ayyuce/chexpert-subset · Datasets at Hugging Face

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	single portable semi-upright frontal view of the chest demonstrates an endotracheal tube in place, with the tip 5.8 cm above the level of the carina. right infrahilar opacity is unchanged. a new left lung base opacity is present, which could be secondary to atelectasis or consolidation. there is interval improvement in aeration of the lungs and no evidence of pleural effusion. cardiomediastinal silhouette is unchanged.
	the left upper extremity picc catheter has been advanced, with the tip at the junction of the left brachiocephalic and the superior vena cava veins. persistent bibasilar opacities consistent with pleural effusions and associated basilar atelectasis. persistent mild pulmonary edema.
	supportive equipment unchanged.
	single upright ap view of the chest demonstrates persistently low lung volumes. no significant change in small right pleural effusion and elevation of right hemidiaphragm.
	interval improvement in pulmonary edema and no focal infiltrates.
	stable right subclavian venous catheter. the lungs are clear without evidence of focal consolidation, pleural effusion, or pneumothorax. the cardiac and mediastinal silhouette is unremarkable. no bony or soft tissue abnormality.
	clear lungs. no focal consolidation. "physician to physician radiology consult line: (543) 465-3550"
	chest 2 views, demonstrate no focal consolidation or pleural effusion. described round opacities along the right lung based on the exam dated 11/4/2003 is not well appreciated on today's exam. cardiac silhouette and vascularity are within normal limits.
	interval placement of endotracheal tube, nasogastric tube and right internal jugular central line. mediastinal drains also noted as well as a left chest tube. progressive decrease in lung volumes and associated increase in bibasilar consolidation. progressive increase in development of a small left pleural effusion. sternotomy wires consistent with recent coronary artery bypass graft.
	the lungs remain clear without focal consolidation, significant effusions or pneumothorax. cardiomegaly appears unchanged, and the thoracic aorta is again noted to be tortuous with atherosclerotic calcification. there has been interval decrease in pulmonary edema.
	stable left picc line. interval extubation. a large bore drainage catheter is seen projecting on the left upper quadrant of the 2.redemonstration of peripheral airspace opacities in both lungs. interval decrease of left pleural effusion.
	mild interstitial pulmonary edema. left greater than right bibasilar atelectasis. decreased small right pleural effusion. dictated by resident: ismael blevins - 8-2-2020 interpreted by attending radiologist: dr. hebert - 08-02 i, the attending signed below, have personally reviewed the images and agree with the report transcribed above. interpreted by attending radiologist: hebert, griffyn i authored by : hebert, griffyn approval date : august 2nd, 2020
	the patient is now status post cardiothoracic surgery. multiple sternal suture wires are identified in the midline with three prosthetic heart valves now seen. an endotracheal tube is identified with its tip at the level of the clavicles. a nasogastric tube extends below the diaphragm, although the distal extent is not seen. the mediastinal drain is just to the right of midline. two right internal jugular central venous catheters have their tips in the brachiocephalic vein. there is patchy bibasilar atelectasis. no significant pulmonary edema. no pneumothorax.
	no pneumothorax. bibasilar opacities may represent atelectasis, infection, or aspiration.
	new nasogastric tube with its tip below the diaphragm and not seen. no change in the enteric feeding tube, endotracheal tube, free thoracic drains, and pa catheter. persistent right greater than left effusions, pulmonary edema, and bibasilar atelectasis.
	the ng/og tube now terminates in the intrathoracic stomach. small loculated right pleural effusion has increased in size, now with component at the apex. small left pleural effusion. persistent bibasilar opacification. mild pulmonary edema. "physician to physician radiology consult line: 940 651-5080" i have personally reviewed the images for this examination and agreed with the report transcribed above.
	there is no evidence of pneumothorax. examination is otherwise unchanged, with stable bilateral basilar lung opacities and postsurgical changes within the mediastinum. the mediastinal contour is stable.
	minimally displaced right lateral rib fractures involving 4th and 8th ribs. no pneumothorax. atelectasis in the left base. slight increase wedge deformity of a mid thoracic vertebra.
	no interval change. persistent bilateral diffuse interstitial prominence consistent with clinical history of congestive heart failure. stable cardiomediastinal silhouette.
	no significant interval change in position of the right internal jugular venous catheter. persistent low lung volumes with interval development of increased interstitial lung markings, consistent with mild interstitial pulmonary edema. however, evaluation is somewhat limited due to breathing motion artifact. bibasilar airspace opacities with a dense airspace consolidation in the left lower lobe/retrocardiac area. persistent left pleural effusion. findings of this examination were discussed with meyer allisandra, md at pager #11/30/2007_7/18/2014 on the evening of 7-18-2014 at 1725 hours.
	it appears dense and may be calcific. however recommend confirmation with an upright pa view. stable minimal blunting of the right costophrenic angle which likely represents pleural thickening or small effusion. the lungs are otherwise clear without evidence of focal consolidation. surgical clips project over the epigastrium. the bones are diffusely osteopenic with dextroscoliosis of the thoracic spine
	no other change. summary code:
	low lung volumes but no evidence of pneumonia. marked scoliosis of the thoracic spine.
	stable redemonstration of right subclavian venous catheter and right sided chest tube. stable redemonstration of rib fractures. persistent low lung volumes. redemonstration of bibasilar atelectasis. no evidence of pneumothorax.
	trace bilateral posterior pleural effusions. no focal parenchymal opacity. cardiomediastinal silhouette is normal. acute posterior left third rib fracture. mild compression deformity within the mid lumbar spine, age indeterminate.
	no consolidations, pleural effusions, pulmonary edema, or pneumothorax are identified. expansile lesions within the lateral aspect of the right eighth and ninth ribs likely reflect sequela of multiple myeloma, given the clinical history. differential considerations also include sequela of recent trauma. 3
	film degraded by motion artifact. lines and tubes unchanged. resolution of right-sided pneumothorax and subcutaneous emphysema. unchanged postoperative changes in the right lung. unchanged left basal opacity and probable bilateral pleural effusions.
	low lung volumes. interval increase in retrocardiac opacity, atelectasis, or consolidation.
	no evidence of pneumothorax or bony fracture. superior mediastinal widening may reflect an ectatic thoracic aorta, however in the setting of trauma, aortic injury cannot be excluded. recommend upright pa and lateral or ct angiogram for further evaluation. low lung volumes. no focal airspace consolidation. no pleural effusions. heart size is at the upper limits of normal, which may be secondary to low lung volumes. subsequent upright frontal view of the chest demonstrates persistent superior mediastinal widening with more distinct border to the thoracic aorta and a well defined aortic knob. this likely represents an ectatic thoracic aorta. if there is clinical concern for aortic injury, ct angiogram may be obtained. preliminary findings were discussed with the trauma team immediately after ct scanning.
	interval placement of a nasogastric tube, the tip of which is not seen on this film. right pleural effusion with increased bibasilar opacities, likely atelectasis. low lung volumes.
	interval placement of tracheostomy. no evidence of focal parenchymal consolidation or pulmonary edema.
	slight improvement of aeration at the right base. otherwise no significant interval change. mild pulmonary edema. may be asymmetric versus a right sided layering effusion. persistent left retrocardiac opacity consistent with atelectasis and/or pneumonia.
	stable cardiomediastinal silhouette with a tortuous thoracic aorta. no new focal consolidation to suggest pneumonia.
	tubes and lines are stable. interval development of a patchy opacity in the left base obscuring the left hemidiaphragm is concerning for interval progression or pneumonia or new aspiration. persistent consolidations at the lateral aspect of the right upper lobe, compatible with pneumonia. there is likely development of layering effusion on the right and a small effusion on the left as well.
	otherwise no significant change. obscuration of the left hemidiaphragm compatible atelectasis, consolidation, or effusion.
	left lower lung consolidation, which may represent pneumonia, or aspiration. diffuse prominence of the pulmonary vessels, which may represent vascular crowding due to low lung volumes, versus pulmonary venous hypertension.
	moderate pulmonary edema. patchy consolidation in the lung bases which may represent areas of air space disease or atelectasis. no large pleural effusions at this time.
	status post aortic valve replacement with post operative lines and tubes as above. bibasilar atelectasis with pleural effusions and mild pulmonary edema.
	persistent right mid and lower lung zone airspace opacities, which represents metastatic mass with possible superimposed infection. interval development of small loculated right-sided pleural effusion tracking along the lateral wall. reticulonodular pattern within bilateral upper lobes corresponds to known metastatic disease. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	stable lines and tubes. interval increased opacity in the left greater than right lung bases may represent worsening pulmonary edema. slight increase in right-sided pleural effusion and stable left pleural effusion.
	low lung volumes with bibasilar opacities which may represent atelectasis or early consolidative process such as pneumonia. a repeat pa and lateral when the patient is able to sit upright would be helpful to further evaluate. blunting of the bilateral costophrenic angles right greater than left consistent with small pleural effusions.
	nasogastric tube tip not visualized. low lung volumes with bilateral pleural effusions and retrocardiac opacities most likely representing atelectasis versus infectious infectious consolidation as clinically correlated. cardiomediastinal silhouette within normal limits for size and unchanged.
	aicd and external pacing wires are stable. there is stable cardiomegaly with mild pulmonary edema. there is likely a small right-sided pleural effusion. there is no pneumothorax.
	interval placement of endotracheal tube with the tip projecting over the mid-trachea. interval placement of esophageal temperature probe with tip projecting over the mid esophagus. interval placement of right ij swan-ganz catheter with tip projecting over the right pa. interval placement of enteric feeding tube with tip projecting below the level of the film. retrocardiac air-space opacification with elevation of the left hemidiaphragm suggesting volume loss. this may be seen with either atelectasis and/or consolidation, and clinical correlation is advised. calcified granuloma projecting over the right lung between the 7/8 posterior rib interspace.
	interval increase in bilateral, patchy, nodular opacities which on the most recent film are showing coalescence and consolidation, especially in the right upper lobe and left perihilar region. this appearance is concerning for worsening of infection. interval placement of feeding tube.
	a single supine view of the chest demonstrates a grossly stable right hydropneumothorax. overall unchanged cardiopulmonary findings, given the difference in projection. stable left upper extremity picc line with the tip projecting over the right atrium as well as stable right pleural drain.
	other supporting lines and tubes are unchanged. there is increased lucency at the lung apices, but no definite pleural lines are seen to suggest a pneumothorax. redemonstration of very low lung volumes. persistent retrocardiac opacity and small left pleural effusion.
	increasing opacification right hemithorax consistent with increasing pleural effusion and/or consolidation. otherwise, no change.
	portable radiograph of the chest dated 2:40 a.m. interval decreased aeration of the lungs, now with low lung volumes. increasing opacification of the bilateral lung bases with an associated small left pleural effusion. stable cardiomediastinal silhouette without evidence of pulmonary edema. subsequent pa and lateral chest radiographs obtained one hour later demonstrate no significant interval change with persistent small bilateral pleural effusions and dense opacification of the bilateral lung bases, left greater than right, which may reflect atelectasis, aspiration or infection.
	the lines and tubes unchanged in position. extensive bilateral parenchymal opacities again seen, most severely involving left lower and right middle lung zones. findings are not significantly changed in one day interval. probable associated left pleural effusion.
	position of supportive device is unchanged. there has been interval improved aeration in the bilateral lung bases and decrease in pulmonary edema. stable small bilateral pleural effusions. cardiomediastinal silhouette is unchanged.
	left chest tube seen with side-port in the mid-portion of the lung. left lower lobe opacification, likely atelectasis versus consolidation. small bilateral pleural effusions. increased interstitial markings suggestive of mild interstitial pulmonary edema.
	no significant interval change.
	i have personally reviewed the images for this examination and agreed with the report transcribed above.
	lines and tubes unchanged. left base is obscured by the external defibrillator pad but there appears to be increased left basilar opacity and increased left pleural effusion. asymmetric generalized opacity within the lungs, right greater than left might represent atypical pulmonary edema, however, this is unchanged.
	insertion left picc line with tip in right atrium. remainder of lines and tubes unchanged in position. moderate pulmonary edema persists associated with bibasilar atelectasis and bilateral pleural effusions.
	there is stable redemonstration of diffuse opacity projecting over the right hemithorax, which may be compatible with a layering pleural effusion with adjacent atelectatic changes. stable redemonstration of right-greater-than-left bibasilar opacities.
	no change in position of endotracheal tube and feeding tube. stable cardiomediastinal silhouette. stable density in the left retrocardiac region which may represent atelectasis or consolidation. likely left pleural effusion, unchanged.
	persistent low lung volumes. slight interval increase in mild bibasilar opacities, atelectasis versus early consolidation.
	mild opacities are seen at the lung bases (right greater than left) which are consistent with atelectasis given the low lung volumes, however pneumonia or aspiration cannot be entirely excluded. heart size is normal. mild to moderate degenerative joint disease of the acromioclavicular joints and degenerative disk disease of the spine are not significantly changed. no pneumothorax.
	right internal jugular venous catheter in place and unchanged. low lung volumes with persistent mild interstitial pulmonary edema. persistent left retrocardiac opacification consistent with left lower lung atelectasis. possible small left pleural effusion present. no other significant interval change.
	upright pa and lateral chest radiograph demonstrates limited quality of the lateral view which prevents evaluation in that projection. no interval change of left picc line. persistent small right pleural effusion. retrocardiac opacification which may represent atelectasis versus consolidation. 5
	moderate partially loculated left-sided pleural effusion with a free-flowing component. bibasilar opacities which may be due to infection or atelectasis. "physician to physician radiology consult line: (758) 689-1690" i have personally reviewed the images for this examination and agreed with the report transcribed above.
	no acute cardiopulmonary process. stable mild cardiomegaly without evidence of chf. multilevel thoracic degenerative changes.
	single semiupright portable radiograph of the chest demonstrates a unchanged appearance of right internal jugular sheath and swan-ganz catheter with the tip in the pulmonary outflow tract, multiple sternotomy wires, prosthetic mitral ring , multiple mediastinal drains, left sided chest tube, and epicardial pacer wires. interval decrease in already low bilateral lung volumes with bibasilar haziness likely representing edema. there is increasing opacification of the right lung base which may represent atelectasis; however, pleural effusion or consolidation would appear similarly. persistent opacification of the left base may represent pleural effusion, atelectasis, or consolidation.
	right internal jugular swan ganz catheter tip again seen in the right pulmonary artery. post sternotomy wires again noted. interval increased right pleural effusion and increased interstitial and air space pulmonary edema bilaterally. borderline cardiomegaly unchanged in appearance.
	bilateral pleural effusions with pulmonary edema.
	ap semiupright chest radiograph demonstrates stable appearance of right ijv catheter and sheath, sternotomy wires, and mechanical mitral and aortic valve prostheses. persistent mild pulmonary edema, retrocardiac opacity, and small left-sided pleural effusion. no significant interval change in cardiopulmonary status.
	normal heart size and pulmonary vascularity. linear atelectasis or scarring in the left midlung. no focal consolidation, pleural effusion, or pneumothorax. bones are unremarkable.
	the lungs remain free of acute consolidation, with normal pulmonary vascularity. cardiomediastinum is within normal limits, with a small fat pad again apparent at the left cardiophrenic angle. no acute osseous abnormality identified.
	moderate to large left-sided pleural effusion and mild right basilar linear atelectasis.
	minimal stranding opacities at the right base likely related to atelectasis. "physician to physician radiology consult line: (739) 707-0982"
	two views of the chest dated 11-13-2006 demonstrate a left picc line with its tip in the cavoatrial junction, unchanged. demonstration of small left pleural effusion, unchanged. lungs are otherwise clear.
	slightly worsened consolidation involving bilateral lungs with associated small, right pleural effusion.
	retrocardiac opacity may represent atelectasis versus consolidation. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	chest 2 views, demonstrate no focal consolidation or pleural effusion. central venous catheter in appropriate position.
	chest 1 view, demonstrate no focal consolidation or pleural effusion
	supine ap view of the chest demonstrates stable positioning of ng tube and et tube. the lungs are clear. no evidence of pleural effusions or pulmonary edema.
	interval slight increase in reticular markings in the lung bases with slightly indistinct vessels are consistent with mild pulmonary edema. otherwise stable prominent heart size, with two-lead aicd device. no focal consolidation to suggest pneumonia.
	tunneled central venous line placed no pneumothorax. normal limited pulsatility. clear lungs laterally, no acute disease.
	pa and lateral views of the chest demonstrate interval improved width of the upper mediastinum. also resolved mediastinal emphysema. stable signs of mild pulmonary edema. no evidence of pulmonary infiltrates, no pleural effusions. new demonstration of a small hyperlucency projecting over the right sixth lateral rib which may be likely an artifact caused by an overlying skin fold.
	ap erect chest radiograph demonstrates an epidural catheter at, with a right apical chest drain and remaining in place. subcutaneous emphysema is seen along the right lateral chest wall, with a likely small residual apical pneumothorax.. mild bibasal atelectasis.
	ett, ng, right ij, and multiple chest tubes and mediastinal drains in stable position. there has been interval decrease in the sizes and density readings of multiple airspace opacities within the lungs, as well as decreased bilateral pleural effusion.
	interval re-development of free intraperitoneal air bilaterally (normal peritoneum). the cardiopulmonary status is not significantly changed. persistent patchy bilateral predominantly perihilar opacities, consistent with edema versus ards versus infection. endotracheal tube, ng tube, feeding tube, left subclavian line in place, unchanged. a swan-ganz catheter is again noted, however, the tip is not clearly visualized (motion artifacts).
	increasing retrocardiac opacity and edema.
	single semi-erect ap view of the chest demonstrates interval placement of an endotracheal tube with the distal tip approximately 4 cm from the carina. there has been placement of a right internal jugular central venous catheter with the distal tip within the proximal superior vena cava. no evidence of pneumothorax. interval increase in small bilateral pleural effusions, left greater than right, as well as bilateral lower lung zone opacities. surgical clips are seen in the right upper quadrant of the abdomen.
	mediastinum is mildly widened and mediastinal hemorrhage cannot be excluded. clinical correlation is recommended. findings were text paged to pager (612) 398-7437 patientiq 1220 hours on the day of this dictation.
	normal cardiomediastinal silhouette. vascularity appears normal. lungs clear. no pleural effusion or pneumothorax. no acute osseous abnormality.
	there is interval increase in interstitial opacification, consistent with edema. a small left pleural effusion may be present. the cardiomediastinal silhouette is unchanged.
	frontal projection of the chest demonstrating mild linear bilateral basilar opacity which may represent atelectasis versus early consolidation. the lungs are hyperinflated. no acute osseous findings. heart size is normal.
	lines and tubes are stable. persistent bibasilar pulmonary opacity.
	there has been interval placement of an acdf at the lower cervical spine. low lung volumes, with bibasilar atelectasis. no significant pulmonary edema or pleural effusion. cardiomediastinal silhouette within normal limits.
	ap semi-erect chest radiograph demonstrates an endotracheal tube, nasogastric tube, right internal jugular venous line, right subclavian venous line and bilateral upper extremity picc line. opacification is seen in the left mid-lower zones with a likely layering pleural effusion. patchy opacification is also seen adjacent to the inferior hilar region on the right.
	post-surgical chest with lines and tubes as above. decreased lung volumes with mild interstitial pulmonary edema, bibasilar atelectasis and bilateral pleural effusions with increased right perihilar opacity representing atelectasis or consolidation.
	ap and lateral views of the chest demonstrate a prominent reticular nodular pattern throughout the lungs along with more focal areas of consolidation at the left base that could represent atelectasis or consolidation. no definite change since 3/19/2007. a ct could be performed if clinically indicated for further evaluation. no pneumothorax. tortuous calcified aorta. visualized osseous structures unremarkable. i have personally reviewed the images for this examination and agreed with the report transcribed above.
	portable chest radiograph demonstrates left upper extremity picc in stable position 4.5 cm below the carina. lungs demonstrate a small right pleural effusion. there is mild fluid overload. demonstration of moderate cardiomegaly and severe degenerative joint disease of the right humeral joint.
	fluctuating left base atelectasis. no evidence of pneumothorax. interval appearance of nodule at the right base which is nonspecific. attention on follow up.
	lungs are clear without focal airspace consolidation. cardiomediastinal silhouette appears unremarkable. no evidence for acute cardiopulmonary disease.
	single semi-upright ap view of the chest demonstrates very low lung volumes. interval development of small left pleural effusion and bibasilar opacities, left greater than right.
	the lungs appear clear, with minimal basilar atelectasis, but no focal consolidation. prominent cardiac size and mediastinal contours, which may be accentuated due to relatively expiratory position of the patient. no pulmonary edema or pleural effusion.

single portable semi-upright frontal view of the chest demonstrates an endotracheal tube in place, with the tip 5.8 cm above the level of the carina. right infrahilar opacity is unchanged. a new left lung base opacity is present, which could be secondary to atelectasis or consolidation. there is interval improvement in aeration of the lungs and no evidence of pleural effusion. cardiomediastinal silhouette is unchanged.

the left upper extremity picc catheter has been advanced, with the tip at the junction of the left brachiocephalic and the superior vena cava veins. persistent bibasilar opacities consistent with pleural effusions and associated basilar atelectasis. persistent mild pulmonary edema.

supportive equipment unchanged.

single upright ap view of the chest demonstrates persistently low lung volumes. no significant change in small right pleural effusion and elevation of right hemidiaphragm.

interval improvement in pulmonary edema and no focal infiltrates.

stable right subclavian venous catheter. the lungs are clear without evidence of focal consolidation, pleural effusion, or pneumothorax. the cardiac and mediastinal silhouette is unremarkable. no bony or soft tissue abnormality.

clear lungs. no focal consolidation. "physician to physician radiology consult line: (543) 465-3550"

chest 2 views, demonstrate no focal consolidation or pleural effusion. described round opacities along the right lung based on the exam dated 11/4/2003 is not well appreciated on today's exam. cardiac silhouette and vascularity are within normal limits.

interval placement of endotracheal tube, nasogastric tube and right internal jugular central line. mediastinal drains also noted as well as a left chest tube. progressive decrease in lung volumes and associated increase in bibasilar consolidation. progressive increase in development of a small left pleural effusion. sternotomy wires consistent with recent coronary artery bypass graft.

the lungs remain clear without focal consolidation, significant effusions or pneumothorax. cardiomegaly appears unchanged, and the thoracic aorta is again noted to be tortuous with atherosclerotic calcification. there has been interval decrease in pulmonary edema.

stable left picc line. interval extubation. a large bore drainage catheter is seen projecting on the left upper quadrant of the 2.redemonstration of peripheral airspace opacities in both lungs. interval decrease of left pleural effusion.

mild interstitial pulmonary edema. left greater than right bibasilar atelectasis. decreased small right pleural effusion. dictated by resident: ismael blevins - 8-2-2020 interpreted by attending radiologist: dr. hebert - 08-02 i, the attending signed below, have personally reviewed the images and agree with the report transcribed above. interpreted by attending radiologist: hebert, griffyn i authored by : hebert, griffyn approval date : august 2nd, 2020

the patient is now status post cardiothoracic surgery. multiple sternal suture wires are identified in the midline with three prosthetic heart valves now seen. an endotracheal tube is identified with its tip at the level of the clavicles. a nasogastric tube extends below the diaphragm, although the distal extent is not seen. the mediastinal drain is just to the right of midline. two right internal jugular central venous catheters have their tips in the brachiocephalic vein. there is patchy bibasilar atelectasis. no significant pulmonary edema. no pneumothorax.

no pneumothorax. bibasilar opacities may represent atelectasis, infection, or aspiration.

new nasogastric tube with its tip below the diaphragm and not seen. no change in the enteric feeding tube, endotracheal tube, free thoracic drains, and pa catheter. persistent right greater than left effusions, pulmonary edema, and bibasilar atelectasis.

the ng/og tube now terminates in the intrathoracic stomach. small loculated right pleural effusion has increased in size, now with component at the apex. small left pleural effusion. persistent bibasilar opacification. mild pulmonary edema. "physician to physician radiology consult line: 940 651-5080" i have personally reviewed the images for this examination and agreed with the report transcribed above.

there is no evidence of pneumothorax. examination is otherwise unchanged, with stable bilateral basilar lung opacities and postsurgical changes within the mediastinum. the mediastinal contour is stable.

minimally displaced right lateral rib fractures involving 4th and 8th ribs. no pneumothorax. atelectasis in the left base. slight increase wedge deformity of a mid thoracic vertebra.

no interval change. persistent bilateral diffuse interstitial prominence consistent with clinical history of congestive heart failure. stable cardiomediastinal silhouette.

no significant interval change in position of the right internal jugular venous catheter. persistent low lung volumes with interval development of increased interstitial lung markings, consistent with mild interstitial pulmonary edema. however, evaluation is somewhat limited due to breathing motion artifact. bibasilar airspace opacities with a dense airspace consolidation in the left lower lobe/retrocardiac area. persistent left pleural effusion. findings of this examination were discussed with meyer allisandra, md at pager #11/30/2007_7/18/2014 on the evening of 7-18-2014 at 1725 hours.

it appears dense and may be calcific. however recommend confirmation with an upright pa view. stable minimal blunting of the right costophrenic angle which likely represents pleural thickening or small effusion. the lungs are otherwise clear without evidence of focal consolidation. surgical clips project over the epigastrium. the bones are diffusely osteopenic with dextroscoliosis of the thoracic spine

no other change. summary code:

low lung volumes but no evidence of pneumonia. marked scoliosis of the thoracic spine.

stable redemonstration of right subclavian venous catheter and right sided chest tube. stable redemonstration of rib fractures. persistent low lung volumes. redemonstration of bibasilar atelectasis. no evidence of pneumothorax.

trace bilateral posterior pleural effusions. no focal parenchymal opacity. cardiomediastinal silhouette is normal. acute posterior left third rib fracture. mild compression deformity within the mid lumbar spine, age indeterminate.

no consolidations, pleural effusions, pulmonary edema, or pneumothorax are identified. expansile lesions within the lateral aspect of the right eighth and ninth ribs likely reflect sequela of multiple myeloma, given the clinical history. differential considerations also include sequela of recent trauma. 3

film degraded by motion artifact. lines and tubes unchanged. resolution of right-sided pneumothorax and subcutaneous emphysema. unchanged postoperative changes in the right lung. unchanged left basal opacity and probable bilateral pleural effusions.

low lung volumes. interval increase in retrocardiac opacity, atelectasis, or consolidation.

no evidence of pneumothorax or bony fracture. superior mediastinal widening may reflect an ectatic thoracic aorta, however in the setting of trauma, aortic injury cannot be excluded. recommend upright pa and lateral or ct angiogram for further evaluation. low lung volumes. no focal airspace consolidation. no pleural effusions. heart size is at the upper limits of normal, which may be secondary to low lung volumes. subsequent upright frontal view of the chest demonstrates persistent superior mediastinal widening with more distinct border to the thoracic aorta and a well defined aortic knob. this likely represents an ectatic thoracic aorta. if there is clinical concern for aortic injury, ct angiogram may be obtained. preliminary findings were discussed with the trauma team immediately after ct scanning.

interval placement of a nasogastric tube, the tip of which is not seen on this film. right pleural effusion with increased bibasilar opacities, likely atelectasis. low lung volumes.

interval placement of tracheostomy. no evidence of focal parenchymal consolidation or pulmonary edema.

slight improvement of aeration at the right base. otherwise no significant interval change. mild pulmonary edema. may be asymmetric versus a right sided layering effusion. persistent left retrocardiac opacity consistent with atelectasis and/or pneumonia.

stable cardiomediastinal silhouette with a tortuous thoracic aorta. no new focal consolidation to suggest pneumonia.

tubes and lines are stable. interval development of a patchy opacity in the left base obscuring the left hemidiaphragm is concerning for interval progression or pneumonia or new aspiration. persistent consolidations at the lateral aspect of the right upper lobe, compatible with pneumonia. there is likely development of layering effusion on the right and a small effusion on the left as well.

otherwise no significant change. obscuration of the left hemidiaphragm compatible atelectasis, consolidation, or effusion.

left lower lung consolidation, which may represent pneumonia, or aspiration. diffuse prominence of the pulmonary vessels, which may represent vascular crowding due to low lung volumes, versus pulmonary venous hypertension.

moderate pulmonary edema. patchy consolidation in the lung bases which may represent areas of air space disease or atelectasis. no large pleural effusions at this time.

status post aortic valve replacement with post operative lines and tubes as above. bibasilar atelectasis with pleural effusions and mild pulmonary edema.

persistent right mid and lower lung zone airspace opacities, which represents metastatic mass with possible superimposed infection. interval development of small loculated right-sided pleural effusion tracking along the lateral wall. reticulonodular pattern within bilateral upper lobes corresponds to known metastatic disease. i have personally reviewed the images for this examination and agreed with the report transcribed above.

stable lines and tubes. interval increased opacity in the left greater than right lung bases may represent worsening pulmonary edema. slight increase in right-sided pleural effusion and stable left pleural effusion.

low lung volumes with bibasilar opacities which may represent atelectasis or early consolidative process such as pneumonia. a repeat pa and lateral when the patient is able to sit upright would be helpful to further evaluate. blunting of the bilateral costophrenic angles right greater than left consistent with small pleural effusions.

nasogastric tube tip not visualized. low lung volumes with bilateral pleural effusions and retrocardiac opacities most likely representing atelectasis versus infectious infectious consolidation as clinically correlated. cardiomediastinal silhouette within normal limits for size and unchanged.

aicd and external pacing wires are stable. there is stable cardiomegaly with mild pulmonary edema. there is likely a small right-sided pleural effusion. there is no pneumothorax.

interval placement of endotracheal tube with the tip projecting over the mid-trachea. interval placement of esophageal temperature probe with tip projecting over the mid esophagus. interval placement of right ij swan-ganz catheter with tip projecting over the right pa. interval placement of enteric feeding tube with tip projecting below the level of the film. retrocardiac air-space opacification with elevation of the left hemidiaphragm suggesting volume loss. this may be seen with either atelectasis and/or consolidation, and clinical correlation is advised. calcified granuloma projecting over the right lung between the 7/8 posterior rib interspace.

interval increase in bilateral, patchy, nodular opacities which on the most recent film are showing coalescence and consolidation, especially in the right upper lobe and left perihilar region. this appearance is concerning for worsening of infection. interval placement of feeding tube.

a single supine view of the chest demonstrates a grossly stable right hydropneumothorax. overall unchanged cardiopulmonary findings, given the difference in projection. stable left upper extremity picc line with the tip projecting over the right atrium as well as stable right pleural drain.

other supporting lines and tubes are unchanged. there is increased lucency at the lung apices, but no definite pleural lines are seen to suggest a pneumothorax. redemonstration of very low lung volumes. persistent retrocardiac opacity and small left pleural effusion.

increasing opacification right hemithorax consistent with increasing pleural effusion and/or consolidation. otherwise, no change.

portable radiograph of the chest dated 2:40 a.m. interval decreased aeration of the lungs, now with low lung volumes. increasing opacification of the bilateral lung bases with an associated small left pleural effusion. stable cardiomediastinal silhouette without evidence of pulmonary edema. subsequent pa and lateral chest radiographs obtained one hour later demonstrate no significant interval change with persistent small bilateral pleural effusions and dense opacification of the bilateral lung bases, left greater than right, which may reflect atelectasis, aspiration or infection.

the lines and tubes unchanged in position. extensive bilateral parenchymal opacities again seen, most severely involving left lower and right middle lung zones. findings are not significantly changed in one day interval. probable associated left pleural effusion.

position of supportive device is unchanged. there has been interval improved aeration in the bilateral lung bases and decrease in pulmonary edema. stable small bilateral pleural effusions. cardiomediastinal silhouette is unchanged.

left chest tube seen with side-port in the mid-portion of the lung. left lower lobe opacification, likely atelectasis versus consolidation. small bilateral pleural effusions. increased interstitial markings suggestive of mild interstitial pulmonary edema.

no significant interval change.

i have personally reviewed the images for this examination and agreed with the report transcribed above.

lines and tubes unchanged. left base is obscured by the external defibrillator pad but there appears to be increased left basilar opacity and increased left pleural effusion. asymmetric generalized opacity within the lungs, right greater than left might represent atypical pulmonary edema, however, this is unchanged.

insertion left picc line with tip in right atrium. remainder of lines and tubes unchanged in position. moderate pulmonary edema persists associated with bibasilar atelectasis and bilateral pleural effusions.

there is stable redemonstration of diffuse opacity projecting over the right hemithorax, which may be compatible with a layering pleural effusion with adjacent atelectatic changes. stable redemonstration of right-greater-than-left bibasilar opacities.

no change in position of endotracheal tube and feeding tube. stable cardiomediastinal silhouette. stable density in the left retrocardiac region which may represent atelectasis or consolidation. likely left pleural effusion, unchanged.

persistent low lung volumes. slight interval increase in mild bibasilar opacities, atelectasis versus early consolidation.

mild opacities are seen at the lung bases (right greater than left) which are consistent with atelectasis given the low lung volumes, however pneumonia or aspiration cannot be entirely excluded. heart size is normal. mild to moderate degenerative joint disease of the acromioclavicular joints and degenerative disk disease of the spine are not significantly changed. no pneumothorax.

right internal jugular venous catheter in place and unchanged. low lung volumes with persistent mild interstitial pulmonary edema. persistent left retrocardiac opacification consistent with left lower lung atelectasis. possible small left pleural effusion present. no other significant interval change.

upright pa and lateral chest radiograph demonstrates limited quality of the lateral view which prevents evaluation in that projection. no interval change of left picc line. persistent small right pleural effusion. retrocardiac opacification which may represent atelectasis versus consolidation. 5

moderate partially loculated left-sided pleural effusion with a free-flowing component. bibasilar opacities which may be due to infection or atelectasis. "physician to physician radiology consult line: (758) 689-1690" i have personally reviewed the images for this examination and agreed with the report transcribed above.

no acute cardiopulmonary process. stable mild cardiomegaly without evidence of chf. multilevel thoracic degenerative changes.

single semiupright portable radiograph of the chest demonstrates a unchanged appearance of right internal jugular sheath and swan-ganz catheter with the tip in the pulmonary outflow tract, multiple sternotomy wires, prosthetic mitral ring , multiple mediastinal drains, left sided chest tube, and epicardial pacer wires. interval decrease in already low bilateral lung volumes with bibasilar haziness likely representing edema. there is increasing opacification of the right lung base which may represent atelectasis; however, pleural effusion or consolidation would appear similarly. persistent opacification of the left base may represent pleural effusion, atelectasis, or consolidation.

right internal jugular swan ganz catheter tip again seen in the right pulmonary artery. post sternotomy wires again noted. interval increased right pleural effusion and increased interstitial and air space pulmonary edema bilaterally. borderline cardiomegaly unchanged in appearance.

bilateral pleural effusions with pulmonary edema.

ap semiupright chest radiograph demonstrates stable appearance of right ijv catheter and sheath, sternotomy wires, and mechanical mitral and aortic valve prostheses. persistent mild pulmonary edema, retrocardiac opacity, and small left-sided pleural effusion. no significant interval change in cardiopulmonary status.

normal heart size and pulmonary vascularity. linear atelectasis or scarring in the left midlung. no focal consolidation, pleural effusion, or pneumothorax. bones are unremarkable.

the lungs remain free of acute consolidation, with normal pulmonary vascularity. cardiomediastinum is within normal limits, with a small fat pad again apparent at the left cardiophrenic angle. no acute osseous abnormality identified.

moderate to large left-sided pleural effusion and mild right basilar linear atelectasis.

minimal stranding opacities at the right base likely related to atelectasis. "physician to physician radiology consult line: (739) 707-0982"

two views of the chest dated 11-13-2006 demonstrate a left picc line with its tip in the cavoatrial junction, unchanged. demonstration of small left pleural effusion, unchanged. lungs are otherwise clear.

slightly worsened consolidation involving bilateral lungs with associated small, right pleural effusion.

retrocardiac opacity may represent atelectasis versus consolidation. i have personally reviewed the images for this examination and agreed with the report transcribed above.

chest 2 views, demonstrate no focal consolidation or pleural effusion. central venous catheter in appropriate position.

chest 1 view, demonstrate no focal consolidation or pleural effusion

supine ap view of the chest demonstrates stable positioning of ng tube and et tube. the lungs are clear. no evidence of pleural effusions or pulmonary edema.

interval slight increase in reticular markings in the lung bases with slightly indistinct vessels are consistent with mild pulmonary edema. otherwise stable prominent heart size, with two-lead aicd device. no focal consolidation to suggest pneumonia.

tunneled central venous line placed no pneumothorax. normal limited pulsatility. clear lungs laterally, no acute disease.

pa and lateral views of the chest demonstrate interval improved width of the upper mediastinum. also resolved mediastinal emphysema. stable signs of mild pulmonary edema. no evidence of pulmonary infiltrates, no pleural effusions. new demonstration of a small hyperlucency projecting over the right sixth lateral rib which may be likely an artifact caused by an overlying skin fold.

ap erect chest radiograph demonstrates an epidural catheter at, with a right apical chest drain and remaining in place. subcutaneous emphysema is seen along the right lateral chest wall, with a likely small residual apical pneumothorax.. mild bibasal atelectasis.

ett, ng, right ij, and multiple chest tubes and mediastinal drains in stable position. there has been interval decrease in the sizes and density readings of multiple airspace opacities within the lungs, as well as decreased bilateral pleural effusion.

interval re-development of free intraperitoneal air bilaterally (normal peritoneum). the cardiopulmonary status is not significantly changed. persistent patchy bilateral predominantly perihilar opacities, consistent with edema versus ards versus infection. endotracheal tube, ng tube, feeding tube, left subclavian line in place, unchanged. a swan-ganz catheter is again noted, however, the tip is not clearly visualized (motion artifacts).

increasing retrocardiac opacity and edema.

single semi-erect ap view of the chest demonstrates interval placement of an endotracheal tube with the distal tip approximately 4 cm from the carina. there has been placement of a right internal jugular central venous catheter with the distal tip within the proximal superior vena cava. no evidence of pneumothorax. interval increase in small bilateral pleural effusions, left greater than right, as well as bilateral lower lung zone opacities. surgical clips are seen in the right upper quadrant of the abdomen.

mediastinum is mildly widened and mediastinal hemorrhage cannot be excluded. clinical correlation is recommended. findings were text paged to pager (612) 398-7437 patientiq 1220 hours on the day of this dictation.

normal cardiomediastinal silhouette. vascularity appears normal. lungs clear. no pleural effusion or pneumothorax. no acute osseous abnormality.

there is interval increase in interstitial opacification, consistent with edema. a small left pleural effusion may be present. the cardiomediastinal silhouette is unchanged.

frontal projection of the chest demonstrating mild linear bilateral basilar opacity which may represent atelectasis versus early consolidation. the lungs are hyperinflated. no acute osseous findings. heart size is normal.

lines and tubes are stable. persistent bibasilar pulmonary opacity.

there has been interval placement of an acdf at the lower cervical spine. low lung volumes, with bibasilar atelectasis. no significant pulmonary edema or pleural effusion. cardiomediastinal silhouette within normal limits.

ap semi-erect chest radiograph demonstrates an endotracheal tube, nasogastric tube, right internal jugular venous line, right subclavian venous line and bilateral upper extremity picc line. opacification is seen in the left mid-lower zones with a likely layering pleural effusion. patchy opacification is also seen adjacent to the inferior hilar region on the right.

post-surgical chest with lines and tubes as above. decreased lung volumes with mild interstitial pulmonary edema, bibasilar atelectasis and bilateral pleural effusions with increased right perihilar opacity representing atelectasis or consolidation.

ap and lateral views of the chest demonstrate a prominent reticular nodular pattern throughout the lungs along with more focal areas of consolidation at the left base that could represent atelectasis or consolidation. no definite change since 3/19/2007. a ct could be performed if clinically indicated for further evaluation. no pneumothorax. tortuous calcified aorta. visualized osseous structures unremarkable. i have personally reviewed the images for this examination and agreed with the report transcribed above.

portable chest radiograph demonstrates left upper extremity picc in stable position 4.5 cm below the carina. lungs demonstrate a small right pleural effusion. there is mild fluid overload. demonstration of moderate cardiomegaly and severe degenerative joint disease of the right humeral joint.

fluctuating left base atelectasis. no evidence of pneumothorax. interval appearance of nodule at the right base which is nonspecific. attention on follow up.

lungs are clear without focal airspace consolidation. cardiomediastinal silhouette appears unremarkable. no evidence for acute cardiopulmonary disease.

single semi-upright ap view of the chest demonstrates very low lung volumes. interval development of small left pleural effusion and bibasilar opacities, left greater than right.

the lungs appear clear, with minimal basilar atelectasis, but no focal consolidation. prominent cardiac size and mediastinal contours, which may be accentuated due to relatively expiratory position of the patient. no pulmonary edema or pleural effusion.