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Generate impression based on findings. | 60 year old female who was recalled from screening mammogram for Right breast mass. Mammogram: Three full-field views and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. 1 cm lobulated mass in question disperses into normal breast tissue in the right breast 12 o'clock position. On full-field views, the lesion in question could not be redemonstrated and could represent part of glandular tissue.Ultrasound: Targeted right breast ultrasound was performed. No suspicious cystic or solid mass was noted. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Status post vein harvest with palpable right medial thigh masses Two adjacent complex cystic collections within the subcutaneous tissues of the right medial thigh. The superior collection measures 5.9 x 4.3 x 2.3 cm; the inferior adjacent collection measures 4.2 X 2.5 x 4.8 cm. These cystic collections demonstrate no evidence for increased vascularity. | Two adjacent complex cystic collections within the subcutaneous tissues of the right medial thigh without evidence for increased vascularity; favor benign etiology such as evolving hematomas. |
Generate impression based on findings. | Female 73 years old Reason: hepatocellular injury, assess for vascular abnormalities and liver architecture, patient with AKI, please assess kidneys History: as above ABDOMENLIVER: Liver is normal in morphology and measures 15.8 cm in length. The hepatic parenchyma is homogenously increased echotexture. No focal mass lesion is evident.BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen is normal in size measuring 11.8 cm in length. RIGHT KIDNEY: The right kidney is normal in size measuring 11.5 cm in length. The renal parenchyma is mildly echogenic but normal in thickness. No hydronephrosis or shadowing stones.LEFT KIDNEY: The left kidney is normal in size measuring 9.2 cm in length. Evaluation of the parenchyma is mildly limited due to technical factors, however the renal parenchyma appears mildly echogenic. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Mildly echogenic hepatic parenchyma which can be seen in hepatic steatosis.2.Mildly echogenic renal parenchyma bilaterally compatible with medical renal disease. No hydronephrosis or stones are evident.3.Normal Doppler examination of the abdomen. |
Generate impression based on findings. | 62-year-old with multiple cysts in both breasts complains of tenderness in both breasts. Ultrasound for both breasts are performed. The patient has a tender spot in the right 12 - 1 o'clock position. There is a simple cyst at one o'clock position in the right breast measuring 15 x 15 mm. Additionally, there are small simple cysts at one o'clock, 12 o'clock, 10 o'clock position and retroareolar region in the right breast. In the left breast, there is a simple cyst measuring 16 x 11 mm at 12 o'clock position, where the patient feels tenderness. There are more simple cysts in the left breast at upper outer quadrant. | Multiple simple cysts in both breasts. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 44-year-old with right breast cellulitis. Right breast ultrasound was performed. There is an irregularly-shaped hypoechoic lesion with increased vascularity, measuring 36 x 23 mm at two o'clock retroareolar region, consistent with abscess formation. Diffuse skin thickening and edema is seen in the right breast. | Abscess formation at two o'clock retroareolar region in the right breast. Diffuse skin thickening and edema in the right breast.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 27 year old pregnant patient with 2 cm mass palpated by her obstetrician. The patient reported initially that she does not know where the lump is but also stated later that lump has been there for years. Patient reports physician palpated mass was located in the right upper outer quadrant. A targeted right ultrasound was performed for the palpable area of concern. In the 10 o'clock position 4 cm from the nipple there is an oval circumscribed parallel oriented hypoechoic heterogeneous mass with mild internal vascularity. This mass measures 7 x 4 x 6 mm. | Benign morphology mass in the right 10 o'clock position likely represents a fibroadenoma. Recommend short term 6 month sonographic follow up to confirm stability. It is also recommended that this result is carefully correlated with physical exam findings as there was difficulty obtaining history from this patient, a specific palpable area of concern from physical exam could not be found in the electronic chart and the referring physician could not be contacted via pager. BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Evaluate for a left axillary lymph nodes. Known left breast cancer. A targeted left ultrasound was performed for the axillary region. Multiple lymph nodes with uniformly thickened cortices, retained hila and retained hilar blood flow are seen. There is no suspicious morphology lymph node or solid or cystic mass identified. | No suspicious morphology axillary lymph node. The patient will be seeing Dr. Chhablani again today.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 80 yo female with past history of left breast cancer, has benign feeling mass in the right breast. Prior ultrasound on 7/24/2014 demonstrated no mass in the palpable area of abnormality in the 3 o'clock position of the right breast. A targeted right ultrasound was performed for the palpable area of concern, previously denoted as the 3 o'clock position. There is no solid or cystic mass identified 4 cm from the nipple, the previous location examined sonographically. In the 3 o'clock position, 2 cm from the nipple, there is a small simple cyst, measuring 3 x 1 x 3 mm. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 26 year old female with history of AML diagnosed at age 11 status post stem cell transplant. Patient palpated left breast mass 1 week ago. Targeted physical examination of the left breast 8 o'clock position 0.5 cm from the nipple in the patient's palpable area of concern demonstrated denser tissue.A targeted left ultrasound was performed for the palpable area of concern. There is no solid or cystic mass identified. Dense breast tissue was demonstrated in the 8 o'clock position, 0.5 cm from the nipple. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Renal transplant with elevated creatinine. Right iliac fossa renal transplant is identified. Ultrasound guidance was provided to the clinical service for performance of an inferior pole biopsy. Three needle passes were made. No immediate post procedure complications identified. | Ultrasound guidance was provided to the clinical service for the performance of a renal biopsy. |
Generate impression based on findings. | 74 year old female who was recalled from screening mammogram for a developing mass in the left breast at anterior upper outer aspect. Mammogram: An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Spiculated 10-mm mass persist on spot compression views. No associated calcifications within the mass. Few loosely scattered calcifications posterior to the mass are mostly unchanged dating back to 2007.Ultrasound: Targeted left upper outer quadrant Ultrasound is performed. Irregular hypoechoic mass with blood flow measures 1.1 x 0.6 x 0.8 cm corresponding to the mammographic abnormality at 2 to 2:30 o'clock position. Located 2 cm posterior and slightly superior is a second taller than wide hypoechoic small lesion with micro-lobulations that measures 4 x 3 mm which probably corresponds to a oval asymmetry, slightly superior and posterior to the spiculated mass in the ML full-field view. | Two suspicious masses in the left breast two o'clock position, need further evaluation with ultrasound guided core biopsy. Findings and recommendations were discussed with the patient in detail.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Female 23 years old Reason: evaluate for appendicitis History: RLQ abdominal pain The appendix was not visualized. An intrauterine pregnancy was visualized on a single image. | 1.Appendix not visualized. |
Generate impression based on findings. | 41 year-old female with a stem cell transplant, now abdominal pain and fever LIVER: Hepatic parenchyma is echogenic and there is mild hepatomegaly.GALLBLADDER, BILIARY TRACT: No cholelithiasis. Bladder wall mildly thickened, but there is ascites present and therefore this is not specific. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Mild/moderate ascites and bilateral pleural effusions.Splenomegaly. | Ascites, pleural effusions and heoatosplenomegaly with echogenic liver. |
Generate impression based on findings. | 52 year-old female with heart failure and ascites. LIVER: Liver echotexture coarsely echogenic and mildly heterogeneous fashion. Within the left lobe of the liver there is a mildly hyperechoic ovoid region measuring 1.3 x 2 . 5 x 2 cm which may have a central linear decrease echogenicity extending to the periphery. This would best be evaluated by dedicated liver CT. Overall hepatic size within normal limits. Venous distention consistent with congestive heart failure.GALLBLADDER, BILIARY TRACT: Dependent sludge within the gallbladder without shadowing gallstones. Gallbladder wall within normal limits.PANCREAS: Exclude a small cystic area in the pancreatic head although the associated pancreatic duct does not appear dilated. Again this could be evaluated by CT or preferably MRCP.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Marked ascites. | Ascites. Coarsened hepatic echotexture.Apparent hyperechoic mass within the liver although this could also represent focal fatty infiltration. Dedicated CT or MR of the liver recommended.Cystic area within the pancreas. M.R.C.P. recommended. |
Generate impression based on findings. | 60 year-old female with abnormal liver function. LIVER: Mildly echogenic. Main portal vein patent with appropriate flow direction.GALLBLADDER, BILIARY TRACT: Mild intrahepatic ductal dilatation with marked dilatation of the common duct as previously noted.PANCREAS: Limited with pancreatic ductal dilatation associate with patient's known pancreatic head mass.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Spleen not visualized. | Mildly echogenic liver with dilated biliary tract as previously noted. Pancreatic ductal dilatation as previously noted. |
Generate impression based on findings. | 51 year old male with hepatitis C. Evaluate for HCC LIVER: Mild increased echogenicity of the liver measuring 16.5 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are increased in echogenicity similar to prior study suggestive of fatty atrophy, somewhat inappropriate for age.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.3 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 10.0 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 12.0 cm in length. | Mild increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 22-year-old female presents with bilateral superior breast pain for few weeks. Patient does not palpate a lump. A targeted bilateral breast ultrasound was performed for the patient’s area of concern. Patient does not palpate a lump however, is tender in the superior bilateral breasts. Normal glandular tissue identified on ultrasound. There is no solid or cystic mass identified. | No sonographic evidence for malignancy corresponding to patient's area of concern in bilateral superior breast.Routine screening mammogram is recommended starting at the age of 40.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 62 year old female. History of thyroid cancer with new positive TG antibodies. Also biochemical evidence of hyperparathyroidism. Please assess thyroid bed lymph nodes and parathyroids. Thyroid has been surgically resected. Echogenic soft tissue focus just inferior to the left thyroid bed in the supraclavicular region is 0.9 x 0.7 x 0.5 cm, previously 1.1 x 0.7 x 0.5 cm, unchanged. No internal vascularity in this lesion on Doppler exam.PARATHYROID GLANDS: No lesions suspicious for a parathyroid adenoma are identified.LYMPH NODES: Benign-appearing left level 3 lymph node is 1.9 x 1.1 x 0.6 cm. No suspicious or enlarged lymph nodes are identified.OTHER: No significant abnormality noted. | Stable echogenic soft tissue focus in the left supraclavicular region. Benign-appearing left level 3 lymph node. No new masses or lymphadenopathy. |
Generate impression based on findings. | 24 year old female. Hyperbilirubinemia. Evaluate for any liver, gallbladder, or duct pathology. LIVER: Diffuse mildly increased echogenicity and coarsened echotexture of the liver consistent with hepatic steatosis/dysfunction. The liver is 16 cm in length. No focal mass. Hepatopetal portal venous flow.GALLBLADDER, BILIARY TRACT: No cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No biliary ductal dilatation. The common duct is 4 mm in diameter, within normal limits.PANCREAS: Visualized pancreatic head is normal in echogenicity. The rest of the pancreas is obscured by bowel gas.RIGHT KIDNEY: Right kidney is 10.5 cm in length. No hydronephrosis.OTHER: Spleen is 14.7 cm in length. Small splenule is noted. Left kidney is 10.5 cm in length. No hydronephrosis. | Mild increased echogenicity and coarsened echogenic of the liver consistent with hepatic steatosis/dysfunction. Mild hepatosplenomegaly. |
Generate impression based on findings. | 59 year-old female with abdominal pain. Evaluate for ascites. Four abdominal quadrants were evaluated for the presence of ascites. No evidence of ascites is noted.Partially imaged liver is increased in echogenicity. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. 2. No ascites. |
Generate impression based on findings. | 68-year-old male. Abdominal pain, fevers. Evaluate for hydronephrosis or fluid collection. RIGHT KIDNEY: Increased echogenicity. No focal mass, shadowing stone, or hydronephrosis.LEFT KIDNEY: Increased echogenicity. No focal mass, shadowing stone, or hydronephrosis.OTHER: Dependent debris in the bladder. Moderate bilateral pleural effusions. Limited images of the liver demonstrate increased echogenicity suggestive of fatty infiltration. | Echogenic kidneys consistent with medical renal disease. No hydronephrosis. Moderate bilateral pleural effusions. |
Generate impression based on findings. | 16-year-old female presents with spell palpated lump in the right breast for two weeks. Family history breast cancer in maternal grandmother. A targeted right ultrasound was performed for the patient’s area of concern. On physical examination, 2-cm mobile nontender soft, palpable mass noted in the right breast 10 o' clock position. Ultrasound demonstrates a possible bilobed or two adjacent smaller hypoechoic parallel oriented, circumscribed masses in the right breast 10 o'clock position, measuring 2.5 x 0.9 x 2 cm, corresponding to a benign fibroadenoma. No suspicious mass noted. | Palpable abnormality right breast 10 o'clock position corresponds to benign fibroadenoma based on imaging. Surgical consultation is recommended. Findings and reformations were discussed with the patient and her mother in detail.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | The patient submitted outside mammogram dated 10/30/2013 and outside right breast ultrasound 3/28/2011, from Northwestern Memorial Hospital. Submitted outside study was compared to the current mammogram dated 3/16/2015. There is no significant change between these two studies.The ultrasound was submitted for comparison only, no official interpretation will be performed. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 82-year-old female with liver lesions likely consistent with cysts. Evaluate liver lesions seen on CT for evidence of malignancy. Also evaluate for signs of chronic liver disease. LIVER: Normal echogenicity of the liver. Multiple cysts are noted in the right hepatic lobe, the largest of which is located along the inferior aspect of the right hepatic lobe measuring 3.6 cm x 3.1 cm x 4.1 cm containing internal septations and some debris with suggestion of peripheral nodularity. Two additional smaller cysts are noted containing thin internal septations, one of which measures 2.5 cm x 1.8 cm x 2.1 cm, and the second cyst measures 1.7 cm x 1.8 cm x 1.4 cm. Main portal vein is patent with appropriate directional flow; peak velocity measures 17.1 cm/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures up to 1.0 cm in caliber. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are increased in echogenicity suggestive of fatty atrophy.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 9.8 cm in length.Normal echogenicity of the left kidney measuring 10.2 cm in length. No hydronephrosis or shadowing calculi are noted. | Dominant complex cyst at the inferior aspect of the right hepatic lobe with suggestion of peripheral nodularity. Recommend MRI for further evaluation. Additional smaller minimally complex cysts are likely benign. |
Generate impression based on findings. | The patient submitted outside mammogram dated 3/25/2014, 10/20/2013, 10/7/2013 and ultrasounds dated 3/25/2014 and 10/22/2013, from Mercy Hospital. Submitted outside study was compared to the current mammogram dated 3/4/2015. There is no significant change between these two studies.Ultrasound images submitted for comparison only, no official interpretation will be performed. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 73 year old female with ascites and AKI. Evaluate liver, vasculature and kidneys. LIVER: Large portion of the liver is occupied by a heterogeneous predominantly solid lesion measuring 9.4 cm x 7.1 cm x 9.1 cm. The main portal vein is patent with appropriate directional flow. Peak velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. Mild gallbladder wall thickening which is nonspecific in the setting of ascites. No pericholecystic fluid. Common duct measures 9 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Obscured by overlying bowel gas.SPLEEN: Normal echogenicity of the spleen measuring 11.2 cm in length.KIDNEYS: Right kidney measures 10.2 cm in length and is increased in echogenicity. Left kidney measures 10 .is an increase in length and is increased in echogenicity. No hydronephrosis or shadowing calculi are noted bilaterally.ABDOMINAL AORTA: Proximal aorta measures 2.4 cm x 2.4 cm. The mid aorta measures 1.8-cm x 1.4-cm.INFERIOR VENA CAVA: The visualized IVC is patent. OTHER: Moderate ascites. | 1. Hepatomegaly with increased echogenicity suggestive of parenchymal dysfunction/fatty infiltration. Large heterogeneous mass corresponds to the lesion noted on CT and does not appear significantly changed. Main portal vein is patent.2. Increased echogenicity of the kidneys suggestive of nonspecific medical renal disease. No obstruction. 3. Moderate ascites.4. Mild gallbladder wall thickening which is nonspecific in the setting of ascites. No sonographic evidence of cholecystitis. |
Generate impression based on findings. | 59 year old female with chronic hepatitis B carrier. Evaluate for malignancy, cirrhosis, portal hypertension. LIVER: Normal echogenicity of the liver measuring 10.1 cm in length. Cyst measures 7 mm x 4 mm x 4 mm. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable. RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 9.1 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen is not well visualized.Normal echogenicity of left kidney measuring 9.4 cm in length. No hydronephrosis or shadowing calculi are noted. | Probable subcentimeter cyst in the right hepatic lobe. |
Generate impression based on findings. | 57-year-old male with weight loss. Evaluate status of thyroid gland anticipation of lung transplant. RIGHT LOBE MEASUREMENTS: 5.1 cm x 2.1 cm x 2.2 cm LEFT LOBE MEASUREMENTS: 5.1 cm x 1.4 cm x 2.6 cmISTHMUS MEASUREMENTS: 4 mm in thicknessRIGHT LOBE: Hypoechoic solid nodule in the midpole measures 7 mm x 8 mm x 6 mm with no definite microcalcifications or internal vascularity. Additional hypoechoic, solid nodule at the inferior pole measures 1.5 cm x 1.1 cm x 1.5 cm with peripheral vascularity and no definite microcalcifications.LEFT LOBE: 1.0-cm cyst at the inferior pole is noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules. Dominant solid nodule in the right inferior pole is amenable to biopsy if clinically indicated. |
Generate impression based on findings. | 80 year-old male with thyroid nodule. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: 3.4 cm x 1.1 cm x 0.9 cmLEFT LOBE MEASUREMENTS: 3.5 cm x 1.5 cm x 1.8 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: No discrete nodules or masses are seen.LEFT LOBE: Hypoechoic solid nodule at the inferior pole is again seen measuring 1.9 cm x 1.6 cm x 1.0 cm, previously 1.9 cm x 1.1 cm x 1.4 cm. There is some internal vascularity; no definite microcalcifications are noted. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant interval change in solid left thyroid nodule. This has been biopsied previously. |
Generate impression based on findings. | 33-year-old female, evaluate for residual thyroid cancer. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: Hypoechoic nodule in the right thyroidectomy bed measures 3 mm x 3 mm x 3 mm, previously 4 mm x 3 mm x 4 mm.LEFT LOBE: Hypoechoic nodule in the left thyroidectomy bed measures 1.0 cm x 0.4 cm x 0.2 cm, previously 0.4 cm x 0.8 cm x 0.3 cm. Additional hypoechoic nodule measures 0.9 cm x 0.3 cm x 0.3 cm, previously 1.1 cm x 0.2 cm x 0.5 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Stable right IB lymph node measuring 6 mm x 2 mm x 6 mm, previously 9 mm x 4 mm x 7 mm.OTHER: No significant abnormality noted. | Stable bilateral hypoechoic foci in the bilateral thyroidectomy beds. Stable right level IB neck lymph node. |
Generate impression based on findings. | 21-year-old female with history of thyroid cysts, enlarged thyroid on exam RIGHT LOBE MEASUREMENTS: 4.4-cm x 2.0 x 1.1 cmLEFT LOBE MEASUREMENTS: 5.1 cm x 1.6 cm x 0.6 cmISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Hypoechoic nodule in the upper pole measures 3 mm x 2 mm x 2 mm containing echogenic foci likely inspissated colloid.LEFT LOBE: Hypoechoic cystic appearing nodule at the inferior pole measures 3 mm x 3 mm x 4 mm containing internal echogenic foci likely inspissated colloid.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 3 benign-appearing lymph node measures 6 mm x 2 mm x 9 mm.OTHER: No significant abnormality noted. | Findings suggestive of bilateral colloid nodules. |
Generate impression based on findings. | 67-year-old male with smoking history. Screening exam Abdominal aortic measurements:Proximal aorta: 2.6 x 2.2 cm.Mid aorta: 1.4 x 1.8 cm.Distal aorta: 1.2 x 1.3 cm.Right common iliac artery: 0.9 x 0.9 x 1.0 cm.left common iliac artery: 0.9 x 1.0 x 1.1 cm. | Normal caliber of the aorta with no evidence of aneurysm. |
Generate impression based on findings. | 87-year-old male with renal failure, likely CKD. Assess for hydronephrosis. RIGHT KIDNEY: Measures 11.6 cm in length. There are multiple predominately simple appearing cysts, the largest of which is located at the superior pole measures 2.5 cm x 2.1 cm x 2.1 cm. No hydronephrosis or shadowing calculi are noted.LEFT KIDNEY: Measures 11.0 cm in length. There are multiple predominately simple appearing cysts, the largest of which is located at the inferior pole measuring 3.5 cm x 2.4 cm x 2.8 cm. No hydronephrosis or shadowing calculi are noted.OTHER: No significant abnormalities noted. | Bilateral predominately simple appearing renal cysts, a couple of which have thin septations. If a more complete evaluation of these cysts is warranted, a dedicated CT renal protocol can be obtained for further evaluation. |
Generate impression based on findings. | 65 year-old female with thyromegaly. RIGHT LOBE MEASUREMENTS: 5.1 cm x 1.1 cm x 1.6 cmLEFT LOBE MEASUREMENTS: 4.7 cm x 0.9 cm x 1.7 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: No discrete nodules or masses are identified.LEFT LOBE: No discrete nodules or masses are identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level benign-appearing lymph node measures 0.8 cm x 0.3 cm x 1.1 cm. Right level 4 benign-appearing lymph node measures 6 mm x 2 mm x 7 mm. Left level 3 benign-appearing lymph node measures 0.7 cm x 0.2 cm x 1.0 cm. Left level 4 benign-appearing lymph node measures 0.9 cm x 0.4 cm x 1.3 cm. No pathologic lymphadenopathy. OTHER: Patient's area of neck swelling was evaluated with no discrete nodules or masses identified. | No discrete nodules or masses were noted. |
Generate impression based on findings. | 56 year old male with cirrhosis. Evaluate for HCC. LIVER: Heterogeneous echotexture of the liver measuring 17.1 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Pancreas not well seen in its entirety due to overlying bowel gas. RIGHT KIDNEY: Measures 11.9 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.2 cm in length. No hydronephrosis or shadowing calculi are noted. Normal echogenicity of the spleen measuring 12.3 cm in length. | 1. Heterogeneous echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. 2. Cholelithiasis with no evidence of cholecystitis. |
Generate impression based on findings. | Call back from screening mammogram for asymmetry and calcifications in both breasts. An ML view and two spot magnification views of both breasts and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense. Compared to the images from 2012, multiple of clustered calcification are mildly increased in benign fashion in both breasts. No uniquely suspicious cluster of calcifications are not noted. A mass in the right retroareolar region seen on the recent screening mammogram partially disperses into normal glandular tissue. Whole breast ultrasound for both breasts is performed. There are no solid or cystic lesions in either breast. | High probability benign calcifications in both breasts. Short interval follow up for both breasts is recommended in 6 months. Results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 65 year-old female with hepatitis C, assess for HCC. LIVER: Mildly echogenic measuring 15.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder is normal in echogenicity. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra-or extrahepatic ability ductal location.PANCREAS: Pancreas is not well seen due to overlying bowel gas.RIGHT KIDNEY: Measures 10.6 cm in length. There is mild pelvocaliectasis. No shadowing calculi are noted.OTHER: Left kidney measures 10.7 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 10.4 cm in length. | 1. Mildly echogenic liver parenchyma suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesion.2. Nonspecific right mild pelvocaliectasis. |
Generate impression based on findings. | 43 year old male with HTN, renal failure. Evaluate for etiology for HTN, assess for renal artery stenosis. ULTRASOUND KIDNEYSRIGHT KIDNEY: Increased in echogenicity measuring 9.9 cm in length. No hydronephrosis or shadowing calculi are noted. LEFT KIDNEY: Increased in echogenicity measuring 10.9 cm in length. No hydronephrosis or shadowing calculi are noted. OTHER: Fluid containing structure adjacent to the bladder presumably represents fluid containing bowel. | 1. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No hydronephrosis. 2. No evidence of renal artery stenosis. |
Generate impression based on findings. | 70-year-old female with cancer status post thyroidectomy and I-131. Evaluate for abnormal masses or nodes. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Hyperechoic nodule is seen in the right thyroidectomy bed measuring 8 mm x 6 mm x 3 mm. LEFT LOBE: Hypoechoic nodule in the left thyroidectomy bed measures 4 mm x 3 mm x 2 mm, unchanged accounting for differences in technique, previously measuring 3 mm x 3 mm x 2 mm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral benign appearing lymph nodes in the neck, the largest on the right measures 1.7 cm x 1.0 cm x 0.5 cm. No pathologic lymphadenopathy. OTHER: No significant abnormality noted. | 1. Hyperechoic subcentimeter nodule in the right thyroidectomy bed with appearance favoring a benign process. 2. Hypoechoic nodule in the left thyroidectomy bed is unchanged. |
Generate impression based on findings. | 75 year old female with incidental thyroid nodule noted on MRI neck. RIGHT LOBE MEASUREMENTS: 1.5 cm x 1.2 cm x 2.9 cm.LEFT LOBE MEASUREMENTS: 1.2 cm x 1.6 cm x 2.8 cm.ISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Heterogeneous echotexture. Multiple subcentimeter nodules are noted, the largest of which is hypoechoic and measures 6 mm x 4 mm x 5 mm. LEFT LOBE: Multiple subcentimeter nodules are noted, the largest of which measures 7 mm x 7 mm x 8 mm and is cystic in appearance. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Multiple bilateral lymph nodes are noted in the neck, the majority of which appear benign with a prominent fatty hilum. However, prominent left neck level 3 lymph node measures 1.3 cm x 0.5 cm x 0.8 cm is noted with suggestion of a fatty hilum. OTHER: No significant abnormality noted. | 1. Prominent left neck level 3 lymph node with suggestion of a fatty hilum. While presence of fatty hilum suggests benignity and node may merely be reactive in etiology, the node is prominent and has an abnormal rounded configuration, correlation with patient's clinical history and follow up is recommended to exclude a neoplastic process. 2. Heterogeneous thyroid gland with bilateral subcentimeter nodule, largest on the left lobe which is predominantly cystic and likely represents a benign colloid nodule. |
Generate impression based on findings. | 21 year old female with known bilateral fibroadenomas presents for follow up ultrasound of right breast. Ultrasound was performed for the known masses at two o'clock position and 6 o'clock position. At two o'clock position, fourth and technique judged from nipple, there is a oval hypoechoic mass measuring 19 x 6 x 16 mm (previous measurement: 17 x 5 x 17 mm). At 6 o'clock position, 2 cm from the nipple, there is a oval hypoechoic mass measuring 11 x 5 x 10 mm (previous measurement: 15 x 5 x 10 mm). There is no significant change in its appearance in both masses. | Benign masses at two o'clock position and 6 o'clock position in the right breast. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 45-year-old female with right breast mass found on screening mammogram. DIGITAL DIAGNOSTIC RIGHT MAMMOGRAM:Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The right upper outer breast mass persists on compression views. No associated calcifications were identified.RIGHT BREAST ULTRASOUND:A targeted right ultrasound was performed for the mammographic area of concern. A 1.5 x 1.2 x 1.5 cm, hypoechoic, ill-defined right breast mass with increased vascularity was identified at the 10 o'clock position 7 cm from the nipple. | Hypoechoic, ill-defined mass of the right breast is suspicious for malignancy. Ultrasound-guided biopsy of this lesion is recommended for further evaluation.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 57-year-old male with worsening proteinuria. Ultrasound guidance provided for biopsy of transplanted kidney. Biopsy needle is seen traversing the renal parenchyma. | Ultrasound guidance provided for biopsy of transplanted kidney which was performed by the nephrology team. |
Generate impression based on findings. | 54-year-old male, rule out HCC LIVER: Coarse echotexture of the liver measuring 15.8 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. Focal hyperechoic focus with ring down artifact in the of the gallbladder fundus is again seen and likely representing focal adenomyomatosis. There is an echogenic nonmobile focus along the nondependent wall of the gallbladder likely a gallbladder polyp measuring 4 mm x 4 mm x 5 mm. Common duct measures 4 mm in caliber. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Not well seen due to overlying bowel gas.RIGHT KIDNEY: Measures 10.6 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 9.5 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen is not visualized. | 1. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions.2. Subcentimeter gallbladder polyp along the nondependent portion of the gallbladder wall. 3. Focal adenomyomatosis of the gallbladder is again seen. |
Generate impression based on findings. | 70 year old female with right upper quadrant pain. Evaluate gallbladder and liver. LIVER: Increased echogenicity of the liver measuring 16.8 cm in length. Cyst in the right hepatic lobe measures 1.2 cm x 1.2 cm x 1.4 cm which corresponds to the hypodense focus on prior CT's and appears unchanged. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec. common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: Multiple shadowing calculi within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Sonographic Murphy's sign is negative. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well seen due to overlying bowel gas.RIGHT KIDNEY: Measures 10.5 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.5 cm in length. No hydronephrosis or shadowing calculi are noted. Spleen measures 8.5 cm in length and is normal in echogenicity. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions.2. Cholelithiasis with no evidence of cholecystitis. |
Generate impression based on findings. | 36 year old female with weight gain, possible right thyroid enlargement. RIGHT LOBE MEASUREMENTS: 2.1 cm x 1.6 cm x 5.1 cmLEFT LOBE MEASUREMENTS: 1.8 cm x 1.3 cm x 4.8 cmISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Normal echotexture with no discrete nodules or masses identified.LEFT LOBE: Normal echotexture with no discrete nodules or masses identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Unremarkable examination. |
Generate impression based on findings. | 35-year-old female with epigastric pain. Evaluate gallbladder for stones, infection. LIVER: Normal echogenicity of the liver measuring 14.8 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Nonmobile echogenic focus with no acoustic shadowing along the gallbladder wall measures 4 mm x 3 mm consistent with a polyp. No gallbladder wall thickening. No pericholecystic fluid. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 12.1 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen measures 11.1 cm in length and is normal in echogenicity. Left kidney measures 12.3 cm in length. No hydronephrosis or shadowing calculi are noted. | Subcentimeter gallbladder polyp. |
Generate impression based on findings. | 70 year-old male with cirrhosis. Evaluate liver for for cirrhosis, evidence of HCC. LIVER: Nodular contour and heterogeneous echotexture of the liver measuring 16.3 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures 6 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well-visualized due to overlying bowel gas.RIGHT KIDNEY: Measures 10.6 cm in length. No hydronephrosis or shadowing calculi are noted. Cyst at the midpole measures 2.3 cm x 2.5 cm x 3.3 cm unchangedOTHER: Spleen measures 15.5 cm in length and is normal in echogenicity.Left kidney measures 10.4 cm in length. No hydronephrosis or shadowing calculi are noted.Incompletely visualized bilateral pleural effusions. | 1. Cirrhotic liver morphology with no focal hepatic lesions.2. Incompletely visualized bilateral pleural effusions. |
Generate impression based on findings. | 42 year old female with epigastric pain, history of gallbladder polyp. LIVER: Normal echogenicity of the liver measuring 13.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Two subcentimeter polyps are noted along the nondependent portion of the gallbladder wall, one of which measures 3 mm x 2 mm x 3 mm and the second measures 5 mm x 4 mm x 5 mm. No gallbladder wall thickening. No cholecystic fluid. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 10.2 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 9.7 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen measures 8.4 cm in length and is normal in echogenicity. | Two subcentimeter gallbladder polyps. |
Generate impression based on findings. | 55 year old female with fever, elevated GGT, elevated alkaline phosphatase. Evaluate for liver/gallbladder pathology. LIVER: Coarse echotexture of the liver measuring 12.6 cm in length. No focal hepatic lesions. Main portal vein is patent the directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Mild gallbladder wall thickening. No evidence of cholelithiasis or sludge. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Increased echogenicity measuring 11.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Increased echogenicity of the left kidney measuring 7.8 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Mild gallbladder wall thickening with no evidence of cholelithiasis or cholecystitis.2. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 24-year-old female with elevated LFTs. Evaluate for liver/gallbladder abnormalities. LIVER: Normal echogenicity of the liver measuring 20.5 cm in length. No focal hepatic lesions. The main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 11.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.6 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen is not visualized.Several small peripancreatic lymph nodes are noted. | Hepatomegaly with no focal hepatic lesions. |
Generate impression based on findings. | 24-year-old male with VP shunt internalized to gallbladder. Right upper quadrant abdominal pain. LIVER: Normal echogenicity of the liver measuring 16.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures is 0.5 m/sec.GALLBLADDER, BILIARY TRACT: Partially visualized VP shunt with tip internalized within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Atrophic measuring 9.2 cm in length. Several shadowing stones are present at the inferior pole, largest of which measures 1.3 cm in length. No hydronephrosis is noted.OTHER: Normal echogenicity of the spleen measuring 10.2 cm in length.Left kidney is not visualized. Incompletely visualized right pleural effusion.Trace ascites. | 1. VP shunt internalized into the gallbladder with no surrounding inflammatory changes. 2. Atrophic right kidney with nephrolithiasis. No hydronephrosis. 3. Trace ascites and incompletely visualized right pleural effusion. |
Generate impression based on findings. | 69-year-old female with hypercalcemia, hyperparathyroidism. Evaluate for abnormal parathyroids. RIGHT LOBE MEASUREMENTS: 4.3 cm x 1.2 cm x 1.4 cmLEFT LOBE MEASUREMENTS: 4.5 cm x 0.9 cm x 1.4 cmISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Multiple nodules are noted. At the mid to upper pole a hypoechoic cystic appearing nodule measures 7 mm x 5 mm x 3 mm. Additional hypoechoic mixed solid cystic nodule at the inferior pole measures 4 mm x 4 mm x 6 mm. A second inferior pole mixed solid cystic hypoechoic nodule measures 1.0 cm x 0.8 cm x 0.6 cm. LEFT LOBE: Hypoechoic mixed solid cystic nodule at the mid pole measures 4 mm x 2 mm x 4 mm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral thyroid nodules as described above. No sonographic evidence of parathyroid adenoma. Please refer to same day nuclear medicine parathyroid SPECT/CT study for additional findings. |
Generate impression based on findings. | 82-year-old male with right inguinal hernia, pain in right lower quadrant. Evaluate for interval change. During Valsalva maneuver, there is redemonstration of a right inguinal hernial sac containing loop of bowel which is reducible and appears similar to prior study. | Right reducible inguinal hernia containing loop of bowel not significantly changed. |
Generate impression based on findings. | 65 year-old male, precardiac transplant evaluation. LIVER: Coarse architecture of the liver measuring 15.4 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. There is a cystic structure measuring 4.7 cm x 5.3 cm x 4.7 cm which appears to arise from the common bile duct near the confluence of the common bile duct with the cystic duct consistent with a choledochocele and appears stable compared to prior CT study dated 3/11/2013. No intrahepatic biliary ductal dilatation. PANCREAS: Not well visualized in its entirety due to overlying bowel gas.SPLEEN: Normal echogenicity of the spleen measuring 10.4 cm in length.KIDNEYS: Right kidney measures 11.4 cm in length. No hydronephrosis or shadowing calculi are noted.Left kidney measures 11.8 cm in length. No hydronephrosis or shadowing wire noted.ABDOMINAL AORTA: Proximal aorta measures 2.8-cm x 2.6-cm. INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: No significant abnormality noted. | 1. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. 2. Findings are consistent with a choledochocele arising from the proximal common bile duct; stable. |
Generate impression based on findings. | 4-year-old male pretransplant workup LIMITED ABDOMENLIVER: The liver measures 11.8 cm in length. Increased echogenicity of the liver is consistent with fat infiltration. No focal hepatic lesions or masses are identified.GALLBLADDER, BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures two mm in diameter.PANCREAS: The visualized head and body of the pancreas are normal in appearance. RIGHT KIDNEY: Kidney measures 8.6 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.SPLEEN: Spleen normal in size and contour, measuring 8.9 cm.OTHER: Free lymphatic fluid in the loculated lymphatic fluid is present within the right upper quadrant and throughout the abdomen. | 1.Increased echogenicity of the liver is consistent with hepatic steatosis.2.Free and loculated lymphatic fluid is present in the abdomen.3.Normal Doppler examination inflow and outflow vessels of the liver. |
Generate impression based on findings. | 81-year-old male with history of cholecystectomy, continued right upper quadrant and right lower quadrant pain. LIVER: Normal echogenicity of the liver measuring 19.7 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Mild intra-and extrahepatic biliary ductal dilatation is again seen. PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: The right kidney is atrophic and increased in echogenicity measuring 11.8 cm in length with moderate to severe hydronephrosis and debris worse when compared to prior CT dated 1/20/2015. No shadowing calculi are noted.OTHER: Left kidney is increased in echogenicity measuring 13.5 cm in length. Cyst in the midpole measures 2.5 cm x 3.6 cm x 2.6 cm. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 13.6 cm in length. | 1. Increased renal echogenicity bilaterally suggestive of parenchymal dysfunction. The right kidney is atrophic with moderate to severe hydronephrosis and debris worse when compared to prior CT. No hydronephrosis in the left kidney. No evidence of nephrolithiasis bilaterally. 2. Mild intra and extrahepatic biliary ductal dilatation is again seen and appears stable. |
Generate impression based on findings. | 64-year-old male with outside hospital Sestamibi scan showing a right inferior gland. Primary hyperparathyroidism. Assess for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 4.4 cm x 1.7 cm x 1.2 cmLEFT LOBE MEASUREMENTS: 3.2 cm x 1.1 cm x 1.0 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: No discrete nodules or masses are notedLEFT LOBE: No discrete nodules or masses are notedISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Hypoechoic extrathyroidal nodule posterior and inferior to the right thyroid lobe measures 9 mm x 6 mm x 4 mm. This corresponds to the uptake seen on outside hospital nuclear medicine Sestamibi scan and is consistent with suspected parathyroid adenoma. LYMPH NODES: Right neck benign appearing lymph node measures 8 mm x 8 mm x 4 mm. Left neck benign appearing lymph nodes are noted, largest measures 1.0 cm x 0.9 cm x 0.3 cm. OTHER: No significant abnormality noted. | Findings are consistent with suspected right parathyroid adenoma as described above. |
Generate impression based on findings. | 70-year-old female with right lower abdominal/groin enlarging mass, possible hernia versus lipoma. In the region of right groin bulge/mass noted by the patient there is a hernial sac containing loops of bowel which increases with Valsalva maneuver and is reducible. | Right inguinal bowel containing reducible hernia. |
Generate impression based on findings. | 5-year-old male with VOD and ascites ABDOMENLIVER: The liver measures 13.1 cm in length. Increased echogenicity of the liver, unchanged. No focal hepatic lesions or masses are identified.GALLBLADDER, BILIARY TRACT: Mild pericholecystic edema, likely related to ascites. No intrahepatic or extrahepatic biliary ductal dilatation is present. Sludge is present within the gallbladder, unchanged.PANCREAS: No significant abnormalities are noted in the visualized head of the pancreas. The body and tail of the pancreas are obscured by bowel gasOTHER: Moderate to large amount of ascites, unchanged. DOPPLER: Color and spectral Doppler were performed on inflow and outflow vessels.PORTAL VENOUS: Patent with hepatofugal flow. Hepatofugal flow is identified in the right, left, and main portal veins. Velocities of main, right, and left portal veins measure 0.2, 0.2, 0.1 m/sec, respectively.HEPATIC ARTERIES: Patent with normal arterial waveform. Common hepatic artery: Peak systolic velocity of 1.5 m/sec. Resistive index 0.9. Right hepatic artery: Peak systolic velocity of 0.6 m/sec. Resistive index 0.8.Left hepatic artery: Peak systolic velocity of 0.4 m/sec. Resistive index 0.8.HEPATIC VEINS: Hepatic veins are patent with normal phasic waveform.INFERIOR VENA CAVA: Non-dilated with no significant abnormalities noted. | Persistent hepatofugal flow throughout the portal venous system. Mildly increased resistive indices in hepatic arterial system. Moderate to large amount of ascites, unchanged. Gallbladder sludge. |
Generate impression based on findings. | 46 year old female with pain along right of umbilicus. Evaluate for hernia. In the region of the palpable area noted by the patient along the right periumbilical area is a benign appearing lymph node measuring 1.8-cm x 1.0 cm x 0.3 cm. No solid or cystic masses noted in this region. No evidence of hernia. | Benign appearing lymph node in the right periumbilical region corresponding to the palpable area noted by the patient. |
Generate impression based on findings. | 49-year-old male with metastatic lung cancer, on Alectinib. CT showed mild diffuse gallbladder wall thickening suggestive of acute inflammation. LIVER: Measures 14.3 cm in length with multiple bilobar hepatic metastatic lesions similar to recent CT study. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/s.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. Gallbladder wall thickening is noted measuring 8 mm in thickness. No pericholecystic fluid. Sonographic Murphy sign is negative. Common duct measures 3 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 9.4 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.2 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen measures 11.3 cm in length and is normal in echogenicity. | 1. Gallbladder wall thickening may represent chronic cholecystitis. No evidence of acute cholecystitis. 2. Multiple bilobar hepatic metastatic lesions similar to recent CT. |
Generate impression based on findings. | 72-year-old male with left lower quadrant pain and CKD, question of ascites. LIVER: Normal echogenicity of the liver measuring 15.9 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 5 mm in caliber. No intra-or extra hepatic biliary ductal dilatation.PANCREAS: Not visualized in its entirety due to overlying bowel gas. The visualized portions are unremarkable.SPLEEN: Normal echogenicity of the spleen measuring 7.9 cm in length.KIDNEYS: Increased echogenicity of the right kidney measuring 10.5 cm in length. No hydronephrosis or shadowing calculi are noted. Increased echogenicity of the left kidney measuring 11.3 cm in length. No hydronephrosis or shadowing calculi are noted. ABDOMINAL AORTA: Proximal aorta measures 2.9 cm x 2.6 cm.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: No ascites. | Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No obstruction. |
Generate impression based on findings. | 45-year-old male with thyroid cancer status post surgery. Evaluate for abnormal masses RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: Hyperechoic focus in the right thyroidectomy bed measures 1.0 cm x 0.6 cm x 0.3 cm.; stable.LEFT LOBE: No discrete nodules or masses in the left thyroidectomy bed. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable benign hyperechoic focus in the right thyroidectomy bed. |
Generate impression based on findings. | 52-year-old female with right upper quadrant pain. Evaluate gallbladder. LIVER: Increased echogenicity of the liver measuring 20.4 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 12.5 cm in length. There is a shadowing stone at the mid to upper pole measuring 1.8 cm x 1.2 cm x 1.7 cm which likely corresponds to the stone seen on CT dated 4/22/2014. No hydronephrosis is noted.OTHER: Left kidney measures 12.1 cm in length. No hydronephrosis or shadowing calculi are noted. Normal echogenicity of the spleen measuring 12.0 cm in length. | 1. Hepatomegaly with increased echogenicity suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. 2. Non obstructing right nephrolithiasis appears similar to CT dated 4/22/2014. 3. No evidence of cholecystitis. |
Generate impression based on findings. | 62 year old female with multinodular goiter. Evaluate for change in nodules. RIGHT LOBE MEASUREMENTS: 6.9 cm x 3.0 cm x 2.0 cmLEFT LOBE MEASUREMENTS: 8.4 cm x 3.9 cm x 2.7 cmISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Heterogeneous in echotexture with multiple nodules similar to prior study. Small right lower pole nodule with coarse calcification measures 4 mm x 4 mm x 4 mm, previously 3 mm x 4 mm x 5 mm.LEFT LOBE: Heterogeneous in echotexture with multiple nodules similar to prior study. Dominant nodule in the midpole measures 3.5 cm x 3.3 cm x 2.3 cm previously measured 3.3 cm x 3.3 cm x 2.2 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Multiple bilateral lymph nodes, although few mildly prominent, benignity favored given fatty hila, may be reactive in etiology. Left benign appearing lymph node measures 1.5 cm x 0.9 cm x 0.5 cm. Multiple benign appearing lymph nodes are seen in the right neck, one which measures 1.0 cm x 0.6 cm x 1.7 cm. OTHER: No significant abnormality noted. | Heterogeneous nodular thyroid compatible with multinodular goiter not significantly changed. |
Generate impression based on findings. | 69 year-old female with encephalopathy status post TIPS LIMITED ABDOMENLIVER: Heterogeneous echotexture with nodular contour measuring 17.5 cm in length. There is a hypoechoic lesion in the deep hepatic lobe which was not seen on prior study.BILIARY TRACT: Status-post cholecystectomy. Common duct measures 1.0 cm in caliber likely related to cholecystectomy. No intrahepatic biliary ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: Normal echogenicity of the spleen measuring 15.3 cm in length.RIGHT KIDNEY: Measures 10.7 cm in length. Cyst at the upper pole measures 3.5 cm x 3.2 cm x 3.6 cm. No hydronephrosis or shadowing calculi is noted.OTHER: Left kidney measures 10.9 cm in length. No hydronephrosis or shadowing calculi are noted.No ascites. | 1. Cirrhotic liver morphology. Hypoechoic lesion in the deep right hepatic lobe is suspicious for an infarct, however cannot exclude a mass in this region. Recommend dedicated liver CT study for further evaluation.2. Patent TIPS with expected hepatofugal flow in the left portal vein. No ascites. 3. Right renal cyst not significantly changed. Findings were discussed with Dr. Laura Carlson by phone on 4/2/2015 9:20 a.m.. |
Generate impression based on findings. | 60 year-old female. Microscopic hematuria. RIGHT KIDNEY: Normal echogenicity. 11.6 cm in length. Focal bulge of the cortex in the midpole may relate to a Dromedary hump. Multiple cysts, the largest in the lower pole, measures 7.8 x 5.9 x 8.1 cm. No shadowing stone.LEFT KIDNEY: Normal echogenicity. 10.5 cm in length. Mild pelvocaliectasis. No shadowing stone. OTHER: Partially collapsed bladder. | Right renal cysts. No solid mass or shadowing stone. |
Generate impression based on findings. | 21 year-old male with epigastric pain, elevated lipase LIVER: Measures 19.2 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/sec.BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized pancreas is unremarkable.SPLEEN: Normal echogenicity of the spleen measuring 11.4 cm in lengthRIGHT KIDNEY: Atrophic with increased echogenicity measuring 8.0 cm in length. OTHER: Left kidney is atrophic with increased echogenicity measuring 6.3 cm in length. | 1. The visualized pancreas is unremarkable. If there is clinical concern for pancreatitis, this can be better evaluated with a contrast enhanced CT study. 2. Hepatomegaly with no focal hepatic lesions.3. Atrophic and echogenic kidneys suggestive of parenchymal dysfunction. |
Generate impression based on findings. | 66 year old male, evaluation for heart transplant. Baseline exam LIVER: Coarse echogenicity of the liver measuring 17.2 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well-visualized overlying bowel gas.SPLEEN: Normal echogenicity of the spleen measuring 11.6 cm in length.KIDNEYS: Right kidney measures 11.1 cm in length. Non obstructing nephrolithiasis is noted. Left kidney measures 11.3 cm in length. No hydronephrosis or shadowing calculi are noted.ABDOMINAL AORTA: Atherosclerotic abdominal aorta with measurements as follows: proximal aorta measures 2.8 cm x 2.4 cm, the mid abdominal aorta measures 2.0 cm x 2.3 cm and the distal abdominal aorta measures 1.9 cm x 2.1 cm.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: Small amount of ascites.Incompletely imaged bilateral pleural effusions. | 1. Hepatomegaly with coarse echotexture suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. 2. Non obstructing right nephrolithiasis.3. Small amount of ascites and incompletely imaged bilateral pleural effusions. |
Generate impression based on findings. | 49 year old male with pancreatitis, epigastric abdominal pain. Evaluate for gallstones. LIVER: Measures 24.1 cm in length. No focal hepatic lesion. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/s. GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. Gallbladder wall measures 4 mm in thickness. No pericholecystic fluid. Common duct measures 8 mm in caliber which tapers distally to 6 mm. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Right kidney measures 13.9 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen measures 14.8 cm in length.Left measures 13.9 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Hepatosplenomegaly with heterogeneous echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesion. 2. No evidence of cholelithiasis. |
Generate impression based on findings. | 42 year old male with right cervical lymphadenopathy. Evaluate lymph nodes, soft tissue In the right lateral neck at the area of palpation noted by the patient there is a lymph node measuring 1.2 cm x 0.6 cm x 1.1 cm with suggestion of a prominent fatty hilum and central vascularity favoring a reactive etiology. There are multiple additional smaller lymph nodes in the right lateral neck which are benign in appearance. In the left neck there is a prominent lymph node measuring 0.8 cm x 0.4 cm x 2.0 cm which is elongated in contour with prominent fatty hilum and nonspecific heterogeneity of the cortex. Additional smaller benign appearing lymph nodes are also present. | Bilateral lymph nodes as described above felt to be most likely reactive in etiology. |
Generate impression based on findings. | 47-year-old female with history of thyroid cancer status post thyroidectomy. Evaluate for masses and lymphadenopathy RIGHT LOBE MEASUREMENTS: Status post thyroidectomy LEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No discrete nodules or masses in the thyroidectomy bed.LEFT LOBE: No discrete nodules or masses in the thyroidectomy bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Several small benign appearing lymph nodes in the neck. No pathologic lymphadenopathy.OTHER: No significant abnormality noted. | No evidence of disease recurrence or pathologic lymphadenopathy. |
Generate impression based on findings. | 84-year-old male with history of multinodular goiter. Evaluate degree of substernal component. Evaluate for growth of nodules, adenopathy. RIGHT LOBE MEASUREMENTS: 6.5 cm x 3.1 cm x 2.5 cmLEFT LOBE MEASUREMENTS: 7.5 cm x 3.4 cm x 3.3 cmISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Heterogeneous in echotexture. Dominant solid nodule at the mid pole measures 2.9 cm x 2.2 cm x 3.8 cm, not significantly changed from prior exam. Subcentimeter cystic nodule at the upper pole is unchanged.LEFT LOBE: Heterogeneous in echotexture. Dominant heterogeneous solid nodule at the mid to inferior pole is difficult to definitively measure due to substernal extension however measures approximately 2.5 cm x 3.1 cm x 3.7 cm, not significantly changed. Previously noted smaller spongiform nodule at the mid pole is less apparent on today's exam but likely smaller in size.ISTHMUS: Solid isthmus nodule is again seen measuring 1.0 cm x 0.6 cm x 1.1 cm not significantly changed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with multiple bilateral thyroid nodules not significantly changed compared to prior exam. |
Generate impression based on findings. | 49 year old male with polycystic kidney disease, evaluate left renal lesion, superior pole RIGHT KIDNEY: Renal parenchyma is completely replaced by innumerable cysts compatible with history of polycystic kidney disease. There is a mixture of simple and complex cysts. The ability of ultrasound to detect smaller, solid masses and polycystic kidneys is limited. Kidney grossly enlarged. No obvious hydronephrosis.LEFT KIDNEY: Renal parenchyma is completely replaced by innumerable cysts compatible with history of polycystic kidney disease. There is a mixture of simple and complex cysts. The ability of ultrasound to detect smaller, solid masses and polycystic kidneys is limited. Kidney grossly enlarged. No obvious hydronephrosis.Left upper pole hyper density noted on prior CT study is difficult to visualize given the innumerable cysts present. OTHER: No significant abnormalities noted. Bladder poorly distended. | Findings are compatible with patient's history of polycystic kidney disease. Left upper pole hyper density noted on prior CT study is difficult to visualize given the innumerable complex cysts present. |
Generate impression based on findings. | 30 year-old female with right upper quadrant pain LIVER: Upper normal in size. No focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: Gallbladder contains a small common deep tendon and shadowing gallstone without wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Echogenicity appears within normal limits.OTHER: Complex splenic cyst without change | Gallstone without complication. No interval change. |
Generate impression based on findings. | 61-year-old male with CHF, atrial fibrillation/Cardiac thrombus and newly diagnosed ALL complaining of abdominal tenderness with LFT abnormalities. Evaluate for biliary obstruction and portal vein abnormalities. Limited exam as patient could be hold breath or lie in decubitus position. LIVER: Normal echogenicity of the liver measuring 12.8 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder is normal in echogenicity. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 2 mm in caliber. No intra-or extra hepatic ductal dilatation.PANCREAS: Not well-visualized due to overlying bowel gas.RIGHT KIDNEY: Increased in echogenicity measuring 11.1 cm in length. No hydronephrosis or shadowing calculi are noted. OTHER: Increased echogenicity of the left kidney measuring 11.7 cm in length. No hydronephrosis or shadowing calculi are noted. Normal echogenicity of the spleen measuring 10.3 cm in length. | 1. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No obstruction. 2. No evidence of biliary obstruction. Portal vein is patent. |
Generate impression based on findings. | 87-year-old male with abnormal liver function. LIVER: The liver is normal in size and echotexture. There is no focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: No biliary tract dilatation. The gallbladder is somewhat collapsed with multiple large, shadowing calcarine and sludge. The wall, however, is not thickened and the patient was not tender over the gallbladder.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Nephrolithiasis without hydronephrosis. Large, simple lower pole cyst. Second highly complex cystic mass arising from the midpole with relatively thick internal septation and wall nodularity measuring 4.2 cm in diameter is unchanged from prior examinations.OTHER: Left kidney demonstrates nephrolithiasis without hydronephrosis.Splenic size upper normal.Small amount of ascites. | Liver appears unremarkable.Borderline splenomegaly.Multiple gallstones and sludge within the gallbladder without obvious complication.Bilateral nephrolithiasis without obstruction.Highly complex right renal cystic mass unchanged.Simple right renal cyst. |
Generate impression based on findings. | 43-year-old male with renal insufficiency. Real-time ultrasound guidance was provided for right renal biopsy. Fluid adjacent to the kidney noted on post procedure imaging. | Ultrasound guidance. Postprocedural perirenal fluid. |
Generate impression based on findings. | 37-year-old male with hypercalcemia. Evaluate for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 6.3 cm x 2.1 cm x 2.7 cmLEFT LOBE MEASUREMENTS: 5.9 cm x 1.9 cm x 2.3 cmISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Normal homogeneous echotexture with no discrete nodules or masses are identifiedLEFT LOBE: Normal homogeneous echotexture with no discrete nodules or masses are identifiedISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign-appearing left neck level 2 lymph node measures 1.1-cm x 0.4 cm x 2.0-cm. No pathological lymphadenopathy.OTHER: No significant abnormality noted. | Unremarkable examination. Specifically no sonographic evidence of parathyroid adenoma is noted. |
Generate impression based on findings. | 26-year-old male with history of HBV, evaluate for HCC structural disease. LIVER: Normal echogenicity of the liver measuring 15.9 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder is contracted limiting evaluation for wall thickening. No pericholecystic fluid. Common duct measures 2 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.1 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 9.3 cm in length.Normal echogenicity of the left kidney measuring 9.2 cm in length. No hydronephrosis or shadowing calculi are noted. | Unremarkable examination. |
Generate impression based on findings. | 56 year old female with history of HCV cirrhosis with abdominal pain, ascites, fever. Evaluate for acute cholecystitis, liver structure, portal veins, and IVC. LIVER: Cirrhotic liver morphology. No focal hepatic lesions. Main portal vein is patent with appropriate direction of flow; peak velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder is markedly thick chest walls although this is not specific in the face of ascites. No shadowing gallstones. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Moderate ascites. | Gallbladder wall thickening which is not specific with associated ascites. No gallstones.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 28 year old female with bilateral breast masses/fibrocystic breasts. Family history of breast cancer diagnosed in aunt in her 40s. Patient reports palpable area of concern in the right greater than left 6 to 7 o'clock position. Limited bilateral breast physical examination of the palpable area of concern in the lower outer quadrants demonstrated mobile thickening in the right breast near 7:00. A targeted bilateral ultrasound was performed for the palpable area of concern. There is no solid or cystic mass identified in the 6-7 o'clock positions. Areas of dense glandular tissue are noted bilaterally. | No sonographic evidence for malignancy. Clinical correlation with physical exam is recommended. As long as these benign results are concordant with physical exam, then routine follow up is recommended. BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 52-year-old female with palpable abnormalities in the right breast for one week. Patient reports they feel linear. Limited physical examination of the right breast 11 and 8 o'clock positions in the patient's palpable area of concern was unremarkable. No mass was palpated.A targeted right ultrasound was performed for the patient’s palpable area of concern in the 11 and 8 o'clock positions, 5 cm from the nipple. There is no solid or cystic mass identified. | No sonographic evidence for malignancy. The patient may be palpating the Cooper's ligaments. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 51-year-old female with large oval breast mass in the right upper mid breasts at least 5 cm, which was first noticed a month ago, and has significantly and quickly grown. Patient denies history of trauma or fevers/chills. History of benign right breast biopsy 20 years ago. Family history of breast cancer diagnosed in mother age 73. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A linear scar marker was placed over the right breast. Triangular palpable marker was placed over the right upper, slightly inner breast, mid depth partially obscured masses or large lobulated mass are noted under the palpable marker. Total extent measures 74 x 69 x 52 mm (AP X TR X CC). The patient cannot tolerate spot compression views due to pain.ULTRASOUND | Large complex solid and cystic mass in the right 12 o'clock breast, for which biopsy and surgical consultation are recommended. The patient was discussed with Donna Christian and an appointment with Dr. Swati Kulkarni was arranged. She is also scheduled for ultrasound guided biopsy that day. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 50 female with right upper quadrant pain. LIVER: Hepatomegaly. Liver is coarsely echogenic which is non-specific. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Mild hepatomegaly with echogenic liver. Normal gallbladder and biliary tract. |
Generate impression based on findings. | 48 -Year-old female with prior hemi-thyroidectomy. Follow-up right nodule. RIGHT LOBE MEASUREMENTS: 4.4 x 1.7 x 1.7 cmLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: There is again noted an almost isoechoic but mildly heterogeneous and predominantly solid nodule in the mid right lobe, measuring 1 x 1 x 1 cm without change. This has an incomplete hypoechoic rim. There may be a small isoechoic nodule in the far inferior right lobe, difficult to compare the prior exam.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Dominant right lobe mass is stable. There is small mass in the far inferior right lobe and follow up in 6 months recommended. No mass in the left bed. |
Generate impression based on findings. | 26-year-old male with morbid obesity, elevated AST/ALT. Evaluate for fatty liver disease. Limited evaluation due to patient's body habitus.LIVER: Increased in echogenicity of the liver measuring 20.2 cm in length. Evaluation of the deep liver is limited by beam attenuation. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/s. GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. The common duct measures 3 mm in caliber. No intra-or extrahepatic ability ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Measures 12.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 13.6 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 13.8 cm in length. | Hepatomegaly with increased echogenicity suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 60 year-old female with history of thyroid cancer. Follow-up. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: There is again noted a hyperechoic focus in the right thyroid bed which appears stable measuring 0.5 x 0.5 x 0.8 cm.LEFT LOBE: There is again noted in the left thyroidectomy bed an ovoid hypoechoic focus measuring 0.3 x 0.3 x 0.6 cm which may represent lymph nodeISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable ultrasound of the thyroid. |
Generate impression based on findings. | 30 year-old female with thyroid nodules. RIGHT LOBE MEASUREMENTS: 1.9 x 2.1 x 5 cmLEFT LOBE MEASUREMENTS: 1.5 x 1.6 x 5.1 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: There is a spongiform nodule in the midportion of the right lobe measuring approximately 0.5 x 0.8 by 0.7 cm . Although this measures slightly larger than on the prior exam the appearance is again consistent with benign nodule. There is again noted a large, solid and mildly hypoechoic and heterogeneous nodule at the posterior aspect of the lower pole. This measures 2 x 1.7 x 2.3 cm without change.LEFT LOBE: Small colloid cyst with comet tail artifact in the lower pole is stable measuring 0.2 x 0.2 x 0.4 cmISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No change in large right lobe mass. Other findings as noted above. |
Generate impression based on findings. | 50 year-old female with epigastric/right upper quadrant pain. LIVER: Liver is normal in size and echotexture. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder wall is normal to upper normal without pericholecystic fluid. Dependent gallstones are present within the gallbladder. The gallbladder is not distended. The biliary tract is normal in caliber.PANCREAS: Poorly visualized due to bowel gas.RIGHT KIDNEY: Highly echogenic without hydronephrosis.OTHER: Highly echogenic left kidney without hydronephrosis. Small cyst. | Gallstones with gallbladder wall normal to upper normal. No gross evidence for acute cholecystitis.Highly echogenic kidneys as previously noted. |
Generate impression based on findings. | 33 year old female with history of thyroid cancer status post thyroidectomy. Evaluate for adenopathy, recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No discrete nodules or masses are noted in the thyroidectomy bed.LEFT LOBE: Hypoechoic nodular focus within or adjacent to the thyroidectomy bed measures 6 mm x 2 mm x 4 mm and is unchanged. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2 benign-appearing lymph node measures 1.6 cm x 0.5 cm. No pathologic lymphadenopathy. OTHER: No significant abnormality noted. | Unchanged hypoechoic nodular focus within or adjacent to the left thyroidectomy bed. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Known bilobar metastasis not well appreciated on the ultrasound. Liver length 13.1 cmGALLBLADDER, BILIARY TRACT: Diffuse abnormal gallbladder wall thickening and trace pericholecystic fluid associated with gallstones and positive Murphy sign. Mild bilobar intrahepatic ductal dilatation associated with extrahepatic ductal dilatation. Common bile duct diameter 1.1 cm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney 10.9 cm in lengthOTHER: Left kidney 10.6 cm in length. No ascites. | Diffuse abnormal gallbladder wall thickening and trace pericholecystic fluid associated with gallstones and positive Murphy sign. Findings consistent with acute cholecystitis. Associated with mild bilobar intrahepatic ductal dilatation and moderate extrahepatic ductal dilatation. |
Generate impression based on findings. | 53-year-old male with history of hepatitis C, screening for HCC. LIVER: The liver measures 16.3 cm in length and demonstrates increased echotexture. No focal lesions are identified. Portal vein flow is hepatopetal and measures 0.2 m/sec.BILIARY TRACT: Status post cholecystectomy. The common duct measures 4 mm in diameter.PANCREAS: Limited evaluation of the pancreas due to overlying bowel gas.SPLEEN: The spleen measures 9 cm in length, without significant abnormality.RIGHT KIDNEY: The right kidney measures 11 cm in length and is normal in echotexture and morphology. OTHER: The left kidney measures 10.6 cm in length, and has normal echotexture and morphology. | Hepatic steatosis, without focal mass or other significant abnormality. |
Generate impression based on findings. | Thyroid nodule RIGHT LOBE MEASUREMENTS: 4 x 1.3 x 1.6 cmLEFT LOBE MEASUREMENTS: No significant abnormality noted.ISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | US THYROID, 4/6/2015 9:03 AMCLINICAL INFORMATION:Thyroid noduleCOMPARISON: 7/12/2013 TECHNIQUE: Thyroid ultrasoundFINDINGS:RIGHT LOBE MEASUREMENTS: 4 x 1.3 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.4 x 1.4 x 1.1 cmISTHMUS MEASUREMENTS: Zero .1 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Little significant change in the dominant solid left thyroid nodule now measuring 1.6 x 0.8 x 1 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. |
Generate impression based on findings. | 46 year old female patient with history of known right breast cancer with metastases to the right axilla presents for follow up after 12 cycles of neoadjuvant chemotherapy. A right breast ultrasound was performed. The previously identified lesion in the right breast in the 10:00 o'clock position currently measures 1.6 x 1.1 x 1.1 cm, previously 3.6 x 2.6 x 2.6 cm. Previously biopsied right axillary lymph node with clip measures 0.9 x 0.6 x 0.3 cm, previously 1.7 x 0.9 x 1.1 cm. | Moderate response to chemotherapy of right breast cancer and axillary lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 52 year old female who was recalled from screening mammogram for 13-mm bilobed asymmetry in the medial right breast with a possible correlate in the inferior right breast . Mammogram: An ML view and two spot compression and spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Bilobed asymmetry in question disperses into normal breast tissue. Loosely scattered calcifications were noted in the right upper outer quadrant on the ML view and further evaluated with spot magnification views. Most of them later on ML view, suggestive of milk of calcium. Multiple benign morphology, masses in the lateral right breast are unchanged.Ultrasound: Targeted medial right breast ultrasound was performed to evaluate the mammographic area in question. No suspicious cystic or solid mass noted. Normal glandular tissue noted. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Right upper quadrant pain LIVER: No significant abnormalities noted. Liver length is 16.1 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge with mild gallbladder wall thickening. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.2 cm in lengthOTHER: Left kidney 10.2 cm in length. Spleen 12.5 cm in length. No ascites. Right pleural effusion. | Gallbladder sludge with mild gallbladder wall thickening; some component of chronic inflammation cannot be excluded. No ductal dilatation. |
Generate impression based on findings. | 61-year-old male with history of hepatitis C. LIVER: Mildly increased echogenicity of the liver parenchyma, without focal mass or other significant abnormality. The liver measures approximately 16 cm in length.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. Right kidney measures 9.6 cm.OTHER: Status post splenectomy. Left kidney measures 10 cm. | No focal masses or findings of portal hypertension. |
Generate impression based on findings. | Leukocytosis LIVER: No significant abnormalities noted. Liver length 16.7 cmGALLBLADDER, BILIARY TRACT: Gallbladder not visualized. Mildly prominent extrahepatic bile duct with maximal diameter of 0.7 cm. No intrahepatic ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic parenchyma without obstruction. Right kidney 9.7 cm in length.OTHER: Spleen 12.4 cm in length. 2-cm low attenuation focus within the spleen; favor benign etiology. Trace ascites. Bilateral pleural effusions. | Mildly prominent extrahepatic bile duct. Gallbladder not visualized. Unremarkable liver without evidence for intrahepatic ductal dilatation. Echogenic right renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without obstruction. Trace ascites. |