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Generate impression based on findings. | 62-year-old male with history of thyroid cancer, status post thyroidectomy. THYROID: The patient is status post thyroidectomy. RIGHT THYROIDECTOMY BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LEFT THYROIDECTOMY BED: Within the superior left thyroidectomy bed there is a 5 x 4 x 4 mm hypoechoic focus which is not clearly demonstrated on the recent prior study. No evidence of calcifications or hypervascularity. Focus is non-specific and indeterminate in appearance. The 12/05/2012 study demonstrated a similar appearing focus measuring 5 x 5 x 5 mm, however, the anatomic location cannot be confirmed with certainty. Attention to this region on subsequent follow-up imaging is recommended. ISTHMUS BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LYMPH NODES: Bilateral morphologically unremarkable and normal-sized lymph nodes are identified.PARATHYROID GLANDS: No significant abnormality noted.OTHER: At level 4 of the left side of the neck there is a 9 x 8 x 7 mm hypoechoic focus which appears to connect to adjacent vasculature, and may represent a small tributary vessel. Attention to this region on subsequent follow up is recommended. | 1. Indeterminate 5-mm focus within the superior left thyroidectomy bed, not noted on the immediate prior study, but may correspond to a 2012 study finding although the anatomic location cannot be confirmed with certainty. Attention to this area on subsequent follow-up ultrasound is recommended.2. 9-mm hypoechoic focus at level for the left side of the neck; favor a small tributary vessel as opposed to a small lymph node. Attention to this region on subsequent imaging is recommended. |
Generate impression based on findings. | 20 year-old male with acute pancreatitis and right upper quadrant pain. Evaluate for biliary duct stone or biliary ductal dilatation. LIVER: The liver is normal in morphology, echogenicity and size, measuring 18 cm in craniocaudal dimension. Normal hepatopetal portal venous blood flow with velocity measuring 20 cm/sec. No intrahepatic biliary ductal dilatation.BILIARY TRACT: A normally distended gallbladder is present without wall thickening, gallstones, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common bile duct measuring 5 mm.PANCREAS: Evaluation of the pancreas is limited to the pancreatic head due to overlying bowel gas shadowing. The visualized portion of the pancreas is unremarkable.SPLEEN: The spleen is normal in morphology, echogenicity and size, measuring 11.5 cm in length.RIGHT KIDNEY: The right kidney measures 10.5 cm in length without hydronephrosis or shadowing calculus. OTHER: The left kidney measures 12 cm in length without hydronephrosis or shadowing calculus. | No biliary ductal dilatation or other specific finding to account for the patient's right upper quadrant pain. Limited evaluation of the pancreas due to overlying bowel gas. |
Generate impression based on findings. | 61-year-old male with a reported history of papillary thyroid carcinoma in 2011, status post thyroidectomy and non-Hodgkin's lymphoma diagnosed in 2013 during lymph node dissection. THYROID: The patient is status post thyroidectomy. RIGHT THYROIDECTOMY BED: Status post thyroidectomy with no evidence of residual or recurrent disease in the right thyroidectomy bed. LEFT THYROIDECTOMY BED: Status post thyroidectomy. Within the inferior left thyroidectomy bed there is a poorly defined 1.4 x 1.3 x 1.3 cm complex hypoechoic focus that is not clearly identified on the prior outside hospital ultrasound images. This may correspond to a cluster of small lymph nodes seen on the outside hospital CT, but this cannot be reliably confirmed given the different modalities. Attention to this area is recommended on subsequent imaging.ISTHMUS BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LYMPH NODES: There are numerous bilateral enlarged cervical lymph nodes at multiple levels. Some of them demonstrate a rounded morphology. No discrete microcalcifications are identified. For future reference, the largest lymph node on the right measures 1.5 x 0.7 x 2.1 cm in superior level II of the neck. One of the regions of the patient's palpable concern is located in the submandibular area and corresponds to a conglomeration of lymph nodes, area measures approximately 2.8 x 1.7 x 2.8 cm.The largest lymph node on the left measures 1.2 x 0.8 x 2.5 cm in mid level III of the neck. | 1. Non-specific hypoechoic focus in the inferior left thyroidectomy bed may represent small lymph nodes, as seen on the outside CT exam, however this is equivocal. Attention to this region on subsequent imaging is recommended.2. Increased size and number of bilateral cervical lymph nodes, some of which demonstrate abnormal rounded morphology. This is increased from the prior comparison ultrasound. Discrete intralesional microcalcifications are not identified; for this reason, lymphoma is favored as the etiology of the bilateral lymphadenopathy given the patient's history. 3. The region of palpable concern on the right side of the neck corresponds to a conglomeration of enlarged lymph nodes. |
Generate impression based on findings. | 32-year-old female with history of papillary thyroid carcinoma status post thyroidectomy in 2011. THYROID: The patient is status post thyroidectomy. RIGHT THYROIDECTOMY BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LEFT THYROIDECTOMY BED: Status post thyroidectomy with no evidence of residual or recurrent disease. ISTHMUS BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LYMPH NODES: Bilateral morphologically unremarkable and normal-sized lymph nodes are identified, including a right level 2 lymph node measuring 0.9 x 0.3 x 1.5 cm, compared to 0.9 x 0.4 x 1.9 cm previously and a left level 4 lymph node measuring 1.0 x 0.6 x 2.1 cm, compared to 0.6 x 0.5 x 2.1 cm previously, with a prominent fatty-hilum. | No evidence of tumor recurrence or suspicious lymphadenopathy. |
Generate impression based on findings. | 64-year-old female with a history of recurrent ovarian cancer and abdominal distention. Evaluate for ascites. Targeted ultrasound was performed of the 4 abdominal quadrants to assess for ascites. There is a very small amount of fluid in the abdomen and at least small bilateral pleural effusions. | Minimal ascites and at least small bilateral pleural effusions partially seen. |
Generate impression based on findings. | 34-year-old with history of left breast carcinoma and left axillary lymph node metastases. Patient additionally has right breast DCIS. Now with palpable right axillary lymph node. Ultrasound obtained for further characterization. A targeted right ultrasound was performed of the right axilla for the palpable area of concern. A total of 6 normal-appearing lymph nodes were identified within the right axilla. No abnormal lymph nodes are seen. | No abnormal lymph nodes in the right axilla.BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 60 year-old female with a history of thyroid cancer. Status post total thyroidectomy. Evaluate for evidence of tumor recurrence and the previously seen lesion. THYROID: The patient is status post thyroidectomy. RIGHT THYROIDECTOMY BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LEFT THYROIDECTOMY BED: Stable small medial hypoechoic focus in the anterior left thyroid bed measuring 2 x 1 x 5 mm, compared to 2 x 4 x 5 mm previously, unchanged and suggestive of scarring.ISTHMUS BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LYMPH NODES: Bilateral morphologically unremarkable and normal-sized lymph nodes are identified.PARATHYROID GLANDS: No significant abnormality noted.OTHER: At level IV on the right there is an hypoechoic structure which appears to correspond to the previously described right level IV lymph node. On today's examination it appears tubular with internal blood flow on Color Doppler and in contiguity to the adjacent vasculature, most consistent with a vessel. No additional suspicious foci are identified in this region. | 1. The previously described right level IV lymph node has either resolved or corresponds to a vessel as described above. No evidence of tumor recurrence or suspicious lymphadenopathy. 2. Left thyroidectomy bed focus suggestive of a scar. |
Generate impression based on findings. | 87 year-old female with tachycardia and abnormal thyroid function tests. Evaluate for multinodular goiter. RIGHT LOBE MEASUREMENTS: 3.3 x 2.4 x 5.2 cmLEFT LOBE MEASUREMENTS: 2.3 x 2.3 x 5.9 cmISTHMUS MEASUREMENTS: 3 mm.RIGHT LOBE: There is a 2.1 x 2.4 x 2.7 cm hypoechoic interpolar solid nodule with small cystic components. There is mild internal vascularity and no definite associated calcifications. The margins are well-defined. There are numerous additional sub-5-mm nodules in the right thyroid lobe. LEFT LOBE: There is a 0.8 by 0.8 x 1.2 cm inferolateral left thyroid hypoechoic nodule with peripheral vascularity. The margins are well-defined. Punctate intralesional punctate echogenic foci, nonspecific, nonshadowing, no definite comet tail artifact. No definite flow seen within this nodule. Additional sub-5-mm nodules are scattered throughout the left thyroid lobe.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted. | 1. Indeterminate dominant 2.7 cm right thyroid nodule. Given the large size of the right thyroid nodule, further evaluation with fine needle aspiration may be considered. 2. Numerous other smaller nodules seen bilaterally. |
Generate impression based on findings. | 24 year old female with neurofibromatosis Type I with abdominal pain and nausea. LIVER: The liver is normal in morphology, echogenicity and size, measuring 15.6 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: A normally distended gallbladder is present without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common hepatic duct measuring 4 mm.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 11.4 cm.RIGHT KIDNEY: The right kidney measures 11.2 cm in length without hydronephrosis or shadowing calculus. OTHER: The left kidney measures 12.6 cm in length without hydronephrosis or shadowing calculus. | No specific findings to account for the patient's right upper quadrant pain. Please note that the pancreas is obscured by overlying bowel gas. |
Generate impression based on findings. | 68 year old female with abnormal alkaline phosphatase and lipase. History of cholecystectomy and lupus on steroids. The study was limited due to the patient's body habitus and bowel gas shadowing.LIVER: The liver parenchyma is coarse and mildly hyperechoic. The liver measures 13.9 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is also hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 3 mm. The patient is status post cholecystectomy.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen is mostly obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11.4 cm in length without hydronephrosis or shadowing calculus. OTHER: There is mild generalized body wall edema. Small amount of ascites and pleural effusions. | 1. Limited study as described above without biliary ductal dilatation.2. Heterogeneous and coarse liver parenchyma likely related to steatosis/diffuse parenchymal dysfunction.3. Trace ascites and bilateral pleural effusions. |
Generate impression based on findings. | 76 year old female with history of metastatic lung cancer. Elevation of LFTs. Evaluate for obstruction. LIVER: The liver is minimally coarsened. No discrete mass lesion is identified; this may be better characterized with CT/MRI as clinically warranted, given the presence of metastatic lesions on the CT from 05/16/2014. The liver measures 16.1 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation is identified. Normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: The common bile duct is dilated up to 10 mm and tapers smoothly to the hepatic hilum. A normally distended gallbladder is present. There is focal fundal hyperechoic thickening with associated ring-down artifact, likely representing focal adenomatosis. No gallstones, focal tenderness or pericholecystic fluid.PANCREAS: The visualized portions of the pancreatic body and head appear grossly normal.SPLEEN: The visualized portions of the spleen are unremarkable. It measures 7.6 cm in length.RIGHT KIDNEY: The right kidney measures 12.7 cm in length without hydronephrosis or shadowing calculus. 3.0-cm simple the inferior pole cyst. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11 cm in length without hydronephrosis or shadowing calculus. 1.5-cm simple appearing interpolar cyst, better characterized on prior CT. | 1. Common bile duct dilatation up to 10 mm is decreased compared to the prior CT from 12/5/2014. No intrahepatic biliary ductal dilatation is evident.2. No discrete liver mass lesion is identified; this may be better characterized with CT/MRI as clinically warranted, given the presence of metastatic lesions on the CT from 05/16/2014. 3. Focal gallbladder fundal adenomyomatosis, of no clinical significance. |
Generate impression based on findings. | 68-year-old male with hepatitis C presenting for hepatocellular carcinoma screening. LIVER: The hepatic parenchyma is mildly coarse and the liver capsule is nodular consistent with cirrhosis. No focal lesion is identified. The liver measures 15 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common bile duct measures 6 mm in caliber, within normal limits. Status post cholecystectomy.PANCREAS: No significant abnormalities noted.SPLEEN: The spleen measures 11.7 cm.RIGHT KIDNEY: The right kidney measures 13.9 cm in length without hydronephrosis or shadowing calculus. There is a 1.4-cm hypoechoic lower pole lesion, characterized as a simple cyst on the prior MRI. Color Doppler demonstrates hilar blood flow.OTHER: Status post left nephrectomy. | Cirrhotic liver morphology without a discrete hepatic lesion. |
Generate impression based on findings. | 21-year-old with history of bilateral breast fibroadenomas. Interval follow up exam to assess for stability. History of breast cancer in the patient's mother diagnosed at age 51 and the patient's maternal grandmother. A whole breast ultrasound was performed for the palpable areas of concern. In the 11 o'clock position in the right breast 1 cm from the nipple is a 1.2 x 1.3 x 1.2 centimeters (previously 1.2 x 1.1 x 1.2 cm) round nearly isoechoic mass with circumscribed margins and through transmission. At the 9 o'clock position in the right breast 3 cm from the nipple a 1.1 x 0.6 x 1.6 cm (previously 1.2 x 0.6 x 1.7 cm) oval, parallel hypoechoic mass is present.At the 3 o'clock position of the left breast 1 cm from the nipple a 0.7 x 0.4 x 0.6 cm (previously 0.7 x 0.9 x 0.4 cm) parallel hypoechoic mass is present.No significant internal vascularity is noted in any lesion. | Stable bilateral masses most likely are presenting fibroadenomata. Continued follow-up with repeat bilateral breast ultrasound in one year is recommended.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 34-year-old male with a history of hepatitis B and a gallbladder polyp. Presents for HCC screening. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16.2 cm in length. No discrete lesion is identified. No intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: A normally distended and folded over gallbladder is present. Noted again is a mildly echogenic, non-shadowing nondependent focus measuring 4 x 3 x 4 mm along the gallbladder wall, compatible with a polyp, not significantly changed in size accounting for differences in technique.No diffuse wall thickening, pericholecystic fluid, or focal tenderness.No extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreatic body and head are unremarkable.SPLEEN: The spleen is normal in morphology, echogenicity, and size, measuring 10.1 cm in length.RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | No focal hepatic lesion. Stable subcentimeter gallbladder polyp. |
Generate impression based on findings. | RIGHT LOBE MEASUREMENTS: 5.8 x 2.0 x 1.8 cmLEFT LOBE MEASUREMENTS: 6.0 x 2.6 x 4.5 cmISTHMUS MEASUREMENTS: 7 mmRIGHT LOBE: Multiple predominantly subcentimeter nodules are present. Spongiform 7 x 5 x 8 mm interpolar nodule is unchanged. Within the inferior pole in the posterior aspect of the gland is a 1.3 x 1.1 x 0.7 cm solid nodule with small cystic components with a spongiform appearance. No increased vascularity or calcifications. The margins are relatively well defined. LEFT LOBE: The left thyroid lobe is mostly replaced by a 4.8 x 2.3 x 4.1 cm complex predominantly isoechoic solid nodule. No suspicious calcifications or hypervascularity. The nodule margins are relatively well-defined.ISTHMUS: Heterogeneously thickened isthmus.PARATHYROID GLANDS: No parathyroid adenoma candidate was visualized.FINE NEEDLE ASPIRATION REPORT:OPERATORS: Doctors Patel and Trilisky; The attending physician, Dr. Patel, was present for theentire procedure.TECHNIQUE: Following a discussion of the procedure with the patient, including its risks (pain, bleeding, infection, and adequate sample), benefits, alternatives and steps to prevent infection, an informed written consent was obtained and documented in the patient's chart. The time-out form was completed to confirm patient identity and side/type of procedure.Localizing US demonstrated at the target dominant 1.3-cm inferior left pole posteriorly located nodule. The skin over the target area was cleansed with Betadine. Transducer was sterilely sheathed. Local anesthesia was obtained using 1% lidocaine, superficially and at depth. Using aseptic technique, and continuous ultrasound guidance, several attempts were made to aspirate the nodule, however, the patient expressed significant discomfort during the procedure in-spite of additional local anesthetic, the deep location of the nodule made visualization difficult and the medial to lateral approach was complicated by the patient's musculature. The procedure was discontinued with the patient's consent before adequate sampling was obtained. The patient tolerated the procedure well without immediate complications. Routine post procedure instructions were communicated to the patient.COMPLICATIONS: NoneESTIMATED BLOOD LOSS: Less than 1 cc. An adhesive bandage was placed on the patient’s skin. | 1.Multinodular goiter. The dominant left nodule was reportedly previously biopsied and confirmed to be a colloid nodule. The dominant right 1.3 cm nodule has a spongiform appearance and is felt to most likely represent a colloid nodule.2.Attempted ultrasound guided fine needle aspiration of the dominant left 1.3 cm nodule was unsuccessful due to the deep location of the nodule limiting visibility and patient discomfort as described above. |
Generate impression based on findings. | 72 old female with thyroid nodules. RIGHT LOBE MEASUREMENTS: 1.8 x 2.0 x 5.8 cmLEFT LOBE MEASUREMENTS: 1.4 x 2.5 x 5.0 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: There are numerous right thyroid lobe nodules. Most of these are nearly completely cystic with small echogenic peripheral foci compatible with colloid cysts. The largest measures 1.6 x 1.3 x 1.0 cm and contains dependent debris. The margins are well-defined without calcifications or other specific suspicious sonographic features.LEFT LOBE: The left thyroid lobe contains numerous nodules, most are nearly completely cystic with small echogenic peripheral foci, compatible with colloid cysts. There is a 1.2 x 1.1 x 1.9 cm nodule with coarse calcifications and obscured posterior margins. The visualized margins are well-defined. There is no increased vascularity. This nodule is stable to slightly decreased in size compared to the prior study (from 2003) where it measured 1.6 x 1.4 x 2.0 cm.ISTHMUS: 2.0 x 0.8 x 1.8 cm cystic colloid nodule in the right aspect of the isthmus.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically unremarkable and normal size lymph nodes are noted bilaterally.OTHER: No significant abnormality noted. | 1. Coarsely calcified 1.9-cm left thyroid lobe nodule, stable to slightly decreased in size compared to 2003, benignity is favored. 2. Multiple bilateral colloid cysts. |
Generate impression based on findings. | 25-year-old male with a history of hepatitis B. Evaluate for evidence of cirrhosis. LIVER: The liver is normal in morphology, echogenicity and size, measuring 18 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. The liver capsule is smooth. Normal hepatopetal portal venous blood flow is present at 17 cm/sec.BILIARY TRACT: Normal common duct caliber at the hilum, measuring 2 mm. Normally distended gallbladder without wall thickening, pericholecystic fluid, focal tenderness or gallstones.PANCREAS: The visualized portions of the pancreatic body and head are unremarkable. The common bile duct at the pancreatic head is normal in caliber, measuring 3 mm.SPLEEN: The spleen is mildly enlarged, measuring 12.7 cm in length.RIGHT KIDNEY: The right kidney measures 11 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | The spleen is top-normal in size which is non-specific. Otherwise, no sonographic evidence of advanced liver disease, as clinically questioned. No focal hepatic lesion. |
Generate impression based on findings. | 84 year old male with hyperbilirubinemia. The study was very limited as the patient did not want to lie flat and resisted the exam.LIVER: The liver is normal in morphology, echogenicity and size, measuring 13.2 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: A normally distended gallbladder is present with sludge but no wall thickening, pericholecystic fluid, or focal tenderness. The common duct measures 3 mm in caliber at the hilum, within normal limits.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable.SPLEEN: The spleen is poorly visualized.RIGHT KIDNEY: The right kidney measures 9.3 cm in length without hydronephrosis or shadowing calculus.OTHER: The left kidney is poorly visualized. Note is made of a moderate right pleural effusion. | 1. Limited examination as described above without biliary ductal dilatation. 2. Biliary sludge without specific evidence of acute cholecystitis.3. At least moderate right pleural effusion.4. No right hydronephrosis. Non-visualized left kidney. |
Generate impression based on findings. | 74 year old female with asymmetric swelling and tenderness of the right lower portion of the neck. Evaluate for thyroid enlargement. RIGHT LOBE MEASUREMENTS: 3.0 x 1.2 x 1.3 cmLEFT LOBE MEASUREMENTS: 3.6 x 1.5 x 1.2 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: The right thyroid lobe is normal in morphology, echogenicity, and size without a discrete nodule.LEFT LOBE: The left thyroid lobe is normal in morphology, echogenicity, and size without a discrete nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal thyroid examination. |
Generate impression based on findings. | 51-year-old male with hepatitis C. Evaluate for HCC. LIVER: The liver parenchyma is mildly increased and coarsened in echogenicity. No discrete lesion is identified. It measures 17.8 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common duct measures 5 mm in caliber, within normal limits. The patient is status post cholecystectomy.PANCREAS: The visualized portions of the pancreatic body and head are normal.SPLEEN: The spleen is normal morphology, echogenicity and size, measuring 11.8 cm in length.RIGHT KIDNEY: The right kidney measures 10.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 10.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | Mild hepatic parenchymal hyper-echogenicity suggesting underlying hepatic steatosis and/or parenchymal dysfunction. No discrete liver lesion. |
Generate impression based on findings. | 41 year old female with right upper quadrant and epigastric pain. LIVER: The liver is minimally coarse in echogenicity. There is normal hepatopetal portal venous blood flow at 20 cm/sec. The common bile duct is normal in caliber at the porta hepatis, measuring 2.5 mm. The liver is normal in size, measuring 16.6 cm in the craniocaudal dimension.BILIARY TRACT: The common bile duct at the level of the pancreas is normal in caliber, measuring 3 mm. A normally distended gallbladder is present with no wall thickening, pericholecystic fluid, focal tenderness or cholelithiasis.PANCREAS: The partially visualized pancreatic head is unremarkable. The remaining pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The poorly visualized spleen measures 7.7 cm in length, within normal limits.RIGHT KIDNEY: The right kidney measures 9.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 9.9 cm in length without hydronephrosis or other discrete abnormality. | No specific findings to account for the patient's right upper quadrant pain. |
Generate impression based on findings. | 86-year-old male with urinary retention presents for suprapubic bladder catheter placement. Ultrasound was provided during and for confirmation of suprapubic catheter placement. Preprocedural images demonstrate predominantly anechoic urine with small, echogenic foci representing debris in a normally distended bladder. After placement of the catheter the retention balloon is visualized within the lumen of the bladder. | Imaging was provided for successful suprapubic urinary bladder catheter placement. |
Generate impression based on findings. | 51 year-old female with right upper quadrant pain. LIVER: The liver is normal in morphology, echogenicity and size, measuring 13.3 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: A normally distended gallbladder is present without wall thickening, pericholecystic fluid, focal tenderness or gallstones. No extrahepatic biliary ductal dilatation with the common bile duct measuring 3 mm in caliber.PANCREAS: The visualized portions of the pancreatic body and head are normal in appearance.SPLEEN: The poorly visualized spleen measures 7 cm in length.RIGHT KIDNEY: The right kidney measures 9.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 10.7 cm in length with no hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | No gallstones or evidence of acute cholecystitis. |
Generate impression based on findings. | 69-year-old female with history of hepatitis C. Presents for HCC screening. LIVER: The liver capsule is smooth. The liver is normal in morphology and size, measuring 15.6 cm in craniocaudal dimension. There is mild coarsening of the hepatic parenchyma. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 3 mm.PANCREAS: The visualized portions of the pancreatic head and body are normal.SPLEEN: The spleen has normal morphology, echogenicity and size, measuring 9.5 cm in length.RIGHT KIDNEY: The right kidney measures 10.2 cm in length without hydronephrosis or shadowing calculus. Note is made of a 2.7-cm peripelvic simple appearing cyst. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 11.2 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | Mildly coarsened liver may represent diffuse parenchymal dysfunction. No discrete hepatic lesion. |
Generate impression based on findings. | 79-year-old male with history of childhood radiation. RIGHT LOBE MEASUREMENTS: 3.4 x 1.9 x 1.6 cmLEFT LOBE MEASUREMENTS: 3.3 x 1.9 x 1.2 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: The right thyroid lobe is normal in morphology, echogenicity, and size without a discrete nodule.LEFT LOBE: The left thyroid lobe is normal in morphology, echogenicity and size without a discrete nodule.ISTHMUS: The isthmus is normal in morphology, echogenicity and size without a discrete nodule.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal appearing thyroid. |
Generate impression based on findings. | 23-year-old female with a large right thyroid goiter. RIGHT LOBE MEASUREMENTS: 5.3 x 3.2 x 4.2 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.3 x 1.5 cmISTHMUS MEASUREMENTS: 6 mmRIGHT LOBE: The right thyroid lobe is replaced by a 2.8 x 4.6 x 4.3 cm isoechoic solid nodule with small cystic components. The nodule is vascular without any associated calcifications. The visualized margins are well defined.LEFT LOBE: The left thyroid lobe is heterogeneous and contains numerous sub-5 mm predominately hypoechoic nodules without a single dominant nodule.ISTHMUS: The isthmus is heterogeneous with numerous sub-5 mm nodules.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically unremarkable and normal sized cervical lymph nodes are noted.OTHER: No significant abnormality noted. | 1. 4.6-cm right thyroid lobe solid nodule is amenable to FNA if clinically warranted. 2. Numerous sub-5 mm hypoechoic left thyroid nodules. |
Generate impression based on findings. | 59-year-old male with hepatitis C and ascites. Evaluate for cirrhosis. LIVER: The liver parenchyma is mildly coarsened. The liver measures 18.3 cm in craniocaudal dimension. The liver capsule is nodular consistent with cirrhosis. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is normal hepatopetal portal venous blood flow at 20 cm/sec. The common bile duct is 2 mm at the hepatic hilum, within normal limits.BILIARY TRACT: A partially distended gallbladder is present with diffuse wall thickening up to 7 mm which is nonspecific in the setting of hepatitis/cirrhosis. There are no gallstones, pericholecystic fluid, or focal tenderness.The common bile duct measures 4 mm at the pancreatic head, within normal limits.PANCREAS: Limited evaluation of the pancreatic body/head is unremarkable. SPLEEN: The spleen measures 11.8 cm in length, at the upper limits of normal.RIGHT KIDNEY: The right kidney measures 7.9 cm. It is atrophic with cortical thinning and hyperechogenicity compatible with chronic medical renal disease. No hydronephrosis or shadowing calculus is identified. Color Doppler demonstrates hilar blood flow.OTHER: There is a moderate amount of ascites.The left kidney measures 7.6 cm. It is atrophic with cortical thinning and hyperechogenicity compatible with medical renal disease. Note is made of a 9-mm simple-appearing cyst. No hydronephrosis or shadowing calculus is identified. Color Doppler demonstrates hilar blood flow. | 1. Cirrhotic liver morphology without a discrete focal lesion.2. Diffuse gallbladder wall thickening is nonspecific in the setting of chronic liver disease and without associated specific findings of acute cholecystitis.3. Findings consistent with chronic medical renal disease. |
Generate impression based on findings. | 74-year-old female with history of coagulopathy, and abnormal LFTs. LIVER: The liver is mildly coarse and increased in echogenicity. There may be mild liver capsule nodularity. No focal hepatic lesion or intrahepatic biliary ductal dilatation is evident. The liver measures 12.7 cm in craniocaudal dimension. Normal hepatopetal portal venous blood flow is present at 30 cm/sec.BILIARY TRACT: A partially distended gallbladder is present with a mildly prominent wall thickness of 3.2 mm, which is likely in part due to underdistention. No pericholecystic fluid, gallstones or focal tenderness. The common bile duct is normal in caliber for the patient's age, measuring up to 7 mm.PANCREAS: Evaluation of the pancreas is limited by overlying bowel gas shadowing.SPLEEN: The spleen measures 7.2 cm in length without a focal lesion evident.RIGHT KIDNEY: The right kidney measures 8.6 cm in length without hydronephrosis. There is decreased corticomedullary differentiation. OTHER: The left kidney is decreased in size, measuring 8.2 cm in length without hydronephrosis or shadowing calculus. There is decreased of corticomedullary differentiation. Small volume ascites. | 1. Mildly coarse and echogenic liver parenchyma may represent diffuse fatty infiltration and/or parenchymal dysfunction. Possibly nodular liver contour raises the possibility of cirrhosis.2. Small volume ascites.3. Findings compatible with medical renal disease. |
Generate impression based on findings. | 71 year old female with history of primary hyperparathyroidism and thyroid nodules. RIGHT LOBE MEASUREMENTS: 3.4 x 1.4 x 1.4 cm.LEFT LOBE MEASUREMENTS: 3.7 x 1.1 x 0.9 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: There is a 1.0 x 0.7 x 1.0 cm mildly hypoechoic, solid, interpolar nodule without increased vascularity or associated calcifications. The margins are well-defined. This nodule previously measured 1.0 x 0.7 x 1.0 cm. LEFT LOBE: The left thyroid lobe is mildly heterogeneous without a discrete nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically unremarkable and normal sized bilateral cervical lymph nodes are present.OTHER: No significant abnormality noted. | Stable right 1 cm solid nodule. No additional significant interval change. |
Generate impression based on findings. | 55 year-old female with abdominal discomfort and nausea. LIVER: The liver parenchyma is mildly heterogeneous and increased in echogenicity. The liver is mildly increased in size measuring 21.2 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: A normally distended gallbladder is noted without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm.PANCREAS: The visualized pancreatic body and head are normal.SPLEEN: The spleen measures 9.2 cm in length.RIGHT KIDNEY: The right kidney measures 10.2 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. OTHER: The left kidney measures 10.5 cm in length without hydronephrosis, shadowing calculus or a discrete lesion evident. | Mildly coarsened heterogeneous liver parenchyma compatible with diffuse fat infiltration and/or parenchymal dysfunction. No focal hepatic lesion or biliary ductal dilatation. |
Generate impression based on findings. | 58 year-old female with anemia. Mildly prominent renal collecting systems on prior study. A targeted ultrasound was performed of the 4 quadrants of the abdomen and midline. There is a moderate volume of ascites. Small effusions. | Moderate volume ascites. Ultrasound is inadequate for evaluation of a retroperitoneal bleed; CT is recommended when feasible if there is continued clinical concern of a retroperitoneal bleed. |
Generate impression based on findings. | 32 year-old female with goiter. RIGHT LOBE MEASUREMENTS: 5.6 x 2.0 x 1.7 cmLEFT LOBE MEASUREMENTS: 6.0 x 1.9 x 1.5 cmISTHMUS MEASUREMENTS: 5 mmRIGHT LOBE: The right thyroid lobe is heterogeneous in echotexture with multiple sub-5 mm hypoechoic nodules with no discrete dominant nodule. LEFT LOBE: The left thyroid lobe is heterogeneous in echotexture with multiple sub-5 mm hypoechoic nodules with no discrete dominant nodule. Adjacent to the inferior aspect of the left thyroid lobe there is an 8 x 5 x 8 mm hypoechoic focus which may represent an exophytic nodular extension of the thyroid gland or an enlarged parathyroid adenoma. ISTHMUS: The isthmus is heterogeneous in echotexture with multiple subcentimeter hypoechoic nodules.PARATHYROID GLANDS: See above.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with numerous sub-5 mm hypoechoic nodules with no discrete dominant nodule. Adjacent to the inferior left thyroid lobe there is an 8-mm focus which may represent an exophytic nodular extension of the thyroid gland or a parathyroid adenoma; correlate with serum calcium and PTH. |
Generate impression based on findings. | 58-year-old male with HCV cirrhosis. Evaluate for HCC. LIVER: The liver contour is nodular and the parenchyma is moderately coarsened, consistent with cirrhosis. No discrete mass or intrahepatic biliary ductal dilatation evident. Normal hepatopetal portal venous blood flow is present at 20 cm/sec.BILIARY TRACT: The common bile duct at the level of the pancreatic head is normal in caliber, measuring 3 mm. A partially contracted gallbladder is noted with no wall thickening, pericholecystic fluid, focal tenderness or gallstones.PANCREAS: The visualized pancreatic head and body are unremarkable.SPLEEN: The spleen is mildly enlarged, measuring 13.7 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney measures 11.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 13.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.There is mild ascites. | Cirrhotic liver morphology, mild splenomegaly, and small volume ascites. No discrete liver lesion or biliary ductal dilatation. |
Generate impression based on findings. | 59-year-old female with history of kidney stones. RIGHT KIDNEY: The right kidney measures 13.1 cm in length without hydronephrosis or shadowing calculus. There is a 4.7 x 3.4 x 5.0 cm interpolar mildly complex cyst, unchanged accounting for differences in technique.LEFT KIDNEY: The left kidney measures 12.9 cm in length without hydronephrosis. There is a 1.4 x 1.6 x 1.5 cm interpolar simple appearing cyst. There are at least two shadowing echogenic foci consistent with persistent non-obstructing nephrolithiasis, the largest of which measures 1.7 cm. URINARY BLADDER: The urinary bladder is collapsed and thus poorly visualized.OTHER: No significant abnormalities noted. | Persistent non-obstructing left nephrolithiasis the largest of which measures 1.7 cm. Bilateral simple to minimally complex cysts. |
Generate impression based on findings. | 56-year-old male with upper abdominal pain. Elevated lipase consistent with pancreatitis. Evaluate for cholelithiasis. LIVER: The liver parenchyma is mildly coarsened. No intrahepatic biliary ductal dilatation is evident. The liver measures 15 cm in craniocaudal dimension. Note is made of a 2.7-cm right hepatic lobe simple-appearing cyst. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common bile duct is mildly prominent, measuring 7 mm at the hilum, unchanged. A normally distended gallbladder is noted without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 9.9 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney is malrotated as seen on the prior CT. It measures 11.1 cm in length without hydronephrosis, shadowing calculus or a discrete lesion evident. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 10.9 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. | 1. The pancreas is obscured by overlying bowel gas shadowing. 2. No evidence of cholelithiasis or acute cholecystitis as clinically questioned. 3. Stable prominence of the common bile duct. 4. Mildly coarsened hepatic parenchyma suggesting diffuse fatty infiltration and/or parenchymal dysfunction. |
Generate impression based on findings. | 76 year-old female with primary hyperparathyroidism. RIGHT LOBE MEASUREMENTS: 5.2 x 1.5 x 1.9 cmLEFT LOBE MEASUREMENTS: 4.4 x 2.1 x 1.4 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: The right thyroid lobe is heterogeneous in appearance with several spongiform nodules and sub-centimeter hypoechoic nodules. In the superior pole of the right thyroid lobe is a coarsely calcified .9 x .8 x 1.1 cm nodule whose visualized margins are well-defined. LEFT LOBE: The right thyroid lobe is heterogeneous in appearance with several spongiform nodules and sub-centimeter hypoechoic nodules. The largest nodule measures 1.3 x 0.9 x 1.1 cm in the inferior pole with a spongiform appearance, compatible with a colloid nodule. ISTHMUS: The isthmus is heterogeneous in appearance with no discrete dominant nodule. PARATHYROID GLANDS: Immediately caudal to the right thyroid lobe is a 0.9 x 0.8 x 1.1 cm hyperechoic mildly vascular focus. Similarly, there is a 1.1 x 0.6 x 0.8 cm hyperechoic avascular focus immediately caudal to the left thyroid lobe.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Hyperechogenic foci immediately caudal to the right and left thyroid lobes are non-specific and can represent focal fat; the appearance would be atypical for parathyroid adenomas. Correlation with a nuclear medicine parathyroid scan is suggested.2. Coarsely calcified 1.1-cm right superior pole nodule. Fine needle aspiration should be considered. 3. Multiple bilateral subcentimeter nodules, many of which have a characteristic spongiform appearance of colloid nodules. |
Generate impression based on findings. | Male 61 years old Reason: hydronephrosis History: hydronephrosis RIGHT KIDNEY: Kidney measures 10.7 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass. 1.4 x 1.4 x 1.0 cm exophytic anechoic lesion arising from a superior pole consistent with a simple renal cyst, unchanged from the prior CT examination.LEFT KIDNEY: Kidney measures 10.2 cm in length. There is mild/moderate hydronephrosis and hydroureter extending into the pelvis and measuring up to 1.4 cm in cross-sectional dimension. There is a shadowing hyperechoic focus in the superior pole collecting system consistent with a nonobstructing renal stone, measuring 0.7 x 1.0 x 0.6 cm. There is an additional shadowing hyperechoic focus in the proximal left ureter measuring 1.7 x 1.2 x 0.8 cm compatible with a nonobstructing ureteral stone.OTHER: No significant abnormalities noted. | 1.Mild/moderate hydronephrosis of the left kidney, with associated hydroureter extending into the pelvis, the etiology of which is uncertain.2.Nonobstructing stone in the proximal left ureter as well as the left superior pole collecting system as detailed above.3.Normal renal cortical echogenicity bilaterally. |
Generate impression based on findings. | 75-year-old female with a right-sided thyroid nodule incidentally seen on a PET/CT. RIGHT LOBE MEASUREMENTS: 4.0 x 0.9 x 1.2 cmLEFT LOBE MEASUREMENTS: 2.7 x 0.8 x 0.9 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: There is a 5 x 5 x 8 mm isoechoic solid nodule in the interpolar region with a thin hypoechoic rim and mild vascularity. No associated calcifications. Additional subcentimeter nodules are noted. Otherwise, the right lobe is normal in morphology, echogenicity, and size.LEFT LOBE: The left thyroid lobe is normal morphology, echogenicity, and size without a dominant nodule evident.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically unremarkable and normal-sized cervical lymph nodes are noted.OTHER: No significant abnormality noted. | 8mm right thyroid solid nodule without specific suspicious sonographic features. |
Generate impression based on findings. | Ms. Alston is a 69 year old female status post bilateral mastectomy in August 2014. She now presents with a palpable lump in the left lateral reconstructed breast. The physician palpated area of concern in the left lateral breast is marked. Upon physical exam, there is a palpable superficial mobile mass present.A targeted left ultrasound was performed for the palpable area of concern. There is an ovoid hyperechoic solid mass measuring 2.1 x 0.6 x 2.8 cm. This mass is not associated with any vascularity. It is superficially located. There is no suspicious solid or cystic mass identified. | Sonographic findings compatible with fat necrosis in the left lateral reconstructed breast. No sonographic evidence for malignancy. Patient may continue to follow-up with surgery as clinically warranted. All results and recommendations were relayed to the patient and Sarah Petraitis at the time of dictation.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 33-year-old female with abdominal pain. Unclear history of kidney stones. RIGHT KIDNEY: The right kidney measures 13.9 cm in length with no hydronephrosis, shadowing calculus or discrete lesion evident. Note is made of a prominent column of Bertin, symmetric bilaterally. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 13.4 cm in length with no hydronephrosis or shadowing calculus. There is a 1.4 x 1.2 x 0.8 cm hyperechoic, interpolar cortical lesion without significant associated shadowing.Note is made of a prominent column of Bertin, symmetric bilaterally. Color Doppler demonstrates hilar blood flow.URINARY BLADDER: The urinary bladder is normally distended with anechoic urine.OTHER: No significant abnormalities noted. | 1. No hydronephrosis or shadowing nephrolithiasis. 2. Nonspecific 1.4-cm left interpolar hyperechoic lesion could represent an angiomyolipoma or fat. CT could help further characterize this lesion. |
Generate impression based on findings. | 48 male with history of focal gallbladder wall thickening. LIVER: The liver is normal in morphology, echogenicity and size measuring 18 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. The liver capsule is smooth. Normal hepatopetal portal venous blood flow at 15 cm/sec is present. BILIARY TRACT: There is a normally distended gallbladder with normal wall thickness of 2 mm. Note is made of a focal thickening of the gallbladder fundus of approximately 8 mm. There is cholelithiasis but no pericholecystic fluid or focal tenderness. The common bile duct at the level of the pancreatic head is normal in caliber, measuring 4 mm. More proximally it measures 2 mm at the porta hepatis.PANCREAS: The visualized portions of the pancreatic body and head are unremarkable. SPLEEN: The spleen is normal in morphology, echogenicity, and size, measuring 11.5 cm in length.RIGHT KIDNEY: The right kidney measures 9.9 cm without hydronephrosis and contains subcentimeter simple appearing cysts. There are small collecting system foci with twinkle artifact on color Doppler compatible with nonobstructive non-shadowing calculi. OTHER: The left kidney measures 10.6 cm in length without hydronephrosis. Note is made of a 1.3-cm simple appearing parapelvic cyst. Small foci of twinkle artifact on color Doppler are compatible with nonobstructive non-shadowing calculi.Trace ascites. | 1. Cholelithiasis without focal tenderness, pericholecystic fluid or diffuse wall thickening.2. Nonspecific gallbladder fundus focal thickening. Re-evaluation in 6 months is recommended to assure stability.3. Probable bilateral nonobstructive non-shadowing calculi.4. Trace ascites. |
Generate impression based on findings. | 74-year-old female with right upper quadrant and epigastric pain. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16.6 cm in craniocaudal dimension. Note is made of a 1 x 1 x 0.7 cm right hepatic lobe echogenic lesion without posterior shadowing or enhanced through transmission. No additional hepatic lesions are identified and the liver capsule is smooth. No intrahepatic biliary ductal dilatation. There is normal hepatopetal portal venous blood flow at 20 cm/sec. The hepatic duct measures 3 mm at the porta hepatis, normal.BILIARY TRACT: There is a normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. The common bile duct at the level of the pancreatic head is normal in caliber measuring 3 mm.PANCREAS: The visualized portions of the pancreatic body and head are normal.SPLEEN: The poorly visualized spleen measures 5 cm in length.RIGHT KIDNEY: The right kidney measures 8.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: Limited evaluation of the left kidney, which measures 8.8 cm in length, shows no hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. | 1. No specific findings to account for the patient's right upper quadrant and epigastric pain, accounting for the incomplete visualization of the pancreas. 2. Incidental 1 cm right hepatic lobe lesion likely represents a benign hemangioma in the absence of chronic liver disease. If there is a history of chronic liver disease further evaluation with a dedicated liver CT and/or MRI is recommended. |
Generate impression based on findings. | 36-year-old male with history of NASH. LIVER: The liver parenchyma is moderately coarse and echogenic. It is normal in size, measuring 15.5 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal lesion is identified. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: There is a normally distended gallbladder without wall thickening, pericholecystic fluid, gallstones or focal tenderness. No extrahepatic biliary ductal dilatation with the common bile duct, measuring 2 mm.PANCREAS: The suboptimally visualized pancreatic head and body are unremarkable.SPLEEN: The spleen is normal morphology, echogenicity and size, measuring 10.6 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney measured 11.3 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 10.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | Coarse and echogenic liver parenchyma compatible with diffuse fatty infiltration without a focal lesion evident. |
Generate impression based on findings. | 47-year-old male status post LVAD with drainage around the drive line. Evaluate for fluid collection. A targeted portable ultrasound was performed of the left lower quadrant along the course of the LVAD drive line. There is no discrete fluid collection. | No discrete fluid collection. |
Generate impression based on findings. | 48-year-old male status post LVAD with drainage around the drive line. Evaluate for fluid collection. A targeted portable ultrasound was performed of the left lower quadrant along the course of the LVAD drive line. There is no discrete fluid collection. | No discrete fluid collection. |
Generate impression based on findings. | 22 year old female with left flank pain and frequency. RIGHT KIDNEY: The right kidney measures 11 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 10.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.URINARY BLADDER: The urinary bladder is normally distended with anechoic urine. No ureteral jets are visualized. | Normal sonogram of the kidneys and bladder. |
Generate impression based on findings. | 29-year-old male with abdominal distention. Evaluate for liver pathology. LIVER: The liver is normal in morphology, and echogenicity. It is borderline enlarged, measuring 20 cm in the craniocaudal dimension. No intrahepatic biliary dilatation or focal hepatic lesion is evident. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common bile duct is normal in caliber, measuring 3 mm. The gallbladder is nearly completely contracted, resulting in apparent wall thickness of 3 mm. No gallstones or focal tenderness is evident. PANCREAS: The visualized pancreatic body and head are normal.SPLEEN: The spleen is mildly enlarged, measuring 11.6 cm.RIGHT KIDNEY: The right kidney is shrunken, measuring 7 cm in length and is markedly echogenic. No hydronephrosis. Note is made of a 1.4 cm simple appearing cyst. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney has been removed.There is a moderate amount of ascites. | 1. The liver is borderline enlarged, otherwise there are no specific findings of liver disease. 2. Moderate volume ascites.3. Atrophic right kidney. |
Generate impression based on findings. | 66 year old female with a right lobe nodule. Previously biopsied and showed a follicular lesion of uncertain significance. RIGHT LOBE MEASUREMENTS: 2.3 x 2.7 x 4.9 cmLEFT LOBE MEASUREMENTS: 1.1 x 1.4 x 3.5 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: The right lobe is nearly completely replaced by a 3.5 x 2.3 x 2.7 cm isoechoic solid nodule with increased vascularity and well-defined margins. No associated calcifications.LEFT LOBE: The left thyroid lobe is normal in morphology, echogenicity, and size and contains a 5 x 4 x 2 mm superior pole hypoechoic nodule with no specific suspicious sonographic features.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 3.5-cm solid right thyroid lobe nodule. 5-mm left superior pole hypoechoic nodule with no specific suspicious sonographic features. |
Generate impression based on findings. | Elevated LFTs LIVER: Mildly coarse echogenic liver echotexture without worrisome mass. 1.9 x 2.3 x 2.4 benign cystic focus right lobe of liver. Liver length 17.5 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in length.OTHER: Spleen 10.6 cm in length. No ascites. | Mildly coarse echogenic liver echotexture suggestive for fatty infiltration without worrisome mass or ductal dilatation. No ascites. |
Generate impression based on findings. | 42 year-old female with new onset right upper quadrant pain with history of acute hepatic failure secondary to Tylenol overdose. LIVER: The liver parenchyma is coarse. There is a focal hyperechogenic geographic region measuring 5.7 cm without mass effect, compatible with focal fatty infiltration. The remainder of the liver is coarse. The liver is normal in size, measuring 16.8 cm in the craniocaudal dimension. The liver capsule is smooth. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with common bile duct measuring 4 mm at the level of the pancreatic head. A normally distended gallbladder is present with sludge. There is mild diffuse wall thickening up to 5 mm markedly improved from the prior study. There may be a small amount of pericholecystic fluid, but no focal tenderness.PANCREAS: The visualized pancreatic head and body are normal.SPLEEN: The spleen measures 10.8 cm without a focal abnormality evident.RIGHT KIDNEY: The right kidney measures 14-cm in length with no hydronephrosis, shadowing calculus or discrete lesion evident. Echogenic cortex. OTHER: The left kidney measures 12.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Echogenic cortex.There is a trace amount of ascites. Small left pleural effusion. | 1. Gallbladder sludge, moderate yet improved diffuse gallbladder wall thickening without focal tenderness; overall, these findings are not specific for acute cholecystitis. 2. Coarse hepatic parenchyma with suspected focus of focal fatty infiltration is compatible with diffuse parenchymal dysfunction. 3. Trace ascites. Small left pleural effusion. 4. Echogenic renal cortices compatible with medical renal disease. |
Generate impression based on findings. | 68 year-old male with a history of cholestasis and TPN. LIVER: The liver parenchyma is mildly coarsened. It is normal in size, measuring 19 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The gallbladder is distended and contains sludge and small gallstones. There is no wall thickening, pericholecystic fluid or focal tenderness. The common bile duct is normal in caliber at the pancreatic head, measuring 4 mm.PANCREAS: The visualized portions of the pancreatic head and body are normal.SPLEEN: The spleen measures 10.6 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney measures 12.6 cm in length without hydronephrosis or shadowing calculus. There is a lobulated multiseptated lower pole cystic lesion measuring 2.9 x 2.2 x 3.3 cm, as seen on the prior CT, likely a minimally complex cyst. OTHER: The patient is status post left nephrectomy. | Dilated gallbladder with cholelithiasis and biliary sludge without specific findings of acute cholecystitis. |
Generate impression based on findings. | 32-year-old female with right upper quadrant pain and nausea. History of lung cancer and prior liver metastases. LIVER: The liver parenchyma is moderately coarsened and hyperechogenic. It is normal in length, measuring 14.8 cm in length. No intrahepatic biliary ductal dilatation or focal hepatic lesion is identified. Normal hepatopetal portal venous blood flow at 22 cm/sec.BILIARY TRACT: No biliary ductal dilatation with the common bile duct measuring 4 to 5 mm. A normally distended gallbladder is seen without gallstones, wall thickening, pericholecystic fluid, or focal tenderness.PANCREAS: The suboptimally visualized pancreatic body and head are unremarkable.SPLEEN: The spleen measures 10.5 cm in length without a discrete focal abnormality.RIGHT KIDNEY: The right kidney measures 10.9 cm in length without hydronephrosis or shadowing calculus. Color Doppler demonstrates hilar blood flow. OTHER: There is a small right pleural effusion. The left kidney is suboptimally visualized without hydronephrosis. It measures approximately 8.3 cm in length.There is trace ascites in the right upper quadrant. | 1. Findings suggesting diffuse fatty infiltration and/or parenchymal hepatic dysfunction.2. No specific findings to account for the patient's right upper quadrant pain.2. Trace ascites and a small right pleural effusion. |
Generate impression based on findings. | 68 year old female with HCV. Evaluate for cirrhosis or HCC. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16 cm in the craniocaudal dimension. The liver capsule is smooth. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. There is normal hepatopetal portal venous blood flow at 19 cm/sec.BILIARY TRACT: A normally distended gallbladder is present without gallstones, wall thickening, pericholecystic fluid, or focal tenderness.No extrahepatic biliary ductal dilatation with the common bile duct measuring 5 mm.PANCREAS: The visualized pancreatic head is unremarkable. SPLEEN: The spleen measures 7.7 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney measures 12 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. OTHER: The left kidney measures 10.4 cm without hydronephrosis, shadowing calculus, or discrete lesion evident. | No focal hepatic lesion or specific stigmata of cirrhosis. |
Generate impression based on findings. | 57-year-old female with a history of stem cell transplant. Now with transaminitis. LIVER: The liver is minimally coarsened. It measures a 18.8 cm in craniocaudal dimension. No focal hepatic lesion or intrahepatic ductal dilatation is evident. There is normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: There is a normally distended gallbladder with a 4-mm non-shadowing nondependent focus which may represent a small adherent gallstone or polyp. No extrahepatic biliary ductal dilatation with the common bile duct measuring 4 mm at the pancreatic head.PANCREAS: The visualized pancreatic head and body are normal.SPLEEN: Marked splenomegaly, measuring 19 cm in length.RIGHT KIDNEY: The right kidney measures 9.5 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 10.2 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. | 1. Coarse echogenic liver echotexture suggests chronic liver disease/parenchymal dysfunction without a discrete mass or biliary ductal dilatation.2. Small adherent gallstone versus subcentimeter gallbladder polyp.3. Marked splenomegaly. |
Generate impression based on findings. | 40 year old female with history of cervical cancer. Elevated creatinine and history of hydronephrosis. RIGHT KIDNEY: The right kidney measures 14.5 cm in length. There is moderate hydronephrosis, increased from the prior studies. No shadowing calculus or discrete lesion is evident. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 14.4 cm in length with minimal collecting system prominence, similar to the prior study. Color Doppler demonstrates hilar blood flow. No focal lesion or shadowing calculus is identified.URINARY BLADDER: The urinary bladder is partially distended. No ureteral jets are visualized.OTHER: No significant abnormalities noted. | Moderate right hydronephrosis has slightly progressed and minimal left collecting system prominence is similar to the prior study.These findings were relayed to the ordering service (Dr. Hassenfritz) at 1010 on 01/07/2015. |
Generate impression based on findings. | 74-year-old male with a family history of abdominal aortic aneurysm. The proximal, mid, and distal aorta measure 1.9, 1.8 and 1.6 cm in AP dimension. The right and left common iliac arteries measure 1.1 and 1.3 cm in AP dimension.Atherosclerotic calcification is noted. | No evidence of aneurysmal dilatation of the aorta. |
Generate impression based on findings. | 43 year-old male with obesity and transaminitis. LIVER: The liver is mildly coarsened and increased in echogenicity. It is normal in size, measuring 15 cm in the craniocaudal attention with no intrahepatic biliary ductal dilatation or focal hepatic lesion evident. The liver capsule is smooth. Normal hepatopetal portal venous blood flow at 24 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 6 mm at the level of the pancreatic head. Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid, or focal tenderness.PANCREAS: The poorly visualized pancreatic head is grossly unremarkable. SPLEEN: The spleen measures 11.2 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 10.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. OTHER: The left kidney measures 10.6 cm without hydronephrosis, shadowing calculus or discrete lesion evident. | Coarse echogenic liver parenchyma most commonly seen in diffuse fatty infiltration without a discrete lesion or biliary ductal dilatation. |
Generate impression based on findings. | 32 year-old female with right upper quadrant pain. Evaluate for abscess underneath right upper quadrant incision. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16 7 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: A 1.3 cm mobile gallstone is noted in a normally distended gallbladder without wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary duct dilatation with the common bile duct measuring up to 3 mm.PANCREAS: The visualized pancreatic head and body are unremarkable.SPLEEN: The spleen measures 10.5 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 10.2 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: Targeted ultrasound was performed of the right upper quadrant incision site and demonstrates no discrete fluid collection.The left kidney measures 10.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | Cholelithiasis without evidence of acute cholecystitis. No fluid collection at the site of the patients right upper quadrant incision. |
Generate impression based on findings. | 55-year-old male with a history of brain cancer in remission. Smoking. Presents with left neck palpable abnormality. Targeted ultrasound was performed of the patient's left neck palpable abnormality. The abnormality corresponds to an asymmetric prominence of the tubercle of the left greater cornu of the hyoid bone when compared to the right. There is no soft tissue abnormality or lymphadenopathy. | The palpable abnormality corresponds to an asymmetric prominence of the tubercle of the greater cornu of the hyoid bone; of no clinical significance. No soft tissue mass or lymphadenopathy. |
Generate impression based on findings. | 73 year-old female with right lower quadrant pain. Evaluate for fluid. The study was limited by the patient's body habitus. Targeted evaluation of the 4 abdominal quadrants demonstrates no significant fluid. | No significant peritoneal fluid. |
Generate impression based on findings. | 51 year old female with elevated PTH and calcium. RIGHT LOBE MEASUREMENTS: 1.5 x 2.5 x 5.9 cmLEFT LOBE MEASUREMENTS: 1.2 x 2.5 x 5.4 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: The right thyroid lobe is normal in morphology, echogenicity and size without a discrete dominant nodule.LEFT LOBE: The left thyroid lobe background parenchyma is normal in echogenicity. There is a 1.4 x 0.9 x 0.6 cm superior pole solid hypoechoic nodule with well defined margins. No hypervascularity or associated calcifications. Additional, 8 x 5 x 7 mm inferior pole hypoechoic nodule with minimal vascularity and well-defined margins. No associated calcifications. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Immediately dorsal to the inferior pole of the left thyroid lobe is a 1.1 x 0.7 x 1.4 cm hypoechoic lesion without significant vascularity which may represent a parathyroid adenoma. LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. 1.4 cm lesion immediately dorsal to the inferior pole of the left thyroid lobe may represent a parathyroid adenoma; correlate with nuclear medicine study.2. 1.4 cm left thyroid lobe solid indeterminate nodule. |
Generate impression based on findings. | 57-year-old male with HCV cirrhosis. Evaluate for HCC. LIVER: The liver parenchyma is moderately coarsened and nodular in contour. It is normal in size, measuring 19.4 cm in the craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 5 mm at the level of the pancreatic head. The gallbladder is full of gallstones, but does not appear significantly distended. There is no wall thickening, pericholecystic fluid, or focal tenderness.PANCREAS: The visualized pancreatic head is unremarkable.SPLEEN: The spleen is mildly enlarged, measuring 13.5 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 11.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 12.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.No significant ascites. | 1. Cirrhotic liver morphology, and mild splenomegaly. No biliary ductal dilatation or focal hepatic lesion.2. Partially contracted gallbladder filled with gallstones. |
Generate impression based on findings. | 70 year-old male with acute kidney injury and possible urinary tract infection. RIGHT KIDNEY: The right kidney measures 12.6 cm in length. There is moderate hydronephrosis and moderate proximal hydroureter. The middle and distal ureter is not visualized. No shadowing calculus or focal renal lesion is evident. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 11.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow.URINARY BLADDER: The urinary bladder is partially distended with anechoic urine. Ureteral jetsOTHER: No significant abnormalities noted. | Moderate right hydroureteronephrosis of uncertain chronicity and etiology.Findings were relayed to primary service (Anderson @ pager 6918) at 1415 on 01/07/2015. |
Generate impression based on findings. | 35 year old female with right upper quadrant pain. The examination is limited and suboptimal due to the patient's body habitus.LIVER: The liver parenchyma is moderately coarse. The liver measures 20 cm in the craniocaudal length. No focal hepatic lesion or intrahepatic biliary ductal dilatation is evident. Normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: A normally distended gallbladder is identified without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common bile duct measuring 4 mm.PANCREAS: Limited evaluation of the pancreatic head and body is grossly unremarkable.SPLEEN: The spleen measures 11 cm in length without a discrete focal abnormality.RIGHT KIDNEY: The right kidney measures 12.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 13 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | Slightly limited study with no specific findings to account for the patient's right upper quadrant pain. Coarsened hepatic parenchyma may represent diffuse fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | 52-year-old female with history of thyroid nodule. RIGHT LOBE MEASUREMENTS: 1.6 x 1.8 x 4.0 cmLEFT LOBE MEASUREMENTS: 0.9 x 1.5 x 3.7 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: 5-mm hypoechoic solid inter-polar nodule without specific suspicious sonographic features. Otherwise, the background thyroid gland is minimally coarse.LEFT LOBE: The left thyroid lobe is minimally coarse without a dominant nodule.ISTHMUS: Within the right aspect of the isthmus is a 1.5 x 1.0 x 1.9 cm complex solid and cystic lesion without associated microcalcifications, or vascularity. The contour is slightly lobulated. The appearance and size is relatively stable.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Relatively stable 1.9-cm right Isthmus complex solid and cystic lesion is amenable to FNA if clinically warranted. |
Generate impression based on findings. | 47 year old female with acute on chronic kidney disease. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.9 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. The renal cortex is moderately hyperechogenic. Color Doppler demonstrates hilar blood flow.LEFT KIDNEY: The left kidney measures 10.3 cm in length without hydronephrosis or shadowing calculus. Note is made of a 1.3-cm superior pole near anechoic lesion, probably a benign cyst. The renal cortex is moderately hyperechogenic. Color Doppler demonstrates hilar blood flow.URINARY BLADDER: The urinary bladder is normally distended with anechoic urine. | No hydronephrosis. Findings compatible with medical renal disease. |
Generate impression based on findings. | 65-year-old male with gram-negative rod sepsis. Evaluate for biliary cause. LIVER: The liver is mildly coarse in echogenicity. It is normal in size measuring 15.8 cm in the craniocaudal dimension. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. Normal hepatopetal portal venous blood flow at 31 cm/sec.BILIARY TRACT: A normally distended gallbladder is present without wall thickening, or pericholecystic fluid. Evaluation for focal tenderness is limited by the patient's mental status.Minimal sludge and possible non-shadowing gallstone.No extrahepatic biliary ductal dilatation, measuring 4 mm.PANCREAS: The visualized pancreatic body and head are unremarkable. There is mild dilatation of the pancreatic duct, measuring 3 mm. There may be a small amount of peripancreatic fluid posteriorly, correlate with lipase.SPLEEN: The spleen measures 10.2 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 11.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident.OTHER: The left kidney measures 11.5 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow.Bilateral pleural effusions are noted. | 1. Biliary sludge and possible gallstone without other specific findings of acute cholecystitis, given the limited evaluation for focal tenderness in the patient's current state.2. Mild pancreatic ductal dilatation and possible peripancreatic fluid. Correlate with lipase.3. No biliary ductal dilatation.4. Bilateral pleural effusions. |
Generate impression based on findings. | Ms. Rush is a 20 year old female presenting with a physician-detected a "mole" in the right breast. She has a family history of breast cancer in her mother (diagnosed at age of 29). Upon physical examination, a small mole is seen in the right inferior breast. No discrete mass is appreciated underneath this mole.A targeted right ultrasound was performed for the patient’s area of concern. In the right inferior breast, 6 o'clock position, no suspicious cystic or solid mass is identified. Inferior to the skin lesion, there was a simple cyst measuring 2 mm. | No sonographic evidence for malignancy. Patient should follow-up with her primary physician as clinically warranted. In addition, given the strong family history, a consideration into initiating surveillance mammography and MRI starting at the age of 25 should be made. All results and recommendations were relayed to the patient.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 28-year-old male with hepatitis B. Evaluate for cirrhosis and HCC. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16.5 cm in length. The liver capsule is smooth. No focal lesion or intrahepatic biliary ductal dilatation is evident. Normal hepatopetal portal venous blood flow at 30 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm. A normally distended gallbladder is present without wall thickening, gallstones, pericholecystic fluid or focal tenderness.PANCREAS: The poorly visualized pancreatic body and head are unremarkable.SPLEEN: The spleen measures 10.8 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 10.8 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | No focal hepatic lesion or specific stigmata of cirrhosis. |
Generate impression based on findings. | 73 year-old male with renal insufficiency. RIGHT KIDNEY: The right kidney measures 9.1 cm in length without hydronephrosis or shadowing calculus. Note is made of a 9 mm simple appearing interpolar cyst. Color Doppler demonstrates hilar blood flow. The renal cortex is moderately echogenic.LEFT KIDNEY: The left kidney measures 9.0 cm without hydronephrosis or shadowing calculus. Note is made of a 1 cm near anechoic lesion likely benign cyst. Color Doppler demonstrates hilar blood flow. The renal cortex is moderately echogenic.URINARY BLADDER: Minimally distended bladder with a presumed Foley, correlate clinically with appropriate positioning. | 1. No hydronephrosis.2. A compatible medical renal disease.3. Presumed Foley is poorly visualized; correlate clinically with appropriate functioning. |
Generate impression based on findings. | 87-year-old male with acute on chronic kidney disease. RIGHT KIDNEY: The right kidney measures 10.4 cm in length without hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. The renal cortex is thinned and echogenic.LEFT KIDNEY: The left kidney measures 9.9 cm in length without hydronephrosis or shadowing calculus. There is a 2.9 x 2.8 x 2.7 cm nearly anechoic, partially septated cystic lesion, likely a septated cyst. Color Doppler demonstrates hilar blood flow. The renal cortex is thinned and echogenic.URINARY BLADDER: The urinary bladder is normally distended with anechoic fluid. There may be mild wall thickening.OTHER: No significant abnormalities noted. | No hydronephrosis. Medical renal disease. Probable septated left renal cyst. |
Generate impression based on findings. | 70 year-old female with autoimmune hepatitis and cirrhosis, evaluate for HCC. LIVER: The liver parenchyma is coarsened and mildly nodular, compatible with cirrhosis. No focal hepatic lesion is evident. It is normal in size, measuring 18 cm in the craniocaudal dimension. There is normal hepatopetal portal venous blood flow with velocity measure 25 cm/sec.GALLBLADDER, BILIARY TRACT: A normally distended gallbladder is present with minimal sludge and mild diffuse wall thickening, but no reported focal tenderness or pericholecystic fluid.No extrahepatic biliary duct dilatation with the common bile duct measuring up to 5 mm at the porta hepatis.PANCREAS: The poorly visualized pancreatic body and head are grossly unremarkable.RIGHT KIDNEY: The right kidney measures 10.1 cm in length without hydronephrosis.OTHER: Note is made of a small echogenic shadowing focus, in the region of the anterior wall of the splenic vein at the level of the pancreatic body head junction, of uncertain clinical significance. The left kidney measures 8 cm in length without hydronephrosis.The poorly visualized spleen measures approximately 8 cm. | 1. Cirrhotic liver morphology without definite focal lesion. 2. Gallbladder sludge without specific evidence of acute inflammation. |
Generate impression based on findings. | 58 year old female with a history of abdominal pain, evaluate for gallstones. LIVER: The liver parenchyma is minimally coarse. The liver capsule is smooth. It is normal in size, measuring 15 cm in the craniocaudal dimension. No focal lesion or intrahepatic biliary ductal dilatation. There is normal hepatopetal portal venous blood flow with velocity measuring 20 cm/sec.GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 3 mm at the pancreatic head. Normally distended gallbladder without wall thickening, pericholecystic fluid, gallstones, or focal tenderness.PANCREAS: The visualized pancreatic body and head are unremarkable.RIGHT KIDNEY: The right kidney measures 9.7 cm without hydronephrosis.OTHER: The left kidney measures 10.8 cm without hydronephrosis. The spleen measures 10 cm in length. | 1. No gallstones or other specific findings to account for the patient's right upper quadrant pain.2. Minimally coarse liver parenchyma, may reflect diffuse fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | 32-year-old male with a provided history of left-sided thyroid nodule and papillary thyroid cancer. RIGHT LOBE MEASUREMENTS: 1.9 x 2.1 x 5.6 cmLEFT LOBE MEASUREMENTS: 1.7 x 1.9 x 5.1 cmISTHMUS MEASUREMENTS: 1 mmRIGHT LOBE: The right thyroid parenchyma is normal in morphology, echogenicity, and size.LEFT LOBE: Seen again in the inferior left thyroid lobe is a 1.4 x 1.2 x 1.5 cm hypoechoic nodule with associated coarse and micro-calcifications, posterior shadowing and lobulated margins. In the medial aspect of the inferior left thyroid lobe is a 6 x 4 x 6 mm very hypoechoic nodule without significant vascularity or definite calcifications.In the lateral aspect of the inferior left lobe is a 5 x 4 x 4 mm hypoechoic nodule without significant vascularity or definite calcifications.The background thyroid parenchyma is normal in echogenicity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a suspicious left level 4 lymph node measuring 9 x 7 x 9 mm with a round morphology, mild vascularity and possible non-shadowing microcalcifications.Right level 4 lymph node measuring 8 x 3 x 5 mm is oval shaped with a probable fatty hilum.Right level 2 lymph node measuring 6 x 3 x 5 mm, is oval-shaped with a probable fatty hilum although underlying non-shadowing microcalcifications cannot be entirely excluded. | 1. 1.5 cm left thyroid nodule with features consistent with provided history of papillary thyroid carcinoma. Additional left indeterminate subcentimeter nodules. 2. Left level 4 lymph node is suspicious for nodal metastatic disease. 3. Right sided lymph nodes, with benign-favoring appearance, see above. |
Generate impression based on findings. | 47-year-old female with hematuria. RIGHT KIDNEY: The right kidney measures 9.5 cm in length without hydronephrosis or shadowing calculus. No discrete lesion is evident.LEFT KIDNEY: The left kidney measures 10.2 cm in length without hydronephrosis or shadowing calculus. No discrete lesion is evident.URINARY BLADDER: The urinary bladder is partially distended with anechoic urine. No ureteral jets are visualized.OTHER: Incidental note is made of a rounded hyperechoic right hepatic lobe lesion measuring 2.8 x 1.9 x 2.6 cm. | 1. No hydronephrosis or shadowing calculus.2. Incidental note is made of a 2.8 cm right hepatic lobe hyperechoic rounded lesion. Although this likely represents a benign hemangioma in the absence of chronic liver disease, confirmation with a dedicated liver CT exam or MRI is suggested. |
Generate impression based on findings. | Ms. Williams is a 19 year old female presenting with a palpable mass in the right breast. Per patient, she has felt it for the past one week. No history of trauma or pain. Upon physical exam at the patient's area of concern, a vague mobile nodular mass is appreciated. A targeted right breast ultrasound was performed for the palpable area of concern. In the right breast, 5:00 position, no suspicious cystic or solid was identified. Normal dense parenchymal breast tissue was identified. | No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted. All results and recommendations were relayed to the patient.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 50 year-old male with increasing liver function tests and right upper quadrant pain. Evaluate for gallstones and cholecystitis. LIVER: The liver is mildly coarse in echogenicity without a focal hepatic lesion or intrahepatic biliary ductal dilatation evident. Liver measures 18.8 cm in craniocaudal dimension. There is a small amount of perihepatic ascites.Normal hepatopetal portal venous blood flow at 19 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring up to 3 mm. There is a normally distended gallbladder with mild diffuse wall thickening of approximately 5 mm, which is nonspecific in the setting of ascites. There is gallbladder sludge. Mild focal tenderness reportedly over the gallbladder fossa is present although the patient is diffusely tender.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 9.3 cm in length without a discrete abnormality.RIGHT KIDNEY: The right kidney measures 10.9 cm in length without hydronephrosis or shadowing calculus evident. OTHER: The left kidney measures 10.5 cm without hydronephrosis or shadowing calculus evident.Incompletely imaged left pleural effusion and small volume ascites. | 1. Gallbladder sludge and mild diffuse gallbladder wall thickening is nonspecific in the setting of ascites, and focal tenderness over the gallbladder fossa is also nonspecific in the setting of reportedly diffuse abdominal tenderness. If there is continued clinical concern for acute cholecystitis, a nuclear medicine HIDA scan should be considered.2. Mildly coarse hepatic echogenicity may represent diffuse fatty infiltration/parenchymal dysfunction.3. Partially visualized left pleural effusion and small volume ascites. |
Generate impression based on findings. | History of poorly differentiated invasive ductal carcinoma of the left breast. Patient received neoadjuvant chemotherapy. Palpable mass in the left breast has recently increased in size. Please evaluate. Note is made that the patient is on Lovenox with marked bruising of the abdomen. History of breast cancer in 3 maternal aunts and two maternal cousins. LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views, an additional MLO view and 2 spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A triangular marker was placed on the skin at the site of palpable mass. Near the 6 o'clock position of the left breast, a 4.5 x 3.2 x 5.5 cm lobulated mass is present containing a percutaneous clip and malignant calcifications. On the most recent mammogram, the mass measured 2.4 x 2.1 x 2.9 cm. On the mammogram of 8/6/2014, the mass measured 4.3 x 4.0 x 4.7 cm. Arterial calcifications are present. The left axilla is obscured by a cardiac generator device.LEFT BREAST ULTRASOUND: On physical examination, the patient has a 4 cm palpable mass at the 6 o'clock position of the left breast. The skin overlying the mass is ecchymotic. A focused left breast ultrasound was performed. At the 6 o'clock position of the left breast, 4 cm from the nipple, a 3.2 x 2.2 x 3.8 cm lobulated hypoechoic mass is present containing in Hydromark clip. Previous measurements on 10/28/2014 were 2.4 x 1.9 x 2.6 cm. On 8/6/2014 the measurements were 4.2 x 3.7 x 2.9 cm. | Interval increase in the size of biopsy proven carcinoma at the 6 o'clock position of the left breast. Given the history of Lovenox and overlying bruising, a portion of the size increase may be due to internal hematoma. Results were discussed with the patient and her daughter.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Biopsy proven left breast invasive ductal carcinoma and DCIS. Patient has been treated with an aromatase inhibitor. Please evaluate for interval changes. On physical examination, no palpable masses were present of the left breast. A targeted left breast ultrasound was performed for the area of clinical concern. At the 12 o'clock position of the left breast, 3 cm from the nipple, a Hydromark clip is present. Previously described 19 x 15 mm mass is significantly smaller, currently measuring 9 x 5 mm. | Interval decrease in the size of left breast biopsy proven cancer. Results were discussed with the patient and her daughter.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 34 year old male with right anterior cervical enlarged lymph node. A targeted ultrasound exam was performed of the patient's right anterior neck, at the site of palpable abnormality. In the right neck, at level 1, there is a corresponding 2.0 x 1.5 x 0.6 cm lymph node with a normal oval morphology and a fatty hilum. No cystic component or associated calcifications. Additional morphologically unremarkable and normal sized cervical lymph nodes are noted. Limited evaluation of the thyroid is normal. | Slightly prominent but morphologically normal appearing right level 1 lymph node. Benign etiology is favored as lymph nodes at this level may normally be prominent. Alternatively, node may be reactive in etiology. |
Generate impression based on findings. | 45 year-old male with persistently mildly elevated LFTs. LIVER: The liver is coarse, echogenic with decreased through transmission, limiting evaluation for a focal lesion. Given this limitation, there is no focal lesion or intrahepatic biliary ductal dilatation. Liver measures 21.4 cm in craniocaudal dimension. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. No extrahepatic biliary ductal dilatation with the common bile duct measuring 2 mm.PANCREAS: The suboptimally visualized pancreatic body and head are grossly unremarkable.SPLEEN: The spleen is mildly enlarged, measuring 14.1 cm in length.RIGHT KIDNEY: The right kidney measures 13.7 cm in length without hydronephrosis. OTHER: The left kidney measures 13.3 cm in length without hydronephrosis. | 1. Hepatomegaly and findings compatible with severe diffuse fatty infiltration of the liver. 2. Mild splenomegaly. |
Generate impression based on findings. | 57-year-old female with a history of thyroidectomy many years prior for goiter, uncertain if partial or complete. Evaluate for residual thyroid tissue. RIGHT LOBE MEASUREMENTS: 2.2 x 2.7 x 5.6 cmLEFT LOBE MEASUREMENTS: Status post left thyroidectomy.ISTHMUS MEASUREMENTS: NoneRIGHT LOBE: The right thyroid lobe echotexture is mildly coarse with a 0.9 x 0.9 x 1.1 cm anechoic cystic nodule, most likely benign. LEFT LOBE: No residual left thyroid lobe tissue.ISTHMUS: No residual isthmus tissue.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post left thyroidectomy. The right thyroid lobe contains a 1.1-cm cystic nodule, most likely benign. |
Generate impression based on findings. | 82-year-old female with sepsis. Evaluate the liver and gallbladder. LIVER: The liver measures 14.2 cm in length. It is mildly coarse and echogenic. No intrahepatic biliary ductal dilatation or focal hepatic lesion is evident. Normal hepatopetal portal venous blood flow at 23 cm/sec.GALLBLADDER, BILIARY TRACT: A normally distended gallbladder is present with mild diffuse wall thickening/pericholecystic fluid measuring 4.3 mm without gallstones. Evaluation for focal tenderness was limited due to the patient's decreased awareness. No extrahepatic biliary ductal dilatation with the common bile duct measuring 5 mm.PANCREAS: The suboptimally visualized pancreatic body and head is grossly unremarkable.SPLEEN: The poorly visualized spleen measures 7 cm in length.KIDNEYS: The right kidney measures 9.6 cm in length without hydronephrosis. The left kidney measures 9.6 cm without hydronephrosis.ABDOMINAL AORTA: Only the proximal aorta is visualized and is not aneurysmally dilated, measuring 2.2 cm in AP dimension.INFERIOR VENA CAVA: The visualized inferior vena cava is patent. | 1. Normally distended gallbladder with mild diffuse wall thickening/pericholecystic fluid. Evaluation for focal tenderness was unreliable given the patient's decreased awareness. Overall, there is no specific evidence of acute cholecystitis. If there is continued clinical concern, a HIDA scan may be considered.2. Coarse and mildly echogenic liver parenchyma may represent diffuse fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | 39-year-old male with right testicular cyst. RIGHT TESTIS: The right testis is normal in morphology, echogenicity and size, measuring 2.5 x 2.9 x 5.2 cm. Spectral Doppler evaluation demonstrates normal flow. There are a few microliths without a discrete parenchymal lesion. LEFT TESTIS: The left testis is normal in morphology, echogenicity, and size, measuring 2.0 x 3.1 x 5.6 cm. Spectral Doppler demonstrates normal flow. There are a few microliths without a discrete parenchymal lesion. RIGHT EPIDIDYMIS: The right epididymis is unremarkable.LEFT EPIDIDYMIS: The left epididymis is unremarkable.OTHER: There are bilateral moderate degree varicoceles. | 1. Bilateral varicoceles as above.2. Scattered testicular microlithiasis without a discrete focal soft tissue lesion. |
Generate impression based on findings. | 48-year-old male status post LVAD with drainage around the drive line. Evaluate for fluid collection. A targeted portable ultrasound was performed of the left lower quadrant along the course of the LVAD drive line. There is no discrete fluid collection. | No discrete fluid collection. |
Generate impression based on findings. | 77-year-old male with elevated LFTs and renal failure. LIVER: The liver measures 18.2 cm in the craniocaudal dimension. There appears to be periportal cuffing. The liver contour is relatively smooth. The parenchyma is mildly coarsened. No focal hepatic lesion or intrahepatic biliary ductal dilatation. Normally oriented portal venous blood flow at 50 cm/sec is slightly pulsatile, which may be seen in the setting of right-sided heart failure. GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring up to 4 mm. No gallstones are evident, however, the gallbladder is distended with moderate diffuse gallbladder wall thickening and pericholecystic fluid, findings that are nonspecific in the setting of ascites. PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen is moderately enlarged, measuring 15.6 cm in length without a discrete abnormality.KIDNEYS: The right kidney measures 12.8 cm in length without hydronephrosis. Note is made of a 2.3 x 2.1 x 2 x 1 cm multiseptated cystic lesion with calcification suspected in the septi. The left kidney is suboptimally visualized, measures 12.8 cm in length without hydronephrosis. There is a 1.5 cm interpolar simple appearing cyst. The renal cortices are mildly hyperechogenic.ABDOMINAL AORTA: The proximal aorta measures 2.2 cm in AP dimension. The mid-distal aorta is not visualized due to overlying bowel gas shadowing.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: The urinary bladder almost entirely contracted around a Foley catheter.Pleural effusions and small volume ascites is present. | 1. Hydropic gallbladder with nonspecific gallbladder wall thickening in the setting of ascites. If there is continued clinical concern for acute cholecystitis, a HIDA scan may be considered. 2. Heterogeneous liver parenchyma may represent diffuse fatty infiltration/parenchymal dysfunction.3. Echogenic renal cortices, compatible with medical renal disease.4. Ascites and pleural effusions. 5. Bilateral simple and minimally complex renal cysts. |
Generate impression based on findings. | 68 year-old female with history of hepatitis C and right upper quadrant pain. The study was limited and suboptimal due to the patient's body habitus.LIVER: The liver is coarse, echogenic and has decreased through transmission, limiting evaluation for a focal lesion. Given this limitation, no focal lesion or intrahepatic biliary dilatation is evident. The liver contour appears slightly nodular, suggesting underlying cirrhosis/fibrosis. Liver is mildly prominent, measuring 20.8 cm in craniocaudal dimension. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: There is a normally distended gallbladder without wall thickening, pericholecystic fluid, gallstones, or focal tenderness.PANCREAS: The pancreas is suboptimally visualized.SPLEEN: The spleen is moderately enlarged, measuring 14.7 cm.RIGHT KIDNEY: The right kidney measures 13.2 cm without hydronephrosis. OTHER: The left kidney measures 14.9 cm without hydronephrosis. | 1. Findings compatible with diffuse fatty infiltration/parenchymal dysfunction, limiting evaluation for a focal lesion. Within this limitation, no focal lesion is evident. If there is continued clinical concern, a dedicated liver CT/MRI should be considered.2. Liver morphology suggestive of early cirrhosis.3. No evidence of gallbladder disease or biliary ductal dilatation.4. Moderate splenomegaly. |
Generate impression based on findings. | 25 year old female with a history of lower quadrant abdominal wall mass previously characterized as lipoma on ultrasound. Targeted ultrasound of the patient's right lower quadrant superficial soft tissues demonstrates an echogenic lobulated malleable mass with well-defined margins and minimal vascularity compatible with a lipoma. On today's examination it measures approximately 6 x 1.7 x 3.9 cm compared to 4.6 x 1.7 x 4.2 cm previously; essentially unchanged given the differences in technique. | Findings compatible with a lipoma, appearing similar to the prior study. |
Generate impression based on findings. | 84 year old female with abdominal pain. Evaluate lesion seen on same day CT exam. The study is limited by the patient's reported contracted state.RIGHT KIDNEY: The right kidney is atrophic and echogenic, measuring 8.4 cm in length. There is a 2.0 x 1.8 x 2.2 cm inferior pole hypoechoic complex lesion corresponding to the lesion seen on the same day CT.LEFT KIDNEY: The left kidney is atrophic and echogenic, measuring 7.9 cm in length. Mild nonspecific heterogeneity of the superior pole of the left kidney is noted. There appears to be a 8 x 5 x 8 mm lower pole hypoechoic lesion which is difficult to characterize on ultrasound, uncertain whether correlates to interpolar region 8 mm lesion seen on the same day CT.OTHER: The urinary bladder is partially distended with anechoic urine. | Limited study as described above.1. 2.2-cm right inferior pole hypoechoic complex mass, again suspicious for a renal cell carcinoma. Additional left renal findings as above.2. Given the patient's contracted state, future follow up of the aforementioned lesions may be better achieved with dedicated CT imaging. |
Generate impression based on findings. | 52 year-old male with chronic hepatitis C and cirrhosis. Evaluate for HCC. LIVER: The liver is moderately coarse in echogenicity and nodular in contour. It measures 12.9 cm in length without a focal lesion or intrahepatic biliary ductal dilatation evident. Normal hepatopetal portal venous blood flow at 22 cm/sec.BILIARY TRACT: The gallbladder is partially contracted. No extrahepatic biliary ductal dilatation with the common bile duct measuring 3 mm.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: Moderate splenomegaly, measuring 15.1 cm without a discrete lesion.RIGHT KIDNEY: The right kidney measures 9.6 cm in length without hydronephrosis. OTHER: The left kidney measures 10.1 cm in length without hydronephrosis. | Cirrhotic liver morphology, without a discrete lesion. Splenomegaly. |
Generate impression based on findings. | 72 year old female with acute kidney injury. RIGHT KIDNEY: The right kidney measures 10.6 cm in length without hydronephrosis or shadowing calculus. There is a 3.2 x 8.3 x 3.3 cm inferior pole septated cyst. There is mild cortical thinning. LEFT KIDNEY: The left kidney measures 10.1 cm in length without hydronephrosis or shadowing cavus. There is a 7 mm inferior pole simple appearing cyst. There is mild cortical thinning. URINARY BLADDER: The urinary bladder is nearly completely contracted. | No hydronephrosis. Simple and minimally complex cysts as above. |
Generate impression based on findings. | 66-year-old male with bladder cancer and impaired renal function. RIGHT KIDNEY: The right kidney measures 11.5 cm in length without hydronephrosis or discrete lesion evident. There is an echogenic shadowing focus in the interpolar region without a recent CT correlate which may be a nonobstructing stone but is nonspecific. LEFT KIDNEY: The left kidney measures 11.2 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident.URINARY BLADDER: The urinary bladder is contracted around a Foley catheter. | No hydronephrosis. |
Generate impression based on findings. | 30 year-old female right upper quadrant pain. The study is slightly limited due to the patient's body habitus and resulting poor ultrasound penetration.LIVER: The liver parenchyma is mildly coarse and echogenic without a discrete lesion or definite intrahepatic biliary ductal dilatation. It is normal in size, measuring 14.5 cm in craniocaudal dimension. The liver capsule is within normal limits. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common bile duct measuring 2 mm. Normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid or focal tenderness.PANCREAS: Limited evaluation of the pancreatic head is unremarkable.SPLEEN: The spleen measures 10.5 cm in length.RIGHT KIDNEY: The right kidney measures 10.7 cm in length without hydronephrosis. OTHER: The left kidney measures 10 cm in length without hydronephrosis. | No cholelithiasis or other specific findings to account for the patient's symptoms. Mildly coarse liver parenchyma may represent diffuse fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | 81 year-old female who is recalled from screening for further evaluation of focal asymmetry with calcifications in the retroareolar right breast. No current breast complaints. RIGHT BREAST DIGITAL DIAGNOSTIC MAMMOGRAM: Right breast ML and two spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The right retroareolar focal asymmetry with calcifications partially disperses with spot compression.RIGHT BREAST ULTRASOUND: On physical examination, no palpable masses were present of the right breast. Targeted right breast ultrasound at the 9 o'clock position demonstrates no suspicious solid or cystic mass. | High probability benign focal asymmetry in the right retroareolar region. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (6 Months). |
Generate impression based on findings. | Ultrasound guidance for biopsy. Proteinuria and renal insufficiency Ultrasound guidance was provided for Dr. Stakus to perform a biopsy of the right kidney. | Sound guidance provided for kidney biopsy. |
Generate impression based on findings. | Male 65 years old Reason: assess for cholecystitis History: rising lft, septic shock now in ards LIVER: The liver measures 17.5 cm in length. There is mildly coarsened echogenicity. The main portal vein is patent, demonstrating hepatopetal flow at 0.2 m/sec. The hepatic artery is patent.BILIARY TRACT: There is a small amount of sludge/non-shadowing stones within the gallbladder neck. There is no evidence of gallbladder wall thickening. The common duct measures 5 mm in maximal diameter and there is no evidence of choledocholithiasis.PANCREAS: No significant abnormality noted. Mild prominence of pancreatic duct again seen.SPLEEN: The spleen measures 7.4 cm in length.RIGHT KIDNEY: The right kidney measures 11.6 cm in length without hydronephrosis., shadowing calculus or discrete lesion evident.OTHER: The left kidney measures 11.9 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Bilateral pleural effusions unchanged. New moderate volume ascites. | 1. Biliary sludge and possible non-shadowing gallstones within the gallbladder neck, without evidence of cholecystitis.2. Stable bilateral pleural effusions and new moderate volume ascites. |
Generate impression based on findings. | 48 years old, Male, Reason: S/p DDRT. now with progressive oliguria History: oliguria TECHNIQUE: Grey scale sonography of the renal transplant; Color/spectral doppler of the renal transplant inflow and outflow vasculature. | Elevated velocity at the anastomosis measuring up to 2.9 meters per second. This would meet the Doppler criteria for narrowing however, intrarenal resistive indices are normal. This may represent postsurgical edema and a full sonography is suggested.Findings discussed with Dr. Bryan at the time of dictation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 27 day old male with right duplex kidney and hydronephrosis. Evaluate for interval change. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: Not Identified Left: Not Identified Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: Duplex right kidney: Grade 2 in both the upper and lower pole moieties. Left: 1 Length*** Right: 5.8 cm Left: 5.0 cm Mean for age: 4.2 cm Range for age: 4.0 - 6.0 cmADDITIONAL OBSERVATIONS: Duplex right kidney. | Duplex right kidney with grade 2 hydronephrosis of both the upper and lower moieties. Grade 1 left-sided hydronephrosis.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | 72-year-old male with recurrent hyperparathyroidism after two prior parathyroid operations. Status post partial thyroidectomy. Please evaluate for adenoma. RIGHT LOBE MEASUREMENTS: Again seen are changes consistent with the patient's history of right lobe thyroidectomy. There is interval development of a focus of hypoechoic tissue in the right thyroid bed, measuring 1.5 x 0.9 x 1.1 cm. LEFT LOBE MEASUREMENTS: 2.9 x 1.4 x 1.6 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: Again seen are changes consistent with the patient's history of right lobe thyroidectomy. There is interval development of a focus of heterogenous but predominately hypoechoic tissue with internal vascularity in the right thyroid bed, measuring 1.5 x 0.9 x 1.1 cm. Additionally, note is made of an round, hypoechoic focus along the inferior margin of the right thyroid bed, measuring 6 x 4 x 4 mm without internal vascularity.LEFT LOBE: The left lobe is again noted to be diffusely heterogeneous and lobulated, appearing slightly decreased in size when compared to the prior study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Note is made of an round, hypoechoic focus along the inferior margin of the right thyroid bed, measuring 6 x 4 x 4 mm without internal vascularity.LYMPH NODES: Normal appearing right level IV cervical lymph nodes are identified.OTHER: No significant abnormality noted. | Heterogenous left lobe of the thyroid with interval development of a 6 mm hypoechoic focus along the inferior margin of the surgical bed of the right lobe of the thyroid gland which may represent a parathyroid adenoma candidate. Further evaluation with a parathyroid nuclear medicine scintigraphic examination could be considered if clinically indicated. |
Generate impression based on findings. | 37 years old, Female, Reason: History of cholecystitis 2012, now w/ recurrent RUQ pain History: RUQ pain, cramping, nausea/vomiting LIVER: The liver measures 13.6 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.2 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 8.4 cm in length. RIGHT KIDNEY: Kidney measures 10 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.8 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | Normal gallbladder and biliary tract with no evidence of cholelithiasis or cholecystitis. |