left caroticojugular space at the skull base. 7. No other significant vascular abnormality in the neck. 8. Bilateral pulmonary emboli. 9. Other findings as described above. The above results were discussed with Dr. Aubery Young on 1/7/2022 8:32 AM, over phone by Dr. Gopi Sirineni.
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Findings: Conventional CT of the brain: Dual based extra-axial enhancing lesion in the right anterior temporal region likely represents metastatic disease measuring 1.7 x 1.7 cm (image 34, series 26). In addition, there are multiple areas of nodular likely pachymeningeal enhancement with index lesion measuring approximately 1 x 0.9 cm in the right frontal opercular region (image 44, series 26). Additional enhancing nodularity along the right MCA cistern and sylvian fissure. There is thickening and encasement of the intracranial part of the right optic nerve and optic chiasm is along with bilateral optic tracts concerning for involvement with metastatic tumor. Further evaluation with MRI of brain with orbit protocol is suggested. Otherwise gray and white matter attenuation differentiation bilateral cerebral hemispheres is maintained. Extensive periventricular white matter hypoattenuation in a pattern compatible with severe small vessel ischemic disease. Ventriculomegaly with crowding of sulcal spaces at the vertex suggests normal pressure hydrocephalus. No intracranial hemorrhage or midline shift. Otherwise bilateral orbits are unremarkable. Mucosal thickening in the left maxillary sinus. No acute calvarial fractures. CT angiogram of the brain: Medially directed small left cavernous ICA aneurysm measuring 3 mm in size (image 304, series 19). Minimal atherosclerotic changes in intracranial vasculature. Fetal origin of left PCA. Hypoplasia V4 segment of the right vertebral artery. Otherwise, the visualized portions of the ICAs and vertebrobasilar system appear within normal limits. Bilateral ophthalmic arteries are patent. CT angiogram of the neck: Large vascular enhancing mass measuring 3.8 x 4.6 cm (image 224, series 6) with stippled calcification in the carotid space encasing the left internal carotid artery without definite narrowing or occlusion suggesting a paraganglioma. The mass appears to extend into the carotico-jugular space at the skull base on the left. Otherwise, visualized portions of the aortic arch and arch vessels are unremarkable. Splaying of the left internal carotid artery and external carotid artery branches. Otherwise, the common, as well as cervical portions of the right internal, and right external carotid arteries appear within normal limits. The visualized vertebral arteries appear within normal limits. Miscellaneous: Partially visualized bilateral pulmonary embolism in bilateral lower lobar and right upper lobar pulmonary artery. Degenerative changes in the cervical spine.
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Findings: Brain parenchyma: Ill-defined hypoattenuation involving the left inferior frontal lobe is noted. Diffuse age-appropriate brain parenchymal volume loss is again seen, resulting in mild exvacuo dilatation of the ventricular system. Periventricular and subcortical white matter hypoattenuation is again noted, suggestive of moderate chronic microvascular ischemic disease. Remote lacunar infarcts are again seen in the right corona radiata, left caudate nucleus and left subinsular cortex. The white-gray matter differentiation is otherwise preserved. Basal cisterns: There is no significant effacement of the basilar cisterns. Extra-axial spaces: Normal appearance. No abnormal extra-axial fluid collections. Hemorrhage: No intracranial hemorrhage is identified. Midline shift: No significant midline shift is seen. Vascular system: Unchanged atherosclerotic calcifications of the bilateral carotid siphons and the left vertebral artery. Soft tissues: Unremarkable without discrete fluid collections. Orbits: Normal appearance. Unchanged bilateral lens replacements. 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: Persistent left posterior ethmoid air cell is also thickening. Otherwise, remain well aerated.
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2,891
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EXAM: CT Abdomen and Pelvis w contrast CLINICAL INFORMATION: Metastatic sarcoma COMPARISON: CT 04/27/2021. TECHNIQUE: CT Abdomen and Pelvis w contrast. Patient weight: 222 lbs. IV contrast: Omnipaque 350, 150 ml, per protocol. Saline flush: 100 ml. IV contrast injection rate: 3 ml per sec. Scan delay: 70sec Scan field of view: 442 mm. DLP: 785 mGy cm. FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Extensive pleural-based metastatic lesions in both the visualized lung bases, better evaluated on recent chest CT dated 01/06/2022. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Small pericardial effusion. ABDOMEN and PELVIS: LIVER: No focal hepatic lesions. BILIARY TRACT: Normal. GALLBLADDER: Small amount of gallbladder sludge. PANCREAS: Normal. SPLEEN: Stable splenomegaly. ADRENALS: Normal. KIDNEYS: Tiny nonobstructing bilateral renal calculi. Kidneys otherwise demonstrate normal, symmetric enhancement. No hydronephrosis or hydroureter. Nonspecific bilateral perinephric stranding without any discrete fluid collection. LYMPH NODES: Small nonspecific periportal lymph nodes. Tiny subcentimeter periaortic lymph nodes. STOMACH / SMALL BOWEL: Stomach and duodenum are partially distended. No abnormal dilatation of small bowel loops. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Interval development of small volume ascites. RETROPERITONEUM: Trace retroperitoneal fluid in the presacral region. Trace fluid in the pararenal space. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality. CONCLUSION: 1. No metastatic disease in abdomen and pelvis. 2. Interval development of small volume abdominal ascites likely secondary to elevated right heart pressure. 3. Other stable abdominal findings as described above. Chest findings are better evaluated on dedicated chest CT performed on 01/06/2022.
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FINDINGS: LOWER CHEST: LUNG BASES / PLEURA: Extensive pleural-based metastatic lesions in both the visualized lung bases, better evaluated on recent chest CT dated 01/06/2022. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Small pericardial effusion. ABDOMEN and PELVIS: LIVER: No focal hepatic lesions. BILIARY TRACT: Normal. GALLBLADDER: Small amount of gallbladder sludge. PANCREAS: Normal. SPLEEN: Stable splenomegaly. ADRENALS: Normal. KIDNEYS: Tiny nonobstructing bilateral renal calculi. Kidneys otherwise demonstrate normal, symmetric enhancement. No hydronephrosis or hydroureter. Nonspecific bilateral perinephric stranding without any discrete fluid collection. LYMPH NODES: Small nonspecific periportal lymph nodes. Tiny subcentimeter periaortic lymph nodes. STOMACH / SMALL BOWEL: Stomach and duodenum are partially distended. No abnormal dilatation of small bowel loops. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: Interval development of small volume ascites. RETROPERITONEUM: Trace retroperitoneal fluid in the presacral region. Trace fluid in the pararenal space. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: No significant abnormality.
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral volume is normal. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. SINONASAL CAVITIES: Left anterior sphenoid sinus mucous retention cyst. Mild scattered ethmoid air cell and right greater than left maxillary sinus mucosal thickening. The bilateral mastoid air cells and paranasal sinuses are otherwise well aerated.
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2,892
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma, MVA. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast. Scan field of view: 290.40 mm. DLP: 1482.60 mGy cm. (accession CT220003451), Scan field of view: 188.40 mm. DLP: 1100.40 mGy cm. (accession CT220003457) 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. MAXILLOFACIAL: No fracture. The orbits appear intact. The mandible appears intact with large sclerotic density, bone island or osteoma in the anterior mandible demonstrated. Multiple dental fillings are present. TMJs are appropriately aligned. The visualized skull base and calvarium appear intact. The mastoid air cells and visualized paranasal sinuses are clear. CONCLUSION: 1. No acute intracranial abnormality evident. 2. No acute maxillofacial or mandibular 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: 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. MAXILLOFACIAL: No fracture. The orbits appear intact. The mandible appears intact with large sclerotic density, bone island or osteoma in the anterior mandible demonstrated. Multiple dental fillings are present. TMJs are appropriately aligned. The visualized skull base and calvarium appear intact. The mastoid air cells and visualized paranasal sinuses are clear.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small cyst in the right lower lobe, possibly sequelae from prior infection. Calcified granuloma in the left upper lobe. No pneumothorax or pleural effusion. Trace dependent atelectasis. HEART / VESSELS: Normal heart size. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is present. No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. Calcified left hilar granulomas. CHEST WALL: Trace bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Small right adrenal hematoma measuring 3.0 x 1.1 cm (image 288, series #601). KIDNEYS: Scattered bilateral subcentimeter hypoattenuating lesions, likely renal cysts. Duplicated right renal collecting system. No hydronephrosis. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Open iliac crest apophyses consistent with skeletal immaturity. THORACIC SPINE: VERTEBRA: DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,893
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. IV contrast: Omnipaque 350, 120 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Mildly displaced anterior left first rib fracture with small left pneumothorax. There is left lower lobe subsegmental atelectasis although contusion/aspiration is not excluded. 2. Trace stranding/fluid near the inferior tip of the spleen, of uncertain significance but a tiny grade 1 injury in this region is difficult to exclude given a small amount of artifact. Clinical correlation recommended. 3. No additional acute traumatic injury within the abdomen or pelvis. 4. Minimal age indeterminate compression deformities of T3 and T4. While these are probably chronic, correlation point tenderness is recommended to exclude acute facture. 5. Indeterminate right breast nodule. Mammographic follow-up is recommended. 6. Trace pelvic free fluid, probably physiologic. 7. Additional findings above. Preliminary results were discussed with Dr. Isabel Dos Santos Marques at 8:28 PM on 1/6/2022 by Dr. Mary Beth Oglesby. Final report findings discussed with Dr. Marques at 1/6/2022 8:59 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 CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small cyst in the right lower lobe, possibly sequelae from prior infection. Calcified granuloma in the left upper lobe. No pneumothorax or pleural effusion. Trace dependent atelectasis. HEART / VESSELS: Normal heart size. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is present. No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. Calcified left hilar granulomas. CHEST WALL: Trace bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Small right adrenal hematoma measuring 3.0 x 1.1 cm (image 288, series #601). KIDNEYS: Scattered bilateral subcentimeter hypoattenuating lesions, likely renal cysts. Duplicated right renal collecting system. No hydronephrosis. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Open iliac crest apophyses consistent with skeletal immaturity. THORACIC SPINE: VERTEBRA: DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,894
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. IV contrast: Omnipaque 350, 120 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Mildly displaced anterior left first rib fracture with small left pneumothorax. There is left lower lobe subsegmental atelectasis although contusion/aspiration is not excluded. 2. Trace stranding/fluid near the inferior tip of the spleen, of uncertain significance but a tiny grade 1 injury in this region is difficult to exclude given a small amount of artifact. Clinical correlation recommended. 3. No additional acute traumatic injury within the abdomen or pelvis. 4. Minimal age indeterminate compression deformities of T3 and T4. While these are probably chronic, correlation point tenderness is recommended to exclude acute facture. 5. Indeterminate right breast nodule. Mammographic follow-up is recommended. 6. Trace pelvic free fluid, probably physiologic. 7. Additional findings above. Preliminary results were discussed with Dr. Isabel Dos Santos Marques at 8:28 PM on 1/6/2022 by Dr. Mary Beth Oglesby. Final report findings discussed with Dr. Marques at 1/6/2022 8:59 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 CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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Findings: The sagittal images demonstrate physiologic cervical lordosis, without subluxations. The vertebral bodies maintain normal height, without acute fractures or suspicious osseous lesions. No significant intervertebral disc space narrowing or extensive degenerative changes are identified. No significant neural foraminal narrowing or central spinal canal stenosis is seen. The craniocervical junction appears unremarkable. The prevertebral and paraspinal soft tissues appear normal.
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2,895
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Craniocervical CT angiogram 1/6/2022 8:14 PM Indication: Trauma Comparison: None Technique: Axial images were obtained during the early arterial phase of a rapid IV infusion of contrast, from the thoracic inlet through the circle of Willis. Following CTA of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. Sagittal and coronal reformatted images were generated. Additional 3D image postprocessing was performed to generate MIP and/or volume rendered images. Patient weight: 140 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 926.30 mGy cm. . Findings: CT C-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: CT C-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 CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small cyst in the right lower lobe, possibly sequelae from prior infection. Calcified granuloma in the left upper lobe. No pneumothorax or pleural effusion. Trace dependent atelectasis. HEART / VESSELS: Normal heart size. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is present. No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. Calcified left hilar granulomas. CHEST WALL: Trace bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Small right adrenal hematoma measuring 3.0 x 1.1 cm (image 288, series #601). KIDNEYS: Scattered bilateral subcentimeter hypoattenuating lesions, likely renal cysts. Duplicated right renal collecting system. No hydronephrosis. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Open iliac crest apophyses consistent with skeletal immaturity. THORACIC SPINE: VERTEBRA: DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,896
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. IV contrast: Omnipaque 350, 120 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Mildly displaced anterior left first rib fracture with small left pneumothorax. There is left lower lobe subsegmental atelectasis although contusion/aspiration is not excluded. 2. Trace stranding/fluid near the inferior tip of the spleen, of uncertain significance but a tiny grade 1 injury in this region is difficult to exclude given a small amount of artifact. Clinical correlation recommended. 3. No additional acute traumatic injury within the abdomen or pelvis. 4. Minimal age indeterminate compression deformities of T3 and T4. While these are probably chronic, correlation point tenderness is recommended to exclude acute facture. 5. Indeterminate right breast nodule. Mammographic follow-up is recommended. 6. Trace pelvic free fluid, probably physiologic. 7. Additional findings above. Preliminary results were discussed with Dr. Isabel Dos Santos Marques at 8:28 PM on 1/6/2022 by Dr. Mary Beth Oglesby. Final report findings discussed with Dr. Marques at 1/6/2022 8:59 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 CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small cyst in the right lower lobe, possibly sequelae from prior infection. Calcified granuloma in the left upper lobe. No pneumothorax or pleural effusion. Trace dependent atelectasis. HEART / VESSELS: Normal heart size. No pericardial effusion. MEDIASTINUM / ESOPHAGUS: Residual thymic tissue is present. No retrosternal hematoma. No pneumomediastinum. Normal appearance of the esophagus. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. Calcified left hilar granulomas. CHEST WALL: Trace bilateral gynecomastia. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Small right adrenal hematoma measuring 3.0 x 1.1 cm (image 288, series #601). KIDNEYS: Scattered bilateral subcentimeter hypoattenuating lesions, likely renal cysts. Duplicated right renal collecting system. No hydronephrosis. No acute injury. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No abnormality. PERITONEUM / MESENTERY: No free intraperitoneal fluid or air. RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: No abnormality. BODY WALL: No significant abnormality. MUSCULOSKELETAL: Open iliac crest apophyses consistent with skeletal immaturity. THORACIC SPINE: VERTEBRA: DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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2,897
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EXAM: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat CLINICAL INFORMATION: Trauma COMPARISON: None. TECHNIQUE: CT Chest with contrast, CT Abdomen and Pelvis w contrast, CT Lumbar Spine from Reformat, CT Thoracic Spine from Reformat. IV contrast: Omnipaque 350, 120 ml, per protocol. FINDINGS: STRUCTURED REPORT: CT CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. CONCLUSION: 1. Mildly displaced anterior left first rib fracture with small left pneumothorax. There is left lower lobe subsegmental atelectasis although contusion/aspiration is not excluded. 2. Trace stranding/fluid near the inferior tip of the spleen, of uncertain significance but a tiny grade 1 injury in this region is difficult to exclude given a small amount of artifact. Clinical correlation recommended. 3. No additional acute traumatic injury within the abdomen or pelvis. 4. Minimal age indeterminate compression deformities of T3 and T4. While these are probably chronic, correlation point tenderness is recommended to exclude acute facture. 5. Indeterminate right breast nodule. Mammographic follow-up is recommended. 6. Trace pelvic free fluid, probably physiologic. 7. Additional findings above. Preliminary results were discussed with Dr. Isabel Dos Santos Marques at 8:28 PM on 1/6/2022 by Dr. Mary Beth Oglesby. Final report findings discussed with Dr. Marques at 1/6/2022 8:59 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 CAP Trauma LOWER NECK: Normal. CHEST: LUNGS / AIRWAYS / PLEURA: Small left pneumothorax. Mild bilateral dependent atelectasis, left greater than right. HEART / VESSELS: No significant abnormality. MEDIASTINUM / ESOPHAGUS: Normal. DIAPHRAGM: Intact. LYMPH NODES: None enlarged. CHEST WALL: Mildly displaced left anterior first rib fracture. Bilateral breast implants are noted. There is a hyperdense nodule seen within the right breast measuring 1.3 cm on image 154, series 502. ABDOMEN and PELVIS: LIVER: Normal. BILIARY TRACT: Normal. GALLBLADDER: No abnormality. PANCREAS: Normal. SPLEEN: There is a trace amount of stranding/fluid seen near the inferior tip of the spleen (image 269, series 501) which is of uncertain significance. There is a small amount streak artifact in this region, although this could possibly obscure a tiny grade 1 injury.. ADRENALS: Normal. KIDNEYS: Normal. LYMPH NODES: None enlarged. STOMACH / SMALL BOWEL: No abnormality. COLON / APPENDIX: No colonic abnormality. The appendix is normal. PERITONEUM / MESENTERY: Trace pelvic free fluid RETROPERITONEUM: Normal. VESSELS: No significant abnormality. URINARY BLADDER: Normal. REPRODUCTIVE ORGANS: Normal appearance of the uterus. Small corpus luteal cyst is noted on the right adnexa. Left adnexa is normal. BODY WALL: Small fat-containing umbilical hernia. MUSCULOSKELETAL: Left first rib fracture, as above. No additional acute abnormality or aggressive osseous lesion. THORACIC SPINE: VERTEBRA: Superior endplate compression deformities of T3 and T4 appear probably chronic. No additional fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal. LUMBAR SPINE: VERTEBRA: No fracture. DISC SPACES AND FACET JOINTS: No acute injury. PREVERTEBRAL SOFT TISSUES: Normal. ALIGNMENT: Normal.
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FINDINGS: BRAIN PARENCHYMA: No intraparenchymal hemorrhage, mass effect or edema. Gray-white matter differentiation is maintained. Cerebral volume is normal. EXTRA-AXIAL SPACES: No epidural, subdural, or subarachnoid hemorrhage. VENTRICULAR SYSTEM: Normal. ORBITS: Normal. SKULL AND SKULL BASE: No acute fracture. FACIAL BONES: No acute fracture. MANDIBLE: Intact. SINONASAL CAVITIES: Left anterior sphenoid sinus mucous retention cyst. Mild scattered ethmoid air cell and right greater than left maxillary sinus mucosal thickening. The bilateral mastoid air cells and paranasal sinuses are otherwise well aerated.
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2,898
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RADIOLOGIC EXAM: CT Head wo contrast, CT Maxillofacial wo contrast CLINICAL INFORMATION: Trauma, MVA. COMPARISON: None. TECHNIQUE: CT Head wo contrast, CT Maxillofacial wo contrast. Scan field of view: 290.40 mm. DLP: 1482.60 mGy cm. (accession CT220003451), Scan field of view: 188.40 mm. DLP: 1100.40 mGy cm. (accession CT220003457) 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. MAXILLOFACIAL: No fracture. The orbits appear intact. The mandible appears intact with large sclerotic density, bone island or osteoma in the anterior mandible demonstrated. Multiple dental fillings are present. TMJs are appropriately aligned. The visualized skull base and calvarium appear intact. The mastoid air cells and visualized paranasal sinuses are clear. CONCLUSION: 1. No acute intracranial abnormality evident. 2. No acute maxillofacial or mandibular 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: 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. MAXILLOFACIAL: No fracture. The orbits appear intact. The mandible appears intact with large sclerotic density, bone island or osteoma in the anterior mandible demonstrated. Multiple dental fillings are present. TMJs are appropriately aligned. The visualized skull base and calvarium appear intact. The mastoid air cells and visualized paranasal sinuses are clear.
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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 mildly prominent and heterogeneous in appearance.
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2,899
|
Craniocervical CT angiogram 1/6/2022 8:14 PM Indication: Trauma Comparison: None Technique: Axial images were obtained during the early arterial phase of a rapid IV infusion of contrast, from the thoracic inlet through the circle of Willis. Following CTA of the neck, reformatted images were produced to optimize visualization of the osseous structures of the cervical spine. Sagittal and coronal reformatted images were generated. Additional 3D image postprocessing was performed to generate MIP and/or volume rendered images. Patient weight: 140 lbs. IV contrast: Omnipaque 350, 120 ml, per protocol. Saline flush: 70 ml. IV contrast injection rate: 4 ml per sec. Scan delay: bolus tracked Scan field of view: 246.90 mm. DLP: 926.30 mGy cm. . Findings: CT C-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: CT C-spine: SKULL BASE AND CERVICOCRANIAL JUNCTION: Visualized portions of skull base including occipital bone and occipital condyles are normal. No evidence of skull base fracture. ATLANTODENTAL INTERVAL: Normal (
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FINDINGS: STRUCTURED REPORT: CT Abdomen Pelvis LOWER CHEST: LUNG BASES / PLEURA: Scattered subsegmental atelectasis. DISTAL ESOPHAGUS: Normal. HEART / VESSELS: Calcified coronary atherosclerosis and aortic valve calcifications. ABDOMEN and PELVIS: LIVER: Subcentimeter hyperattenuating lesions in the inferior right lobe, unchanged. BILIARY TRACT: Mild intrahepatic and extrahepatic biliary dilation, likely related to cholecystectomy. GALLBLADDER: Absent. PANCREAS: Normal. SPLEEN: Normal. ADRENALS: Normal. KIDNEYS: Unchanged right upper pole cyst with wall calcification, Bosniak 2. Other scattered bilateral cysts and subcentimeter hypoattenuating lesions, too small to characterize, are overall unchanged. Worsened right hydroureteronephrosis likely associated to the distended urinary bladder. LYMPH NODES: Mildly enlarged right lower quadrant mesenteric node measuring 1.2 cm (series 301 image 200), without uptake on recent PET. STOMACH / SMALL BOWEL: No gastric abnormality. Mildly dilated jejunal loops in the left upper quadrant without focal transition point, likely postoperative ileus. Interval postsurgical changes of the small bowel in the pelvis. There is abundant disorganized gas and fluid directly inferior to the anastomosis. COLON / APPENDIX: Soft tissue density abutting the right lateral margin of the cecum measures 2.2 x 1.7 cm (series 301 image 244), previously 1.8 x 1.7 cm. Postsurgical changes at the rectosigmoid junction with suture line. PERITONEUM / MESENTERY: Moderate to large volume disorganized gas and fluid in the peritoneum. Portions of the fluid demonstrate increased density. RETROPERITONEUM: Normal. VESSELS: Mild calcified atherosclerosis. URINARY BLADDER: Distended. REPRODUCTIVE ORGANS: Postsurgical changes of hysterectomy and bilateral salpingo-oophorectomy. BODY WALL: Interval midline laparotomy. Mild anasarca. MUSCULOSKELETAL: Degenerative spine changes.
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