ayyuce/chexpert-subset · Datasets at Hugging Face

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	persistent bibasilar atelectasis/consolidation. physician to physician radiology consult line: (172) 812-4078 i have personally reviewed the images for this examination and agreed with the report transcribed above.
	low lung volumes. no significant interval change. persistent atelectasis or consolidation at the left base, stable.
	grossly stable left basilar opacity, likely representing pleural effusion and associated atelectasis. considering the dense retrocardiac opacity, an additional infiltrate is possible. the right lung remains clear. stable cardiomediastinal silhouette.
	no evidence of rib fracture. clear lungs.
	interval placement of line as above without evidence of pneumothorax.
	evidence of increasing volume overload with increased pulmonary edema, bilateral pleural effusions and bibasilar atelectasis.
	endotracheal tube, nasogastric tube, external pacing pads, mitral valve replacement, unchanged. lungs are grossly clear with no evidence of pulmonary edema or pleural effusions. 3
	left lower lobe atelectasis versus consolidation with left pleural effusion.
	interval development of right lower lobe opacity, likely due to airspace consolidation or atelectasis,and less likely effusion. pulmonary venous infarction cannot be excluded. new left costophrenic angle opacity, also likely due to airspace consolidation or atelectasis with or without effusion. findings communicated with ganote, kaleb over the telephone at 13:30 pm on 6/4/2018. dictated by resident: santiago, anthony - 6-4-2018 interpreted by attending radiologist: reed charley, md - 18-4 i, the attending signed below, have personally reviewed the images and agree with the report transcribed above. interpreted by attending radiologist: reed charley, md authored by : charley callie reed, md approval date : 6/4/2018
	pa and lateral upright views of the chest demonstrate stable positioning of a left anterior chest wall dual lead aicd device with right atrial and right ventricular leads. stable cardiomediastinal silhouette with no evidence of pulmonary edema, focal parenchymal opacity, or pleural effusions
	single portable semiupright frontal view of the chest demonstrates interval placement of a left upper extremity picc, with the tip at the level of the carina. a nasogastric tube is in place, with the tip in projection over the stomach. low lung volumes persist. bibasilar opacities may represent atelectasis versus consolidation. no evidence of pulmonary edema or pleural effusion. visualized cardiomediastinal silhouette is almost unchanged.
	lines and tubes unchanged. cardiomediastinal silhouette is normal. no pleural effusions, consolidations, pneumothorax, or pulmonary edema.
	right internal jugular central venous catheter with tip in the superior vena cava. cardiomegaly, mild pulmonary edema. retrocardiac opacity, which may represent consolidation versus atelectasis. small left pleural effusion possible.
	status post lung transplant with sternotomy wires and surgical clips in place, unchanged. there are hazy parenchymal opacifications seen in the bilateral middle lung zones peripherally, which most likely reflect crowding of pulmonary markings in an expiratory film obtained to rule out a pneumothorax. lung fields are otherwise clear. no evidence of a pneumothorax.
	a right picc line and left chest tube remain in place. no associated pneumothorax on this semierect film. abnormal opacity again noted in left mid and lower lung zones with associated small, partially loculated left pleural effusion. linear atelectasis again noted in the right base with associated small, right-sided pleural effusion.
	new median sternotomy wires are in place. right ij line, endotracheal tube, mediastinal drain, and left chest tube are in situ. no evidence of pneumothorax. small left-sided pleural effusion.
	there is associated massive cardiomegaly. multiple sternotomy wires unchanged. left subclavian venous line, tip at the junction of the brachiocephalic vein and superior vena cava.
	single upright ap view of the chest is limited secondary to marked respiratory motion. redemonstration of opacities in the left mid and lower lung zones as well as left pleural effusion.
	pa and lateral chest radiographs demonstrate no focal consolidation, pleural effusion or pneumothorax. chronic diffuse reticular changes again noted. stable cardiomediastinal silhouette pulmonary edema. tortuous thoracic aorta with atherosclerotic calcification. no acute bony abnormalities.
	improving right lung aeration and resolution the, near complete, of right perihilar abnormality. only minimal atelectasis remains. right chest tube remains in place. no pneumothorax. incidental note of prominent aortic knob and severe right shoulder degenerative changes, stable
	single ap portable upright view of the chest demonstrates no interval change to the patient's lines and tubes. large left sided pleural effusion with associated compressive atelectasis or left sided consolidation. interval improved aeration at the left lung apex. patchy opacification in the right lung appears unchanged.
	interval placement of a right-sided picc which terminates 6.5 cm below the carina. recommend retraction by 1.5 cm. left basilar opacity may represent compressive atelectasis versus consolidation i have personally reviewed the images for this examination and agreed with the report transcribed above.
	interval slight increase in pulmonary edema and no significant change in bibasilar opacities and bilateral pleural effusions.
	lines, tubes, and other medical support devices unchanged in position. stable marked enlargement of the cardiomediastinal silhouette. low lung volumes. mild pulmonary edema. left basilar consolidation and small bilateral pleural effusions. no pneumothorax or
	no acute cardiopulmonary disease. left costophrenic angle blunting may represent a small pleural effusion versus scarring. tortuous aorta with atherosclerosis. degenerative changes of the spine.
	06:06 hours compared with 12/7/03. support equipment is unchanged except the et tube has been retracted slightly how having its tip approximately 5 cm above the tracheal carina. cardiomediastinal silhouette is unchanged. the lungs show no interval change with somewhat decreased volume in the right hemithorax. no new opacity or pneumothorax.
	lungs are well-expanded and clear without focal consolidation. normal pulmonary vascular markings. costophrenic sulci are sharp. normal cardiomediastinal silhouette. no acute cardiopulmonary abnormality.
	right-sided picc is not significantly changed with tip projecting over the right atrium. possible bibasilar opacities or vascular crowding. atelectasis or consolidation not excluded. suggest lateral view for additional details as indicated. otherwise, no significant interval change of the chest.
	very low lung volumes with interstitial pulmonary edema.
	interval addition of an enteric tube and the tip is not seen. a right internal jugular venous catheter is present with its tip in the superior vena cava. moderate-sized right pleural effusion unchanged. stable right lower lobe atelectasis. the heart size is normal. the pulmonary vessels are unremarkable.
	two views of the chest demonstrate cardiomediastinal silhouette within normal limits. lungs are clear without evidence of focal consolidation, pulmonary edema, or pleural fluid. visualized osseous structures are without acute fracture
	persistent mild degree of linear opacities in the bilateral mid and lower lungs. no new focal consolidation. prominent cardiac size and silhouette is unchanged. no significant pulmonary edema. small bilateral pleural effusions. pleural calcifications remain unchanged. stable cardiomegaly, and appearance of aortic and mitral valvular replacement. sternotomy wires are intact. epicardial pacer leads are noted.
	blunting may be due to pleural thickening and/or pleural effusions, which are relatively small in size. increased aeration of the lung bases bilaterally, with some mild residual atelectasis in the left base.
	interval increase in opacity within the major fissure of the left lung which may represent an enlarging left pseudotumor. blunting and pleural calcification noted along the left costophrenic sulcus. mild increase in pulmonary edema. results discussed with the emergency room physician on 2/9/2010.
	single upright ap view of the chest demonstrates a small right pleural catheter overlying the right upper lung zone. no evidence of pneumothorax. small amount of subcutaneous emphysema is again seen along the right lateral chest wall. redemonstration of focal opacity in the right upper lung zone.
	blunting of the posterior costophrenic angles bilaterally is noted which could represent a small amount of pleural effusion. otherwise stable cardiomediastinal silhouette and clear lungs with stable appearance of sternotomy wires.
	tip of the endotracheal tube projects 2 cm above the carina. other lines and tubes are unchanged. increased right basilar linear atelectasis with slightly decreased lung volumes. no significant change in small, left pleural effusion and left retrocardiac opacity.
	the tip of the right arm picc line is projected over the superior vena cava. there has been no change in the position of the vp shunt which projects over the right hemithorax. there has been no change in position of the left pigtail catheter which projects over the lateral aspect of the mid left hemithorax. there is a tiny left pneumothorax. there is persistent bibasilar opacities. there are persistent small bilateral pleural effusions..
	single upright ap view of the chest demonstrates interval placement of a left internal jugular central venous catheter with distal tip just within the proximal superior vena cava. no definite pneumothorax. reticular pattern of the lungs, worst in the lung bases, not significantly changed. redemonstration of a 13 mm nodule in the right upper lobe. stable small bilateral pleural effusions. 5
	tracheostomy tube is in position. mild pulmonary edema not significantly changed.
	interval placement of a right tunneled central venous catheter with tip projecting over the cavoatrial junction. normal heart size and pulmonary vascularity. no focal consolidation, pleural effusion, or pneumothorax. bones are unremarkable.
	no significant interval change. markedly widened mediastinum, consistent with mediastinal hematoma. sternal wires. lines and tubes unchanged. bibasilar atelectasis or consolidation with bilateral pleural effusions.
	there is right lower lobe consolidation as well as left perihilar consolidation. left retrocardiac opacification. possible right pleural effusion. findings compatible with aspiration versus pneumonia. ap and lateral chest x-ray can be obtained to further evaluate. left internal jugular venous line in place. no pneumothorax.
	no change in the position of picc catheter. redemonstration of pulmonary edema, bibasilar opacities, and small bilateral pleural effusions, without interval change.
	single frontal radiograph of the chest demonstrates stable postsurgical changes. stable, prominent cardiomediastinal silhouette appeared, there has been interval increase in perihilar opacities, which likely represents worsening pulmonary edema. no focal consolidations in the lungs. visualized osseous structures and soft tissues unremarkable.
	interval post surgical changes with placement of new thoracic spinal fixation rods within the lower thoracic spine, as well as a interpositional cage. surgical skin staples. right chest tube and right upper extremity picc line in place. no pneumothorax. right rib thoracotomy changes. minimal bibasilar atelectasis. the lungs are otherwise clear.
	interval placement of an esophageal temperature probe terminating in the midesophagus and a weighted feeding tube with the tip distal to the inferior margin of the radiograph. interval placement of a right internal jugular central venous catheter terminating in the lower superior vena cava. interval decrease in right basilar opacity and decreased small right pleural effusion. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	opacity left lung base, question atelectasis or consolidation. blunting left costophrenic angle. mild interstitial pulmonary edema.
	enlarged cardiac mediastinal silhouette with perihilar opacities, which likely represent prominent pulmonary vascularity. no frank pulmonary edema. "physician to physician radiology consult line: (293) 804-4333" i have personally reviewed the images for this examination and agreed with the report transcribed above.
	ett appears high, measuring 7.8 cm above the carina. right basilar pneumothorax has improved slightly. persistent right lung opacities consistent with pulmonary contusion vs aspiration or infection. multiple right sided rib deformities and left 8th rib fracture are noted. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	diffuse coarse reticulation of the asymmetrically small right native lung, compatible with chronic interstitial lung disease. unchanged rightward shift of mediastinal structures. multiple surgical clips overlie the left mediastinum, compatible with left lung transplant. the transplanted left lung is clear, without evidence of focal consolidation, pleural effusion, or pneumothorax.
	left internal jugular catheter with tip at the cavoatrial junction. possible mild pulmonary edema. persistently low lung volumes, and left lower lobe opacity representing partial atelectasis versus infiltrate.
	pa and lateral chest without comparison demonstrates normal heart size with normal mediastinal contour for age, including a tortuous, calcified thoracic aorta. lungs are clear. negative for edema, consolidation, or pleural effusions. again demonstrated is a fracture of the left proximal humerus with displacement of the greater tuberosity fragment and inferior subluxation or dislocation of the humeral head relative to the glenoid.
	there is elevation of the left hemidiaphragm and left lower lobe atelectasis versus consolidation. within the right lung apex, there is a calcified nodular opacity which may represent a granuloma. the right lung is otherwise clear. cardiomediastinal silhouette is within normal limits.
	feeding tube remains in place. postsurgical clips are again noted, overall unchanged. small right-sided pleural effusion is again noted, overall unchanged. cardiomediastinal silhouette is overall unchanged. no evidence of increasing pulmonary edema is noted.
	constellation of findings are most consistent with heart failure and edema, however, cannot completely exclude a superimposed infection, especially in the lower lobes. results were discussed with martin, campos at approximately 18:00 hours on 1/30/2012.
	lines and tubes appear unchanged in position. persistent retrocardiac opacity and left pleural effusion, unchanged. low lung volumes.
	et tube, nasogastric tube, and swan-ganz catheter remain in good position. the swan-ganz appears to be in the main pulmonary artery. there is marked interval increase of patchy infiltrates bilaterally with what appears now to be near-complete right upper lobe consolidation. there remains a small persistent right-sided pleural effusion which is tracking up the pleural space as well. the findings are concerning for progressive pulmonary edema or an infectious process. please correlate clinically.
	stable right pneumothorax, and waxy and wavy pattern of right pulmonary and parenchymal opacities, which may be infectious or inflammatory over the sequence of two radiographs.
	endotracheal tube adjusted, tip in the trachea. interval placement of feeding tube, tip in stomach. no change in nasogastric tube or swan-ganz catheter. patchy bilateral opacities in the mid and lower lung zones and reticular pattern throughout lungs, consistent with pneumonia superimposed on edema, unchanged.
	low lung volumes. pulmonary edema has largely resolved. persistent consolidation at the left lung base and band atelectasis in the right mid-lung zone.
	endotracheal tube, left internal jugular venous catheter, and feeding tube, unchanged in position. upper limits of normal heart size. mild edema. persistent bibasilar consolidations from atelectasis, aspiration, or pneumonia, left greater than right, and moderate bilateral pleural effusions. no pneumothorax.
	pa and lateral upright views of the chest demonstrate clear lung fields with no evidence of focal consolidation, pulmonary edema, or pleural effusions. cardiomediastinal silhouette and hila are normal. no radiographic evidence of acute cardiopulmonary disease. bones and soft tissues are unremarkable.
	bibasilar opacities which may reflect atelectasis or early consolidation. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	two views of the chest demonstrate small left pleural effusion and left basilar opacity. small left-sided pneumothorax and left-sided rib fractures are better demonstrated on recent performed chest ct. additional linear atelectasis versus scarring is appreciated in the left lateral midlung zone. right lung remains grossly clear. post surgical changes are appreciated in the left shoulder.
	reticular opacities throughout the bilateral lungs, more dense in the right upper lobe, with associated small bilateral pleural effusions. cardiac size is at the upper limits of normal. these findings are suggestive of moderate pulmonary edema. recommend follow-up radiograph to evaluate the opacity in the right upper lobe. no acute bone abnormality demonstrated.
	interval placement of nasogastric tube. unchanged position of endotracheal tube. stable right-sided pleural effusion with consecutive atelectasis of the right lung. stable left-sided pleural effusion with left lower lobe atelectasis. stable cardiomediastinal silhouette with cardiomegaly/pericardial effusion. unchanged mild pulmonary edema. abdomen, one view: comparison: no comparisons. impression: feeding tube with tip in the distal stomach. non-specific bowel gas distribution. degenerative changes of the lumbar spine and enthesophytes in common places.
	redemonstration of cardiomegaly. unchanged left retrocardiac opacities.
	cardiomediastinal silhouette is upper limits of normal in size. mediastinal contour is normal. there is mild scarring at the right lung apex. the right hemidiaphragm is elevated. there is no pleural effusion. there is no pneumothorax. bony structures appear normal.
	there has been interval enlargement of the left-sided pleural effusion, which is now moderate in size. left sided pneumothorax also appears enlarged. increased left lung atelectasis. there is mild mediastinal shift to the left. there is continued interval enlargement of the left apical subpleural convex density, likely hematoma status post first rib resection. the amount of left-sided subcutaneous emphysema is stable. the right lung is clear.
	interval placement of tubes and lines as described above. possible left-sided deep sulcus sign may represent pneumothorax. retrocardiac opacity likely secondary to atelectasis. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	1 cm rounded opacity in the right upper lobe, possibly representing a calcified granuloma versus a pulmonary nodule. additional vague 1.1-cm opacity at the right cardiophrenic angle. finding may represent overlying shadows versus an additional nodule. cardiomediastinal silhouette unremarkable. lungs are clear without focal consolidation, effusion or edema.
	mild interval improved aeration of the dense right midlung zone consolidation again compatible with aspiration or infection. left basilar consolidation persists. diffuse mild reticular pattern may represent a component of pulmonary edema. stable positioning of the endotracheal tube, nasogastric tube, right internal jugular central line and a left chest dual lead pacer and numerous sternotomy wires.
	redemonstration of patchy right lung base opacity concerning for aspiration pneumonia in the appropriate clinical setting. no change in dense left retrocardiac consolidation and small left pleural effusion. stable appearance of lines, tubes and medical support devices. unchanged small biapical pneumothoraces. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	7 cm rounded opacity in the left mid lung is concerning for possible pneumonia, and there is a tiny left pleural effusion. focal atelectasis or scarring in the right midlung on a background of emphysematous changes. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	frontal and lateral radiograph of the chest demonstrates: 1.a left-sided cardiac pacemaker/icd with one atrial lead and two ventricular leads noted. slightly increased opacity in right mid lung zone, reflective of atelectasis or consolidation. stable moderate cardiomegaly.
	decrease in right-sided pleural effusion and pneumothorax, status post exchange of chest tubes. these findings may be better evaluated with ap and lateral follow up studies.
	frontal and lateral views chest demonstrate stable right internal jugular central line. clear lungs, with no focal consolidation, pleural effusions, or pulmonary edema. cardiomediastinal silhouette is stable and normal in configuration.
	bibasilar opacities 2.small left pleural effusion 3.possible pulmonary edema
	insertion of right pigtail catheter. remainder of lines and tubes unchanged in positions. mediastinal shift to the left with dense opacity in the left retrocardiac region and associated left-sided pleural effusion again noted.
	cardiomediastinal silhouette is within normal limits. lungs appear clear. no pulmonary edema. no pleural effusion. degenerative changes of the spine are present with anterior flowing osteophytes, compatible with d.i.s.h. rounded radio-opaque densities are noted in the right upper quadrant, likely representing gallstones.
	frontal and lateral views of the chest demonstrate a normal cardiomediastinal silhouette. lungs are clear without focal consolidation, effusion, or edema. visualized osseous structures are unremarkable.
	unchanged appearance of left anterior chest wall dual lead cardiac pacemaker with intact right atrial and ventricular leads. interval development of left retrocardiac opacities and small left pleural effusion. stable cardiomediastinal silhouette with redemonstration of calcification of the thoracic aorta. redemonstration of scoliosis and degenerative changes of the thoracic spine as well as radiopaque material, likely methyl methacrylate, in upper thoracic and partially visualized upper lumbar vertebral bodies. 5
	complete opacification of the right lung, likely from a large right pleural effusion. hazy reticular nodular opacities seen in the left lung consistent with moderate pulmonary edema. small left pleural effusion. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	two views of the chest demonstrate atherosclerotic calcification in the aortic arch with cardiomediastinal silhouette otherwise within normal limits. right costophrenic sulcus is incompletely visualized. lungs are otherwise clear without evidence of focal consolidation, pulmonary edema, or pleural fluid. visualized soft tissues and osseous structures are unremarkable.
	a single semiupright portable radiograph of the chest demonstrates unchanged appearance of lines and tubes, and surgical materials. interval decrease in already bilateral low lung volumes. persistent by basilar opacities likely representing small bilateral effusions with adjacent atelectasis and/or consolidation. persistent bilateral mild pulmonary edema.
	no interval change. the lungs remain clear without evidence of pneumonia.
	improving right perihilar and right upper lobe opacity. stable retrocardiac opacity, reflecting atelectasis or consolidation. stable appearance of lines and tubes.
	unchanged ng tube. unchanged right pleural pigtail catheter. stable layering right pleural effusion which probably explains most of the opacity in the right hemithorax. unchanged left effusion. bibasilar atelectasis.
	single frontal view of the chest done on 8/5/2012 at 1032 hours demonstrates left picc seen within the distal superior vena cava. normal pulmonary vasculature and cardiomediastinal silhouette. no evidence of pneumothorax or pleural effusions.
	air space opacities seen within both lung bases and within the right lung apex. within the right mid lung, there is a rounded opacity, which on lateral view corresponds to the lower lobe and could represent an area of consolidation, but loculated empyema cannot be excluded. recommend ct with contrast for further evaluation. cardiomediastinal silhouette, otherwise, stable.
	low lung volumes. interval increase in pulmonary edema. increase bibasilar opacification consistent with either atelectasis or pneumonia. bilateral pleural effusions increased in size.
	there has been interval reduction of the redundant length of coiled feeding tube in the oropharynx. otherwise, the lines and tubes are unchanged. redemonstration of bilateral rib fractures and widened mediastinum. there is persistent pulmonary edema. there is left retrocardiac atelectasis associated with a left- sided effusion.
	single frontal view of the chest demonstrates stable positioning of the left upper extremity picc. the lungs are clear with no focal atelectasis or consolidation. no pleural effusion demonstrated. the cardiomediastinal silhouette is within normal limits.
	follow-up portable semierect single view of the chest shows stable right internal jugular central venous catheter and tracheostomy tube. subcutaneous emphysema is significantly increased bilaterally. bilateral pneumothoraces are increased. pleural effusions show no significant interval change. follow-up portable upright single view of the chest shows stable tracheostomy tube and right internal jugular central venous catheter. interval placement of a right chest tube. bilateral pneumothoraces are decreased. the right pleural effusion is decreased. subcutaneous emphysema shows no significant interval change. follow-up portable semierect single view of the chest shows stable tracheostomy tube, right internal jugular central venous catheter, and interval placement of nasogastric tube with tip in the subdiaphragmatic position. left pneumothorax is stable and right pneumothorax is decreased in size. overlying the right upper chest is likely an external device. follow-up portable upright single view of the chest shows stable right chest tube, right internal jugular central venous catheter, tracheostomy tube and nasogastric tube. bilateral pneumothoraces are significantly increased, more predominantly at the bases. the subcutaneous emphysema is increased bilaterally. if more detailed characterization of the pneumothoraces is desired, a ct could be performed. pager #(542) 738-8002 was notified of these findings.
	stable positioning of the support devices. tip of the right picc is not well appreciated on the current exam. clear lungs. no new focal consolidation, pleural effusion, or pneumothorax.
	the endotracheal tube is 4.7 cm above the carina. other lines and tubes are unchanged positions. lungs volumes are slightly improved. there is a mild left base opacity, which may represent atelectasis, aspiration, or pneumonia. heart size is normal and unchanged.
	feeding tube, nasogastric tube, and left subclavian central venous catheter, unchanged. vp shunt, unchanged. no significant change in pulmonary findings, with low lung volumes and no evidence of consolidation, edema, or effusion.
	single frontal view of the chest taken on 6/3/2019 at 08:33 show a right arm picc line in place. the focality is atypical for pulmonary edema, but can be seen in pneumonia, pulmonary hemorrhage, or severe mitral regurgitation. partial clearing of the right lower lobe with the reappearance of the right hemidiaphragm.. clear left lung.
	this was discussed with weeks, charlotte on 8/23/1997. stable cardiomediastinal silhouette. supportive devices in stable position.

persistent bibasilar atelectasis/consolidation. physician to physician radiology consult line: (172) 812-4078 i have personally reviewed the images for this examination and agreed with the report transcribed above.

low lung volumes. no significant interval change. persistent atelectasis or consolidation at the left base, stable.

grossly stable left basilar opacity, likely representing pleural effusion and associated atelectasis. considering the dense retrocardiac opacity, an additional infiltrate is possible. the right lung remains clear. stable cardiomediastinal silhouette.

no evidence of rib fracture. clear lungs.

interval placement of line as above without evidence of pneumothorax.

evidence of increasing volume overload with increased pulmonary edema, bilateral pleural effusions and bibasilar atelectasis.

endotracheal tube, nasogastric tube, external pacing pads, mitral valve replacement, unchanged. lungs are grossly clear with no evidence of pulmonary edema or pleural effusions. 3

left lower lobe atelectasis versus consolidation with left pleural effusion.

interval development of right lower lobe opacity, likely due to airspace consolidation or atelectasis,and less likely effusion. pulmonary venous infarction cannot be excluded. new left costophrenic angle opacity, also likely due to airspace consolidation or atelectasis with or without effusion. findings communicated with ganote, kaleb over the telephone at 13:30 pm on 6/4/2018. dictated by resident: santiago, anthony - 6-4-2018 interpreted by attending radiologist: reed charley, md - 18-4 i, the attending signed below, have personally reviewed the images and agree with the report transcribed above. interpreted by attending radiologist: reed charley, md authored by : charley callie reed, md approval date : 6/4/2018

pa and lateral upright views of the chest demonstrate stable positioning of a left anterior chest wall dual lead aicd device with right atrial and right ventricular leads. stable cardiomediastinal silhouette with no evidence of pulmonary edema, focal parenchymal opacity, or pleural effusions

single portable semiupright frontal view of the chest demonstrates interval placement of a left upper extremity picc, with the tip at the level of the carina. a nasogastric tube is in place, with the tip in projection over the stomach. low lung volumes persist. bibasilar opacities may represent atelectasis versus consolidation. no evidence of pulmonary edema or pleural effusion. visualized cardiomediastinal silhouette is almost unchanged.

lines and tubes unchanged. cardiomediastinal silhouette is normal. no pleural effusions, consolidations, pneumothorax, or pulmonary edema.

right internal jugular central venous catheter with tip in the superior vena cava. cardiomegaly, mild pulmonary edema. retrocardiac opacity, which may represent consolidation versus atelectasis. small left pleural effusion possible.

status post lung transplant with sternotomy wires and surgical clips in place, unchanged. there are hazy parenchymal opacifications seen in the bilateral middle lung zones peripherally, which most likely reflect crowding of pulmonary markings in an expiratory film obtained to rule out a pneumothorax. lung fields are otherwise clear. no evidence of a pneumothorax.

a right picc line and left chest tube remain in place. no associated pneumothorax on this semierect film. abnormal opacity again noted in left mid and lower lung zones with associated small, partially loculated left pleural effusion. linear atelectasis again noted in the right base with associated small, right-sided pleural effusion.

new median sternotomy wires are in place. right ij line, endotracheal tube, mediastinal drain, and left chest tube are in situ. no evidence of pneumothorax. small left-sided pleural effusion.

there is associated massive cardiomegaly. multiple sternotomy wires unchanged. left subclavian venous line, tip at the junction of the brachiocephalic vein and superior vena cava.

single upright ap view of the chest is limited secondary to marked respiratory motion. redemonstration of opacities in the left mid and lower lung zones as well as left pleural effusion.

pa and lateral chest radiographs demonstrate no focal consolidation, pleural effusion or pneumothorax. chronic diffuse reticular changes again noted. stable cardiomediastinal silhouette pulmonary edema. tortuous thoracic aorta with atherosclerotic calcification. no acute bony abnormalities.

improving right lung aeration and resolution the, near complete, of right perihilar abnormality. only minimal atelectasis remains. right chest tube remains in place. no pneumothorax. incidental note of prominent aortic knob and severe right shoulder degenerative changes, stable

single ap portable upright view of the chest demonstrates no interval change to the patient's lines and tubes. large left sided pleural effusion with associated compressive atelectasis or left sided consolidation. interval improved aeration at the left lung apex. patchy opacification in the right lung appears unchanged.

interval placement of a right-sided picc which terminates 6.5 cm below the carina. recommend retraction by 1.5 cm. left basilar opacity may represent compressive atelectasis versus consolidation i have personally reviewed the images for this examination and agreed with the report transcribed above.

interval slight increase in pulmonary edema and no significant change in bibasilar opacities and bilateral pleural effusions.

lines, tubes, and other medical support devices unchanged in position. stable marked enlargement of the cardiomediastinal silhouette. low lung volumes. mild pulmonary edema. left basilar consolidation and small bilateral pleural effusions. no pneumothorax or

no acute cardiopulmonary disease. left costophrenic angle blunting may represent a small pleural effusion versus scarring. tortuous aorta with atherosclerosis. degenerative changes of the spine.

06:06 hours compared with 12/7/03. support equipment is unchanged except the et tube has been retracted slightly how having its tip approximately 5 cm above the tracheal carina. cardiomediastinal silhouette is unchanged. the lungs show no interval change with somewhat decreased volume in the right hemithorax. no new opacity or pneumothorax.

lungs are well-expanded and clear without focal consolidation. normal pulmonary vascular markings. costophrenic sulci are sharp. normal cardiomediastinal silhouette. no acute cardiopulmonary abnormality.

right-sided picc is not significantly changed with tip projecting over the right atrium. possible bibasilar opacities or vascular crowding. atelectasis or consolidation not excluded. suggest lateral view for additional details as indicated. otherwise, no significant interval change of the chest.

very low lung volumes with interstitial pulmonary edema.

interval addition of an enteric tube and the tip is not seen. a right internal jugular venous catheter is present with its tip in the superior vena cava. moderate-sized right pleural effusion unchanged. stable right lower lobe atelectasis. the heart size is normal. the pulmonary vessels are unremarkable.

two views of the chest demonstrate cardiomediastinal silhouette within normal limits. lungs are clear without evidence of focal consolidation, pulmonary edema, or pleural fluid. visualized osseous structures are without acute fracture

persistent mild degree of linear opacities in the bilateral mid and lower lungs. no new focal consolidation. prominent cardiac size and silhouette is unchanged. no significant pulmonary edema. small bilateral pleural effusions. pleural calcifications remain unchanged. stable cardiomegaly, and appearance of aortic and mitral valvular replacement. sternotomy wires are intact. epicardial pacer leads are noted.

blunting may be due to pleural thickening and/or pleural effusions, which are relatively small in size. increased aeration of the lung bases bilaterally, with some mild residual atelectasis in the left base.

interval increase in opacity within the major fissure of the left lung which may represent an enlarging left pseudotumor. blunting and pleural calcification noted along the left costophrenic sulcus. mild increase in pulmonary edema. results discussed with the emergency room physician on 2/9/2010.

single upright ap view of the chest demonstrates a small right pleural catheter overlying the right upper lung zone. no evidence of pneumothorax. small amount of subcutaneous emphysema is again seen along the right lateral chest wall. redemonstration of focal opacity in the right upper lung zone.

blunting of the posterior costophrenic angles bilaterally is noted which could represent a small amount of pleural effusion. otherwise stable cardiomediastinal silhouette and clear lungs with stable appearance of sternotomy wires.

tip of the endotracheal tube projects 2 cm above the carina. other lines and tubes are unchanged. increased right basilar linear atelectasis with slightly decreased lung volumes. no significant change in small, left pleural effusion and left retrocardiac opacity.

the tip of the right arm picc line is projected over the superior vena cava. there has been no change in the position of the vp shunt which projects over the right hemithorax. there has been no change in position of the left pigtail catheter which projects over the lateral aspect of the mid left hemithorax. there is a tiny left pneumothorax. there is persistent bibasilar opacities. there are persistent small bilateral pleural effusions..

single upright ap view of the chest demonstrates interval placement of a left internal jugular central venous catheter with distal tip just within the proximal superior vena cava. no definite pneumothorax. reticular pattern of the lungs, worst in the lung bases, not significantly changed. redemonstration of a 13 mm nodule in the right upper lobe. stable small bilateral pleural effusions. 5

tracheostomy tube is in position. mild pulmonary edema not significantly changed.

interval placement of a right tunneled central venous catheter with tip projecting over the cavoatrial junction. normal heart size and pulmonary vascularity. no focal consolidation, pleural effusion, or pneumothorax. bones are unremarkable.

no significant interval change. markedly widened mediastinum, consistent with mediastinal hematoma. sternal wires. lines and tubes unchanged. bibasilar atelectasis or consolidation with bilateral pleural effusions.

there is right lower lobe consolidation as well as left perihilar consolidation. left retrocardiac opacification. possible right pleural effusion. findings compatible with aspiration versus pneumonia. ap and lateral chest x-ray can be obtained to further evaluate. left internal jugular venous line in place. no pneumothorax.

no change in the position of picc catheter. redemonstration of pulmonary edema, bibasilar opacities, and small bilateral pleural effusions, without interval change.

single frontal radiograph of the chest demonstrates stable postsurgical changes. stable, prominent cardiomediastinal silhouette appeared, there has been interval increase in perihilar opacities, which likely represents worsening pulmonary edema. no focal consolidations in the lungs. visualized osseous structures and soft tissues unremarkable.

interval post surgical changes with placement of new thoracic spinal fixation rods within the lower thoracic spine, as well as a interpositional cage. surgical skin staples. right chest tube and right upper extremity picc line in place. no pneumothorax. right rib thoracotomy changes. minimal bibasilar atelectasis. the lungs are otherwise clear.

interval placement of an esophageal temperature probe terminating in the midesophagus and a weighted feeding tube with the tip distal to the inferior margin of the radiograph. interval placement of a right internal jugular central venous catheter terminating in the lower superior vena cava. interval decrease in right basilar opacity and decreased small right pleural effusion. i have personally reviewed the images for this examination and agreed with the report transcribed above.

opacity left lung base, question atelectasis or consolidation. blunting left costophrenic angle. mild interstitial pulmonary edema.

enlarged cardiac mediastinal silhouette with perihilar opacities, which likely represent prominent pulmonary vascularity. no frank pulmonary edema. "physician to physician radiology consult line: (293) 804-4333" i have personally reviewed the images for this examination and agreed with the report transcribed above.

ett appears high, measuring 7.8 cm above the carina. right basilar pneumothorax has improved slightly. persistent right lung opacities consistent with pulmonary contusion vs aspiration or infection. multiple right sided rib deformities and left 8th rib fracture are noted. i have personally reviewed the images for this examination and agreed with the report transcribed above.

diffuse coarse reticulation of the asymmetrically small right native lung, compatible with chronic interstitial lung disease. unchanged rightward shift of mediastinal structures. multiple surgical clips overlie the left mediastinum, compatible with left lung transplant. the transplanted left lung is clear, without evidence of focal consolidation, pleural effusion, or pneumothorax.

left internal jugular catheter with tip at the cavoatrial junction. possible mild pulmonary edema. persistently low lung volumes, and left lower lobe opacity representing partial atelectasis versus infiltrate.

pa and lateral chest without comparison demonstrates normal heart size with normal mediastinal contour for age, including a tortuous, calcified thoracic aorta. lungs are clear. negative for edema, consolidation, or pleural effusions. again demonstrated is a fracture of the left proximal humerus with displacement of the greater tuberosity fragment and inferior subluxation or dislocation of the humeral head relative to the glenoid.

there is elevation of the left hemidiaphragm and left lower lobe atelectasis versus consolidation. within the right lung apex, there is a calcified nodular opacity which may represent a granuloma. the right lung is otherwise clear. cardiomediastinal silhouette is within normal limits.

feeding tube remains in place. postsurgical clips are again noted, overall unchanged. small right-sided pleural effusion is again noted, overall unchanged. cardiomediastinal silhouette is overall unchanged. no evidence of increasing pulmonary edema is noted.

constellation of findings are most consistent with heart failure and edema, however, cannot completely exclude a superimposed infection, especially in the lower lobes. results were discussed with martin, campos at approximately 18:00 hours on 1/30/2012.

lines and tubes appear unchanged in position. persistent retrocardiac opacity and left pleural effusion, unchanged. low lung volumes.

et tube, nasogastric tube, and swan-ganz catheter remain in good position. the swan-ganz appears to be in the main pulmonary artery. there is marked interval increase of patchy infiltrates bilaterally with what appears now to be near-complete right upper lobe consolidation. there remains a small persistent right-sided pleural effusion which is tracking up the pleural space as well. the findings are concerning for progressive pulmonary edema or an infectious process. please correlate clinically.

stable right pneumothorax, and waxy and wavy pattern of right pulmonary and parenchymal opacities, which may be infectious or inflammatory over the sequence of two radiographs.

endotracheal tube adjusted, tip in the trachea. interval placement of feeding tube, tip in stomach. no change in nasogastric tube or swan-ganz catheter. patchy bilateral opacities in the mid and lower lung zones and reticular pattern throughout lungs, consistent with pneumonia superimposed on edema, unchanged.

low lung volumes. pulmonary edema has largely resolved. persistent consolidation at the left lung base and band atelectasis in the right mid-lung zone.

endotracheal tube, left internal jugular venous catheter, and feeding tube, unchanged in position. upper limits of normal heart size. mild edema. persistent bibasilar consolidations from atelectasis, aspiration, or pneumonia, left greater than right, and moderate bilateral pleural effusions. no pneumothorax.

pa and lateral upright views of the chest demonstrate clear lung fields with no evidence of focal consolidation, pulmonary edema, or pleural effusions. cardiomediastinal silhouette and hila are normal. no radiographic evidence of acute cardiopulmonary disease. bones and soft tissues are unremarkable.

bibasilar opacities which may reflect atelectasis or early consolidation. i have personally reviewed the images for this examination and agreed with the report transcribed above.

two views of the chest demonstrate small left pleural effusion and left basilar opacity. small left-sided pneumothorax and left-sided rib fractures are better demonstrated on recent performed chest ct. additional linear atelectasis versus scarring is appreciated in the left lateral midlung zone. right lung remains grossly clear. post surgical changes are appreciated in the left shoulder.

reticular opacities throughout the bilateral lungs, more dense in the right upper lobe, with associated small bilateral pleural effusions. cardiac size is at the upper limits of normal. these findings are suggestive of moderate pulmonary edema. recommend follow-up radiograph to evaluate the opacity in the right upper lobe. no acute bone abnormality demonstrated.

interval placement of nasogastric tube. unchanged position of endotracheal tube. stable right-sided pleural effusion with consecutive atelectasis of the right lung. stable left-sided pleural effusion with left lower lobe atelectasis. stable cardiomediastinal silhouette with cardiomegaly/pericardial effusion. unchanged mild pulmonary edema. abdomen, one view: comparison: no comparisons. impression: feeding tube with tip in the distal stomach. non-specific bowel gas distribution. degenerative changes of the lumbar spine and enthesophytes in common places.

redemonstration of cardiomegaly. unchanged left retrocardiac opacities.

cardiomediastinal silhouette is upper limits of normal in size. mediastinal contour is normal. there is mild scarring at the right lung apex. the right hemidiaphragm is elevated. there is no pleural effusion. there is no pneumothorax. bony structures appear normal.

there has been interval enlargement of the left-sided pleural effusion, which is now moderate in size. left sided pneumothorax also appears enlarged. increased left lung atelectasis. there is mild mediastinal shift to the left. there is continued interval enlargement of the left apical subpleural convex density, likely hematoma status post first rib resection. the amount of left-sided subcutaneous emphysema is stable. the right lung is clear.

interval placement of tubes and lines as described above. possible left-sided deep sulcus sign may represent pneumothorax. retrocardiac opacity likely secondary to atelectasis. i have personally reviewed the images for this examination and agreed with the report transcribed above.

1 cm rounded opacity in the right upper lobe, possibly representing a calcified granuloma versus a pulmonary nodule. additional vague 1.1-cm opacity at the right cardiophrenic angle. finding may represent overlying shadows versus an additional nodule. cardiomediastinal silhouette unremarkable. lungs are clear without focal consolidation, effusion or edema.

mild interval improved aeration of the dense right midlung zone consolidation again compatible with aspiration or infection. left basilar consolidation persists. diffuse mild reticular pattern may represent a component of pulmonary edema. stable positioning of the endotracheal tube, nasogastric tube, right internal jugular central line and a left chest dual lead pacer and numerous sternotomy wires.

redemonstration of patchy right lung base opacity concerning for aspiration pneumonia in the appropriate clinical setting. no change in dense left retrocardiac consolidation and small left pleural effusion. stable appearance of lines, tubes and medical support devices. unchanged small biapical pneumothoraces. i have personally reviewed the images for this examination and agreed with the report transcribed above.

7 cm rounded opacity in the left mid lung is concerning for possible pneumonia, and there is a tiny left pleural effusion. focal atelectasis or scarring in the right midlung on a background of emphysematous changes. i have personally reviewed the images for this examination and agreed with the report transcribed above.

frontal and lateral radiograph of the chest demonstrates: 1.a left-sided cardiac pacemaker/icd with one atrial lead and two ventricular leads noted. slightly increased opacity in right mid lung zone, reflective of atelectasis or consolidation. stable moderate cardiomegaly.

decrease in right-sided pleural effusion and pneumothorax, status post exchange of chest tubes. these findings may be better evaluated with ap and lateral follow up studies.

frontal and lateral views chest demonstrate stable right internal jugular central line. clear lungs, with no focal consolidation, pleural effusions, or pulmonary edema. cardiomediastinal silhouette is stable and normal in configuration.

bibasilar opacities 2.small left pleural effusion 3.possible pulmonary edema

insertion of right pigtail catheter. remainder of lines and tubes unchanged in positions. mediastinal shift to the left with dense opacity in the left retrocardiac region and associated left-sided pleural effusion again noted.

cardiomediastinal silhouette is within normal limits. lungs appear clear. no pulmonary edema. no pleural effusion. degenerative changes of the spine are present with anterior flowing osteophytes, compatible with d.i.s.h. rounded radio-opaque densities are noted in the right upper quadrant, likely representing gallstones.

frontal and lateral views of the chest demonstrate a normal cardiomediastinal silhouette. lungs are clear without focal consolidation, effusion, or edema. visualized osseous structures are unremarkable.

unchanged appearance of left anterior chest wall dual lead cardiac pacemaker with intact right atrial and ventricular leads. interval development of left retrocardiac opacities and small left pleural effusion. stable cardiomediastinal silhouette with redemonstration of calcification of the thoracic aorta. redemonstration of scoliosis and degenerative changes of the thoracic spine as well as radiopaque material, likely methyl methacrylate, in upper thoracic and partially visualized upper lumbar vertebral bodies. 5

complete opacification of the right lung, likely from a large right pleural effusion. hazy reticular nodular opacities seen in the left lung consistent with moderate pulmonary edema. small left pleural effusion. i have personally reviewed the images for this examination and agreed with the report transcribed above.

two views of the chest demonstrate atherosclerotic calcification in the aortic arch with cardiomediastinal silhouette otherwise within normal limits. right costophrenic sulcus is incompletely visualized. lungs are otherwise clear without evidence of focal consolidation, pulmonary edema, or pleural fluid. visualized soft tissues and osseous structures are unremarkable.

a single semiupright portable radiograph of the chest demonstrates unchanged appearance of lines and tubes, and surgical materials. interval decrease in already bilateral low lung volumes. persistent by basilar opacities likely representing small bilateral effusions with adjacent atelectasis and/or consolidation. persistent bilateral mild pulmonary edema.

no interval change. the lungs remain clear without evidence of pneumonia.

improving right perihilar and right upper lobe opacity. stable retrocardiac opacity, reflecting atelectasis or consolidation. stable appearance of lines and tubes.

unchanged ng tube. unchanged right pleural pigtail catheter. stable layering right pleural effusion which probably explains most of the opacity in the right hemithorax. unchanged left effusion. bibasilar atelectasis.

single frontal view of the chest done on 8/5/2012 at 1032 hours demonstrates left picc seen within the distal superior vena cava. normal pulmonary vasculature and cardiomediastinal silhouette. no evidence of pneumothorax or pleural effusions.

air space opacities seen within both lung bases and within the right lung apex. within the right mid lung, there is a rounded opacity, which on lateral view corresponds to the lower lobe and could represent an area of consolidation, but loculated empyema cannot be excluded. recommend ct with contrast for further evaluation. cardiomediastinal silhouette, otherwise, stable.

low lung volumes. interval increase in pulmonary edema. increase bibasilar opacification consistent with either atelectasis or pneumonia. bilateral pleural effusions increased in size.

there has been interval reduction of the redundant length of coiled feeding tube in the oropharynx. otherwise, the lines and tubes are unchanged. redemonstration of bilateral rib fractures and widened mediastinum. there is persistent pulmonary edema. there is left retrocardiac atelectasis associated with a left- sided effusion.

single frontal view of the chest demonstrates stable positioning of the left upper extremity picc. the lungs are clear with no focal atelectasis or consolidation. no pleural effusion demonstrated. the cardiomediastinal silhouette is within normal limits.

follow-up portable semierect single view of the chest shows stable right internal jugular central venous catheter and tracheostomy tube. subcutaneous emphysema is significantly increased bilaterally. bilateral pneumothoraces are increased. pleural effusions show no significant interval change. follow-up portable upright single view of the chest shows stable tracheostomy tube and right internal jugular central venous catheter. interval placement of a right chest tube. bilateral pneumothoraces are decreased. the right pleural effusion is decreased. subcutaneous emphysema shows no significant interval change. follow-up portable semierect single view of the chest shows stable tracheostomy tube, right internal jugular central venous catheter, and interval placement of nasogastric tube with tip in the subdiaphragmatic position. left pneumothorax is stable and right pneumothorax is decreased in size. overlying the right upper chest is likely an external device. follow-up portable upright single view of the chest shows stable right chest tube, right internal jugular central venous catheter, tracheostomy tube and nasogastric tube. bilateral pneumothoraces are significantly increased, more predominantly at the bases. the subcutaneous emphysema is increased bilaterally. if more detailed characterization of the pneumothoraces is desired, a ct could be performed. pager #(542) 738-8002 was notified of these findings.

stable positioning of the support devices. tip of the right picc is not well appreciated on the current exam. clear lungs. no new focal consolidation, pleural effusion, or pneumothorax.

the endotracheal tube is 4.7 cm above the carina. other lines and tubes are unchanged positions. lungs volumes are slightly improved. there is a mild left base opacity, which may represent atelectasis, aspiration, or pneumonia. heart size is normal and unchanged.

feeding tube, nasogastric tube, and left subclavian central venous catheter, unchanged. vp shunt, unchanged. no significant change in pulmonary findings, with low lung volumes and no evidence of consolidation, edema, or effusion.

single frontal view of the chest taken on 6/3/2019 at 08:33 show a right arm picc line in place. the focality is atypical for pulmonary edema, but can be seen in pneumonia, pulmonary hemorrhage, or severe mitral regurgitation. partial clearing of the right lower lobe with the reappearance of the right hemidiaphragm.. clear left lung.

this was discussed with weeks, charlotte on 8/23/1997. stable cardiomediastinal silhouette. supportive devices in stable position.