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Generate impression based on findings. | 58 year-old female with history of small thyroid nodules. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: 4.5 cm x 1.5 cm x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 cm x 1.3 cm x 1.4 cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: Heterogeneous echotexture. Small primarily cystic appearing nodule at the midpole measures 4 mm x 4 mm x 4 mm, unchanged.LEFT LOBE: Heterogeneous echotexture. Small primarily cystic appearing nodule at the midpole measures 3 mm x 3 mm x 3 mm unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2 lymph node measures 1.1 cm x 0.8 cm x 0.4 cm. Left neck level 3 lymph node measures 0.8 cm x 0.5 cm x 0.4 cm.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with bilateral cystic appearing nodules unchanged. |
Generate impression based on findings. | 68 year old male with abdominal distention, hepatomegaly on exam. LIVER: Heterogeneous echotexture of the liver measuring 15.7 cm in length. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Small shadowing stones within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Sonographic Murphy's sign is negative. Common duct measures 5 mm in thickness. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 10.3 cm in length. No hydronephrosis or shadowing calculi are noted. Exophytic lower pole cyst measures 1.4 cm x 1.9 cm x 1.9 cm.Normal echogenicity of the spleen measuring 9.1 cm in length. | 1. Heterogeneous echotexture of the liver which may represent areas of focal fatty sparing, however recommend MRI or triple phase CT scan for further evaluation. 2. Cholelithiasis with no evidence of cholecystitis.3. Exophytic left renal cyst. Findings were discussed with Dr. Katarina Veskovic by phone on 3/18/2015 at 4:20 PM. |
Generate impression based on findings. | 38 year-old female right upper quadrant pain. LIVER: Increased echogenicity of the liver measuring 21.6 cm in length. No focal hepatic lesion. Main portal vein is patent with appropriate directional flow, peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder unremarkable. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign negative. Common duct measures 3 mm in caliber. No intra or extrahepatic biliary ductal dilatation.PANCREAS: Distal pancreatic tail is obscured by overlying bowel gas. The visualized pancreas is unremarkable.RIGHT KIDNEY: Normal echogenicity measuring 12.1 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 10.6 cm in length. Normal echogenicity of the left kidney measuring 11.4 cm in length. No hydronephrosis or shadowing calculi are noted. | Hepatomegaly with increased parenchymal echogenicity suggestive of hepatic steatosis/parenchymal dysfunction. |
Generate impression based on findings. | 38 year-old female with goiter, fatigue. Family history of thyroid disease RIGHT LOBE MEASUREMENTS: 2.1 cm x 1.5 cm x 6.3-cmLEFT LOBE MEASUREMENTS: 2.1 cm x 1.7 cm x 7.3-cmISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: Mildly heterogeneous echotexture. Subcentimeter heterogeneous nodule in the upper pole. LEFT LOBE: Mildly heterogeneous echotexture. Dominant heterogeneous nodule at the lower pole measures 2.2 cm x 1.5 cm x 1.4 cm. Additional subcentimeter heterogeneous nodules are seen.ISTHMUS: No significant abnormality noted.LYMPH NODES: No suspicious lymph nodes.OTHER: No significant abnormality noted. | Mildly heterogeneous thyroid gland with bilateral thyroid nodules as above, dominant 2.2 cm mixed solid/cystic nodule in the left lobe would be amenable to FNA if clinically warranted. |
Generate impression based on findings. | Female; 44 years old. Reason: r/o hepatobiliary pathology History: hepatitis LIVER: Liver measures 18.4-cm. Normal echotexture. No focal hepatic lesions. No intra-biliary ductal dilation. Main portal vein is patent with peak systolic velocity of 0.2 m/sec and normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder wall appears prominent, though it measures up to 2 mm. No cholelithiasis, pericholecystic fluid, or sonographic Murphy sign to suggest acute cholecystitis. Common bile duct measures are 4 mm.PANCREAS: No gross abnormalities of the pancreatic head. The pancreatic tail is obscured by overlying bowel gas.RIGHT KIDNEY: Right kidney is 12.1-cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: Left kidney is 12.1-cm in length. Normal cortical echotexture. No hydronephrosis. | 1. Mild hepatomegaly.2. Prominent gallbladder wall, which is nonspecific in the setting of hepatitis. No specific evidence of acute cholecystitis. |
Generate impression based on findings. | Male; 61 years old. Reason: Hepatitis B, eval for HCC History: HBV LIVER: Coarsely echogenic. Measures 14 cm. Right hepatic lobe simple cyst measuring up to 1.2-cm. No suspicious lesion. No intrahepatic biliary ductal dilation. Patent portal vein with normal directional flow.GALLBLADDER, BILIARY TRACT: Gallbladder is normally distended. No gallstones/sludge. No pericholecystic fluid or abnormally increased wall thickness. Stable echogenic focus with ringdown artifact in the gallbladder wall, again suggestive of cholesterolosis or adenomyomatosis. Common bile duct measures 3 mm. PANCREAS: Visualized portion of the pancreatic head is unremarkable. Pancreatic tail is obscured by overlying bowel gas.SPLEEN: No significant abnormality. KIDNEYS: Right kidney measures 10.5 cm, left measures 10.3 cm. Echogenicity is within normal limits. No focal lesions, shadowing calculi, or hydronephrosis.OTHER: No ascites. | 1. Coarse echogenic liver, compatible with diffuse fatty alteration or chronic liver disease.2. No suspicious hepatic lesion.3. Gallbladder adenomyomatosis versus cholesterolosis. |
Generate impression based on findings. | 44 year old female with known right breast cancer, with left tender axillary lymph node, presents for ultrasound evaluation. Focused ultrasound was performed for the left axilla. There are least 4 normal appearing lymph nodes with thin cortices and normal blood flow in the left axilla. No abnormal lymph nodes are seen. | No abnormal lymph nodes in the left axilla. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Male; 59 years old. Reason: ? nodules, nodes History: thyroid cancer s/p surgery, i131 RIGHT LOBE MEASUREMENTS: Surgically absent. No suspicious mass within the surgical bed.LEFT LOBE MEASUREMENTS: Surgically absent. No suspicious mass within the surgical bed.ISTHMUS MEASUREMENTS: Surgically absent. No suspicious mass within the surgical bed.RIGHT LOBE: As above.LEFT LOBE: As above.ISTHMUS: As above.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There are prominent bilateral cervical chain lymph nodes, left greater than right. The largest on the right is in level 5 and measures 1.7 x 0.5 x 1.2 cm. The largest on the right is in level 5 and measures 1 x 0.9 x 1.1 cm. No pathologically enlarged lymph nodes by size criteria. No microcalcifications within the lymph nodes.OTHER: No significant abnormality noted. | Prominent lymph nodes, which are not pathologically enlarged by size criteria. No microcalcifications within the lymph nodes. However, given the prominence of the nodes, close attention at follow-up is recommended. |
Generate impression based on findings. | Pain with palpable abnormality in left groin At site of clinical concern in left inguinal region is ill-defined soft tissue hypoechogenicity with mild adjacent vascularity. Focus measures approximately 0.7 x 0.4 cm. May reflect site of focal cellulitis or a tiny abscess, no drainable fluid is seen. On the contralateral side, nonenlarged benign appearing inguinal lymph nodes seen. | Subcentimeter focus of ill-defined soft tissue hypoechogenicity with mild adjacent vascularity, may reflect site of focal cellulitis or a tiny abscess, no drainable fluid seen. |
Generate impression based on findings. | 66 year old female with hyperparathyroidism. Evaluate for abnormal parathyroid glands and thyroid nodules. RIGHT LOBE MEASUREMENTS: 4.9 cm x 1.6 cm x 1.4 cm.LEFT LOBE MEASUREMENTS: 4.8 cm x 1.4 cm x 1.3 cm. ISTHMUS MEASUREMENTS: 2 mm in thickness.RIGHT LOBE: Heterogeneous echotexture. Several subcentimeter nodules are seen.LEFT LOBE: Heterogeneous echotexture. Several subcentimeter nodules are seen.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Hypoechoic nodular focus which appears separate from the left thyroid lobe inferiorly is seen measuring 4 mm x 4 mm x 3 mm.LYMPH NODES: Benign-appearing right neck level 5 lymph node measuring 1.1 cm x 0.4 cm x 0.6 cm.OTHER: No significant abnormality noted. | 1. Hypoechoic nodular focus inferior to the left thyroid lobe is nonspecific but given history of hyperparathyroidism may represent a parathyroid adenoma. Please refer to same day nuclear medicine scintigraphic study for additional findings. A small lymph node is another differential consideration.2. Subcentimeter thyroid nodules. |
Generate impression based on findings. | 32 year-old female with hyperthyroidism. RIGHT LOBE MEASUREMENTS: 3.2-cm x 6.4 cm x 2.5 cmLEFT LOBE MEASUREMENTS: 2.9 cm x 5.8 cm x 2.5 cmISTHMUS MEASUREMENTS: 1.0-cm in thickness.RIGHT LOBE: Markedly heterogeneous in echotexture and hypervascular. No discrete nodules are identified. LEFT LOBE: Markedly heterogeneous in echotexture and hypervascular. No discrete nodules are identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Multiple bilateral benign-appearing lymph nodes likely reactive.OTHER: No significant abnormality noted. | Enlarged, heterogeneous and hypervascular thyroid gland, appearance consistent with thyroiditis. Multiple likely reactive lymph nodes in the neck. |
Generate impression based on findings. | 74 year-old male with septic shock. Evaluate for cholecystitis. LIVER: Normal echogenicity of the liver measuring 14.3 cm in length. No focal hepatic lesions. The portal vein is patent with appropriate direction of flow; peak velocity measures 0.2 m/sec.BILIARY TRACT: Mildly prominent gallbladder. No gallbladder wall thickening. No pericholecystic fluid. No shadowing calculi are seen. Common bile duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal tail of the pancreas is obscured by overlying bowel gas. The visualized portions of the pancreas are unremarkable.SPLEEN: Normal echogenicity of the spleen measuring 8.6 cm in length.RIGHT KIDNEY: Right kidney measures 11.3 centers in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.0 cm in length. No hydronephrosis or shadowing calculi are noted. | Mildly prominent gallbladder with no evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 73 year-old male with shock, alcohol abuse, CAD, CHF. Evaluate for liver disease. Limited exam as patient was unable to lie in decubitus position.LIVER: Diffuse increased echogenicity of the liver measuring at least 18.2 cm in length. No focal hepatic lesions. 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 hepatic duct measures 7 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well visualized.RIGHT KIDNEY: Right kidney measures 10.3 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measuring 11.5 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen is not well visualized. | 1. Hepatomegaly with increased echogenicity suggestive of parenchymal dysfunction/fatty infiltration.2. No evidence of cholecystitis. |
Generate impression based on findings. | 75 year-old male with fever, abdominal pain, sepsis. Evaluate for cholecystitis. LIVER: Normal echogenicity of the liver measuring 18.6 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate direction of flow; the velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder unremarkable. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common hepatic duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas obscured by overlying bowel gas. The visualized portions are unremarkable.RIGHT KIDNEY: The right kidney measures 12.2 cm in length and is mildly increased in echogenicity. No hydronephrosis or shadowing calculi are noted. Cyst at the midpole measures 1.2 cm x 1.2 cm. OTHER: Left kidney measures 10.3 cm in length and is mildly increased in echogenicity. Hypoechoic focus not well assessed measuring approximately 2.3 cm x 1.9 cm x 1.5 cm.Spleen measures 12.7 cm in length. | 1. Mildly increased echogenicity of the kidneys suggestive of medical renal disease.2. Bilateral cystic renal lesions as described above. 3. No sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | 26 year old male with rising LFTs, cholestasis, history of Crohn's disease. Evaluate for hepatic clot, portal vein thrombosis, bile duct obstruction. LIMITED ABDOMENLIVER: Mild coarse echogenicity of the liver measuring 18.7 cm in length. No focal hepatic lesions.BILIARY TRACT: Contracted gallbladder making assessment for wall thickening difficult. No pericholecystic fluid. Common bile that measures 3 mm in caliber. No intra-or extrahepatic delayed ductal dilatation.PANCREAS: Distal tail of the pancreas is obscured by overlying bowel gas. The visualized portions are unremarkable.SPLEEN: Measures 14.8 cm in length.RIGHT KIDNEY: Measures 11.9 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 12.5 cm in length. No hydronephrosis or shadowing calculi are noted.Incompletely imaged bilateral pleural effusions. | 1. Mild coarse echogenicity of the liver suggestive of parenchymal dysfunction. Mild hepatosplenomegaly. 2. Patent hepatic vasculature. 3. Incompletely imaged bilateral pleural effusions. |
Generate impression based on findings. | 51 year-old female with large left forearm IV infiltration. Assess size of infiltrate, rule out hematoma. In the left upper extremity there is infiltrating edema in the subcutaneous soft tissues diffusely from the level of the biceps to the wrist.Mild infiltrating edema in the subcutaneous tissues in the right elbow.No loculated fluid collection is noted. | Infiltration edema in the bilateral upper extremity soft tissues, left greater than right as described above. Correlation with clinical history is suggested to exclude cellulitis. No loculated fluid collection or a collection that would be amenable to drainage is noted. |
Generate impression based on findings. | 73 year-old female with thyroid nodules. Evaluate for growth or lymphadenopathy. RIGHT LOBE MEASUREMENTS: 4.6 cm x 1.2 cm x 1.4 cm.LEFT LOBE MEASUREMENTS: 6.5 cm x 5.3 cm x 4.5 cmISTHMUS MEASUREMENTS: 5 mm in thicknessRIGHT LOBE: Solid nodule at the lower pole measures 1.2 cm x 0.9 cm x 0.7 cm, previously measured 0.9 cm x 0.6 cm x 0.7 cm.LEFT LOBE: Left lobe is replaced by two large solid nodules, one of which is located in upper pole measuring 4.9 cm x 3.4 cm x 4.7 cm, previously 4.8 cm x 4.7 cm x 4.2 cm. Second nodule in the lower pole measures 3.3 cm x 4.1 cm x 4.5 cm, previously measured 1.7 cm x 4.0 cm x 4.3 cm.ISTHMUS: Subcentimeter nodule measures 3 mm x 2 mm x 4 mm, previously measured 3 mm x 2 mm x 2 mm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral solid nodules slightly increased in size compared to prior study. Dominant nodules in the left lobe were previously biopsied with benign histology. |
Generate impression based on findings. | 24 year old female with right upper quadrant pain, nausea, emesis. Evaluate for GI pathology. LIVER: 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 0.3 m/sec.GALLBLADDER, 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: Not well-visualized.RIGHT KIDNEY: Measures 11.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.9 cm in length. No hydronephrosis or shadowing calculi are noted.Spleen measures 10.8 cm in length. | 1. Heterogeneous echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. 2. No evidence of cholecystitis. |
Generate impression based on findings. | 35-year-old female with right abdominal pain. LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Within the region of the right adnexa there is a mildly complex 5 x 6.1 x 6.7 cm cystic mass which would be best evaluated by dedicated pelvic ultrasound. | Complex cystic mass right adnexa. |
Generate impression based on findings. | 84-year-old male with hyperbilirubinemia and lower extremity edema. Evaluate for cause of conjugated hyperbilirubinemia, concern for hepatic congestion secondary to heart failure. LIVER: Normal echogenicity of the liver measuring 13.3 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measuring 0.3 m/sec with a pulsatile waveform likely due to congestive heart failure.GALLBLADDER, BILIARY TRACT: Gallbladder is not well distended limiting evaluation for wall thickening. Shadowing gallstones within the gallbladder. Focal adenomyosis of the gallbladder. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common bile duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: Visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Mild increased echogenicity of the kidney measuring 9.2 centers in length. Cyst measures 3.8 cm x 3.9 cm x 3.6 cm. no hydronephrosis or shadowing calculi are noted.OTHER: Mild increased echogenicity of the left kidney measuring 10.4 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 11.1 cm in length. | 1. Cholelithiasis with the gallbladder not well distended limiting evaluation for wall thickening, however there is no sonographic evidence of cholecystitis. 2. Patent portal vein with pulsatile waveform likely related to congestive heart failure.2. Mild increased echogenicity of the kidneys suggestive of parenchymal dysfunction. |
Generate impression based on findings. | 90 year-old female with epigastric/upper abdominal pain. LIVER: Normal in size, contour and echogenicity. Small cysts identified.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted except a previously documented cyst.OTHER: Right pleural effusion. | No findings to account for patient's pain.Right pleural effusion.Right renal cyst. |
Generate impression based on findings. | 50 year-old female with history of thyroid cancer status post thyroidectomy. Evaluate for growth of lesions or other adenopathy, or any suspicious lesions that would be amenable to FNA. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Hypoechoic nodule inferior to the right thyroidectomy bed is again seen measuring 5 mm x 5 mm x 4 mm, previously 4 mm 4 mm x 4 mm. Additional hypoechoic nodule inferior to the right thyroidectomy bed and posterior to the right carotid artery measures 8 mm x 5 mm x 5 mm, previously 9 mm x 5 mm x 6 mm.LEFT LOBE: No nodules in the thyroidectomy bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 5 benign appearing lymph node measures one 1.0 cm x 0.3 cm x 1.0 cm. No pathologic lymphadenopathy. OTHER: No significant abnormality noted. | Two hypoechoic nodules, one within and one adjacent to the right thyroidectomy bed are unchanged. |
Generate impression based on findings. | 33-year-old male with Burkitt's lymphoma and HIV and chemotherapy with right groin swelling and pain. Limited evaluation of the right groin demonstrates a highly complex and capsulated fluid collection with internal septation measuring approximately 3.3 X 6 x 6 cm. No gross internal flow by color Doppler | Complex fluid collection right groin. Differential considerations would include a hematoma/infected hematoma, frank abscess or even suppurative lymph node. |
Generate impression based on findings. | 90 year-old female with transaminitis postop. Evaluate portal vein and liver and for obstructive nephropathy. LIVER: Increased in echogenicity measuring 14.2 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common hepatic duct measures 8 mm in caliber with diffuse prominence of the intrahepatic biliary ducts. No common duct dilatation. PANCREAS: Incompletely visualized. SPLEEN: Not well visualized.KIDNEYS: Right kidney measures 15.1 cm in length. Cyst at the upper pole measures 8.3 cm x 6.8 cm x 8.1 cm. No hydronephrosis or shadowing calculi are noted.Left kidney incompletely visualized containing multiple cysts, the largest of which measures approximately 7.2 cm x 5.3 cm x 6.0 cm. No definite hydronephrosis or shadowing calculi are noted.ABDOMINAL AORTA: Patent with appropriate direction of flow. The proximal aorta measures 2.6 cm x 2.3 cm x 1.9 cm. The mid aorta measures 1.9 cm x 1.9 cm x 1.6 cm.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: No significant abnormality noted. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. There is diffuse prominence of the intrahepatic biliary ducts with normal caliber of the common hepatic duct suggestive of hepatic hilar mass/masses or stricture. Recommend CT or MRI for further evaluation. 2. Bilateral renal cysts. |
Generate impression based on findings. | 62-year-old male with mantle cell lymphoma with splenic involvement and splenomegaly. Prior splenic infarct with increasing pain. SPLEEN: There is marked splenomegaly with the spleen measuring at least 24 cm in length. There is no focal splenic abnormality identified on today's exam. There is no peri-splenic or intrasplenic fluid collection.OTHER: No significant abnormalities noted. | Marked splenomegaly without change. No focal splenic abnormality and no evidence for hematoma. |
Generate impression based on findings. | 90 year-old male with urinary retention. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 11.2 cm in length. Echotexture appears within normal limits. There is a 3 cm cyst arising from the upper pole. No hydronephrosis, shadowing calculus or solid mass.LEFT KIDNEY: The left kidney measures 10.4 cm in length. Echotexture appears within normal limits. No hydronephrosis, shadowing calculus or mass.URINARY BLADDER: Bladder is incompletely distended with trabeculation.OTHER: Prostate is enlarged. | No hydronephrosis.Right renal cyst. Enlarged prostate with trabeculated but not distended bladder. |
Generate impression based on findings. | 57 year old female post thyroidectomy for thyroid cancer. Follow-up small focus left thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: No masses. There is identified small hypoechoic area no longer seen.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for mass or abnormal lymph nodes. |
Generate impression based on findings. | 51 year old who is called back from screening mammogram for developing calcifications. Family history of mother and sister with breast cancer. An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. There are pleomorphic calcifications at posterior lower inner left breast, measuring 28 x 40 mm, distributing segmentally. No masses or distortions are associated with these calcifications.Focused ultrasound study was performed for the left breast lower inner quadrant. There are no solid or cystic masses. No increased blood flow is present. | Pleomorphic calcifications at lower inner quadrant in the left breast. Stereotactic core needle biopsy is recommended. Results and recommendations were discussed with the patient and her husband. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 44-year-old female with thyroidectomy for thyroid cancer. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massLEFT LOBE: No massISTHMUS: No massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for recurrent disease |
Generate impression based on findings. | 48-year-old morbidly obese female with neutropenic fever, bacteremia and cutaneous abdominal abscesses. Evaluate for intra-abdominal fluid collection. The examination is extremely limited and inadequate due to body habitus. No gross intra-abdominal/pelvic fluid collection. | Limited exam without fluid collection. |
Generate impression based on findings. | 34-year-old female with transaminitis after stem cell transplant. Evaluate for abnormal blood flow. LIMITED ABDOMENLIVER: Increased echogenicity of the liver measuring 17.8 cm in length. No focal hepatic lesions.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: Visualized portions of the pancreas are unremarkable.SPLEEN: Not well visualized. RIGHT KIDNEY: Increased echogenicity of kidney measuring 12.1 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Increased echogenicity of the left kidney measuring 11.6 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Patent hepatic inflow and outflow vasculature.2. Increased echogenicity of the kidney suggestive of parenchymal dysfunction. No hydronephrosis. |
Generate impression based on findings. | 69 year-old female with abdominal discomfort with known left lower quadrant inguinal hernia. Assess size. In the left lower quadrant there is redemonstration of an inguinal hernia which is accentuated with Valsalva maneuver. No internal peristalsis is noted within the hernia suggestive of fat or collapsed bowel. | Left inguinal hernia containing fat or collapsed bowel. |
Generate impression based on findings. | 32-year-old male with history of thyroid cancer with prior recurrence. Tg has been increased but stable. Small lesions in thyroid bed have been stable. Evaluate for adenopathy or recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Previously noted two hypoechoic foci in the thyroidectomy bed are unchanged, one of which measures 4 mm x 4 mm x 6 mm (previously 4 mm x 4 mm x 4 mm) and the other located more inferiorly measures (5 mm x 5 mm x 7 mm), previously 5 mm 5 mm x 5 mm. New hypoechoic focus in the thyroidectomy bed measures 4 mm x 3 mm x 2 mm.LEFT LOBE: Two hypoechoic foci in the left thyroidectomy bed are not significantly changed, one of which measures 2 mm x 2 mm x 3 mm (previously 3 mm x 3 mm x 3 mm) and the other measures 6 mm x 3 mm x 4 mm (previously 5 mm x 4 mm x 6 mm). ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | New hypoechoic focus in the right thyroidectomy bed is noted. Previously seen hypoechoic foci bilaterally are unchanged. |
Generate impression based on findings. | 60-year-old female with hepatitis C. Evaluate for hepatocellular carcinoma. LIVER: Mildly and coarsely echogenic. Morphologically normal. No focal hepatic abnormality.BILIARY TRACT: The biliary tract is normal in caliber. Color appears unremarkablePANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Mildly echogenic liver without mass. |
Generate impression based on findings. | Male 45 years old Reason: U/S for pt w apparent CKD (creatinine 1.6, BUN 20, GFR mid 40s). He has borderline BP and A1C but no prior dx of HTN, DM History: as above RIGHT KIDNEY: The right kidney measures 11.4 cm. There is no hydronephrosis or shadowing stones. The renal cortex is mildly echogenic suggestive of medical renal disease.LEFT KIDNEY: The left kidney measures 11.1 cm. There is no hydronephrosis or shadowing stones. The renal cortex is mildly echogenic, suggestive of medical renal disease.URINARY BLADDER: The bladder is incompletely distended at time of imaging. | The renal cortex is bilaterally mildly echogenic consistent with medical renal disease. No hydronephrosis or shadowing stones. |
Generate impression based on findings. | 82-year-old male with hyperparathyroidism. RIGHT LOBE MEASUREMENTS: 4.2 cm x 2.0 cm x 2.2 cmLEFT LOBE MEASUREMENTS: 4.1 cm x 1.6 cm x 1.5 cmISTHMUS MEASUREMENTS: 5 mm in thicknessRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Ovoid hypoechoic nodule inferior to the left thyroid lobe is seen measuring 8 mm x 5 mm. This is more heterogeneous than is typical for a parathyroid adenoma, but does not have the appearance of a normal lymph node.LYMPH NODES: Right neck level 2 benign-appearing lymph node measures 1.3 cm x 0.6 cm x 0.2 cm. No pathologic lymphadenopathy.OTHER: No significant abnormality noted. | Hypoechoic nodule inferior to the left thyroid lobe appears to correspond to the focus of increased activity seen on prior parathyroid SPECT CT scan on 10/31/2013 which was noted to be a parathyroid adenoma. |
Generate impression based on findings. | 33 year old female with epigastric pain for 4 days. Pain colicky in nature. Evaluate for gallstones. LIVER: Normal echogenicity of the liver measuring 14.0 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Dense shadowing in the expected region of the gallbladder consistent with collapsed gallbladder containing multiple stones. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common bile duct measures 5 mm in thickness. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Normal echogenicity measuring 10.1 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney is normal echogenicity measuring 10.2 cm in length. No hydronephrosis or shadowing calculus are noted.Normal echogenicity of the spleen measuring 11.1 cm in length. | Findings consistent with collapsed gallbladder containing multiple stones. No evidence of acute cholecystitis. |
Generate impression based on findings. | 65 year old male with diminished urine output. Transplant kidney. Evaluate for obstruction. RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Transplanted kidney measures 12.2 cm in length. No parenchymal abnormality.COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: Poorly distendedOTHER: No significant abnormality noted | No hydronephrosis. No change from prior exam. |
Generate impression based on findings. | 33-year-old male with borderline hypertension, CKD. Evaluate kidneys. ULTRASOUND KIDNEYSRIGHT KIDNEY: Measures 11.6 cm in length. There is diffuse parenchymal loss with secondary caliectasis likely due to volume loss. No hydronephrosis. No shadowing calculi.LEFT KIDNEY: Normal in echogenicity measuring 11.5 cm in length. No hydronephrosis or shadowing calculi.OTHER: No significant abnormalities noted. | 1. Diffuse right renal parenchymal loss with secondary caliectasis. No hydronephrosis bilaterally. 2. No evidence of renal artery stenosis. |
Generate impression based on findings. | 70 year-old female. Her quadrant tenderness, liver distention, low platelets. Ultrasound for hepatomegaly, biliary disease, cirrhosis? LIVER: Normal echogenicity and echotexture of the liver. No focal hepatic mass. The liver is 15.9 cm in length. Hepatopetal portal venous flow with undulation of the waveform and dilated hepatic veins, likely related to congestion from right heart failure.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. Common duct is 4 mm in diameter, within normal limits. Cholelithiasis without evidence of acute cholecystitis.PANCREAS: Visualized pancreatic head is normal in echogenicity. The rest of the pancreas is obscured by bowel gas.OTHER: Small amount of right upper quadrant ascites. | 1. Cholelithiasis without evidence of acute cholecystitis. No biliary ductal dilatation. Liver length is at the upper limits of normal. Small amount of perihepatic ascites.2. Findings consistent with right heart failure. |
Generate impression based on findings. | 36-year-old male. Patient with left testicular pain. Evaluate for torsion. RIGHT TESTIS: Normal echogenicity. No focal mass. 4.2 x 2.4 x 3.1 cm.LEFT TESTIS: Normal echogenicity. Small 2 mm hypoechoic focus in the central testicle which fills completely with flow on color Doppler images is likely a vessel. No suspicious testicular mass. 3.8 x 2.2 x 2.9 cm.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: Mild asymmetrically increased vascularity to the left epididymis raises the possibility of epididymitis.OTHER: Symmetric color Doppler flow and normal arterial waveforms of both testicular speaks against torsion. | No evidence of testicular torsion. Mild hyperemia to the left epididymis, raises possibility of mild epididymitis. |
Generate impression based on findings. | 76-year-old male. Abnormal LFTs. Evaluate for obstruction. LIVER: Normal echogenicity and echotexture the liver. The liver is 12 cm in length. No focal hepatic mass. Hepatoportal venous flow.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. Common duct is 3 mm, within normal limits. Gallbladder sludge. Trace pericholecystic fluid, nonspecific in presence of ascites. Patient is not tender over the gallbladder.PANCREAS: Visualized pancreatic head is normal in echogenicity. Remainder of the pancreas is obscured by bowel gas.RIGHT KIDNEY: Right kidney is than 20 cm in length and has a cyst. No hydronephrosis.OTHER: Large bilateral pleural effusions. Trace perisplenic fluid. | No biliary ductal dilatation. Gallbladder sludge with trace pericholecystic fluid, nonspecific in presence of ascites. Large bilateral pleural effusions. |
Generate impression based on findings. | 85-year-old female. Evaluate for portal vein thrombosis. Cirrhosis progression. Renal status. Acute on chronic renal failure. Decompensated liver. LIVER: Nodular contour of the liver with coarsened echotexture consistent with cirrhosis. The liver is 15.7 cm in length. No suspicious focal mass. Hepatoportal venous flow with a normal velocity.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. The common duct is 4 mm, within normal limits. Dense shadowing in the gallbladder fossa, likely due to gallbladder packed with stones.PANCREAS: VIsualized portions of the pancreatic head and neck are normal in echogenicity. Remainder of pancreas is obscured by bowel gas.SPLEEN: No focal lesion. Spleen is 12.7 cm in length.KIDNEYS: Right kidney is 10.7 cm in length and contains a cyst with a thin septation. No hydronephrosis. Left kidney is surgically resected.ABDOMINAL AORTA: Normal in caliber measuring up to 2.6 cm in the proximal aorta and 2.3 cm in the mid aortaINFERIOR VENA CAVA: Patent.OTHER: Small amount of abdominal ascites. | Small amount of ascites. Cirrhosis. Patent portal vein. No hydronephrosis. Cholelithiasis. |
Generate impression based on findings. | 52-year-old female. CHF presenting with right upper quadrant abdominal pain, back pain, positive UA from OSH. Evaluate for pyelonephritis, liver/gallbladder, biliary tree. LIVER: Diffusely increased echogenicity of the liver consistent with hepatic steatosis/dysfunction. The liver is 19.7 cm in length. No focal lesion is identified. Hepatoportal venous flow.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. The common duct is 7 mm in caliber, at the upper limits of normal. Status post cholecystectomy.PANCREAS: Visualized portions of the pancreatic head are normal echogenicity. The remainder of the pancreas is obscured by bowel gas.SPLEEN: No significant abnormality noted.KIDNEYS: Right kidney is 12.2 cm. Left kidney is 13.9 cm. Normal echogenicity of both kidneys. No hydronephrosis. No evidence of an abscess.ABDOMINAL AORTA: Aorta is patent. 3.3 cm in caliber in the proximal aorta, 2.6 cm in the mid aorta, 1.8 cm in the distal aorta.INFERIOR VENA CAVA: Patent.OTHER: Bladder is underdistended. | Findings consistent with hepatic steatosis/dysfunction and hepatomegaly. No hydronephrosis or evidence of a renal abscess. Mildly ectatic proximal abdominal aorta. |
Generate impression based on findings. | 71-year-old female with shock, hepatic abnormality, cirrhosis. Evaluate for cholangitis. LIVER: Coarse in echotexture with a nodular contour measuring 13.5 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/sec. Small amount of perihepatic fluid.GALLBLADDER, BILIARY TRACT: Multiple shadowing stones within the gallbladder. Mild gallbladder wall thickening measuring 4 mm in thickness. No pericholecystic fluid. Unable to assess for sonographic Murphy's sign. Common duct measures 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal tail of the pancreas is obscured by overlying bowel gas. The remaining portions of the visualized pancreas are unremarkable.SPLEEN: Not well visualized. KIDNEYS: Right kidney measures 9.0 cm in length and is increased in echogenicity. Left kidney measures 10.2 cm in length and is increased in echogenicity. No shadowing calculi or hydronephrosis is noted. ABDOMINAL AORTA: The visualized aorta appears patent.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: Foley catheter within a decompressed bladder limits adequate evaluation.Right pleural effusion. Fluid filled stomach. | 1. Cirrhotic liver morphology with no focal hepatic lesions noted. 2. Cholelithiasis with mild gallbladder wall thickening which is nonspecific in the setting ascites, however findings could represent early cholecystitis. 3. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. No obstruction. 4. Small amount of perihepatic fluid. Right pleural effusion. |
Generate impression based on findings. | 64-year-old male with hepatitis C. LIVER: Coarse echotexture of the liver measuring 15.8 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Common duct measures 2 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Pancreatic tail is obscured by overlying bowel gas. Remaining portions of the visualized pancreas are unremarkable.RIGHT KIDNEY: Measures 10.9 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen measures 9.9 cm in length and is normal in echogenicity.Left kidney measures 11.4 cm in length. No hydronephrosis or shadowing calculi are noted. | Coarse echotexture of the liver suggestive of proximal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 61-year-old female with shock liver, recent aortic bifemoral bypass. Limited exam as patient is intubated and unable to lie in decubitus position.LIVER: Coarse heterogeneous echotexture measuring 16.8 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Collapsed gallbladder filled with stones. 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.RIGHT KIDNEY: Measures 11.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney and spleen are not well visualized.Small amount of left upper quadrant ascites. | 1. Cholelithiasis with no evidence of cholecystitis.2. Coarse heterogeneous echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration.3. Small amount of ascites. |
Generate impression based on findings. | 74-year-old male with thrombocytopenia. Evaluate for hepatomegaly and splenomegaly. LIVER: Increased echogenicity of the liver measuring 16.0 cm in length. No focal hepatic lesions. 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 4 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well assessed.RIGHT KIDNEY: Right kidney measures 12.0 cm in length. No hydronephrosis or shadowing calculus are noted.OTHER: Spleen is mildly enlarged measuring 12.1 cm in length.Left kidney measures 12.2 cm in length. No hydronephrosis or shadowing calculus are noted. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. 2. Borderline splenomegaly. |
Generate impression based on findings. | 22-year-old male status post OLT remote history of HCC. LIVER: Coarse echogenicity of the liver measuring 12.5 cm in length. No focal hepatic lesions. 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: Not well-visualized.RIGHT KIDNEY: Measures 10.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen is normal in echogenicity measuring 11.4 cm in length.Left kidney measures 11.0-cm in length. No hydronephrosis or shadowing calculi are noted. | Coarse echogenicity of the liver suggestive of hepatic dysfunction/fatty infiltration. No focal hepatic lesion. |
Generate impression based on findings. | 28 year old female with history of abdominal wall hernia repair at age 11 now with periumbilical pain. Evaluate for hernia recurrence. Post surgical changes of hernia repair with mesh placement is noted with no evidence of hernia recurrence at rest and with Valsalva maneuver. | Postsurgical changes with no evidence of hernia recurrence. |
Generate impression based on findings. | 59-year-old female with uptrending AST/ALT. Evaluate for hepatic abnormalities. LIVER: Coarse echogenicity of the liver measuring 25.6 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: Sludge within the gallbladder. Small amount of pericholecystic fluid. No gallbladder wall thickening. Sonographic Murphy's sign is negative. Common duct measures 2 mm in thickness. No intra-or extra hepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas is obscured by overlying bowel gas. The visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Measures 12.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen measures 10.6 cm in length and is normal in echogenicity.Left kidney is not well assessed measuring 10.9 cm in length. No definite hydronephrosis or shadowing calculi are noted. | 1. Sludge within the gallbladder with small amount of pericholecystic fluid however no definite evidence of cholecystitis.2. Hepatomegaly with coarse echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | 70-year-old female with cirrhosis, HCC screening LIVER: Coarse echogenicity of the liver measuring 13.0 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Shadowing stones within the gallbladder which is not well distended limiting evaluation for wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail are obscured by overlying bowel gas. Remaining portions of the visualized pancreas unremarkable.RIGHT KIDNEY: Measures 9.8 cm in length. No hydronephrosis or shadowing calculi noted.OTHER: Normal echogenicity of the spleen measuring 11.8 cm in length.Left kidney measures 10.3 cm in length. No hydronephrosis or shadowing calculi noted. | 1. Coarse echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. 2. Cholelithiasis with no definite evidence of cholecystitis. |
Generate impression based on findings. | 40 year-old male with history of significant alcohol abuse, elevated transaminases. Evaluate for liver pathology. LIVER: Increased echogenicity of the liver measuring 19.2 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. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 2 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail of the pancreas obscured by overlying bowel gas. The visualized portions of the pancreas are unremarkable.RIGHT KIDNEY: Measures 10.1 cm in length. No hydronephrosis or shadowing calculi or noted.OTHER: Left kidney measures 10.8 cm in length. No hydronephrosis or shadowing calculi or noted.Normal echogenicity of the spleen measuring 8.3 cm in length. | Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. |
Generate impression based on findings. | 70 year-old with acute kidney failure RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Kidney measures 9.7 cm with normal echotexture. Mild prominent corticomedullary differentiation is noted compared to prior study. COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels No significant abnormality notedPeak systolic velocity of the iliac artery is .5 m/sec.Proximal 1. 2 m/secMid 0.7 m/secDistal 0.3 m/secThe intrarenal resistive indices measure between 0.71 and 0.82.Minimal tardus parvus.OTHER: No significant abnormality noted | No definite evidence of renal artery stenosis. |
Generate impression based on findings. | 61-year-old with known breast cancer and palpable left supraclavicular nodes. A targeted left ultrasound was performed for the area marked by the clinical service in the supraclavicular region. There are multiple adjacent small masses. Several of these are highly compatible with abnormal morphology lymph nodes. These measure up to 9 mm. The largest mass is a mixed echogenicity mass with increased vascularity measuring 2.0 x 1.9 cm. This could represent an additional lymph node replaced by tumor. | Multiple masses at the site of palpable concern most compatible with abnormal lymph nodes. The patient is followed by Dr. Jaskowiak.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Thyroid nodules, RIGHT LOBE MEASUREMENTS: 7 x 1.5 x 2.6 cmLEFT LOBE MEASUREMENTS: 6.1 x 1.7 by 2.4 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: A predominantly cystic circumscribed, oval nodule measures 0.4 by 0.3 x 0 .4 cm in the upper pole. An irregularly-shaped hypoechoic nodule right, adjacent to it measures 1.1 x 1 x 0.8 cm possibly colloid in nature. However, few specks of calcifications are noted within it, further evaluation with ultrasound guided FNA is recommended. Also, comparison with prior ultrasound should be performed to look for interval changeLEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology, level 2 right neck lymph nodes identified.OTHER: No significant abnormality noted. | Atypical features in an irregularly-shaped hypoechoic right upper pole nodule possibly colloid in nature however, few specks of calcifications within it. Further evaluation with ultrasound guided FNA is recommended. If prior imaging is submitted, comparison with prior ultrasound should be performed to look for interval change |
Generate impression based on findings. | 45 year old female presents for follow-up of known left breast cysts. Previously had pain associated with these cysts, however has no complaints of pain today. No family history of breast cancer. On physical examination, no discrete palpable abnormality is identified.A targeted left ultrasound was performed for the patient's area of concern. Multiple tiny (<0.5 cm) benign cysts are visualized, unchanged from prior examination. No ultrasound features are present to suggest malignancy. No increased vascularity. No solid mass is appreciated. | Multiple tiny, benign left breast cysts, unchanged from prior examination. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, for which the patient is due in September 2015. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 39-year-old male with elevated alkaline phosphatase, pre-heart transplant evaluation. LIVER: Slight coarse echogenicity of the liver measuring 20.1 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: Normal echogenicity of 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.SPLEEN: Normal echogenicity measuring 11.6 cm in length.KIDNEYS: Right kidney measures 10.4 centers in length. No hydronephrosis or shadowing calculi are noted. Limited evaluation of the left kidney measuring 10.2 cm in length. No definite hydronephrosis or shadowing calculi are noted.ABDOMINAL AORTA: The proximal visualized aorta is patent measuring 2.0 cm x 1.8 cm x 0.8 cm. The remaining abdominal aorta is obscured by overlying bowel gas.INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow.OTHER: Bladder is well distended with no significant abnormalities noted. The prostate is visualized and is unremarkable. | Slight coarse echogenicity of the liver suggestive of parenchymal dysfunction/fat infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 52-year-old female with right upper quadrant pain and tenderness, palpable cord in the right abdomen. LIVER: Normal 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: Normal echogenicity of the gallbladder. No gallbladder wall thickened. No pericholecystic fluid. Sonographic Murphy's sign is negative. 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 11.7 cm in length. Cyst at the upper pole measures 1.6 x 1.7-cm x 1.6 cm. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.7 cm in length. Cyst at the lower pole measures 1.4 cm x 1.0 cm x 1.1 cm. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 8.9 cm in length. | Bilateral renal cysts. Otherwise unremarkable examination. |
Generate impression based on findings. | 29 year old female with thyrotoxicosis. Evaluate for nodule, vascularity. RIGHT LOBE MEASUREMENTS: 6.4 cm x 1.1 cm x 2.4 cmLEFT LOBE MEASUREMENTS: 6.5 cm x 1.4 cm x 2.4 cmISTHMUS MEASUREMENTS: 5 mm in thicknessRIGHT LOBE: Heterogeneous in echotexture with slight increased vascularity. No discrete nodules are identified. LEFT LOBE: Heterogeneous in echotexture with slight increased vascularity. Predominantly solid nodule with hypoechoic halo at the mid to lower pole measures 5 mm x 4 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. | 1. Heterogeneous and enlarged thyroid gland suggestive of thyroiditis. 2. Subcentimeter solid left thyroid nodule. Continued surveillance is recommended. |
Generate impression based on findings. | 67-year-old female with goiter RIGHT LOBE MEASUREMENTS: 6.0 cm x 2.4 cm x 1.4 cm. LEFT LOBE MEASUREMENTS: 5.5 cm x 2.5 cm x 1.6 cm ISTHMUS MEASUREMENTS: 2 mm in thicknessRIGHT LOBE: Predominantly cystic nodule at the upper pole measures 7 mm x 7 mm x 4 mm. Spongiform appearing nodule at the lower pole measures 1.9 cm x 1.4 cm x 1.0 cm. LEFT LOBE: Spongiform appearing nodule at the upper pole measures 1.1 cm x 0.7 cm x 0.5 cm. Additional spongiform appearing nodule at the lower pole measures 1.7 cm x 1.2 cm x 1.1 cm. `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, majority of which are spongiform in appearance and the other is predominantly cystic. Continued surveillance is recommended. |
Generate impression based on findings. | 74-year-old female, evaluate ascites. There is moderate four quadrant ascites noted. | Moderate four quadrant ascites. |
Generate impression based on findings. | 41 year old female with ascites, anasarca. Moderate four quadrant ascites is noted. Incompletely visualized bilateral pleural effusions. | Moderate four quadrant ascites. Bilateral pleural effusions. |
Generate impression based on findings. | 41-year-old female status post BMT, worsening bilirubin, jaundice. Evaluate for VOD versus obstruction. LIMITED ABDOMENLIVER: Enlarged measuring 21.0 cm in length and is heterogeneous in echotexture. No focal hepatic lesions. 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: Tail of the pancreas is obscured by overlying bowel gas. The visualized portions are unremarkable. SPLEEN: Spleen is enlarged measuring 16.2 cm in length. RIGHT KIDNEY: Measures 12.1 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 12.6 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.Abdominal ascites.Incompletely visualized bilateral pleural effusions. | 1. Hepatosplenomegaly with heterogeneous echotexture of the liver suggestive of parenchymal dysfunction/infiltration. Patent inflow and outflow hepatic vasculature.2. Abdominal ascites and bilateral pleural effusions. |
Generate impression based on findings. | 69-year-old with LFTs elevation after allo-SCT and donor lymphocyte infusion LIVER: Liver measures 17.4 cm with normal echotexture. No intrahepatic biliary ductal dilatation. No focal lesions noted.BILIARY TRACT: Gallbladder is well distended and normal gallbladder wall thickness without pericholecystic fluid. No evidence of gallstones.PANCREAS: No significant abnormalities noted.SPLEEN: Mild splenomegaly, spleen, measures 13.3 cm, with normal echotexture.KIDNEY: Right measures 11.6 cm the left kidney measures 11.8 cm. Normal echotexture noted. No hydronephrosis. No focal lesions are noted.OTHER: No ascites | Mild splenomegaly. Normal echotexture of the liver. |
Generate impression based on findings. | 73 year old female with history of metastatic breast cancer abdominal pain, cholestasis. Evaluate for biliary obstruction. Limited exam as patient is laying in left lateral decubitus position and minimally responsive.LIVER: Coarse heterogeneous echotexture of the liver measuring 15.5 cm in length with numerous hypodense solid lesions seen diffusely throughout the liver most consistent with metastatic disease which has progressed from prior CT study dated 10/6/2014. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Multiple shadowing stones within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Common duct measures 6 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: Measures 9.1 cm in length. No hydronephrosis or shadowing calculi noted.OTHER: Left kidney and spleen are not visualized due to patient positioning. | 1. Multiple solid lesions throughout the liver are most consistent with metastatic disease with interval progression compared to prior CT study dated 10/6/2014. Heterogeneous echotexture of the liver parenchyma suggestive of parenchymal dysfunction/fatty infiltration. No biliary obstruction.2. Cholelithiasis with no evidence of cholecystitis. Findings were discussed with Dr. Erica Mackenzie by phone on 3/23/2015 at 3:50 PM. |
Generate impression based on findings. | 60-year-old female with abdominal pain, right flank pain. Choledocholithiasis on CT, evaluate for acute cholecystitis. LIVER: Coarse echotexture 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 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Stones within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 5 mm in caliber. No intra-or extrahepatic biliary ductal dilatation. No evidence of choledochal lithiasis within the visualized portions of the common bile duct.PANCREAS: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 11.2 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Spleen measures 10.2 cm in length.Left kidney measures 12.9-cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Cholelithiasis with no evidence of cholecystitis. No choledocholithiasis within the visualized common bile duct. 2. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 63-year-old male with history of gastric cancer with recent biliary drain placement, abdominal pain with concern for cholecystitis on CT. LIVER: Mild increased echogenicity of the liver measuring 20.6 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: There is gallbladder wall thickening measuring 8 mm in thickness. No stones are visualized within the gallbladder. No pericholecystic fluid. Sonographic Murphy's sign is negative. A drain is noted within the biliary tract limiting evaluation for common bile duct caliber, however there is no intrahepatic biliary duct dilatation. PANCREAS: Obscured by overlying bowel gas.RIGHT KIDNEY: Measures 12.0 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.6 cm in length and is normal in echogenicity. There is mild pelvicaliceal dilatation of the inferior pole. No shadowing calculi are noted.Normal echogenicity of the spleen measuring 10.3 cm in length. | 1. Gallbladder wall thickening is noted with no evidence of cholelithiasis. Given that these findings are new based on prior CT scans, this is suspicious for acute acalculous cholecystitis.2. Mild increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. 3. Mild left sided pelvicaliceal dilatation. |
Generate impression based on findings. | 82 year-old female with HBV, evaluate for HCC. LIVER: Coarse echotexture and nodular contour of the liver measuring 13.5 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. Common duct measures 6 mm in caliber. No intra-or extrahepatic biliary duct dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 6.6 cm in length and is increased in echogenicity. No hydronephrosis or shadowing calculi are noted. OTHER: Left kidney measures 8.5 cm in length and is increased in echogenicity. Multiple cysts are noted, one of which measures 1.3 cm x 1.0 cm x 0.7 cm. No hydronephrosis or shadowing calculi are noted. Normal echogenicity of the spleen measuring 7.9 cm in length.Small amount of perihepatic fluid and in Morrison's pouch. | 1. Cirrhotic liver morphology with no focal hepatic lesions.2. Small amount of perihepatic fluid and in Morrison's pouch. 3. Increased echogenicity of the kidneys suggestive of or obstruction. Left renal cysts. |
Generate impression based on findings. | 39 year old female with low TSH. RIGHT LOBE MEASUREMENTS: 4.9 cm x 2.0 cm x 1.6 cmLEFT LOBE MEASUREMENTS: 5.5 cm x 1.8 cm x 1.4 cmISTHMUS MEASUREMENTS: No significant abnormality noted.RIGHT LOBE: Heterogeneous echotexture with two nodules noted, dominant nodule in the lower pole is is predominately cystic measuring 2.5 cm x 1.4 cm x 1.1 cm. The second smaller nodule is mixed solid cystic and appears spongiform in appearance. LEFT LOBE: Heterogeneous echotexture containing multiple nodules which are mixed solid cystic in appearance and containing echogenic foci with comet tail artifact most consistent with colloid nodules. Reference nodule in the lower pole measures 1.1 cm x 0.9 cm x 1.2 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 3 benign appearing lymph node measuring 0.5 cm x 0.3 cm x 1.3 cm.Additional left level 2 lymph node not containing a prominent fatty hilum measures 1.1 cm x 0.9 cm x 0.5 cm. OTHER: No significant abnormality noted. | 1. Heterogeneous thyroid gland suggestive of thyroiditis. Bilateral thyroid nodules as described above for which continued surveillance is recommended. 2. Bilateral neck lymph nodes with lymph node in the left neck not containing a prominent fatty hilum and is likely reactive. Continued surveillance is recommended. |
Generate impression based on findings. | 23 year old female with flank pain. Evaluate for urinary obstruction, lesions, stones or other abnormality. RIGHT KIDNEY: Normal echogenicity measuring 10.8 cm in length. No hydronephrosis or shadowing calculi are noted.LEFT KIDNEY: Normal echogenicity measuring 11.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Bladder is well distended with no significant abnormalities noted. | Unremarkable examination. |
Generate impression based on findings. | 42 year-old female with Murphy's, questionable wall thickness, positive stone. Evaluate for cholecystitis. LIVER: Increased 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 0.4 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Common duct measures 5 mm in thickness. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal tail of the pancreas is obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 9.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 8.2 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 6.6 cm in length. | Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No sonographic evidence of cholelithiasis or cholecystitis. |
Generate impression based on findings. | 59-year-old male. Cirrhosis. Evaluate for lesions. LIVER: Diffusely increased echogenicity and coarse echotexture of the liver consistent with fatty infiltration. No focal lesion. Liver is 19.9 cm in length.GALLBLADDER, BILIARY TRACT: Gallbladder has been surgically resected. No biliary ductal dilatation. The common duct is 5 mm in caliber, within normal limits.PANCREAS: The visualized pancreatic head is normal in echogenicity. The remainder of the pancreas is obscured by bowel gas.SPLEEN: Spleen measures 11.9 cm in length. No focal lesion identified.RIGHT KIDNEY: Right kidney is 11.3 cm in length and contains a 2.8 cm cyst. No hydronephrosis.OTHER: Left kidney is 14 centimeters in length. No hydronephrosis. | Diffuse fatty infiltration/parenchymal dysfunction of the liver without focal mass. |
Generate impression based on findings. | 33-year-old male. Bilateral maxillofacial swelling, eyelid swelling. Evaluate for lymph node calcification or swelling? Neck masses? Edematous thickening of the subcutaneous tissues of the chin without a focal mass. Benign appearing normal-sized lymph node in the right upper neck. No lymphadenopathy. | Targeted area of site of swelling in the chin demonstrated subcutaneous edema without evidence of a focal mass or lymphadenopathy. |
Generate impression based on findings. | 59-year-old female with history of bridging fibrosis. Evaluate for HCC. LIVER: Coarse echotexture of the liver measuring 18.5 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: Distal body and tail of the pancreas are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Measures 9.7 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 11.5 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 9.7 cm in length. | Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 75-year-old female with pancreatic adenocarcinoma with known liver metastases, now with abdominal swelling, evaluate for ascites. There is large four quadrant abdominal ascites. Incompletely visualized bilateral pleural effusions.Coarse echotexture and nodular contour of the visualized liver consistent with cirrhotic liver morphology. | 1. Large four quadrant abdominal ascites and bilateral pleural effusions. 2. Cirrhotic liver morphology. |
Generate impression based on findings. | 73 year old male with cirrhosis status post TIPS. Evaluate TIPS patency. LIMITED ABDOMENLIVER: Measures 13.4 cm in length with coarse echotexture and nodular contour consistent with cirrhosis. No focal hepatic lesions.BILIARY TRACT: Shadowing stones within 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.SPLEEN: Borderline enlarged spleen measuring 13.3 cm in length. RIGHT KIDNEY: Normal echogenicity of the right kidney measured 11.5 cm in length. Mid to upper pole cyst measures 2.6 cm x 3.2 cm x 3.9 cm. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 13.1 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Cirrhotic liver morphology with no focal hepatic lesions. Patent TIPS as well as hepatic inflow and outflow vasculature.2. Cholelithiasis with no evidence of cholecystitis. 3. Right renal cyst. 4. Borderline enlarged spleen. |
Generate impression based on findings. | 31-year-old female. Right upper quadrant pain. Evaluate for cholecystitis. LIVER: Normal echogenicity and echotexture of the liver. The liver is 14 cm in length. No focal hepatic lesion. Hepatopetal portal venous flow.GALLBLADDER, BILIARY TRACT: No cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Common duct is 4 mm in caliber, within normal limits.PANCREAS: Pancreas is obscured by bowel gas.KIDNEYS: Right kidney is 9.6 cm in length. Left kidney is 10.4 cm in length. No hydronephrosis.OTHER: Spleen is 8 cm in length. | No evidence of acute cholecystitis or cholelithiasis. |
Generate impression based on findings. | 25-year-old male. Complicated UTI. Chronic hydronephrosis. RIGHT KIDNEY: Severe hydroureteronephrosis with marked cortical thinning/atrophy. The kidney is 10 cm in length. No abscess is identified.LEFT KIDNEY: Severe hydroureteronephrosis with moderate cortical thinning/atrophy. The kidney is 12.8 cm in length. No abscess is identified.OTHER: Collapsed bladder with a Foley balloon. | Severe bilateral hydroureteronephrosis with associated marked cortical thinning/atrophy, greater on the right. No renal abscess is evident.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 32-year-old female with Papillary thyroid cancer. Assess lateral lymph nodes. RIGHT LOBE MEASUREMENTS: 5.5 cm x 1.6 cm x 2.2 cmLEFT LOBE MEASUREMENTS: 4.8 cm x 1.7 cm x 1.5 cmISTHMUS MEASUREMENTS: 7 mm in thicknessRIGHT LOBE: No discrete nodules identifiedLEFT LOBE: No discrete nodules identifiedISTHMUS: Conglomerate mass along the Isthmus is noted measuring 1.2 cm x 2.4 cm with lobular margins and internal echogenic foci likely microcalcifications as well as internal vascularity on Doppler exam.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small bilateral benign appearing lymph nodes in the neck.OTHER: No significant abnormality noted. | Dominant Isthmus mass as described above. No sonographic evidence of nodal metastases. |
Generate impression based on findings. | 26-year-old male. Elevated AST and ALT, elevated ACE level, lacrimal gland swelling. Evaluate liver for any changes suspicious for sarcoidosis. LIVER: Normal echogenicity of the liver, which measures 18 cm in length. No focal lesion. Hepatopetal portal venous flow.GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. Common duct is 4 mm in diameter, with the normal limits. No cholelithiasis or gallbladder wall thickening.PANCREAS: Visualized portions of the pancreatic head and neck show normal echogenicity. The rest of the pancreas is obscured by bowel gas.RIGHT KIDNEY: Normal echogenicity without focal mass. 11.3 cm in length. No hydronephrosis.OTHER: The spleen is 11.3 cm in length. Left kidney is 11.9 cm in length without hydronephrosis. | Normal appearance of the liver with no focal lesions. |
Generate impression based on findings. | 58-year-old male with transaminitis. Evaluate for liver pathology or portal vein thrombosis. Limited study due to patient body habitus.LIVER: Increased echogenicity of the liver measuring 15.9 cm in length. No focal hepatic lesions. The main portal vein is patent with appropriate directional flow: Peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Sludge within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Cannot assess for sonographic Murphy's sign. Common duct is obscured due however there is no intrahepatic biliary ductal dilatation noted. PANCREAS: Obscured by overlying bowel gas.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 11.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 14.2 cm in length.Normal echogenicity of the left kidney measuring 10.6 cm in length. No hydronephrosis or shadowing calculi are noted. | Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Portal vein is patent.Sludge within the gallbladder with no sonographic evidence of cholecystitis. |
Generate impression based on findings. | 39-year-old female with left lower quadrant palpable lipoma near hip Mild prominence of left upper thigh musculature anteriorly in comparison to the right hip/upper thigh region. No cystic or solid mass noted in this region. | Mild prominence of left upper thigh musculature with no mass identified. |
Generate impression based on findings. | 64 year old female with elevated LFTs/GGTP, evaluate for fatty liver/NASH LIVER: Normal echogenicity of the liver measuring 15.2 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. No pericholecystic fluid. Sonographic Murphy's sign is negative. 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: Normal echogenicity of the right kidney measuring 11.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 12.3 cm in length.Normal echogenicity of the left kidney measuring 12.5 cm in length. No hydronephrosis or shadowing calculi are noted. | Unremarkable examination. |
Generate impression based on findings. | 29 year-old female with recent elevated liver enzymes and epigastric abdominal pain. LIVER: Normal echogenicity of the liver measuring 13.8 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.1 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. Pericholecystic fluid. Common duct measures 2 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Measures 10.5 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 8.9 cm in length. Cyst measures 7 mm x 7 mm x 7 mm.Left kidney measures 10.8 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted. | Splenic cyst. Otherwise unremarkable examination. |
Generate impression based on findings. | 69-year-old male with jaundice, abnormal overlying. Evaluate hepatic and portal vein. LIMITED ABDOMENLIVER: Increased echogenicity of the liver measuring 17.3 cm in length. No focal hepatic lesions.BILIARY TRACT: Normal echogenicity of 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.SPLEEN: Enlarged measuring 16.4 cm in length and is normal echogenicity.RIGHT KIDNEY: Measures 11.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 10.8 cm in length. No hydronephrosis or shadowing calculi are noted. Moderate ascites. | 1. Hepatosplenomegaly with increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Patent hepatic inflow and outflow vasculature.2. Moderate ascites. |
Generate impression based on findings. | 49 year old female one year post islet cell transplant. Evaluate portal vein. LIVER: Normal echogenicity of the liver measuring 14.5 cm in length. No focal hepatic lesions. The portal vein is patent with appropriate directional flow; peak velocity measures 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. Common duct measures 7 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal body and tail are obscured by overlying bowel gas. The remaining visualized portions are unremarkable.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.2 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 9.5 cm in length. Normal echogenicity of the left kidney measuring 10.9 cm in length. No hydronephrosis or shadowing calculi are noted. | Patent portal vein. |
Generate impression based on findings. | 57 year-old female with goiter on Synthroid for suppression RIGHT LOBE MEASUREMENTS: 3.3 cm x 1.5 cm x 2.3 cmLEFT LOBE MEASUREMENTS: 4.3 cm x 1.5 cm x 1.5 cmISTHMUS MEASUREMENTS: 5 mm in thickness.RIGHT LOBE: Heterogeneous echotexture. Solid nodule again seen at the inferior pole measuring 1.7 cm x 1.3 cm x 1.1 cm, previously 0.9 cm x 1.1 cm x 1.2 cm.LEFT LOBE: Heterogeneous in echotexture with no discrete nodules identified.ISTHMUS: Nodule along the right side of the isthmus is again seen measuring 2.2 cm x 2.0 cm x 0.9 cm, previously measured 2.2 cm x 2.2 cm x 1.5 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: In the right submandibular region corresponding to the patient's palpable lump is a lymph node with normal fatty hilum measuring 2.0 cm x 0.8 cm x 1.4-cm.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with solid nodules as described above unchanged. Benign appearing lymph node in the right mandibular region corresponding to the patient's palpable lump. |
Generate impression based on findings. | 63-year-old with biopsy proven left breast cancer, left breast ultrasound requested to evaluate interval change in size of the known cancer. A targeted left ultrasound was performed. 10 o'clock position of the left breast. There is a iso-to hypoechoic, irregular mass with internal calcifications that appears unchanged from prior study, measures 3.4 x 1.5 by 3.1 cm, mostly unchanged from prior study, when it measured 3.4 x 1.5 x 3.2 cm. | No interval change in size of known left breast cancer on ultrasound.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 63 year-old male with questionable history of sarcoidosis. Evaluate liver, hepatic vein and artery. LIMITED ABDOMENLIVER: Coarse and echogenic in appearance measuring 18.3-cm in length. No focal hepatic lesions.BILIARY TRACT: Sludge and stones within the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. 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.SPLEEN: Normal in echogenicity measuring 14.9 cm in length. RIGHT KIDNEY: Measures 11.4 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.OTHER: Left kidney measures 12.1 cm in length and is normal in echogenicity. No hydronephrosis or shadowing calculi are noted.Moderate ascites. | 1. Hepatomegaly with coarse and increased echotexture suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. Patent hepatic inflow and outflow vasculature.2. Sludge and cholelithiasis with no evidence of cholecystitis.3. Moderate ascites. |
Generate impression based on findings. | 54 year old female. Left thyroid nodule. RIGHT LOBE MEASUREMENTS: 5.9 x 2.3 x 2.4 cm.LEFT LOBE MEASUREMENTS: 6.1 x 1.7 x 1.8 cm.ISTHMUS MEASUREMENTS: 0.4 cm in AP dimension.RIGHT LOBE: Nodule 1: Upper pole, mixed solid and cystic, 1.5 x 0.8 x 1 cm (previously 1.5 x 0.8 x 1.1 cm), punctate echogenic foci with ringdown artifact, most suggestive of a colloid nodule.Nodule 2: Mid/inferior pole, solid, 2.4 x 1.6 x 1.2 cm (previously 2.3 x 1.6 x 1.1 cm), previously biopsied to be a colloid nodule.LEFT LOBE: Small cystic, benign appearing focus. No suspicious nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Complex cystic lesion with a solid mural nodule just to the left of midline at the level of the hyoid bone measures 1.3 x 1.9 x 2.1 cm, previously 1.6 x 1.8 x 2.5 cm, consistent with biopsy proven papillary thyroid carcinoma. | Complex cystic solid lesion inferomedial to the left submandibular gland consistent with biopsy prove papillary thyroid carcinoma, suspected to be within a thyroglossal duct cyst, not significantly changed. Two right thyroid nodules, unchanged. |
Generate impression based on findings. | 63 year old female with history of T2N0 SCC vocal cord cancer. Right cervical palpable lymph node on exam which was marked by clinical service. In the region of palpable lesion which was marked by the clinical service in the right neck there is mild asymmetric thickening of the subcutaneous soft tissues in comparison with the left. No cystic or solid masses are identified in this region. Right thyroid hypoechoic nodule is noted measuring 9 mm x 7 mm x 6 mm. | 1. Mild subcutaneous soft tissue thickening in the region of palpable abnormality with no discrete mass identified.2. Right thyroid hypoechoic subcentimeter nodule. |
Generate impression based on findings. | 56-year-old male. Right upper quadrant tenderness. LIVER: Normal echogenicity and echotexture of the liver with no focal mass. Liver length is 18 cm.GALLBLADDER, BILIARY TRACT: No cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No biliary ductal dilatation. The common duct is 6 mm in diameter, within normal limits.PANCREAS: The visualized pancreatic head is normal in echogenicity. The remainder of the pancreas is obscured by bowel gas.RIGHT KIDNEY: Right kidney is 9.8 cm in length. No hydronephrosis or focal mass.OTHER: Spleen is 8.8 cm in length. Left kidney is 10.3 cm in length. No focal mass or hydronephrosis. | Unremarkable right upper quadrant ultrasound with no specific findings to explain patient's symptoms. |
Generate impression based on findings. | 56-year-old female with HBV, HCC screening. LIVER: Coarse echotexture of the liver measuring 14.1 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 2 mm in thickness. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Distal 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 .8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 9.6 cm in length. No hydronephrosis or shadowing foci are noted.Normal echogenicity of the spleen measuring 6.7 cm in length. | Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 71 female with right upper quadrant pain, chills, CVA tenderness. History of cholecystectomy and reported renal cyst. LIVER: Increased echogenicity of the liver measuring 14.4 cm in length. No focal hepatic lesions. Main portal vein is patent with appropriate directional flow; peak velocity measures 0.2 m/s. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common duct measures 7 mm in caliber. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Tail of the pancreas is obscured by overlying bowel gas. Visualized portions of the pancreas are unremarkable. RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.8 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the spleen measuring 7.8 cm in length. Normal echogenicity of the left kidney measuring 11.2 cm in length. No hydronephrosis or shadowing calculi are noted. | Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions. |
Generate impression based on findings. | 68 year old female with history of thyroid nodules. RIGHT LOBE MEASUREMENTS: 4.1 cm x 1.7 cm x 1.8 cmLEFT LOBE MEASUREMENTS: 4.6 cm x 1.5 cm x 1.8 cmISTHMUS MEASUREMENTS: 4 mm in thickness. RIGHT LOBE: Heterogeneous echotexture. Two hypoechoic nodules are again seen, one of which measures 3 mm x 4 mm x 2 mm at the midpole (previously 4 mm x 3 mm x 2 mm) and the other at the inferior pole measures 7 mm x 4 mm x 4 mm (previously 6 mm x 4 mm). LEFT LOBE: Heterogeneous echotexture. Three solid hypoechoic nodules are again noted. Largest at the inferior pole measures 1.4 cm x 1.6 cm x 1.2 cm, previously 1.4 cm x 1.7 cm x 1.2 cm. The remaining smaller predominantly solid nodules are not significantly changed, one of which measures 6 mm x 7 mm x 5 mm (previously 5 mm x 5 mm x 4 mm), and the other measures 5 mm x 6 mm x 6 mm (previously 4 mm x 6 mm x 3 mm). ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with bilateral thyroid nodules unchanged. |
Generate impression based on findings. | 65-year-old female with history of thyroid cancer status post surgery and I-131. Evaluate for abnormal masses. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No discrete nodules or masses are noted in the thyroidectomy bed. LEFT LOBE: No discrete nodules or masses are noted in the thyroidectomy bed. ISTHMUS: No discrete nodules or masses are noted in the thyroidectomy bed. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2 benign-appearing lymph node measures 6 mm x 4 mm x 8 mm. Left neck level 2 benign-appearing lymph node measures 0.8 cm x 0.3 cm x 1.5 cm. Additional left neck level 3 benign-appearing lymph node measures 0.4 cm x 0.3 cm x 1.6 cm.OTHER: No significant abnormality noted. | No evidence of recurrence in the thyroidectomy bed. No pathologic lymphadenopathy. |
Generate impression based on findings. | 76 year old female with family history of thyroid cancer. History of thyroid nodules, new nodule per patient report. RIGHT LOBE MEASUREMENTS: 1.9 cm x 1.5 cm x 4.1 cmLEFT LOBE MEASUREMENTS: 1.2 cm x 1.1 cm x 4.0 cmISTHMUS MEASUREMENTS: 1 mm in thickness.RIGHT LOBE: Three predominantly solid nodules are again seen. Dominant nodule at the midpole laterally measures 1.6 cm x 1.0 cm x 0.8 cm, previously measured 1.7 cm x 1.0 cm x 1.0 cm and contains echogenic foci with posterior acoustic shadowing similar to prior study. Nodule at the upper pole measures 9 mm x 8 mm x 4 mm, previously 9 mm x 8 mm x 7 mm. Nodule at the inferior pole measures 0.7 cm x 0.5 cm x 1.1 cm, previously measured 1.0 cm x 1.0 cm x 0.6 cm.LEFT LOBE: Two nodules are again seen. Predominant solid nodule at the lower pole measures 6 mm x 6 mm x 8 mm, previously 7 mm x 6 mm x 5 mm. Additional predominantly solid nodule at the lower pole measures 4 mm x 3 mm x 2 mm, previously 4 mm x 3 mm x 2 mm.ISTHMUS: Predominantly solid nodule along the right side of the isthmus measures 1.1 cm x 0.7 cm x 0.5 cm, previously 1.0 cm x 0.7 cm x 0.4 cm. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2/3 benign appearing lymph node measures 1.2 cm x 1.0 cm x 0.5 cm. Additional right neck level 2/3 benign appearing lymph node measures 1.8 cm x 1.2 cm x 0.5 cm. Left neck level 2/3 benign appearing lymph node measures 8 mm x 6 mm x 3 mm. No pathologic lymphadenopathy. OTHER: No significant abnormality noted. | Bilateral thyroid nodules unchanged. |
Generate impression based on findings. | 59-year-old male, evaluate for growth of right posterior neck mass for extension into deeper tissues, malignant features as well as tissue composition. Along the right posterior neck in the region of the palpable area is a subcutaneous heterogeneous solid mass measuring 3.9 cm x 1.9 cm. | Right posterior neck subcutaneous mass corresponding to the palpable area noted by the patient. While this has characteristics compatible with a lipoma, note that the specificity of ultrasound for characterizing subcutaneous masses is relatively poor and correlation with MRI is recommended if clinically warranted. |
Generate impression based on findings. | 42-year-old female with history of follicular thyroid cancer status post thyroidectomy. Evaluate for interval change. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: Benign-appearing lymph node in the inferior margin of the thyroidectomy bed measures 4 mm x 4 mm x 8 mm unchanged.LEFT LOBE: No discrete nodules or masses in the thyroidectomy bed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck benign-appearing level 3 lymph node measures 1.1 cm x 0.8 cm x 0.3 cm. Left neck level 2 lymph node measures 2.2 cm x 1.0 cm x 0.6 cm. Additional smaller nodules are seen. No pathology lymphadenopathy. OTHER: No significant abnormality noted. | Right thyroidectomy bed benign appearing lymph node unchanged. No regional lymphadenopathy. |