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Generate impression based on findings. | Hepatitis B LIVER: Unremarkable echogenicity without mass. Liver length 14.1 cmGALLBLADDER, BILIARY TRACT: Stable subcentimeter gallbladder polyp measuring 0.2 cm in diameter. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 9.2 cm in length.OTHER: The left kidney 10.9 cm in length. Spleen 8.7 cm in length. No ascites. | Stable examination. Normal liver echogenicity without mass or ductal dilatation. Stable subcentimeter gallbladder polyp. No ascites. |
Generate impression based on findings. | 63 year old female who was recalled from screening mammogram for right breast calcifications. Family history of breast carcinoma in her mother at age 63 a maternal aunt at age 62. RIGHT DIAGNOSTIC MAMMOGRAM: An ML view and two spot magnification 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 densities. There is redemonstration of pleomorphic, branching calcifications within the upper outer right breast, a middle depth associated with a persistent, partially obscured mass. RIGHT BREAST ULTRASOUND: A targeted right ultrasound was performed for the mammographic area of concern. At the 11 o'clock position, approximately 3 cm from the nipple, there is an irregular hypoechoic mass with internal echogenic foci, and an echogenic halo measuring 1.3 x 1.2 x 2.1 cm. Mild internal vascularity is present. | Suspicious 2.1 cm mass with associated calcifications at the 11 o'clock position of the right breast for which ultrasound guided core needle biopsy is recommended. Findings and recommendations were discussed with the patient, and all questions were answered.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | History of regional enteritis with abnormal liver enzymes LIVER: Mildly coarse and echogenic liver parenchyma without mass. Liver length 16.5 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.7 cm in lengthOTHER: Left kidney 12.3 cm in length. Spleen 9.3 cm in length. No ascites. | Mildly coarse and echogenic parenchyma raises the possibility of fatty infiltration/parenchyma dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Renal stones RIGHT KIDNEY: Normal echogenicity without mass, stone, or hydronephrosis. 9.1 cm in lengthLEFT KIDNEY: Normal parenchymal echogenicity without mass or hydronephrosis. Punctate nonobstructing left renal stone again noted. Left kidney 8.9 cm in length.OTHER: Bladder nondistended | Stable punctate nonobstructing left renal stone. No right renal stone. No hydronephrosis. |
Generate impression based on findings. | History colon cancer with abdominal pain and elevated alk phos LIVER: Diffusely heterogeneous and echogenic liver. 4.1 x 3 x 2.7 segment 7 right lobe hypoechoic liver mass. Liver length is 17.9 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge and stones with mild gallbladder wall thickening. Negative Murphy's sign. No ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.6 cm in length.OTHER: Left kidney 10.5 cm in length. Spleen 10.1 cm in length. Mild ascites. | Diffusely heterogeneous and echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction without ductal dilatation. Right lobe liver mass worrisome for neoplasm; both primary and metastatic etiologies should be considered. Would recommend correlation with dedicated liver contrast cross-sectional imaging.Gallbladder stones and sludge with mild gallbladder wall thickening probably secondary to the presence of mild ascites. No convincing evidence to suggest acute inflammation at this time. |
Generate impression based on findings. | Elevated creatinine RIGHT KIDNEY: Echogenic renal parenchyma without mass, stone, or significant hydronephrosis. 11.3 cm in length.LEFT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. 12.4 cm in length.OTHER: Bladder nondistended. Moderate ascites again noted. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or significant hydronephrosis. Moderate ascites again noted. |
Generate impression based on findings. | 83 year old female status post right lumpectomy and complete axillary dissection in 2006 for IDC and DCIS, presents with palpable abnormality with the left axilla noted on physical examination. Patient received radiation, chemotherapy, and Arimidex. No current breast complaints. No family history of breast cancer. On physical examination, there is a 1.0 cm mobile circumscribed mass in the low left axilla. A targeted left axillary ultrasound was performed for the palpable area of concern. At the area of palpable abnormality, there are two adjacent lymph nodes. The first measures 0.7 x 0.7 x 0.7 cm, with cortical thickening measuring up to 0.5 cm, and effacement of the fatty hilum. No significant abnormal vascularity is identified within this node. The second measures 0.7 x 0.5 x 1.0 cm with complete effacement of the fatty hilum, and no appreciable vascularity on Doppler imaging. | Two indeterminant adjacent lymph nodes within the low left axilla, at the site of palpable abnormality. Ultrasound guided biopsy of these lymph nodes is recommended for definitive histologic diagnosis. These findings were discussed with the patient, and Joly Jose, APN, at the time of the examination.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Hepatitis C LIVER: Mildly heterogeneous and echogenic liver echotexture without mass. Liver length 15.3 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.4 cm in lengthOTHER: Left kidney 11.5 cm in length. Spleen 12 cm in length. No ascites. | Mildly heterogeneous and echogenic liver echotexture suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Prominent thyroid on examination. History salivary gland carcinoma. RIGHT LOBE MEASUREMENTS: 1.3 x 1.1 x 3.6 cmLEFT LOBE MEASUREMENTS: 1 x 1.1 x 3.5 cmISTHMUS MEASUREMENTS: 0.1 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: 0.3 x 0.3 x 0.3 lower pole hypoechoic noduleISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal sized thyroid gland. Subcentimeter hypoechoic left thyroid nodule. No adenopathy. |
Generate impression based on findings. | Papillary carcinoma status post resection now with local recurrence RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy. Multiple hypoechoic nodules within the left thyroid bed. A level 3 nodule measures 0.6 x 0.9 x 0.7 cm. Slightly more inferior level 3 nodule measures 0.8 x 0.2 x 1.3 cm. A level 4 nodule measures 1.7 x 1.7 x 1.3 cm. However, the inferior extent of this level 4 nodule extends into the thoracic inlet and its size is probably under estimated.ISTHMUS: Status post thyroidectomy without mass.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple hypoechoic nodules within the left thyroid bed spanning levels 3 and 4 consistent with suspected local recurrence. The inferior level 4 nodule extends into the thoracic inlet and is therefore not completely visualized. No regional cervical lymphadenopathy. |
Generate impression based on findings. | Male; 54 years old. Reason: R lateral shoulder dermal thickening, evaluate for deep mass History: above In the area of the palpable abnormality overlying the right deltoid muscle is a 2.9 x 0.9 x 2.4 cm area of subcutaneous edema. No underlying mass is identified. There is no drainable collection. | Subcutaneous edema but no discrete mass or drainable collection in the area of the patient's reported abnormality. Correlate clinically for signs/symptoms of cellulitis. |
Generate impression based on findings. | Hepatitis C LIVER: Coarse echogenic liver parenchyma again noted. No mass. Liver length 13.9 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Stable right renal cyst. Right kidney 10.1 cm in length.OTHER: Left kidney 10.4 cm in length. Spleen 9.6 cm in length. No ascites. | Stable echogenic liver parenchyma consistent with chronic liver disease without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 6.9 x 3.8 x 3.9 cmLEFT LOBE MEASUREMENTS: 5.5 x 2.4 x 2.4 cmISTHMUS MEASUREMENTS: 1.3 cmRIGHT LOBE: Interval increase in size of several of the previous noted multiple spongiform appearing nodules. An upper pole nodule now measures 3.7 x 3.1 x 2.7 cm; this is in comparison to 1.1 x 1.6 x 2.2 cm in 2011. A lower pole nodule now measures 2 x 1 x 2.5 cm; this is in comparison to 1.1 x 1.1 x 1.2 cm 2011.LEFT LOBE: Interval increase in size of several of the previous noted mixed cystic and solid nodules. A mid pole nodule now measures 2.3 x 1.6 x 1.8 cm; this compares to 1.2 x 1.5 x 1.9 cm in 2011. A lower pole nodule now measures 1.8 x 1.2 x 1.5 cm; this is in comparison to 0.7 x 0.9 x 1 cm in 2011.ISTHMUS: Slight interval increase in size of the previous noted spongiform isthmic nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in size of several of the previous noted thyroid nodules. Multinodular goiter is favored. |
Generate impression based on findings. | 15-year-old male with right neck lymphangioma Several prominent submandibular cervical lymph nodes are noted with normal morphology. In the right submandibular region inferior to the parotid gland is a small, 1.8-cm simple fluid collection without vascularity or soft tissue component corresponding to the region of abnormality seen on prior CT. | Small residual fluid collection at the site of questioned lymphangioma. |
Generate impression based on findings. | Right thyroid nodule RIGHT LOBE MEASUREMENTS: 5.9 x 1.9 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.3 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Diffusely heterogeneous gland. Predominantly solid lower pole nodule measuring 2 x 1.5 x 1.5 cm.LEFT LOBE: Diffusely heterogeneous gland without nodule.ISTHMUS: Diffusely heterogeneous gland without nodulePARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffusely heterogeneous thyroid gland. Predominantly solid right lower lobe thyroid nodule as described. No regional adenopathy. |
Generate impression based on findings. | 14-year-old female with breast painVIEWS: Chest AP/lateral (two views) 3/3/15 16:55 The cardiothymic silhouette is normal. The cardiac apex, aortic arch and stomach are left-sided. Note is made of a soft tissue mass overlying the left breast, better evaluated on recent ultrasound. | No acute cardiopulmonary abnormality. Soft tissue mass within the left breast is better evaluated on prior ultrasound. |
Generate impression based on findings. | 14-year-old female with right lower quadrant pain The appendix measures 9 mm diameter with thickened wall but is partially compressible, without surrounding inflammatory changes or fluid. | Dilated partially compressible appendix without surrounding inflammatory changes, equivocal for appendicitis. Follow up clinical exam and/or imaging is recommended. |
Generate impression based on findings. | 27 year old woman with history of painful left sided breast mass felt with menstrual cycle two weeks ago. No significant family history. A targeted left ultrasound was performed for the palpable area of concern. There is currently no palpable mass. Ultrasound shows normal fibroglandular tissue but no solid or cystic mass. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 37 year old woman with history of left breast cancer, BRCA1 positive, s/p right prophylactic mastectomy and reconstruction, now with palpable mass. A targeted right ultrasound was performed for the palpable area of concern. Normal fat lobulations are seen, some of which appear mildly inflammed but there is no solid or cystic mass identified. | Mild fat inflammation without sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female; 48 years old. Reason: Mass R shoulder measures 0.5 cm, evaluate History: mass Sonographic interrogation in the region of the patient's palpable abnormality reveals a 1.4 x 0.7 x 1.2 cm encapsulated lesion located beneath the subcutaneous fat. This has longitudinal internal striations and echogenicity similar to the adjacent musculature. No internal vascular flow is seen. | Corresponding to patient's palpable abnormality is a 1.4 cm lesion with a sonographic appearance compatible with a lipoma. |
Generate impression based on findings. | Eight hours old male with left renal pelvis measuring 7.5 mm on prenatal ultrasound. Evaluate for structural abnormalities. KIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 4.1 cm Left: 4.3 cm Mean for age: 5.0 cm Range for age: 4.0 - 6.0 cmADDITIONAL OBSERVATIONS: Please note that ultrasound can underestimate the degree of hydronephrosis in a newborn due to dehydration. | Normal examination. Please note ultrasound can underestimate the degree of hydronephrosis in a newborn due to dehydration. Recommend follow up ultrasound in one week for definitive evaluation.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning.Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | Male; 40 years old. Reason: enlarging, reportedly tender left testicular lump. Evaluate further History: palpable left testicular lump RIGHT TESTIS: 3.0 x 2.1 x 4.4 cm. Normal echotexture and vascularity. No intratesticular mass evident.LEFT TESTIS: 3.3 x 2.3 x 4.5 cm. Normal echotexture and vascularity. No intratesticular mass evident.RIGHT EPIDIDYMIS: 1.3 x 1.3 x 1.3 cm. Normal ultrasound appearance.LEFT EPIDIDYMIS: 1.2 x 1.1 x 1.7 cm. Normal ultrasound appearance.OTHER: There is a collection of dilated vessels with increased flow during Valsalva underlying the area of the patient's palpated abnormality. This finding is seen bilaterally. Small bilateral hydroceles. | Bilateral varicoceles and small hydroceles. No intratesticular mass is evident. |
Generate impression based on findings. | 55 year old with history of diabetes and obesity with chronic elevated LFTs; evaluate for NASH/NAFLD vs cirrhosis. LIVER: The liver measures 18.8 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m /s.BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 6 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 11.6 cm in length. RIGHT KIDNEY: Kidney measures 11.1 cm in length. Normal echotexture. Simple cyst measuring 6.4 x 7.9 x 6.5. LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass. | 1.Cholelithiasis.2.Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | The patient submitted outside mammogram dated 12/18/12, 12/14/11. Submitted outside study was compared to the current mammogram dated 2/16/15. A 1.0 cm mass in the left upper outer breast is new when compared to the prior studies. Recommend ultrasound guided needle biopsy for this mass. | A 1.0 cm mass in the left upper outer breast is new when compared to the prior studies. Recommend ultrasound guided needle biopsy for this mass.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | The patient submitted outside mammogram dated 12/18/12, 12/14/11. Submitted outside study was compared to the current mammogram dated 2/16/15. A 1.0 cm mass in the left upper outer breast is new when compared to the prior studies. Recommend ultrasound guided needle biopsy for this mass. | A 1.0 cm mass in the left upper outer breast is new when compared to the prior studies. Recommend ultrasound guided needle biopsy for this mass.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 54 year-old female with history of right thyroid lesion, evaluate for progression. RIGHT LOBE MEASUREMENTS: 5.0 x 2.4 x 2.4 cm, previously 4.5 x 2.4 x 2.8 cmLEFT LOBE MEASUREMENTS: 5.2 x 2.4 x 2.2 cm, previously 4.7 x 2.9 x 2.7 cmISTHMUS MEASUREMENTS: 0.6 cm in thickness. RIGHT LOBE: Diffusely heterogeneous thyroid. Small hyperechoic nodule in the right superior gland measures 0.3 x 0.3 x 0.3 cm, unchanged.LEFT LOBE: Diffusely heterogeneous thyroid.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No parathyroid glands visualized. LYMPH NODES: Several benign appearing right level 2 and level 3 lymph nodes are present. | Diffusely heterogeneous thyroid with small hyperechoic lesion in the right superior gland, not significantly changed and likely benign. |
Generate impression based on findings. | 58 year-old female with ascites and elevated lipase, evaluate for cholelithiasis or infection. LIVER: The liver measures 15.5 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 10.4 cm in length. RIGHT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. Mild hydronephrosis. LEFT KIDNEY: Kidney measures 13.1 cm in length. Normal echotexture. Mild hydronephrosis. OTHER: Ascites. | 1.No evidence of cholelithiasis or cholecystitis.2.Abdominal ascites and bilateral pleural effusions. 3.Mild righter greater than left hydronephrosis. |
Generate impression based on findings. | 13-year-old female with bilateral fibroadenomas; clinical decrease in size of the right breast mass with increase in size of the known left breast mass. On physical examination, an additional mass is noted within the lower left breast. Ultrasound is requested for characterization of the new left breast mass, and to demonstrate stability of the known bilateral masses. A targeted left ultrasound was performed for the palpable areas of concern. At the one o'clock position of the left breast, 3 cm from the nipple, there is redemonstration of a parallel, circumscribed oval hypoechoic mass measuring 2.1 x 0.9 x 2.2 cm (previously 1.1 x 0.5 x 1.1 cm). This mass demonstrates mild peripheral vascularity. At the 6 o'clock position of the left breast, 5 cm from the nipple, there is a parallel, circumscribed, oval hypoechoic mass measuring 1.7 x 0.7 x 1.4 cm. The mass demonstrates increased vascularity.A targeted right ultrasound is performed for the palpable area of concern. At the 10 o'clock position of the right breast, 2 cm from the nipple, there is a 1.5 x 0.6 x 1.9 cm parallel, macrolobulated hypoechoic mass decreased in size from prior examination (previously 2.1 x 1.2 cm). This mass demonstrates minimal peripheral vascularity. | 1. Increase in size of the previously demonstrated mass at the one o'clock position of the left breast, measuring 2.2 cm on today's examination. This finding likely represents a fibroadenoma. 2. New circumscribed hypoechoic mass at the 6 o'clock position of the left breast measuring 1.7 cm. This finding likely represents a fibroadenoma. 3. Decrease in size of the previously identified right breast mass now measuring 1.9 cm, corresponding to biopsy proven fibroadenoma.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Male; 39 years old. Reason: s/p orchiectomy for relapsed ALL on 3/2/15 with persistent severe pain of unclear cause. Exclude hematoma or other History: pain RIGHT TESTIS: 3.6 by 2.6 x 2.7 cm. Normal vascularity. Within the right testicle at the level of the previously seen hypoechoic lesion is a 1.5 x 1.6 x 2.1 cm hyperechoic focus with an internal hypoechoic portion. LEFT TESTIS: 4.2 x 2.2 x 2.6 cm. Normal echotexture and vascularity. The previously seen hypoechoic lesion is no longer identified. Dystrophic appearing calcifications redemonstrated.RIGHT EPIDIDYMIS: 5.9 x 2.6 x 4.4 cm and hypervascular.LEFT EPIDIDYMIS: 2.9 x 0.7 x 1.3 cm, normal in appearance.OTHER: Edema in the soft tissues of the right groin and in the area of the incision but no drainable fluid collection.Orchiopexy clips noted on the right.Small right and minimal left hydrocele. | Findings compatible with acute epididymitis on the right.Postsurgical changes in the right groin and testicle. Heterogeneous 1.6 cm hyperechoic focus with hypoechoic component in the testicle, entity most likely reflects a hematoma given patient's history, correlation with patient's procedural history recommended to confirm interval removal of entirety of previously seen focal hypoechoic lesion in right testicle, abscess is considered less likely as there is no evidence of increased vascularity.Interval resolution of hypoechoic left testicle lesion.Findings discussed with Dr Artz by telephone at 4:50 pm. |
Generate impression based on findings. | 49-year-old female post resection of mediastinal thyroid and left lobe, with papillary thyroid microcarcinoma. RIGHT LOBE MEASUREMENTS: 4.6 x 1.7 x 1.7 cm. No change in 5 mm cyst.LEFT LOBE MEASUREMENTS: Post thyroidectomy. ISTHMUS MEASUREMENTS: Not measurable on today's examRIGHT LOBE: No change in 5 mm cyst.LEFT LOBE: No massesISTHMUS: Not visible on today's study.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is again noted an enlarged subclavicular lymph node on the left measuring 1 x 1.4 by 2 cm, not significantly changed.OTHER: No significant abnormality noted. | Stable examination with resolution of thickened isthmus. Stable left subclavicular lymph node. |
Generate impression based on findings. | 57-year-old male with hepatitis C. Evaluate for mass. LIVER: Hepatomegaly with liver measuring 22 cm in length. The parenchyma is heterogeneously echogenic. No focal mass. No obvious cirrhotic morphology. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Normal gallbladder and biliary tract.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Small cyst. OTHER: Dromedary hump left kidney with small cyst. | Coarsely echogenic, enlarged liver. |
Generate impression based on findings. | 43 year old female who has a complaint of new palpable left breast mass with tenderness. History of bilateral breast cysts. Clinical service requests ultrasound given her history of cysts. A targeted left ultrasound was performed for the patient’s area of concern. At the 12 o'clock position of the left breast, 2 cm from the nipple there is a well-circumscribed anechoic cyst measuring 1.5 x 1.6 x 1.8 cm. Numerous surrounding subcentimeter simple appearing cysts are also noted. | Benign, simple cyst at the 12 o'clock position of the left breast, corresponding to patient's palpable abnormality. No sonographic evidence of malignancy. As long as the patient's physical examination remains unchanged, bilateral diagnostic mammogram is recommended annually, which the patient will be due for in September 2015. Results and recommendation were discussed with the patient. Additionally, the patient will discuss her symptomatic cyst with Donna Christian today. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 42 year old female who was recalled from screening mammogram for left breast asymmetry. No family history of breast cancer. LEFT DIAGNOSTIC 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. There is redemonstration of a 0.8 cm oval mass at the 6 o'clock position of the left breast, which persists on spot compression imaging.LEFT BREAST ULTRASOUND: A targeted left ultrasound is performed for the mammographic area of concern. The 6 o'clock position of the left breast, 4 cm from the nipple, there is question of a partially circumscribed hypoechoic lesion measuring 0.7 x 0.7 cm. This lesion is subtle and does not demonstrate increased vascularity. | Persistent 0.8 cm mass at the 6 o'clock position of the left breast, with questionable sonographic correlate. Given visualization of this area is best seen on mammogram, a stereotactic guided biopsy of this lesion is recommended. Results and recommendation were discussed with the patient, who expressed understanding. The patient's daughter was present to facilitate translation.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 46 year old female with epigastric pain LIVER: Normal in size with echogenic parenchyma likely due to fatty infiltration.GALLBLADDER, BILIARY TRACT: Gallbladder is mildly distended with wall thickening and a hypoechoic rim in the surrounding parenchyma. Non--- mobile stone in the gallbladder neck. Findings consistent with acute cholecystitis. Patient not tender over the gallbladder but has received pain medication.PANCREAS: Limited due to bowel gas.RIGHT KIDNEY: Small cyst.OTHER: No significant abnormalities noted. | Findings consistent with acute cholecystitis. Emergency room notified at 8:50 a.m. |
Generate impression based on findings. | 43 year-old female with right-sided submandibular gland tenderness and swelling. Right submandibular gland appears normal and relatively symmetrical with the left. No shadowing calculus or ductal dilatation. The posterior auricular region on the right was also evaluated due to patient discomfort without mass or collection. | No submandibular gland stone or ductal dilatation. |
Generate impression based on findings. | 46 year old woman with history of cysts and fibroadenomas seen in left breast on prior ultrasound. A targeted left ultrasound was performed for the previously seen masses on ultrasound. Left breast implant is noted.In the left breast, 8'o clock position 2 cm from the nipple, 2 contiguous anechoic masses with posterior acoustic enhancement are seen measuring 8 x 5 x 5 mm, unchanged in size and appearance from the prior examination.In the left breast, 8'o clock position 4 cm from the nipple, 3 contiguous hypoechoic circumscribed masses are seen measuring 3 x 3mm, 3 x 3mm, and 2 x 2mm, unchanged in size and appearance from the prior examination. | Stable cysts and fibroadenomas of the left breast. No evidence of malignancy. Followup with annual diagnostic mammogram and possible ultrasound is recommended and due in about 6 months. Results and recommendations discussed with patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 76 are old female with ovarian carcinoma and abnormal liver function. LIVER: Liver is normal in size. There is marked parenchymal heterogeneity in the right lobe, with superficial complex cystic masses consistent with implants, as well as poorly defined, hyperechoic parenchymal lesions in the right lobe . Findings are consistent with progressive metastatic disease to liver.GALLBLADDER, BILIARY TRACT: Gall bladder contains sludge without gross wall thickening or pericholecystic fluid. Mild, focal biliary tract dilatation associated with mass. Biliary tract otherwise normal in caliberPANCREAS: Limited due to bowel gas.RIGHT KIDNEY: Parapelvic cysts and mild calyectasis without change.OTHER: Left kidney with parapelvic cysts and mild calyectasis without change. | Progressive surface and parenchymal disease involving the liver.Gallbladder sludge without complication segmental biliary tract dilatation associated with hepatic metastatic disease. |
Generate impression based on findings. | 71 year old female with nontoxic multinodular goiter and dysphagia for follow-up. RIGHT LOBE MEASUREMENTS: 6.2 by 2.7 x 2.2 cmLEFT LOBE MEASUREMENTS: 7.4 x 3 x 2.7 cmISTHMUS MEASUREMENTS: 1.6 cmRIGHT LOBE: Complex nodule with cystic components in the inferior right lobe measures 1.6 x 2.4 by 3.6 cm without significant change. Multiple other nodules likely stable.LEFT LOBE: Nodules are less well-defined on today's study. Anterior upper pole nodule which is solid but demonstrates comet tail artifact suggestive of colloid measures 0.7 x 1.2 cm in transverse which is unchanged. Not adequately visualized in longitudinal dimension for measurement.Posterior left lobe solid nodule with cystic component measures are 0.6 x 0.6 cm in transverse which is unchanged. Not adequately visualized in longitudinal dimension for measurement. Other nodules appear slightly more confluent on today's exam.ISTHMUS: Spongiform during nodule measures 1.4 x 2.7 by 3 cm without significant change.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Although the thyroid measures slightly bigger than prior study and some nodules are less well-defined, reference nodules appear stable. |
Generate impression based on findings. | 32-year-old male with Burkitt's tumor or lymphoma and each IV. Palpable mass at level of left knee. In the posterior medial soft tissues at the level of the knee joint there is a complex cystic mass measuring 1.5 x 2.5 x 3.3 cm corresponding to the couple abnormality. There is no surrounding abnormality in the soft tissues and no obvious vascularity. | Baker's cyst left knee is the most likely consideration. Hematoma or abscess less likely possibilities. |
Generate impression based on findings. | 50 years, Male, pain for 10 years. RIGHT TESTIS: 3.9 x 2.0 x 3.1 cm. Normal echotexture and vascularity. No intratesticular mass evident.LEFT TESTIS: 3.3 x 2.1 x 2.0 cm. Normal echotexture and vascularity. No intratesticular mass evident.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Small bilateral hydroceles and small left-sided varicocele | Small bilateral hydroceles and small left-sided varicoceleI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 42 year old female who was recalled from screening mammogram for new left breast masses. No family history of breast cancer. LEFT DIAGNOSTIC MAMMMOGRAM: An ML view and three spot compression views of the left 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. There is redemonstration of a new 1.0 cm mass within the posterior upper inner left breast, which persists on spot compression imaging. Additionally, there is redemonstration of a 1.0 cm mass within the outer slightly inferior left breast, which persists on spot compression imaging.LEFT ULTRASOUND: On physical examination, no palpable lesions are identified.At the 10 o'clock position of the left breast, 4 cm from the nipple, there is a well-circumscribed anechoic cyst with posterior acoustic enhancement measuring 0.7 x 0.6 x 0.7 cm. A second simple appearing cyst is noted deep to this measuring 0.9 x 0.7 x 1.1 cm. This lesion likely corresponds to the new mammographic abnormality seen within the upper inner left breast. No significant vascularity associated with these lesions on Doppler imaging.At the 4 o'clock position of the left breast, 6 cm from the nipple, there is a circumscribed nearly anechoic cyst with posterior acoustic enhancement within the deep breast measuring 1.0 x 1.0 x 1.0 cm. This lesion is felt to correspond to the new mammographic mass seen within the outer slightly inferior breast. No significant vascularity is associated with this lesion on Doppler imaging. | Simple left breast cysts, corresponding to the new masses visualized on mammogram.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. | 50 year-old female with hyperparathyroidism. Evaluate for parathyroid adenoma. RIGHT LOBE MEASUREMENTS: 4.7 x 1.5 x 1.1 cmLEFT LOBE MEASUREMENTS: 4.9 x 1.6 x 1.1 cmISTHMUS MEASUREMENTS: 0.5-cmRIGHT LOBE: Ovoid 0.3 x 0.5 x 0.8 solid nodule. Heterogeneous echotexture.LEFT LOBE: No significant abnormality noted. Heterogeneous echotexture.ISTHMUS: Heterogeneous echotexture.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous thyroid with at least one discrete small right-sided solid nodule.No extrathyroidal mass. |
Generate impression based on findings. | 69-year-old female partial right nephrectomy for clear cell renal cell carcinoma. RIGHT KIDNEY: Deformity due to prior partial nephrectomy. No gross, solid mass. No hydronephrosis or shadowing calculus. Kidney measures 11.3 cm in lengthLEFT KIDNEY: Kidney measures 11 cm in length. No hydronephrosis, shadowing calculus or mass.OTHER: No gross bladder abnormality | No ultrasound evidence for renal mass. |
Generate impression based on findings. | 51 year-old female with right upper quadrant pain and chills. LIVER: Normal in size and echotexture.GALLBLADDER, BILIARY TRACT: Dependent gallstone in the gallbladder without wall thickening, distention or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Head and body are normal. Tail is not well seenRIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Dependent gallstone without complication. |
Generate impression based on findings. | 59 year old female with history of bilateral papillary renal cancer post partial nephrectomies. Evaluate for recurrence. Polycystic kidney disease. RIGHT KIDNEY: Kidney is grossly enlarged measuring at least 18.3 cm in length. Multiple simple and complex cysts throughout the right kidney as well as calcification. No obvious solid mass. Detection of small solid masses in this patient by ultrasound would be limited. No hydronephrosis.LEFT KIDNEY: Kidney is grossly enlarged measuring at least 19.9 cm in length. Multiple simple and complex cysts throughout the right kidney as well as calcification. No obvious solid mass. Detection of small solid masses in this patient by ultrasound would be limited. No hydronephrosis.OTHER: Bladder incompletely distended. | Polycystic kidneys with simple and complex cystic masses. No gross change. |
Generate impression based on findings. | 36-year-old male with renal transplant and elevated creatinine. Ultrasound guidance was provided for biopsy of the transplanted kidney in the right iliac fossa. | Ultrasound guidance |
Generate impression based on findings. | 74-year-old female with thyroid mass and neck adenopathy and prior CT. RIGHT LOBE MEASUREMENTS: 4.1 x 1.8 x 1.6 cmLEFT LOBE MEASUREMENTS: 1.8 x 1.8 x 5.1 cmISTHMUS MEASUREMENTS: 0.2-cmRIGHT LOBE: Heterogeneous in echotexture. Cystic nodule with comet tail artifact consistent with colloid measuring 0.5 x 0.5 x 0.5 cm. Very small, hypoechoic nodules present as well.LEFT LOBE: Heterogeneous in echo architecture. Spongiform appearing lower pole nodule measuring 0.8 x 0.7 x 1 cm likely with comet tail artifact consistent with colloid nodule. Posterior solid nodule with internal dense rim calcification measuring 1.4 x 1.3 x 2.3 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Abnormal lymph nodes identified in the left neck including a round cystic -- appearing level 3 node measuring 0.5 x 0.5 x 0.7 cm a round solid 0. 5 x 0.5 x 0.8 cm level 3 node and a predominantly cystic level floor/supraclavicular cystic node measuring 0.9 x 0.9 x 0.9 cm. OTHER: No significant abnormality noted. | Solid left thyroid nodule with smaller nodules most suggestive of colloid nodules.Necrotic -- appearing left neck lymph nodes.US GUIDED FNA; 3/6/2015 12:46 PMCLINICAL INFORMATION AND PRE-OPERATIVE DIAGNOSIS: Thyroid mass, neck adenopathyPOST-OPERATIVE DIAGNOSIS : SameCOMPARISON: Same-day ultrasound, CT neck from 2/19/15OPERATORS: Doctors paushter; The attending physician, Dr. paushter, performed the procedure. TECHNIQUE: Following a discussion of the procedure with the patient, including its risks, benefits, alternatives and steps to prevent infection, an informed written consent was obtained and documented in the patient's chart. The time-out form was completed to confirm patient identity and side/type of procedure.Localizing US demonstrated large solid left thyroid mass and necrotic -- appearing left supraclavicular lymph node. The skin over the target area was cleansed with chlorhexidine. Transducer was sterilely sheathed. Local anesthesia was obtained using 1% lidocaine, superficially and at depth. Using aseptic technique, and continuous ultrasound guidance, the thyroid lesion was sampled using 25 gauge needles. Two fine needle aspirations were performed. The left supraclavicular lymph node was sampled using 25-gauge needles. Four fine needle aspirations were performed.Cytology was present to confirm specimen adequacy. Specimen was handed to cytology. The patient tolerated the procedure well without immediate complications. Routine post procedure instructions were communicated to the patient.COMPLICATIONS: NoneESTIMATED BLOOD LOSS: Less than 5 cc. An adhesive bandage was placed on the patient’s skin. |
Generate impression based on findings. | 74-year-old female with thyroid mass and neck adenopathy and priorCT. RIGHT LOBE MEASUREMENTS: 4.1 x 1.8 x 1.6 cmLEFT LOBE MEASUREMENTS: 1.8 x 1.8 x 5.1 cmISTHMUS MEASUREMENTS: 0.2-cmRIGHT LOBE: Heterogeneous in echotexture. Cystic nodule with comet tail artifactconsistent with colloid measuring 0.5 x 0.5 x 0.5 cm. Very small, hypoechoic nodulespresent as well.LEFT LOBE: Heterogeneous in echo architecture. Spongiform appearing lower pole nodulemeasuring 0.8 x 0.7 x 1 cm likely with comet tail artifact consistent with colloid nodule.Posterior solid nodule with internal dense rim calcification measuring 1.4 x 1.3 x 2.3cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Abnormal lymph nodes identified in the left neck including a round cystic --appearing level 3 node measuring 0.5 x 0.5 x 0.7 cm a round solid 0. 5 x 0.5 x 0.8 cmlevel 3 node and a predominantly cystic level floor/supraclavicular cystic node measuring0.9 x 0.9 x 0.9 cm. OTHER: No significant abnormality noted. | Solid left thyroid nodule with smaller nodules most suggestive of colloidnodules.Necrotic -- appearing left neck lymph nodes.US GUIDED FNA; 3/6/2015 12:46 PMCLINICAL INFORMATION AND PRE-OPERATIVE DIAGNOSIS: Thyroid mass, neck adenopathyPOST-OPERATIVE DIAGNOSIS : SameCOMPARISON: Same-day ultrasound, CT neck from 2/19/15OPERATORS: Doctors paushter; The attending physician, Dr. paushter, performed theprocedure. TECHNIQUE: Following a discussion of the procedure with the patient, including its risks,benefits, alternatives and steps to prevent infection, an informed written consent wasobtained and documented in the patient's chart. The time-out form was completed toconfirm patient identity and side/type of procedure.Localizing US demonstrated large solid left thyroid mass and necrotic -- appearing leftsupraclavicular lymph node. The skin over the target area was cleansed with chlorhexidine. Transducer was sterilelysheathed. Local anesthesia was obtained using 1% lidocaine, superficially and at depth. Using aseptic technique, and continuous ultrasound guidance, the thyroid lesion wassampled using 25 gauge needles. Two fine needle aspirations were performed. The leftsupraclavicular lymph node was sampled using 25-gauge needles. Four fine needleaspirations were performed.Cytology was present to confirm specimen adequacy. Specimen was handed to cytology. The patient tolerated the procedure well without immediate complications. Routine postprocedure instructions were communicated to the patient.COMPLICATIONS: NoneESTIMATED BLOOD LOSS: Less than 5 cc. An adhesive bandage was placed on the patient?sskin. |
Generate impression based on findings. | 52 year old female who was recalled from screening mammogram for new right breast mass. No family history of breast cancer. MAMMOGRAM: An ML view 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. Within the anterior, upper outer right breast, there is redemonstration of a new, circumscribed mass which persists on spot compression imaging, measuring approximately 0.7 cm. Approximately 2 cm posterior to this new mass, there is an intramammary lymph node.RIGHT BREAST ULTRASOUND: On physical examination, no palpable lesion is identified.At the 11 o'clock position of the right breast, 3 cm from the nipple, there is a 0.5 x 0.2 x 0.6 cm cluster of cysts. No significant vascularity is associated with this lesion.At the 11 o'clock position of the right breast, 5 cm from the nipple, there is a 0.7 cm benign intramammary lymph node. | Clustered cysts at the 11 o'clock position of the right breast, corresponding to the finding on prior mammogram.No mammographic or sonographic 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. | 62-year-old male with history of thyroid cancer recurrence with surgery. Follow-up abnormalities on prior ultrasound. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: There is some soft tissue echogenicity adjacent to surgical clips, unchanged in the interim and poorly measurable.LEFT LOBE: There is again noted hypoechoic soft tissue echogenicity in the left fibroid that which is unchanged, measuring 0.2 x 0 . 5 x 0.7 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable exam. |
Generate impression based on findings. | 50 old male with abdominal discomfort. Aorta is normal in caliber with no evidence for aneurysm. Both common iliac arteries are normal in caliber as well. There is not significant atherosclerotic change. | No evidence for AAA. |
Generate impression based on findings. | 34-year-old male with chronic kidney disease. RIGHT KIDNEY: The right kidney measures 11.3 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 11.5 cm in length. Echotexture is normal. No hydronephrosis, shadowing calculus or mass.OTHER: Patient voided prior to exam. | Normal renal ultrasound. |
Generate impression based on findings. | 71-year-old male with cirrhosis and hepatitis C. Evaluate for hepatocellular carcinoma. LIVER: Liver is relatively small and coarsely echogenic consistent with parenchymal disease. No focal mass identified. Color and spectral Doppler demonstrates patency and for direction in the main portal vein with low velocities.BILIARY TRACT: Gallbladder is collapsed with stones. The biliary tract is normal in caliber.PANCREAS: Limited due to bowel gasSPLEEN: Marked splenomegaly.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Small left renal cyst. | Stable examination without evidence for solid hepatic mass. |
Generate impression based on findings. | Female 78 years old Reason: 78yo F w/ acute on chronic renal failure, r/o obstruction History: as above RIGHT KIDNEY: The right kidney measures 8.1 cm. The renal cortex is hyperechoic. There is no hydronephrosis and no shadowing renal stone. There is a 2.9-cm simple cyst.LEFT KIDNEY: The left kidney measures 8.5 cm. The renal cortex is hyperechoic. There is no hydronephrosis and no shadowing renal stone.BLADDER: The bladder is decompressed by a Foley catheter and is not evaluated.OTHER: No significant abnormalities noted. | The renal cortex is hyperechoic bilaterally consistent with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | 54-year-old female with history of throat tightness, globus sensation, thyroid enlargement on physical exam. Evaluate for thyromegaly, thyroid nodule RIGHT LOBE MEASUREMENTS: 1.6 cm x 2.0 cm x 5.5 cmLEFT LOBE MEASUREMENTS: 2.0 cm x 1.7 cm x 5.5 cmISTHMUS MEASUREMENTS: 0.4 cm in thicknessRIGHT LOBE: Along the midpole of the right thyroid lobe there is a cystic nodule measuring 0.3 cm x 0.3 cm x 0.3 cm and contains no internal vascularity and no definite microcalcifications. Along the inferior pole of the right thyroid lobe there is a mixed solid-cystic nodule measuring 0.6 cm x 0.4 cm x 0.5 cm with no increased internal vascularity and no definite microcalcifications. LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a small lymph nodes in the left neck, at the level 3 measuring 0.8 cm x 0.4 cm x 1.3 cm.OTHER: No significant abnormality noted. | Two subcentimeter nodules in the right thyroid lobe with no suspicious features noted. |
Generate impression based on findings. | Female; 34 years old. Reason: assess for causes of elevated LFTs History: rhabdomyolysis, calf pain, LFT elevation (primarily AST/ALT) LIVER: Diffusely coarsened echotexture of the liver, most suggestive of fatty infiltration. Otherwise, significant abnormalities noted.BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted in the pancreatic head. Pancreatic tail obscured by overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Fatty infiltration of the liver. |
Generate impression based on findings. | Male 64 years old Reason: 64 yo with HTn adn new CKD (?AKI) perofrm renal us for eval of size shape and echogenicitiy as well as blood flow History: 64 yo with HTn adn new CKD (?AKI) perofrm renal us for eval of size shape and echogenicitiy as well as blood flow ULTRASOUND KIDNEYSRIGHT KIDNEY: Right kidney measures 11.2 cm. Echogenic kidney. Multiple subcentimeter cysts. No evidence of hydronephrosis.LEFT KIDNEY: Left kidney measures 10.9 cm. Echogenic kidneys. Multiple cysts largest measuring 2 cm diameter. No hydronephrosis.OTHER:No significant abnormalities noted. | Normal Doppler study. Bilateral echogenic kidneys and simple cysts |
Generate impression based on findings. | Female 68 years old Reason: assess hydronephrosis History: worsening serum creatinine RIGHT KIDNEY: Right kidney measures 7.8 cm. significant echogenic kidney. Subcentimeter cysts are unchanged. No evidence of hydronephrosis.LEFT KIDNEY: Left kidney measures 8.1 cm. Significant echogenic kidney. Simple appearing 2.7 x 2.8 cm cyst is slightly increased in size compared to previous study. No evidence of hydronephrosis.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Bilateral significantly echogenic kidneys. Simple cysts are unchanged. |
Generate impression based on findings. | 54 year old female with bilateral thyroid nodules and anterior superior neck mass. RIGHT LOBE MEASUREMENTS: 6.0 cm x 2.2 cm x 2.1 cm. LEFT LOBE MEASUREMENTS: 6.0 cm x 1.7 cm x 1.5 cm. ISTHMUS MEASUREMENTS: 4 mm in thickness.RIGHT LOBE: A relatively isoechoic nodule is seen along the midpole of the right lobe measuring 0.9 cm x 0.8 cm x 0.8 cm and contains no internal vascularity or definite microcalcifications. There is inferior extension of the right thyroid lobe measuring 1.6 cm x 1.1 cm x 1.1 cm with no increased vascularity or definite microcalcifications. LEFT LOBE: Along the midpole of the left thyroid lobe there is a slightly hypoechoic heterogeneous nodule measuring 1.1 cm x 0.8 cm x 1.2 cm with no internal vascularity or definite microcalcifications. ISTHMUS: No significant abnormality noted. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small subcentimeter lymph node along the left lateral neck. OTHER: In the neck at level 6 superior to the isthmus there is a heterogeneous nodule measuring 1.4 cm x 0.7 cm x 1.6 cm with no internal vascularity or definite microcalcifications. This may be separate from the thyroid gland. | 1. Multiple thyroid nodules bilaterally that do not meet size criteria for biopsy. There is what apparently represents an inferior extension of the right thyroid lobe, further described above, however attention to this area is recommended on subsequent imaging. 2. Heterogeneous nodule in the neck at level 6 superior to the isthmus which was subsequently biopsied, pathology report pending. |
Generate impression based on findings. | 3o year old female with acute liver failure. Evaluate for portal vein thrombosis. LIVER: Liver is enlarged measuring 20.8 cm in length and is normal in echogenicity. The portal vein is patent with appropriate flow and no evidence of thrombus. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common bile duct measures 3 mm in caliber. No intra or extrahepatic biliary ductal dilatation. PANCREAS: Normal echogenicity with no pancreatic ductal dilatation. KIDNEYS: Increased echogenicity of the renal parenchyma, right greater than left. There is mild fullness of the left renal collecting system. OTHER: Status post splenectomy. Foley in a decompressed bladder limits evaluation. | 1. Portal vein is patent with no evidence of thrombus. 2. Increased echogenicity of the renal parenchyma, right greater than left, nonspecific, suggestive of medical renal disease. 3. Mild fullness of the left renal collecting system. |
Generate impression based on findings. | Ultrasound images were obtained intraoperatively. There is a tube noted within the bladder. | Intraoperative images showing tube placement within the bladder. |
Generate impression based on findings. | 87 year old female with left breast invasive lobular carcinoma (two sites), on neoadjuvant Arimidex. Evaluate response to treatment. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts 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. There is decreased asymmetry in the left upper outer breast, adjacent to the coil-shaped clip. There is redemonstration of a winged shaped clip within the left retroareolar region. There has been no significant mammographic change within the left retroareolar region.ULTRASOUND: A targeted left ultrasound was performed. At the 2:00 position of the left breast, 5 cm from the nipple, there is redemonstration of the irregular hypoechoic mass today measuring 0.6 x 0.6 x 0.9 cm (previously 1.3 x 0.8 x 1.2 cm), with adjacent Hydromark clip.Within the left retroareolar region, there is redemonstration of a heterogeneous, hypoechoic lobulated mass today measuring 2.7 x 1.2 x 2.2 cm (previously 4.3 x 2.0 x 3.4 cm). Increased peripheral vascularity is present surrounding this mass. | Interval decrease in size of biopsy proven breast carcinomas within the retroareolar and two o'clock positions of the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 70 year old female with left scalp/neck lump and headache. Additional patient noted a palpable mass in the left back. In the left scalp region there is a relatively hypoechoic solid nodule measuring 1.0 x 0.7-cm x 1.1-cm with no internal vascularity or definite microcalcifications. Additionally, patient noted a palpable mass in the left back. Limited ultrasound showed an echogenic heterogeneous solid mass measuring 3.6 cm x 0.9 cm 3.1 cm with no increased internal vascularity or definite microcalcifications. | 1. In the left scalp findings may represent a small lymph node, although other considerations include a sebaceous cyst or small lipoma. 2. In the left back findings favor a lipoma. If definite characterization is needed, MRI can be obtained. |
Generate impression based on findings. | 30 year-old female presents for short-term follow up of high probability benign mass, likely fibroadenoma. Family history breast carcinoma in her mother at age 32, as well as maternal and paternal grandmothers. On physical examination, no palpable masses were present within the left breast. Patient states she no longer feels any palpable abnormality at the previous site of concern.A targeted left ultrasound was performed for the area of previously demonstrated abnormality. At the two o'clock position of the left breast, 4 cm from the nipple, there is redemonstration of a parallel, hypoechoic mass measuring 0.4 x 0.1 x 0.2 cm (previously 0.4 x 0.2 x 0.3 cm). | Slight decrease in size of the previously demonstrated mass of the left upper outer quadrant. Follow-up should be directed by Dr. Jaskowiak. Given her family history and breast density, consideration should be given to bilateral screening breast MRI.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 67 year old female, evaluate thyroid nodules. RIGHT LOBE MEASUREMENTS: 4.2 cm x 1.7 cm x 1.7-cm. LEFT LOBE MEASUREMENTS: 3.0 cm x 1.6 cm x 1.4 cmISTHMUS MEASUREMENTS: 4 mm in thickness. RIGHT LOBE: Heterogeneous parenchyma with no discrete nodules. LEFT LOBE: Heterogeneous parenchyma. There is a fluid collection containing internal septations and questionable solid components that courses along the left thyroid lobe posteriorly and continues along the lateral anterior aspect of the thyroid lobe. This was not seen on outside hospital CT neck dated 11/8/2014. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Indeterminant predominately cystic fluid collection along the left thyroid lobe. Correlation with recent nuclear medicine parathyroid SPECT/CT scan is recommended. |
Generate impression based on findings. | 67 year old male with elevated LFTs, evaluate for Budd-Chiari. LIMITED ABDOMENLIVER: Measuring 17.6 cm in length and is normal in echogenicity. BILIARY TRACT: Gallbladder is normal in echogenicity. Gallbladder wall measures 4 mm in thickness likely related to ascites. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common bile duct measures 3 mm in caliber. No intra or extrahepatic biliary ductal dilatation. PANCREAS: The tail is obscured by overlying bowel gas. The remaining portions are normal in echogenicity with no pancreatic ductal dilatation.SPLEEN: Spleen measures upper limits of normal at 12.3 cm in length and is normal in echogenicity. RIGHT KIDNEY: Measures 10.7 cm in length and is normal in echogenicity. OTHER: Heterogeneous collection in the left lower quadrant likely correlates with known hematoma given findings on recent CT.Small bilateral pleural effusions. Small perihepatic ascites. Left kidney measures 11.9 cm in length and is normal in echogenicity. | 1. The portal veins, hepatic arteries and veins are patent with appropriate velocity and flow. 2. Heterogeneous collection in the left lower quadrant likely correlates with known hematoma given findings on recent CT.3. Small bilateral pleural effusions and perihepatic ascites. |
Generate impression based on findings. | 55-year-old male, advanced heart failure workup. LIVER: Liver measures 19.1 cm in length with slight nodular contour of the liver likely related to passive hepatic congestion. There is mild pulsatility of the main portal vein. There is perihepatic ascites. GALLBLADDER, BILIARY TRACT: Gallbladder is normal with pericholecystic fluid. Gallbladder wall measures 3 mm in thickness. Sonographic Murphy's sign is negative. Common bile duct measures 3 mm in caliber. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Tail of pancreas is obscured by overlying bowel gas however the remaining pancreatic parenchyma is normal in echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Measures 11.4 cm in length with no hydronephrosis.OTHER: Left kidney is normal measuring 11.5 cm in length. Spleen is normal measuring 11.9 cm in length. | Perihepatic ascites with slight nodular contour of the liver likely related to passive hepatic congestion. Thickened gallbladder wall likely related to ascites. |
Generate impression based on findings. | 61-year-old female with HCV cirrhosis. Evaluate for HCC. LIVER: Measures 18.7 cm in length with nodular contour and coarse echotexture.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common bile duct measures 8 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The distal tail of the pancreas is obscured by overlying bowel gas. The remaining pancreatic parenchyma is normal in echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Measures 10.0 cm in length and is normal in echogenicity with no evidence of hydronephrosis.OTHER: Left kidney measures 12.1 cm in length and is normal in echogenicity with no evidence of hydronephrosis. Spleen measures 14.7 cm in length and is normal in echogenicity. | Cirrhotic liver morphology with no focal hepatic lesions. Hepatosplenomegaly. |
Generate impression based on findings. | 61-year-old female with transaminitis, asymptomatic. History of hepatitis C, screening. Evaluate prior benign lesions. LIVER: Coarse echotexture of the liver measuring 16.0 cm in length. Again seen is a predominantly anechoic lesion in the left hepatic lobe measuring 2.8 cm x 3.3 cm x 4.8 cm with thin internal septation. The previously noted smaller hepatic cyst is no longer visualized. GALLBLADDER, BILIARY TRACT: There is a 3-mm gallbladder polyp. Gallbladder wall measures 2 mm in thickness. No pericholecystic fluid. Common bile duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: The visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Right kidney measures 9.3 cm in length and is normal in echogenicity with no evidence of hydronephrosis.OTHER: Left kidney measures 10.1 cm in length and is normal in echogenicity with no evidence of hydronephrosis. Spleen is normal in echogenicity measuring 7.9 cm in length. | 1. Minimally complex cystic lesion in the left hepatic lobe not significantly changed. No new lesions identified. 2. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration.3. 3-mm gallbladder polyp. |
Generate impression based on findings. | 71-year-old female with HCV. Evaluate for chronic liver disease. LIVER: Coarse echotexture of the liver measuring 15.7 cm in length. No focal hepatic lesions are identified.GALLBLADDER, BILIARY TRACT: There is sludge in the gallbladder. No pericholecystic fluid. Gallbladder wall measures 2 mm in thickness. Common bile measures 6 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in echogenicity with no pancreatic ductal dilatation.RIGHT KIDNEY: Right kidney measures 10.3 cm in length with increased echogenicity of the renal cortex. A cyst in the upper full measures 2.4 cm x 1.7 cm x 2.0 cm.OTHER: Left kidney measures 10.6 cm in length with increased echogenicity of the renal cortex.Spleen is normal in echogenicity measuring 7.2 cm in length. | 1. Findings suggestive of hepatic steatosis but no focal hepatic lesions. 2. Increased bilateral renal echogenicity raises the possibility of parenchymal dysfunction. There is a benign appearing cyst in the upper pole of the right kidney. 3. Sludge in the gallbladder with no evidence of cholecystitis. |
Generate impression based on findings. | 90 year-old male with hematuria. RIGHT KIDNEY: The right kidney measures 8.8 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. There is a benign appearing cyst in the upper pole measuring 6.1 cm x 7.2 cm x 5.3 cm. Small echogenic focus compatible with an angiomyolipoma measuring 4 mm x 4 mm x 4 mm. LEFT KIDNEY: The left kidney measures 8.5 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. There is a benign appearing cyst in the inferior pole measuring 4.4 cm x 3.1 cm x 4.3 cm. URINARY BLADDER: The bladder is distended with trabeculation of the bladder wall and contains echogenic material likely debris or blood. There is significant postvoid residual. OTHER: Prostate is enlarged measuring 6.4 cm x 5.7 cm x 5.0 cm. Incidentally noted right hepatic lobe cyst measuring 4.4 cm x 3.1 cm x 4.3 cm and is benign in appearance. | 1. Significant postvoid bladder residual with trabeculation of the bladder wall; bladder contains debris or blood associated with an enlarged prostate. 2. Benign appearing bilateral renal cysts as well as a possible small angiomyolipoma in the right kidney. 3. Incidentally noted benign appearing hepatic cyst. |
Generate impression based on findings. | 33 year old female with right upper quadrant pain. LIVER: Measures 17.9 cm in length, upper limits of normal, and is normal in echogenicity.BILIARY TRACT: Status post cholecystectomy. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal echogenicity with no evidence of pancreatic ductal dilatation.SPLEEN: Normal echogenicity of the spleen measuring 10.3 cm in length RIGHT KIDNEY: Measures 11.27 m in length and is normal in echogenicity with no evidence of hydronephrosis.OTHER: Left kidney measures 10.7 cm in length and is normal in echogenicity with no evidence of hydronephrosis. | No significant abnormality noted to account for the patient's symptoms. |
Generate impression based on findings. | 49-year-old male with chronic mild elevated ALT. Evaluate for NASH versus inflammation/scarring. LIVER: Measures 16.1 cm in length and is diffusely increased in echogenicity suggestive of fatty infiltration.BILIARY TRACT: Gallbladder is normal in echogenicity. No gallbladder wall thickening. No pericholecystic fluid. No gallbladder wall thickening. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.SPLEEN: Measures 14.5 cm in length, upper limits of normal, and is normal in echogenicity.RIGHT KIDNEY: The right kidney measures 10.7 cm in length and is normal in echogenicity with no evidence of hydronephrosis. OTHER: Left kidney measures 11.3 cm in length and is normal in echogenicity with no evidence of hydronephrosis. | Findings suggestive of hepatic steatosis. |
Generate impression based on findings. | 32 year-old female with right upper and lower quadrant pain, early satiety, anorexia. Evaluate for appendicitis. The appendix is visualized and appears normal in caliber and echogenicity and is compressible. No free fluid or lymphadenopathy.The visualized liver appears normal in echogenicity. There as stones in the gallbladder with no evidence of cholecystitis. No gallbladder wall thickening. No pericholecystic fluid. No intra-or extrahepatic biliary ductal dilatation. | 1. Cholelithiasis with no evidence of cholecystitis.2. No evidence of appendicitis. |
Generate impression based on findings. | 80 year-old female patient with chronic kidney disease. RIGHT KIDNEY: Echogenic renal parenchyma compatible with medical renal disease/parenchymal dysfunction. No hydronephrosis or shadowing renal calculi.LEFT KIDNEY: Echogenic renal parenchyma compatible with medical renal disease/parenchymal dysfunction. No hydronephrosis or shadowing renal calculi. Multiple renal cysts. A mildly complex cyst in the superior pole of the left kidney measures 1.4 cm.OTHER: No significant abnormalities noted. | 1.Echogenic renal parenchyma compatible with medical renal disease/parenchymal dysfunction.2.Mildly complex cyst in the superior pole of the left kidney. |
Generate impression based on findings. | FDG avid right thyroid nodule RIGHT LOBE MEASUREMENTS: 4.5 x 2.2 x 2.2 cmLEFT LOBE MEASUREMENTS: 4.5 x 1.9 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Multiple right thyroid nodules. The dominant midpole nodule in is solid and measures 1.9 x 1.4 x 1.9 cm. Spongiform upper pole nodule measures 0.8 x 0.5 x 0.8 cm. A hypoechoic spongiform nodule within the lower pole measures 1.2 x 2.8 x 0.7 cm.LEFT LOBE: Multiple subcentimeter nodules. Representative upper pole nodule measures 0.5 x 0.4 by 0.4 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple thyroid nodules bilaterally. The dominant solid nodule within the right thyroid gland corresponds to the FDG avid lesion on PET/CT. This nodule will be biopsied today. |
Generate impression based on findings. | 50 year old female with a thyroid cyst, fatigue. Evaluate for progression RIGHT LOBE MEASUREMENTS: 5.3 cm x 2.4 cm x 2.7 cmLEFT LOBE MEASUREMENTS: 5.1 cm x 1.4 cm x 2.4 cmISTHMUS MEASUREMENTS: 0.3 cm in thicknessRIGHT LOBE: At the upper pole there is a mixed solid cystic nodule measuring 1.6 cm x 0.9 cm x 1.7 cm previously measured 1.5 cm x 1.7 cm x 1.9 cm. At the inferior pole there is an additional heterogeneous vascular nodule measuring 1.2 cm x 0.7 cm x 1.6 cm previously measured 1.2 cm x 0.8 cm x 1.7 cm. LEFT LOBE: At the midpole there is a heterogeneous nodule measuring 0.6 cm x 0.3 cm x 0.6 cm, previously measured 0.7 cm x 0.6 cm x 0.4 cm. there is no internal vascularity or definite microcalcifications. At the inferior pole there is an additional solid nodule measuring 0.7 cm x 0.4 cm x 0.6 cm previously measured 0.7 cm x 0.5 cm x 0.6 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign appearing right neck level 2 lymph node measures 6 mm x 3 mm x 10 mmOTHER: No significant abnormality noted. | No significant interval change in the bilateral thyroid nodules. |
Generate impression based on findings. | Call back from screening whole breast ultrasound for right breast findings. Focused ultrasound was performed for upper outer quadrant of right breast. There is no solid or cystic lesions or other abnormalities. | No sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 47 year old with palpable bilateral axillary lymph nodes. History of fibromyalgia and seronegative arthritis. Focused ultrasound was performed for both axillae. There are multiple lymph nodes with borderline cortical thickening. As they are multiple and symmetric, they are likely due to her systemic condition. | No sonographic evidence of malignancy. Benign lymphadenopathy in both axillae. Results were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Elevated LFTs LIVER: Coarse echogenic liver echotexture without mass. Liver length 13.5 cmGALLBLADDER, BILIARY TRACT: Gallbladder sludge without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. Right kidney 8 cm in length.OTHER: Echogenic left renal parenchyma without mass, stone, or hydronephrosis left kidney 9 cm in length. Spleen 8.2 cm in length. No ascites. | Coarse echogenic kidneys suggestive for fatty infiltration/parenchymal dysfunction without mass or ductal dilatation. Gallbladder sludge without acute inflammation. Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction without obstruction. No ascites. |
Generate impression based on findings. | Female; 50 years old. Reason: kidney stones History: stones RIGHT KIDNEY: Right kidney measures 10.8-cm. Normal cortical echotexture and thickness. No hydronephrosis. No stones or masses.LEFT KIDNEY: Left kidney measures 11.5-cm. Normal cortical echotexture and thickness. No hydronephrosis. No stones or masses.OTHER: Bladder is underdistended. | No renal calculi. No hydronephrosis. |
Generate impression based on findings. | 69-year-old male with right flank pain. Evaluate for renal stone, hydronephrosis, renal parenchymal disease, gallstones, liver mass. Limited exam due to patient positioning as imaging was obtained in the upright position, patient was not able to lie supine.LIVER: Coarse echotexture of the liver with a nodular contour compatible with cirrhosis. The liver measures 16.1 cm in length. Main portal vein is patent with appropriate directional flow.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. No evidence of cholelithiasis. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in echogenicity. No evidence of pancreatic ductal dilatation.SPLEEN: Normal echogenicity of the spleen measuring 10.3 cm in length.KIDNEYS: Right kidney measures 9.6 cm in length and is increased in echogenicity with no evidence of hydronephrosis. Left kidney measures 10.1 cm in length and is increased in echogenicity with no evidence of hydronephrosis.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Cirrhotic liver morphology. 2. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No obstruction. |
Generate impression based on findings. | 71-year-old male with hepatitis C. Screen for HCC. LIVER: Diffuse increased echogenicity of the liver measuring 16.5 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow. GALLBLADDER, BILIARY TRACT: Comet tail artifact in the gallbladder consistent with adenomyomatosis of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Common bile duct measures 4 mm in caliber. No intra or extrahepatic biliary ductal location.PANCREAS: The visualized portions of the pancreas are normal in echogenicity. No pancreatic ductal dilatation. RIGHT KIDNEY: Normal echogenicity of the right kidney measured 11.6 cm in length. No hydronephrosis.OTHER: Normal echogenicity of the left kidney measuring 10.7 cm in length. No hydronephrosis.Normal echogenicity of the spleen measuring 8.7 cm in length. | 1. Diffuse increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesion.2. Adenomyomatosis of the gallbladder. |
Generate impression based on findings. | 41 year-old male with hepatitis B. HCC screening. LIVER: Diffuse increased echogenicity of the liver measuring 16.0 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow.GALLBLADDER, BILIARY TRACT: Linear echogenic strands within the gallbladder are again seen and appear similar to prior study. No pericholecystic fluid. No gallbladder wall thickening. Common bile duct measures 4 mm in caliber. No intra or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in echogenicity. No pancreatic ductal dilatation.RIGHT KIDNEY: The right kidney measures 12.3 cm in length. No hydronephrosis.OTHER: Left kidney measures 11.9 cm in length. No hydronephrosis. Normal echogenicity of the spleen measuring 12.5 cm in length. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesion. 2. Linear echogenic strands within the gallbladder may represent septations or adherent sludge, however given stability compared to prior exam, findings favor internal gallbladder septations. |
Generate impression based on findings. | 21-year-old female with postprandial pain and nausea/vomiting, evaluate for gallstone disease. LIVER: Normal echogenicity of the liver measuring 14.2 cm in length. No focal hepatic lesion. Main portal vein is patent with appropriate directional flow, however with elevated velocity up to 60 cm/s which is nonspecific on this nondedicated exam.GALLBLADDER, BILIARY TRACT: Gallbladder is normal in echogenicity with no evidence of gallstones. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 11.6 cm in length. No hydronephrosis.OTHER: Normal echogenicity of the left kidney measuring 11.2 cm in length. No hydronephrosis. Normal echogenicity of the spleen measuring 10.2 cm in length. | 1. Elevated main portal vein velocity which is nonspecific on this nondedicated exam. 2. No evidence of cholelithiasis. |
Generate impression based on findings. | 59 year-old female with abnormal LFTs. LIVER: Normal echogenicity of the liver measuring 15.6 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. No intra or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal echogenicity with no evidence of pancreatic ductal dilatation.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.5 cm in length. No hydronephrosis.OTHER: Normal echogenicity of the left kidney measuring 10.2 cm in length. No hydronephrosis.Normal echogenicity of the spleen measuring 8.7 cm in length. | Unremarkable examination. |
Generate impression based on findings. | Male 70 years old Reason: BPH - H/O urinary retention, H/O urosepsis. Post-void residual. Please evaluate. The patient had voided immediately prior to the study. Distended images of the bladder were therefore not obtained. The residual urine within the bladder was measured at this time.RIGHT KIDNEY: The right kidney measures 12.3 cm. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measures 12.6 cm. The renal cortex is normal in echogenicity. There is no hydronephrosis or shadowing renal stone. Previously identified renal cyst is poorly visualized today.BLADDER: The bladder is poorly distended.POSTVOID IMAGES: The residual urine was measured at 2.4 x 3.6 x 2.4 cm (volume is 7.8 mL).OTHER: The prostate gland is markedly enlarged measuring 4.2 x 4.7 x 5.0 cm. | 1. No significant post void residual. 2. Prostatomegaly. |
Generate impression based on findings. | 31 year-old female with right upper quadrant pain, cholelithiasis, evaluate for common bile duct stone. LIVER: Coarse echotexture of the liver measuring 19.7 cm in length. No focal hepatic lesion.GALLBLADDER, BILIARY TRACT: Several shadowing stones with layering sludge within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Mild prominence of the common bile duct which appears to taper distally with no evidence of shadowing choledocholithiasis.PANCREAS: Pancreatic duct caliber at upper limits of normal. The pancreas is not well assessed due to overlying bowel gas.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 11.3 cm in length. No hydronephrosis.OTHER: Normal echogenicity of the left kidney measuring 10.9 cm in length. No hydronephrosis. Normal echogenicity of the spleen measuring 10.3 cm in length. | 1. Cholelithiasis and sludge without evidence of cholecystitis. 2. Mild prominence of the common bile duct proximally however appears to taper distally with no definite evidence of echogenic choledocholithiasis. 3. Pancreatic duct at upper limits of normal, however pancreas not well assessed due to overlying bowel gas. 4. Course echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. Stable mild hepatomegaly. |
Generate impression based on findings. | Reason: HCV, Hepatitis B carrier. Evaluate for HCC History: HBV carrier. LIVER: The liver is normal in size, echogenicity, and contour, measuring 11.3 cm in length. No focal hepatic lesion is identified.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. No gallbladder wall thickening, cholelithiasis, or sonographic Murphy sign. Gallbladder sludge is noted.PANCREAS: Pancreatic tail is obscured by overlying bowel gas. Otherwise, no abnormality is identified.SPLEEN: The spleen is normal in size, measuring 8 cm in length.RIGHT KIDNEY: The right kidney measures 9.6 cm in length. No evidence of renal stone or hydronephrosis. OTHER: The left kidney measures 8.8 cm in length. No evidence of renal stone or hydronephrosis. | No focal hepatic lesion identified. |
Generate impression based on findings. | 65 year old male with abdominal distention, transaminitis, hyperbilirubinemia. Limited exam due to patient body habitus.LIVER: Coarse echotexture of the liver and nodular contour suggestive of underlying cirrhosis. Liver measures 20.9 cm in length. Portal vein is patent with appropriate directional flow. No focal hepatic lesion. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: Right kidney measures 13.7 cm in length. No hydronephrosis.OTHER: Left kidney measures 13.8 cm in length. No hydronephrosis.Spleen measures 14.2 cm in length.Upper abdominal ascites. | 1. Hepatosplenomegaly. Coarse echotexture and nodular contour of the liver suggestive of underlying cirrhosis.2. Upper abdominal ascites. |
Generate impression based on findings. | 39-year-old female with right quadrant pain, evaluate for gallstones. LIVER: Extremely coarse, hyperechoic parenchyma. Liver is enlarged, measuring 18 cm in length. Contour normal.GALLBLADDER, BILIARY TRACT: A single 9 mm gallstone is identified. No gallbladder wall thickening, pericholecystic fluid, intra or extrahepatic biliary dilatation.PANCREAS: Pancreatic body and tail are obscured by overlying bowel gas. No significant abnormality is noted.KIDNEYS: The right kidney measures 11 cm in length. The left kidney measures 12 cm in length. No hydronephrosis, renal mass, or stone is identified.OTHER: Spleen measures 12.1 cm in length. | 1.Cholelithiasis without evidence of cholecystitis.2.Hepatic steatosis with mild hepatomegaly. |
Generate impression based on findings. | Male 75 years old Reason: AKI on CKD with uptrending Cr despite holding diuresis, reduced UOP. Please assess. History: As above RIGHT KIDNEY: The right kidney measures 10.1 cm. The renal cortex is increased in echogenicity. There is no hydronephrosis or shadowing calculus.LEFT KIDNEY: The left kidney measures 10.3 cm. The renal cortex is increased in echogenicity. There is no hydronephrosis or shadowing calculus. Left upper pole renal cyst is again noted.OTHER: The bladder is incompletely distended. | No evidence of hydronephrosis. Echogenic renal cortex bilaterally consistent with medical renal disease. |
Generate impression based on findings. | 55 year-old male with urinary retention. Ultrasound was provided as guidance for placement of suprapubic catheter performed by urology team. Again seen is echogenic material within the bladder. The bladder wall is thickened. Final imaging reveals portion of suprapubic catheter within the bladder. | Ultrasound was provided as guidance for placement of suprapubic catheter performed by urology team. Final imaging reveals portion of suprapubic catheter within the bladder. Echogenic material within the bladder with bladder wall thickening is again noted, clinical correlation is recommended. |
Generate impression based on findings. | 68 year-old male with HCV. LIVER: Coarse echogenicity of the liver measuring 19.3 cm in length. Benign-appearing cyst in the right lobe of the liver measures 8 mm x 4 mm x 5 mm.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Prominence of the common bile duct proximally measuring 10 mm in caliber which tapers distally to 5 mm. No evidence of choledocholithiasis. PANCREAS: The visualized portions of the pancreas are normal in echogenicity. No pancreatic ductal dilatation.RIGHT KIDNEY: Measures 11.0 cm in length. No hydronephrosis. Benign-appearing cyst in the midpole measures 1.1 cm x 1.1 cm x 1.0 cm.OTHER: Left kidney measures 11.8 cm in length. No hydronephrosis.Normal echogenicity of the spleen measuring 10.7 cm in length. | 1. Hepatomegaly with coarse echotexture suggestive of parenchymal dysfunction/fatty infiltration.2. Prominence of the common bile duct which tapers distally. No evidence of choledocholithiasis. |
Generate impression based on findings. | 55 year-old female with Hashimoto's, left lobe slightly more prominent. RIGHT LOBE MEASUREMENTS: 3.7 cm x 1.2 cm x 1.2 cm.LEFT LOBE MEASUREMENTS: 3.7 cm x 1.3 cm x 0.7 cm.ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: Minimally heterogeneous echotexture with no discrete nodule identified.LEFT LOBE: Minimally heterogeneous echotexture with no discrete nodule identified.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted. | Unremarkable examination. |
Generate impression based on findings. | 65 year-old female with pancreatitis, evaluate for cholelithiasis. LIVER: Coarse echotexture of the liver measuring 14.0 cm in length. Portal vein is patent with appropriate directional flow. No focal hepatic lesion.GALLBLADDER, BILIARY TRACT: Shadowing calculus within the gallbladder without evidence of cholecystitis. No gallbladder wall thickening. No pericholecystic fluid. No intra or extra hepatic biliary ductal dilatation.PANCREAS: Hypoechoic pancreas.RIGHT KIDNEY: Measures 9.6 cm in length. No hydronephrosis.OTHER: Left kidney measures 10.1 cm in length. No hydronephrosis.Normal echogenicity of the spleen measuring 7.0 cm in length. | 1. Cholelithiasis without evidence of acute cholecystitis.2. Coarse echotexture of the liver suggestive of parenchymal dysfunction. |
Generate impression based on findings. | 86 year old male with left groin mass/testicular mass RIGHT TESTIS: Atrophic changes seen, testis measures 4.0 cm x 2.5 cm x 2.2 cm.LEFT TESTIS: Atrophic changes seen, testis measures 3.7 cm x 2.4 cm x 2.5 cm.RIGHT EPIDIDYMIS: Measures 3.3 cm x 1.0 cm x 1.0 cm and contains cyst measuring 5 mm x 5 mm x 6 mm. LEFT EPIDIDYMIS: Measures 3.8 cm x 0.8 cm x 1.0 cm and contains cyst measuring 4 mm x 3 mm x 13 mm. OTHER: Heterogeneous structure in the region of the reported lump in the left groin measuring 2.3 cm x 2.0 cm x 3.2 cm which does not change in size with Valsalva maneuver. There is no significant internal vascularity. Bilateral moderate hydroceles, more complex on the left. | 1. Nonspecific heterogeneous structure in the left groin which does not change with Valsalva maneuver making inguinal hernia less likely. Correlation with patient's clinical history recommended and MRI may be obtained for further evaluation. 2. Bilateral atrophic testes with moderate hydroceles, more complex on the left. Bilateral epididymal cysts. |
Generate impression based on findings. | 76 year old male with metastatic thyroid cancer. Evaluate for lymph nodes. RIGHT LOBE MEASUREMENTS: 4.5 cm x 1.9 cm x 1.7 cmLEFT LOBE MEASUREMENTS: 10.0 cm x 4.8 cm x 2.5 cm.ISTHMUS MEASUREMENTS: 3 mm in thicknessRIGHT LOBE: Hypoechoic subcentimeter nodule at the mid to lower pole measuring to up 6 mm. LEFT LOBE: Diffusely heterogeneous in echotexture. ISTHMUS: No significant abnormality noted.ILYMPH NODES: No suspicious lymphadenopathy. Right neck level 2 lymph node with fatty hilum measuring 2.0 cm x 0.5 cm 1.2 cm. Left neck level 2 lymph node with fatty hilum measuring 1.6 cm x 0.6 cm x 0.8 cm. | 1. Diffusely heterogeneous left thyroid lobe likely reflecting patient's known primary thyroid malignancy. Additional hypoechoic subcentimeter nodule is seen in the right thyroid lobe. 2. Bilateral lymph nodes with fatty hila, may be reactive. |
Generate impression based on findings. | 35 year-old male with transaminitis. LIVER: Normal echogenicity of the liver measuring 13.5 cm in length. No focal hepatic lesion. Portal vein is patent with appropriate directional flow.BILIARY TRACT: Normal echogenicity of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Not well assessed due to overlying bowel gas.SPLEEN: Normal echogenicity measuring 9.7 cm in length.RIGHT KIDNEY: Mild fullness of the collecting system. No nephrolithiasis delineated. OTHER: Left kidney measures 9.9 cm in length. No hydronephrosis. No shadowing intrarenal stone seen. | Mild fullness of the right renal collecting system which may be physiologic. |
Generate impression based on findings. | 72-year-old male with increased LFTs on chemotherapy. Evaluate for obstruction or mass. LIVER: Normal echogenicity of the liver measuring 13.9 cm in length. No focal hepatic lesions. Patent portal vein with appropriate directional flow.BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common bile duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.SPLEEN: Normal echogenicity of the spleen measuring 7.8 cm in length.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 12.2 cm in length. Renal cyst at the midpole measures 1.0 cm x 0.8 cm x 1.4 cm. No hydronephrosis or shadowing calculi are noted. OTHER: Normal echogenicity of the left kidney measuring 11.9 cm in length. Upper pole cyst measures 2.7 cm x 2.9 cm x 2.8 cm. No hydronephrosis or shadowing calculi are noted. | Unremarkable examination. Stable bilateral renal cysts. |