Instruction: Generate impression based on medical findings.

Input: Right upper quadrant pain. Known fatty liver. LIVER: 18.5 cm in length. Non-cirrhotic liver morphology. Coarsened parenchymal echogenicity, compatible with known steatosis. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Possible 1 to 2 mm gallstones. Otherwise unremarkable appearance of the gallbladder.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.2 cm in length. The left kidney is 11.0 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 10.2 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid identified.

Output: No acute intra-abdominal abnormality identified.


Instruction: Generate impression based on medical findings.

Input: 36-year-old female patient with history of thyroidectomy for benign disease. Question of residual tissue. RIGHT LOBE: Status post thyroidectomy without residual tissue identified.LEFT LOBE: Status post thyroidectomy without residual tissue identified.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology lymph nodes are noted in the bilateral neck.OTHER: No significant abnormality noted.

Output: Status post thyroidectomy without residual tissue identified.


Instruction: Generate impression based on medical findings.

Input: Male 64 years old Reason: r/o recurrence History: h/o thyroid cancer. US in 4/16 showed possible new abnormal node. This is a 6 month follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy. 3 mm cystic focus in the left superior thyroid bed is unchanged.LYMPH NODES: Benign-appearing level 5 lymph node is unchanged.OTHER: No significant abnormality noted.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: 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.

Output: 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.


Instruction: Generate impression based on medical findings.

Input: Thyroid cancer status post surgery and I-131 RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: Benign-appearing lymph nodes. The cervical lymph nodes are decreased in size compared to prior, measuring up to 8 mm, previously 16 mm.OTHER: No significant abnormality noted.

Output: No evidence of recurrent disease. Decreased size of the previously prominent cervical lymph nodes.


Instruction: Generate impression based on medical findings.

Input: Female; 57 years old. Reason: r/o fatty liver disease History: elevated GGT LIVER: The liver measures 22.1 cm in length. This diffuse coarse and echogenic with geographic areas of focal sparing. No suspicious lesions are identified.The main portal vein is patent and demonstrates normal direction of flow with a peak velocity of 20 cm/sec.BILIARY TRACT: The gallbladder is normal in appearance without cholelithiasis. The common bile duct measures 5 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head of the pancreas is unremarkable. The body and tail of the pancreas are obscured by overlying bowel gas.SPLEEN: The spleen measures 10.2 cm in length.RIGHT KIDNEY: The right kidney measures 11.1 cm in length. There is no hydronephrosis, shadowing renal stone, or suspicious lesion identified. OTHER: The left kidney measures 10.2 cm in length. There is no hydronephrosis, shadowing renal stone or suspicious lesion identified.

Output: Hepatomegaly and diffuse hepatic steatosis.


Instruction: Generate impression based on medical findings.

Input: History of renal stones status post lithotripsy, per patient RIGHT KIDNEY: 11.2 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.LEFT KIDNEY: 10.6 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis.BLADDER: Collapsed.OTHER: No significant abnormality noted.

Output: No renal stones evident. No hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: Elevated ammonia. LIVER: The liver is normal in morphology, size and contour. It is heterogeneous and mildly echogenic in echotexture. It measures 15.5 cm in craniocaudal dimension. No focal lesion. Normal hepatopedal portal venous blood flow at 22 cm/s.BILIARY TRACT: Normally distended gallbladder without wall thickening, pericholecystic fluid or focal tenderness. No gallstones. No biliary ductal dilatation. PANCREAS: The visualized portions of the pancreatic head and body are unremarkable.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Mild right-sided pelvocaliectasis. No shadowing nephrolithiasis or focal lesion. 11.4 cm in length.OTHER: The left kidney measures 10.3 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. The spleen is 9 cm in length.

Output: Mildly coarse echogenic liver parenchyma may reflect parenchymal dysfunction and/or fatty infiltration.Mild right-sided pelvocaliectasis without shadowing nephrolithiasis.


Instruction: Generate impression based on medical findings.

Input: Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no suspicious solid or cystic mass identified. Bilateral cysts are noted. Bilateral breast implants do not show evidence of rupture.

Output: No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram.


Instruction: Generate impression based on medical findings.

Input: 76 years old, Female, Reason: 76 yo F, New onset kidney failure History: elevated Cr, lactic acid RIGHT KIDNEY: Kidney measures 10.3 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. There is trace perinephric fluid on the right. Right superior simple-appearing cyst measures 4.5 x 3.0 x 3.6 cm appearing similar to the recent CT study. Right renal stone measures up to 1.3 cm. No evidence of hydronephrosis.LEFT KIDNEY: Kidney measures 8.8 cm in length. Increased echogenicity of the kidneys consistent with medical renal disease. Left renal cyst measures 2.6 x 2.9 x 3.4 cm. Nonobstructing left renal stone measures up to 0.7 cm. No evidence of hydronephrosis.OTHER: Trace ascites.

Output: 1.Increased echogenicity of the kidneys bilaterally is consistent with medical renal disease.2.Nonobstructing nephrolithiasis bilaterally.3.Bilateral renal cysts.


Instruction: Generate impression based on medical findings.

Input: Age: 21 years. Sex : Male. Reason for study: shoddy bilateral posterior cervical lymph nodes, also reports soreness in the bilateral submandibular area Ultrasound of the neck revealed numerous prominent cervical lymph nodes.Right submandibular benign appearing node: 1.8 x 0.6 cm.Right posterior cervical benign appearing lymph node: 0.7 x 0.2 cm.Right posterior cervical hypoechoic lesion, presumably representing a small lymph node: 1.2 x 0.3 x 0.65 cm Normal appearing submandibular glands and thyroid gland.

Output: Hypoechoic lesion in the right posterior cervical triangle corresponding to region of palpable tenderness measures 1.2 x 0.3 cm and presumably represents a small lymph node.


Instruction: Generate impression based on medical findings.

Input: Female 42 years old; Reason: r/o growth of nodules, adenopathy, worrisome features History: h/o thyroid nodules. US in 5/14 showed stable nodule on one side, and decreased on the other. However, stable nodule was possibly subtly larger, so this will be a one year follow up study RIGHT LOBE MEASUREMENTS: 5 x 1.8 x 1.7 cm, previously 4.9 x 1.9 x 1.9 cm.LEFT LOBE MEASUREMENTS: 5.1 x 1.6 x 2.2 cm, previously 5.4 x 1.8 x 1.7 cm.ISTHMUS MEASUREMENT: 0.4 cm, previously 0.5 cm.RIGHT LOBE: Again noted is predominantly hypoechoic lesion in the right inferior lobe, measuring 1.7 x 1.2 x 1.4 cm, as compared to 1.8 x 1.6 x 1.2 cm on the prior exam, slightly decreased in size. This was reportedly previously biopsied demonstrating colloid nodule. No vascularity or microcalcifications are noted within the nodule.LEFT LOBE: Again noted is predominantly hyperechoic and solid nodule with cystic components in the left inferior lobe measuring 1.5 x 1.3 x 0.9 cm, previously 1.6 x 1.4 x 1.2 cm, slightly decreased in size as compared to the prior exam. No microcalcifications noted. Peripheral vascularity is noted.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Slight interval decrease in size of bilateral thyroid nodules.


Instruction: Generate impression based on medical findings.

Input: 49-year-old female with history of previous benign right lumpectomy as well as benign right breast biopsy, with result of PASH. Patient reports continued right breast and axillary pain x1 year. A targeted right ultrasound was performed for the patient’s area of concern. There is no solid mass identified. Subcentimeter simple cysts are identified in the left breast at the 10:00 position.

Output: No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.


Instruction: Generate impression based on medical findings.

Input: Ms. Plesniak is a 29-year-old with a personal history of bilateral breast reduction at age of 19. She presents today with palpable abnormality in the right breast lower outer quadrant. Family history of breast cancer in paternal grandmother. On physical exam, there is a palpable mass in the right breast 8:00 location corresponding to the site of clinical concern.A targeted right gray scale and color Doppler ultrasound was performed for the palpable area of concern. In the right breast 8:00 position 6 cm from nipple, there is a 1.4 x 0.8 x 1.0 cm hypoechoic mass with rim calcification and marked posterior acoustic shadowing. This corresponds to the palpable abnormality and is consistent with an oil cyst. No suspicious solid or cystic masses are seen elsewhere in the right lateral breast.

Output: 1.4 cm benign oil cyst corresponding to the palpable abnormality in the right breast. No sonographic evidence for malignancy. As long as the patient's physical exam remains unchanged, annual screening mammogram is recommended, starting at the age of 40. The finding and recommendations were discussed with the patient at a time of the exam.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.


Instruction: Generate impression based on medical findings.

Input: 68 years old, Female, Reason: eval left kidney for hydronephrosis/lesion History: left flank pain, hx pyelonephritis RIGHT KIDNEY: Kidney measures 12.1 cm in length. Normal echotexture. No hydronephrosis or shadowing calculus. There is an anechoic simple appearing cyst in the superior pole of the right kidney measuring 1.6 x 1.4 x 1.6 cm.LEFT KIDNEY: Kidney measures 12.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.Bladder: The bladder is not completely distendedOther: Increased echogenicity of the liver is consistent with fatty infiltration.

Output: 1.No evidence of hydronephrosis as clinically questioned. No evidence of shadowing calculus.2.Echogenicity of the renal parenchyma is within normal limits bilaterally.3.Echogenic liver.


Instruction: Generate impression based on medical findings.

Input: Male 62 years old Reason: assess for liver lesions History: Hx of HCV LIVER: Mildly hyperechoic hepatic mass with a hypoechoic rim, measuring 3.5 x 3.7 x 4.1 cm is highly concerning for malignancy. Background liver appears coarse and nodular compatible with cirrhosis. Two other hyperechoic foci in the liver are nonspecific. Main portal vein is patent with normal directional flow and a peak velocity of 14.3 cm/s.BILIARY TRACT: Stones and sludge are present within the gallbladder. Cholesterol deposits are also present within the gallbladder wall. No evidence of acute blood or inflammation. No intra or extrahepatic biliary ductal dilatation.PANCREAS: The visualized portions of the pancreas are normal in appearance.SPLEEN: Spleen is normal in appearance measuring 9.1 cm.KIDNEYS: There is a partially visualized horseshoe kidney. No hydronephrosis or shadowing stone is identified.OTHER: No significant abnormalities noted.

Output: 1.Hyperechoic hepatic mass with a hypoechoic rim is highly concerning for malignancy. Recommend dedicated hepatic CT or MRI to further characterize.2.Cirrhotic liver morphology.3.Incidental note of a horseshoe kidney.


Instruction: Generate impression based on medical findings.

Input: Male, 40 years old. Worsening CKD. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.0 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.1 cm in length, with increased cortical echogenicity. No shadowing stones or hydronephrosis.OTHER: The bladder is incompletely distended. Bilateral ureteral jets are noted.

Output: 1.No hydronephrosis.2.Increased renal cortical echogenicity, compatible with medical renal disease.


Instruction: Generate impression based on medical findings.

Input: 62-year-old male with history of thyroid cancer. Evaluate for recurrent disease. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massLEFT LOBE: No massISTHMUS: No massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically normal lymph nodes at levels two and three on the right and level five on the left. Left submandibular region was scanned due to patient stating palpable abnormality. In this location there is a morphologically normal 1.7 x 1.5 x 1.6 cm lymph nodeOTHER: No significant abnormality noted.

Output: No evidence for recurrent disease. Results discussed with the patient at his request.


Instruction: Generate impression based on medical findings.

Input: 22-year-old female patient with thyroid cancer status post surgery and I-131 with palpable left supraclavicular node. Question of abnormal masses, nodes. Patient reports currently having a cold. RIGHT LOBE: Status post thyroidectomy without residual or recurrent tissue identified.LEFT LOBE: Status post thyroidectomy without residual or recurrent tissue identified.ISTHMUS: Status post thyroidectomy without residual or recurrent tissue identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: There is a right level three nondescript lymph node measuring 1.0 x 0.7 x 0.3 cm. An additional nondescript left level three lymph node measures 1.0 x 0.4 x 2.5 cm. A benign morphology lymph node in the left supraclavicular region measures 0.7 x 0.3 x 1.4 cm.OTHER: No significant abnormality noted.

Output: 1. Status post thyroidectomy without residual or recurrent tissue identified in the thyroid bed.2. Non-descript borderline enlarged bilateral level III lymph nodes; these may be reactive in etiology, however, should be followed.


Instruction: Generate impression based on medical findings.

Input: Right upper quadrant pain with nausea and vomiting LIVER: Mildly coarse echotexture again noted. Liver length 19.3 cm. No mass.GALLBLADDER, BILIARY TRACT: Gallbladder sludge and stones without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 11.1 cm in lengthOTHER: Left kidney 13 cm in length. Spleen 13.6 cm in length.

Output: Gallbladder sludge and stones without acute inflammation or ductal dilatation. Hepatomegaly with coarse echotexture suggestive for fatty infiltration again noted. No ascites.


Instruction: Generate impression based on medical findings.

Input: 58-year-old female with history of multinodular thyroid presents for evaluation of nodules. RIGHT LOBE MEASUREMENTS: 4.9 x 2.1 x 2.7 cm.LEFT LOBE MEASUREMENTS: 4.0 x 1.4 x 1.9 cm.ISTHMUS MEASUREMENTS: 0.3 cm.RIGHT LOBE: Nodule 1: Measures approximately 3.0 x 1.4 cm. Appears stable in comparison to the prior study.Nodule 2: Measures approximately 1.3 x 0.9 x 1.5 cm. Appears stable in comparison to the prior study.The parenchyma appears slightly hypervascular.LEFT LOBE: Nodule 1: Measures approximately 1.2 x 1.0 x 1.1 cm. Appears stable in comparison to the prior study.Nodule 2: Measures approximately 0.9 x 0.8 x 1.4 cm. Appears stable in comparison to the prior study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1. Multinodular goiter as described above. Appears stable in comparison to the prior study.2. Hypervascular parenchyma on the right; cannot exclude underlying component of thyroiditis.


Instruction: Generate impression based on medical findings.

Input: Acute renal insufficiency RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 9.2 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.8 cm in length.OTHER: Bladder nondistended.

Output: Mildly echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction.


Instruction: Generate impression based on medical findings.

Input: Chronic renal disease RIGHT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.9 cm in lengthLEFT KIDNEY: Mildly echogenic parenchyma without mass, stone, or hydronephrosis. 10.7 cm in length.OTHER: Bladder nondistended.

Output: Mildly echogenic renal parenchyma suggestive for medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: RIGHT KIDNEY: Normal parenchymal echogenicity. No worrisome mass or hydronephrosis. Stable subcentimeter stone measuring subcentimeter stone measuring 0.8 x 0.9 x 0.5 cm. Right kidney 15.2 cm. in lengthLEFT KIDNEY: AbsentOTHER: Bladder nondistended

Output: Stable nonobstructing subcentimeter right renal stone.


Instruction: Generate impression based on medical findings.

Input: 67-year-old female presents with swelling of her right wrist. There is a clinical concern for fluid collection. There is edema of the soft tissue of the right wrist without a loculated fluid collection or mass.

Output: 1. Edema of the soft tissue of the right wrist without discrete fluid collection or mass.


Instruction: Generate impression based on medical findings.

Input: Liver failure LIMITED ABDOMENLIVER: Markedly echogenic liver echotexture noted without obvious mass. Liver length 18.7 cm.BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.4 cm in length RIGHT KIDNEY: No significant abnormalities noted. 11.2 cm in lengthOTHER: Left kidney 10.9 cm in length. Trace ascites.

Output: Markedly echogenic liver echotexture suggestive for severe fatty infiltration of the liver without mass. Cholelithiasis without acute inflammation or ductal dilatation. Trace ascites.Visualized hepatic vessels patent with normal directional flow. Left and right branches of the hepatic artery could not be visualized due to technical limitations of the exam including severe echogenicity of liver parenchyma.


Instruction: Generate impression based on medical findings.

Input: HCV cirrhosis LIVER: Cirrhotic morphology again noted without mass. Liver length 15 cm.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.3 cm in lengthOTHER: Left kidney 11.1 cm in length. Spleen 13.3 cm in length. No ascites.

Output: Stable cirrhotic morphology without mass or ductal dilatation. No ascites.


Instruction: Generate impression based on medical findings.

Input: Male; 52 years old. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer. 1 year follow up study RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No suspicious mass in the right thyroid bed.LEFT LOBE: Redemonstrated 3 x 3 x 6 mm hyperechoic focus in the left thyroid bed (previously 4 x 3 x 5 cm), unchanged. A new 4 x 3 x 5 mm hypoechoic lesion with flow on color Doppler is seen in the left thyroid bed.ISTHMUS: No suspicious mass in the isthmus bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right: Level 6 lymph node measures 6 x 3 x 7 mm with increased vascularity.Left: A 3 x 3 x 4 mm level 4 and a subclavicular 5 x 3 x 4 mm lack a normal fatty hilum.OTHER: No significant abnormality noted.

Output: Abnormal lymph nodes and a new lesion in the left thyroid bed suspicious for recurrence. The thyroid bed lesions are small and may not be amenable to biopsy. The lymph nodes are amenable to biopsy.


Instruction: Generate impression based on medical findings.

Input: Epigastric pain LIVER: No significant abnormalities noted. 18 cm in lengthBILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 11 cm in lengthRIGHT KIDNEY: Stable minimally complex cyst. Right kidney 9.2 cm in length.OTHER: Left kidney 9.8 cm in length. No ascites.

Output: Cholelithiasis without acute inflammation or ductal dilatation. Liver size upper limits of normal without mass. No ascites.


Instruction: Generate impression based on medical findings.

Input: 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.

Output: 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.


Instruction: Generate impression based on medical findings.

Input: 46-year-old female with history of thyroid nodules. Rule out growth of nodules, adenopathy. If nodule is growing, is it amenable to FNA? RIGHT LOBE MEASUREMENTS: 6 x 1.9 x 2 cmLEFT LOBE MEASUREMENTS: 5 x 1.8 x 1.7 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: Heterogenous echotexture. In the right lower pole, a 1.8 x 0.8 x 1.2 cm isoechoic nodule with a hypoechoic rim is stable in size and appearance since the 1/18/2016 exam.LEFT LOBE: Heterogenous echotexture. In the left upper pole, a 1.8 x 1 x 1.2 cm isoechoic nodule is stable in size and appearance. A 1 x 0.6 x 1.1 cm hypoechoic nodule of the posterior left mid pole was not specifically measured on the prior exam but is not significantly changed.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1. Mildly enlarged thyroid gland with stable bilateral nodules.


Instruction: Generate impression based on medical findings.

Input: Female 39 years old Reason: r/o recurrence, adenopathy History: h/o thyroid cancer, s/p lobectomy RIGHT LOBE MEASUREMENTS: Patient is status post right thyroidectomyLEFT LOBE MEASUREMENTS: 1.6 x 1.0 x 5.6 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Patient is status post right thyroidectomy. No residual or recurrent thyroid tissue.LEFT LOBE: The thyroid is normal echogenicity. No new nodules are present.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No local lymphadenopathy.OTHER: No significant abnormality noted.

Output: Unchanged, post right thyroidectomy, appearance of the thyroid. No evidence of recurrent disease.


Instruction: Generate impression based on medical findings.

Input: Right flank pain and dysuria RIGHT KIDNEY: Unremarkable echogenicity without mass, stone, or hydronephrosis. 10.5 cm in lengthLEFT KIDNEY: Unremarkable echogenicity without mass, stone, or hydronephrosis. 12.6 cm in lengthOTHER: Bladder nondistended

Output: Negative renal ultrasound. Normal parenchymal echogenicity without mass, stone, or hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: Ms. Wassenhove is a 87 year female with known left breast cancer undergoing neoadjuvant hormonal therapy. She presents today for follow-up ultrasound to evaluate treatment response. A targeted left breast ultrasound was performed at the site of known malignancy. In the left breast 2:00 location, approximately 4 cm from the nipple, the index malignancy now measures 2.1 x 1.3 x 1.9 cm, compared to 1.6 x 1.1 x 2.0 cm. There continues to be minimal associated vascularity.

Output: Slight interval increase in known left breast cancer. BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter.


Instruction: Generate impression based on medical findings.

Input: 86-year-old female with hyperparathyroidism. RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 5.7 x 2.1 x 2 cm.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 7.1 x 2.6 x 3.5 cm.ISTHMUS MEASUREMENTS: The isthmus measures 2.1 cm in thickness.RIGHT LOBE: Multinodular appearance. Partially cystic nodule with eccentric solid component of the right lower pole measuring 1.7 x 1.1 x 1.2 cm, and the solid portion of this nodule measures 1 x 0.7 x 0.7 cm.LEFT LOBE: Multinodular appearance. Heterogeneity of the enlarged left thyroid lobe limits visualization for accurate measurement of discrete nodules.ISTHMUS: Heterogenous predominantly hyperechoic nodule of the thyroid isthmus measuring 2.1 x 3.2 x 2.3 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1. Multinodular thyroid goiter. The measured nodules of the thyroid isthmus and right lower pole demonstrate characteristics most compatible with "low suspicion" nodules per ATA criteria. These nodules are amenable to percutaneous biopsy as clinically recommended.2. No definite candidates for a parathyroid adenoma. Please refer to the same day nuclear medicine exam for more details.