Instruction: Generate impression based on medical findings.

Input: Reason: congenital abnormality of R arm, evaluate for abnormality of chest History: congenital anomaly Unremarkable cardiac and mediastinal silhouette. Large lung volumes with no significant abnormalities.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 56 yearsGender: MaleReason for Study: Reason: ett History: ett Support devices unchanged with ET tube tip 3 cm above the carina.Markedly decreased lung volumes with stable cardiomediastinal silhouette.Basilar opacities are compatible with pleural effusions and edema/atelectasis.

Output: Support devices unchanged. Stable cardiopulmonary appearance with pleural effusions, edema, and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: pna? History: cough, chest pain Unremarkable cardiac and mediastinal silhouette. Very mild upper zone interstitial opacity with bronchial thickening compatible with bronchitis and bronchiolitis.No specific evidence of pneumonia.

Output: Findings compatible with bronchitis and bronchiolitis. No sign of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.80yo M w/ Richter transformation, worsening respiratory distress, O2 89% on venti Moderate to large left pleural effusion with underlying atelectasis and depression of the left hemidiaphragm, not significantly changed. Port catheter with its tip in the SVC.

Output: Moderate to large left pleural effusion and atelectasis without significant interval change.


Instruction: Generate impression based on medical findings.

Input: 39-year-old male with history of metastatic colorectal carcinoma CHEST:LUNGS AND PLEURA: Multiple, scattered micronodules in bilateral lungs are unchanged.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple liver metastases are again noted. Index left hepatic lesion measures 2.7 x 1.9 cm on image number 80, series number 4, not significantly changed from previous study.Largest confluent lesion in the right hepatic lobe now measures 12 by 9.3 cm, slightly smaller compared to previous study. Other hepatic lesions are grossly unchanged.SPLEEN: Splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Index right iliac lymph node measures 10 by 11 mm in image number 172, series number 4, unchanged.Index right obturator node measures 10 x 7 mm on image number 183, series number 4, not significantly changed.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Minimal interval decrease in the size of the large hepatic confluent metastatic lesion. Other hepatic metastases and index lesions are stable.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: Infiltrates History: Fever Right central catheter has been retracted with the tip located at the level of the superior azygos vein.There is no evidence of edema, consolidation or pleural effusion. Multilevel degenerative changes of the thoracic spine. No pneumothorax. The heart size is normal. Several prominent vessels are noted on the lateral view, correlating to findings on sagittal images from prior CT. Previously questioned right mid zone nodularity is no longer present.

Output: No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o acute process History: sob Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: intubated History: intubated ET tube and NG tube unchanged.Stable cardiomediastinal silhouette.Redemonstration of right upper lobe atelectasis.Mild left retrocardiac subsegmental atelectasis.No new pulmonary opacities noted.

Output: Support devices unchanged. Stable cardiopulmonary appearance with right upper lobe atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 32 years old.History of cystic fibrosis with frequent infections. Dyspnea and hemoptysis. Evaluate for pneumonia. Right chest port unchanged in position. Gastrostomy tube retention device. Abdominal shield.Multiple bronchial embolization coils and a glue cast projects over the upper thorax.Extensive bronchial abnormalities consistent with known cystic fibrosis. There is some unsharpness in the left upper lobe anatomy which may indicate edema or bronchiolitis secondary to distal airways fluid or infection.

Output: Subtle unsharpness of the left upper lobe anatomy nonspecific and could reflect sequela of early infection. Conservative plain film follow-up suggested.


Instruction: Generate impression based on medical findings.

Input: Female, 22 years old.Reason: Prior to VQ scan History: SOB Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 72-year-old male with renal cell carcinoma, status post chemotherapy CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No change in expansile courteous but predominantly sclerotic lesion involving the right rib.ABDOMEN:LIVER, BILIARY TRACT: Multiple metastatic lesions are unchanged. Most of the liver parenchyma is replaced with these masses. Lesion in the left lateral segment measures 5.5 x 3.0-cm image number 100, series number 3. A second reference lesion in the right lobe measures 6.9 x 5.4 cm image number 113, series number 3.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right nephrectomy. Evaluation of the left kidney is limited due to lack of IV contrast.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Stable examination with a right rib lesion and multiple liver metastases


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: worsening hypoxia History: hypoxia Severe interstitial and airspace opacities consistent with ARDS, unchanged.Right jugular catheter, tip in SVC.

Output: No change in severe pulmonary opacities consistent with ARDS.


Instruction: Generate impression based on medical findings.

Input: MRSA and empyema Persistent cardiopulmonary appearance with no widened mediastinum, stable and comparable with recent CT. Pleural effusions with bilateral scattered four-quadrant opacities are also similar without definite new superimposed focal disease. Retrocardiac partial consolidation again cannot be excluded.No new hardware

Output: Stable mediastinal appearance with unchanged nonspecific pulmonary opacities with pleural effusions


Instruction: Generate impression based on medical findings.

Input: Female, 21 years old.Reason: CAT P History: fever/chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Prior pulmonary opacities have resolved.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 64 years old Female. Reason: evaluate for PE History: chest pain. PULMONARY ARTERIES: Negative for pulmonary embolism.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Coronary artery calcifications are noted. Occlusion of the proximal left subclavian artery. The subclavian artery fills with contrast distal to the origin of the left vertebral artery. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Moderate-sized sliding hiatal hernia

Output: 1.Negative for pulmonary embolism.2.Occlusion of the origin of the left subclavian artery with probable retrograde filling from the left vertebral artery. Recommend clinical correlation to signs and symptoms of left subclavian steal syndrome.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: Cardiopulm pathology/lines History: Cardiopulm pathology/lines Unchanged widened mediastinum contiguous with the left apex following aneurysm repair.Two left chest tubes with no pneumothorax.One left chest tube removed.Pleural effusion stable.Tracheostomy tube tip approximately 5 cm above the carina.A Dobbhoff tube extends below the lower margin of the image.Right jugular catheter tip at cavoatrial junction level.

Output: Unchanged widened mediastinum contiguous with soft tissue over the left apex.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Reason: eval for free air History: abd pain The lungs and pleural spaces are clear. The heart size is upper limits normal. No associated pulmonary edema or evidence of infection. No evidence of pneumoperitoneum.

Output: No evidence of pneumoperitoneum.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: rule out pneumonia History: hx of hiv, renal transplant, cough x 4 days, sob Small lower zone nodular opacities suggestive of nipple shadows. The lungs and pleural spaces are clear. The heart size is normal.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Potential stem cell donor. Normal heart size. No pleural fluid or pneumothorax. No focal pulmonary opacities

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 24 yearsGender: FemaleReason for Study: Reason: 5 days cough, fever, malaise, productive sputum, eval for pna. History: see above The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: 70 years old Female. Reason: hx of MVP, chf, presenting with cp. sob n/v. History: sob, cp. The cardiac and mediastinal silhouette is enlarged with cephalization of pulmonary veins. There is a mild interstitial changes in the lower lungs.

Output: The above findings are consistent with mild congestive heart failure.


Instruction: Generate impression based on medical findings.

Input: Male, 44 years old.History of shortness of breath. The cardiomediastinal silhouette is unchanged and normal. No focal pulmonary opacities are identified. There appears to be blunting of the left costophrenic angles indicating interval development of small pleural effusion.

Output: Interval development of small left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: please assess for worsening pleural effusions History: as above; known lung cancer Increase in size of left-sided pleural effusion, moderate in degree. No substantial change in underlying pulmonary opacities except at the left lung base, likely representing atelectasis. Small right-sided pleural effusion or thickening again noted. Heart size difficult to assess but likely unchanged. No pneumothorax.

Output: Increase in size of left-sided pleural effusion, moderate in degree. Pulmonary opacities consistent with history of lung cancer.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Status post intubation. Evaluate endotracheal tube tip. Endotracheal tube tip is approximately 4 cm above the carina.Remaining support devices are unchanged.Further partial reexpansion of the left lung with residual atelectasis and retrocardiac opacity.Stable appearance of right lower zone opacities suggestive of edema with trace right pleural effusion.

Output: Further partial reexpansion of the left lung with residual atelectasis and retrocardiac opacity.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: right upper lobe consolidation, follow-up chest Xray History: as above Near resolution of prior right upper lobe peripheral opacity.Mild scarring elsewhere and evidence of healed granulomatous disease is unchanged.Unremarkable mediastinal contours and cardiac silhouette.

Output: Near resolution of prior right upper lobe opacity which may have been infection or infarction.


Instruction: Generate impression based on medical findings.

Input: Status post pacemaker rule out pneumothorax. Left subclavian pacemaker with leads projecting over the right atrium and right ventricle directed towards the apex. Chest wall vertical staple line. Unchanged cardiomegaly and low lung volumes. Retrocardiac atelectasis/consolidation on the left persists. Mild interstitial edema-like abnormality. No visible pneumothorax.

Output: No visible pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 57 yearsGender: MaleReason for Study: Reason: ETT placement History: intubated ET tube with its tip 6 to 7 cm above the carina.NG tube with side port at the GE junction.Stable cardiac enlargement.Nonspecific perihilar/basilar opacities unchanged.

Output: ET tube with its tip 6 to 7 cm above the carina. NG tube with side-port at the GE junction with subsequent imaging demonstrates appropriate advancement. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Age: 47 yearsGender: MaleReason for Study: Reason: r/o PNA, hx lvad History: cough Left-sided ICD and LVAD unchanged.Stable cardiomediastinal silhouette.Persistent elevation of the left hemidiaphragm with minimal basilar atelectasis.No new pulmonary opacity noted.No pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 83 years old.Reason: r/o aspiration History: AMS New small bilateral pleural effusions with bibasilar atelectasis.

Output: New small bilateral pleural effusions with bibasilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Age: 82 yearsGender: FemaleReason for Study: Reason: ETT History: ETT ET tube and right IJ venous catheter unchanged.Decreased lung volumes with stable cardiomediastinal silhouette.Basilar opacities compatible with atelectasis and possible effusions.

Output: ET tube with its tip 2 cm above the carina. Stable cardiopulmonary appearance with basilar atelectasis and possible small effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Reason: decreased breath sounds left base History: as above No pleural effusion or pneumothorax. No focal pulmonary abnormality. Cardiomediastinal silhouette is upper limits of normal, but unchanged from prior. Tortuous thoracic aorta.Sternotomy hardware intact.

Output: No acute cardiopulmonary abnormality, specifically no pneumothorax.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: CT follow up History: CT follow up Right chest tube, with a small right pneumothorax best seen laterally, and right chest wall soft tissue emphysema.Small lung volumes with interstitial opacities that are stable.

Output: Small right pneumothorax, right chest tube in place.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Left PICC line extends into the right atriumDecreased lung volumes with basilar suspected atelectasis and/or scarring, requiring serial imaging to confirm. A partially collapsed azygos lobe is otherwise observed, a normal variant.A focal nodular radiopacity measuring approximately 2 cm projects over T8, of uncertain exact location, its characteristics suggest a mediastinal abnormality such as a calcified lymph node which would correlate with scattered granuloma in the spleen, however additional imaging would be helpful to confirm.

Output: PICC line placed, tip in right atrium


Instruction: Generate impression based on medical findings.

Input: Age: 23 yearsGender: FemaleReason for Study: Reason: examine for aspiration History: wheeze Right central venous catheter unchanged.Decreased lung volumes with unremarkable cardiomediastinal silhouette.The lungs are clear.No pleural effusions.

Output: No acute cardiopulmonary abnormalities identified . No specific evidence of infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Malignant neoplasm pleura. Chest tubes in place. Right chest tubes terminate in the lung apex. Small right pneumothorax with maximal pleural separation at the apex of about 7 mm. Subcutaneous emphysema. Low lung volumes. Diffuse interstitial and airspace opacities unchanged.

Output: 7 mm right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male 3 years old Reason: assess for pneumonia versus foreign body History: acute respiratory distress, excessive coughing, increased work of breathingVIEWS: Chest and soft tissue neck AP/lateral (4 views) 12/11/2015 Soft tissue neck: Normal, visualized paranasal sinuses pneumatization. Normal alignment of the cervical spine with no prevertebral soft tissue thickening. No evidence of tracheal compression or deviation.Chest: The aortic arch, cardiac apex and stomach are left-sided.Cardiac silhouette is normal in size and shape. Peribronchial thickening and left lower lobe opacity likely pneumonia. . No effusions or pneumothorax.

Output: Peribronchial thickening with superimposed left lower lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: 49-year-old male with shortness of breath. CHEST:LUNGS AND PLEURA: Scattered micronodules bilaterally, likely postinflammatory in etiology. Calcified granuloma in the left lower lobe. No suspicious masses, or pleural effusion.Mild bronchial wall thickening bilaterally, predominantly in the lower lobes.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.CHEST WALL: No significant abnormality noted. UPPER ABDOMEN: No significant abnormality noted.

Output: 1. Findings compatible with bronchitis/bronchiolitis.2. Scattered micronodules bilaterally, likely postinflammatory in etiology. However, if patient has a high-risk history (for example, smoking history), follow-up CT in 12 months is recommended to confirm stability/resolution.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: eval sgc History: sgc Stable position of support devices with the femoral Swan-Ganz catheter terminating distal, projecting over the right middle and lower lobes.Slight improved aeration. Persistent opacity at the right base and left perihilar location. No pneumothorax.

Output: Swan-Ganz catheter remains in a distal position, projecting over the right middle and lower lobes.


Instruction: Generate impression based on medical findings.

Input: Female, 20 years old.History of sickle cell disease presenting with acute chest pain. Unchanged cardiomegaly. No pleural effusion. No focal pulmonary opacity. No pneumothorax.

Output: No significant cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: eval of lung fields History: postop cardiac patient ET tube tip approximately 4 cm above the carina.Swan-Ganz catheter tip in the main pulmonary artery.Small lung volumes with mild basilar opacity compatible with atelectasis and small effusions.No pneumothorax.

Output: Postoperative findings with basilar atelectasis and effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Aortic valve replacement postop. Right mainstem bronchus intubation. Two right-sided jugular catheters, the more medial of the two catheters appears slightly kinked at the skin insertion site and terminates at the level of the right jugular vein, and the second more inferolateral introducer terminates at the level of the right brachiocephalic vein near its confluence with the left.Mediastinal or pericardial drain in place. Valvular prosthesis. Sternotomy hardware. Basal atelectasis, mild. Vascular unsharpness nonspecific and may indicate very mild edema. No pneumothorax.

Output: Right mainstem bronchus intubation. 3347 Moore notified via text page at the time of dictation.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: eval acute process History: nausea Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: DesaturationVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above carina. NG tube tip in the stomach. The umbilical lines are unchanged. Left upper extremity PICC tip at the confluence of the brachiocephalic veins. Cardiothymic silhouette normal. Mediastinal shift from left to right has improved. There are bilateral pulmonary interstitial emphysema left greater than right unchanged. The moderate size left pneumothorax has decreased. There are two chest tubes on the left.

Output: Left pneumothorax has decreased with improved mediastinal shift.


Instruction: Generate impression based on medical findings.

Input: Reason: hypoxia History: hypoxia Underinflated lungs with no visible cardiopulmonary abnormalities.Enteric tube traversing the esophagus.Surgical clips in the right axilla.

Output: No gross abnormalities


Instruction: Generate impression based on medical findings.

Input: Female, 26 years old.Reason: fever, chills History: fever chills The lungs and pleural spaces are clear. The heart size is normal.

Output: No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: Apical blebs, chest pain, eval for spontaneous pneumothorax History: sob, chest pain No acute abnormality.No specific evidence of infection or failure.No significant pneumothorax.Apical scarring unchanged.

Output: No pneumothorax or other acute abnormality.


Instruction: Generate impression based on medical findings.

Input: CHEST:LUNGS AND PLEURA: Visualization of the lung parenchyma is limited by the field of view and length of scan which excludes a substantial amount of the lungs. No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted in the extra cardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: No significant extra cardiovascular abnormality on this limited field of view.


Instruction: Generate impression based on medical findings.

Input: 78-year-old male with history of colon carcinoma CHEST:LUNGS AND PLEURA: Right upper lobe calcified granuloma not significant change from previous study.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter lesion in the liver is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Unremarkable study.


Instruction: Generate impression based on medical findings.

Input: Female, 23 years old.Reason: central line placement History: see above Moderate to severe diffuse coarsened pulmonary opacities have progressed and again suspicious for progression of infection. Consider atypical infection if the patient is immunocompromised. Right jugular line has been placed with tip over the SVC/RA junction. No pneumothorax.

Output: Progression of bilateral opacities very suspicious for infection. No pneumothorax post right IJ catheter, tip over the SVC/RA junction.


Instruction: Generate impression based on medical findings.

Input: Age: 35 yearsGender: FemaleReason for Study: Reason: midsternal cp, sob, cough History: above The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 39 years old.Reason: chest pain History: chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Lead placement check. Cardiomyopathy 2-lead left subclavian ICD is observed with lead tips in the gross expected location. The more proximal lead projects over the right atrium, however the ventricular lead is to the right of midline. Please correlate with postprocedural imaging. No superimposed pulmonary post procedural complicationModerate nonspecific cardiomegaly with extensive coronary and annular calcifications.Lungs are clear other than minimal scarring

Output: ICD lead placed


Instruction: Generate impression based on medical findings.

Input: Reason: assess for infection History: hypercapnic respiratory failure Markedly underinflated lungs with increased basilar opacities compatible with atelectasis and nonspecific consolidation.Probable moderate cardiomegaly, exaggerated by projection.Stabilization rods in the thoracic spine.

Output: Increased basilar atelectasis and nonspecific consolidation compatible with aspiration and infection.


Instruction: Generate impression based on medical findings.

Input: Age: 67 yearsGender: FemaleReason for Study: Reason: cough and bronchiolitis History: cough and bronchiolitis The cardiomediastinal silhouette is unremarkable.Increased lung volumes on compatible with COPD.Well-defined calcified nodule in the right lung base compatible with old granulomatous disease.No focal areas of consolidation.No pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Female, 77 years old.Reason: s/p TECAB History: s/p TECAB The cardiomediastinal silhouette is at the upper limits of normal. Tortuous aorta.Right greater than left pleural effusions and bibasilar subsegmental atelectasis, decreased from prior. Improved aeration of the left lung base. No pneumothorax.Surgical clips project over the superior mediastinum.

Output: Right greater than left pleural effusions and bibasilar subsegmental atelectasis decreased from prior with improved aeration of the left lung base.


Instruction: Generate impression based on medical findings.

Input: Septicemia Motion degrades sensitivity.Mildly improving overall aeration with decreased patchy opacities observed in both bases which remain otherwise greater on the left with marked cardiomegaly, layered effusions and small lung volumes. Superimposed mild edema in a largely parahilar distribution cannot be excluded.ETT, NG and right subclavian catheters are otherwise similar

Output: Mildly improving aeration although changes are minimal


Instruction: Generate impression based on medical findings.

Input: GI bleed, evaluate for capsule endoscopy location Upper abdominal surgical clips and coils similar to prior study. Nonvisualization of radiodense device suggestive of a endoscopy capsule. Nonobstructive bowel gas pattern. Multilevel spinal degenerative disease.

Output: Endoscopy capsule not visualized. No bowel obstruction.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o mets History: none Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Reason: New diagnosis of Lung Ca with Chest tubes in place; evaluate for PTX History: as above 6-cm right basilar mass consistent with known lung cancer.Moderate right pneumothorax despite two right pleural drains.Left jugular catheter tip at SVC/RA junction level.

Output: Moderate right pneumothorax despite pleural drain and known right basilar lung cancer.


Instruction: Generate impression based on medical findings.

Input: Check IA BP The IABP marker remains projected of the aortic arch. ICD and right jugular PICC line unchanged.Moderate nonspecific cardiomegaly and grossly clear lungs unchanged. Midline sternotomy

Output: IABP marker unchanged


Instruction: Generate impression based on medical findings.

Input: 62-year-old female with history of uterine cancer and renal vein sarcoma. Complains of increasing left flank pain and hip pain and left lower extremity swelling. CHEST:LUNGS AND PLEURA: Two subcentimeter nodules in the right lower lobe on image number 135 and 144, series number 5.MEDIASTINUM AND HILA: Extensive superior and mediastinal adenopathy is again noted. Reference left paratracheal lymph node now measures 2.5 x 1.9 cm image number 16, series number 3. Previous described right paratracheal lymph node has coalesced with a lower right paratracheal lymph node and now measures 2 x 1.8 cm on image number 18, series number 3. Overall the size and the number of the lymph nodes have increased in the interval.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal adrenal mass measuring 2.6 x 2.5 cm on image number 83, series number 3.KIDNEYS, URETERS: Bilateral ureteral stents in both kidneys. Moderate hydronephrosis persists.RETROPERITONEUM, LYMPH NODES: Minimal interval increase in the confluent retroperitoneal soft tissue. A reference metastatic soft tissue measurement in the left para-aortic region measures 1.3 x 2.5 cm on image number 106, series number 3. Right retrocrural soft tissue density has also increased in the interval. Left renal vein is again encased by this soft tissue density.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Not visualized.BLADDER: Bilateral double-J stents.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ill-defined soft tissue surrounding the sigmoid colon and may be secondary to metastatic disease versus postsurgical/radiation changes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Interval increase in the size and number of the mediastinal adenopathy and retroperitoneal adenopathy. New subcentimeter lung nodules in the right lobe.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath ETT remains 4 cm above the carina. NG coiled in proximal stomach. Left jugular catheter terminates in the SVC just beyond the confluence.Persistent mild cardiomegaly with a right lower lobe opacity. Small effusion.

Output: ETT and persistent right pleural effusion and lower lobe nonspecific opacity unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: intubation History: intubation Severe cardiomegaly with lower lung zone edema, atelectasis and effusions, gradually worsening.Tubes and catheters are unchanged.

Output: Worsening CHF.


Instruction: Generate impression based on medical findings.

Input: 77 years old Female. Reason: systolic CHF with new SOB. Evaluate for pulm edema History: above. There is a minimal basilar interstitial opacity appears similar to the prior study. This may represent a very mild edema, but this is no significant pleural effusions. Mild cardiomegaly is noted. No septal line is seen. No specific evidence of infection. The left chest wall ICD electrodes are stable in position.

Output: Mild cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: 78-year-old patient with new bladder cancer. History of prostate cancer, evaluate for metastatic bladder cancer. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Borderline enlarged mediastinal lymph nodes. A referenced precarinal lymph node measures 15 x 13 mm image number 35.CHEST WALL: Asymmetric soft tissue density in the left breast which may represent gynecomastia. However further evaluation with mammography is recommended.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder has diffuse wall thickening with irregular borders and stranding within the perivesical fat.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: 3 x 2 cm lobulated soft tissue lesion in the right gluteal subcutaneous tissue with multiple calcifications is partially imaged. The etiology of this lesion is unknown. Clinical correlation and if necessary biopsy may be helpful.OTHER: No significant abnormality noted

Output: Borderline enlarged mediastinal lymph nodes. Right gluteal subcutaneous soft tissue mass.Thickwalled bladder with irregular borders and perivesical fat stranding.


Instruction: Generate impression based on medical findings.

Input: Male, 26 years old.Mechanical ventilation. Tracheostomy tube tip 2 cm above the level of the carina. Peripheral catheter from the right terminates at the level of the right subclavian vein near the clavicular head. Ventriculoperitoneal shunt catheter noted.Right upper lobe is partially collapsed, probably due to a mucous plug. Bilateral posterior lung field opacity with atelectasis about the same.

Output: Partial collapse of the right upper lobe, presumably due to bronchial mucus plugging. Opacities in the posterior lung fields likely reflect aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Acute respiratory failure Right chest wall Port-A-Cath tip is in the SVC. Left upper extremity PICC tip is in the SVC. Esophageal stent, enteric tube and left chest wall skin staples are unchanged. Tracheostomy tube is in place.New small amount of subcutaneous gas is noted in the left chest wall.Low lung volumes.New anterior left hydropneumothorax. Interval collapse of the left lower lobe.Bilateral nonspecific pulmonary opacities.

Output: New, loculated anterior left hydropneumothorax. Interval collapse of the left lower lobe.


Instruction: Generate impression based on medical findings.

Input: Male, 90 years old.Reason: eval for chf, pna, metastatic dx., hx of prostate cancer with cough History: cough. sob Left basilar scar like opacities unchanged, as is emphysema.Heart size normal.No evidence of metastases.

Output: No significant abnormality other than emphysema, and no evidence of metastases.


Instruction: Generate impression based on medical findings.

Input: Right upper segmentectomy Right chest tube projects into the apex with mild asymmetry in lung volumes and decreased on the right compatible with recent surgery. No distinct superimposed cardiopulmonary abnormality within this limitation. No significant pneumothorax.

Output: Right chest tube well-positioned with mild volume loss correlating with expected surgical changes


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Reason: history of PTX History: history of pTX Right pleural effusion surrounding lung, but the prior pneumothorax is no longer seen. Increased right basilar consolidation.Right pleural catheter.Left lung unremarkable.Right jugular catheter, tip in SVC.

Output: Increased right basilar consolidation and pleural fluid, with no pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 87-year-old female with history of tachypnea and increased O2 requirements. Cholecystectomy clips are present in the right upper abdomen. Right upper extremity PICC with tip at the cavoatrial junction. Left pleural catheter with tip near the midline. Mild cardiomegaly and left lower lobe consolidation. Small left pleural effusion. Stable calcified nodules in left upper lobe.

Output: Unchanged left basilar consolidation and pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: neutropenic fever History: see above PICC terminates in the SVC. No focal lung consolidation or evidence of overt left-sided heart failure. Unchanged cardiomegaly. Prominent central pulmonary arteries again noted. Azygos vein is again larger than expected. No large pleural effusion or pneumothorax. Large patient body habitus. Postoperative changes again noted within the upper abdomen.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: 20 years old Female. Reason: Evaluate for etiology of shortness of breath History: chest pain, shortness of breath, vaso-oclusive crises. There is no evidence for infiltrate in both lung, pleural effusion or pneumothorax. The cardiac silhouette is normal.

Output: Unremarkable examination


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Dyspnea status post liver RFA and resection (hepatic hemangioma). Evaluate cause for shortness of breath. Right upper quadrant drain unchanged in position. Right jugular introducer terminates at the level of the clavicular head.Lung volumes remain low. Elevation of the right hemidiaphragm unchanged. There is mild basal atelectasis and groundglass opacity which may reflect aspirated secretions. In the left base, airspace opacity appears progressed and may reflect pneumonia. No pneumothorax.

Output: Persistent left base airspace opacity which may reflect aspiration pneumonia in the appropriate clinical context. Atelectasis on the right. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 83 years old.Reason: s/p MVR, TVR, CABG, MAZE History: s/p MVR, TVR, CABG, MAZE Improvement in pleural effusions, left lower lobe consolidation and cardiomegaly.Mild basilar edema and small pleural effusions persist. Status post mitral and tricuspid repair.Left subclavian pacemaker, leads unchanged in position.

Output: Residual basilar edema and pleural effusions, improved since the prior study.


Instruction: Generate impression based on medical findings.

Input: 83-year-old female with history of lymph node enlargement CHEST:LUNGS AND PLEURA: Bilateral scattered micronodules are unchanged. Index left upper lobe nodule measures 5-mm image number 16, series number 6.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall mass measuring 2.9 x 1.6 cm on image number 14, series number 4. This mass is isodense to the surrounding musculature and in retrospect, it was present on the previous study measuring 2.5 x 1.9 cm on image number 12, series number 6.Borderline enlarged right axillary lymph nodes. Index node measures 9 mm in diameter on image number 16, series number 4, not significantly changed from previous study. Small left axillary lymph nodes are also unchanged.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific, scattered punctate hypodense lesions in the liver, too small to adequately characterize.SPLEEN: UnremarkablePANCREAS: Cystic lesion in the body and head of the pancreas are grossly unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts are unchanged. Left lower pole renal stone is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Right chest wall mass and borderline enlarged right axillary lymph nodes, minimally enlarged to a stable.Scattered micronodules are stable. Spiculated left upper lobe nodule is stable.Other findings are also stable compared to previous study.These findings are discussed and acknowledged by Dr. Chhablani


Instruction: Generate impression based on medical findings.

Input: Reason: post op History: post op Chest tubes on the right with minimal pneumothorax.Basilar opacities consistent with atelectasis and effusion, greater on the right.

Output: Basilar atelectasis and small right effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.Reason: iabp and swan position History: iabp, swan Intra-aortic balloon pump tip terminates immediately superior to the left mainstem bronchus. The right IJ Swan-Ganz catheter tip appears slightly superiorly angulated, possibly in the proximal right superior pulmonary artery. The remaining support devices are unchanged in position.Stable size of large left pleural effusion and associated atelectasis. No interval pneumothorax. Mild edema persists.

Output: Stable size left pleural effusion with mild pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Pleural neoplasm status post pleurectomy and decortication with air leak. Left chest tube has been retracted. The left apical pneumothorax is larger, now with maximal pleural separation from the chest wall of 2.5-cm. Diffuse subcutaneous emphysema. Elevation of the left hemidiaphragm with adjacent atelectasis and at least a small volume of pleural fluid. Right chest port unchanged in position.

Output: Increase in size of left pneumothorax, now 2.5-cm.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: tachypnea History: tachypnea PICC terminates in the SVC. Esophageal probe device appears to have been removed. Otherwise, lines and tubes, unchanged. Patchy opacities in the lungs bilaterally are unchanged. No large pleural effusion or pneumothorax. Unchanged heart size.

Output: Unchanged patchy lung opacities consistent with aspiration or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Age: 31 yearsGender: MaleReason for Study: Reason: increasing O2 requirement, lactic acidosis, eval RLL opacification History: RLL opacification Tracheostomy tube, enteric tube, and right IJ venous catheter unchanged.Stable cardiomediastinal silhouette.Persistent left retrocardiac consolidation/atelectasis.Mild improvement in the right basilar opacity.No new pulmonary opacities identified.

Output: Persistent left retrocardiac consolidation/atelectasis. Interval improvement in the right basilar opacity. Support devices unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: s/p picc -eval placement History: s/p right picc Right upper extremity PICC is kinked within the SVC with tip directed cranially.Right chest port tip in the RA.Enteric tube tip in the stomach.Moderate basilar and perihilar subsegmental atelectasis/scarring.Blunting of the costophrenic angles may represent small pleural effusions or additional scarring at the lung bases.

Output: PICC is kinked within the SVC with tip directed cranially.Findings were discussed with Alaine Kamm, NP on 4/20/2016 at 3:00pm.


Instruction: Generate impression based on medical findings.

Input: History of pancreatic cancer gram-negative bacteremia CHEST:LUNGS AND PLEURA: Bilateral emphysema. Multiple bilateral lung nodules. The nodule in the right middle lobe measures 10 x 7 mm image number 62/99.MEDIASTINUM AND HILA: Enlarged thyroid gland with multiple nodules.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple new hypodense lesions in both the liver suspicious for metastatic disease. A reference lesion in the left lobe measures 2.3 x 2.2 cm on image number 84/204. Pneumobilia and minimal intrahepatic prominence is present. A metallic stent is seen in the common bile duct. A plastic stent extends into the pancreatic duct.SPLEEN: No significant abnormality noted.PANCREAS: Patient's known pancreatic head mass measures 4.5 x 3.9 cm on image number 124, slightly enlarged from previous study. Plastic stent in the pancreatic duct.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral small kidneys in multiple cysts and vascular calcifications are unchanged.RETROPERITONEUM, LYMPH NODES: Portacaval, gastrohepatic, peripancreatic adenopathy is increased in size. A reference portacaval lymph node now measures 2.8 x 1.5 cm. Previously it was measuring 2.2 x 10 mm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Aortobifemoral bypass graft is again noted. Infrarenal abdominal aortic aneurysm with severe occlusive changes and bilateral occluded native iliac arteries are unchanged.PELVIS:UTERUS, ADNEXAE: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Interval slight increase in the size of the pancreatic head mass and retroperitoneal adenopathy. New hepatic metastases.Bilateral lung nodules suspicious for metastatic disease.Enlarged thyroid with multiple nodules.


Instruction: Generate impression based on medical findings.

Input: Age: 29 yearsGender: MaleReason for Study: Reason: PTX and atelectasis History: SOB Left thoracic vent unchanged.There are decreased lung volumes.Stable cardiomediastinal silhouette.Bilateral pulmonary opacities with left retrocardiac consolidation/atelectasis similar to the prior exam.No new pulmonary opacities identified.No evidence of pneumothorax.

Output: No interval change in the extensive pulmonary opacities. No evidence of a pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: patient with CT in place, h/o esophagectomy, w/ intrathoracic anastomosis, s/p esoph leak and pleural patch, assess for acute processes History: assess for acute processes Right chest tube and esophageal stent, unchanged.Moderate pleural effusions and basilar atelectasis.Minimal residual apical pneumothorax following chest tube removal.

Output: Minimal residual pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 55-year-old male metastatic thyroid cancer, evaluate for growth LUNGS AND PLEURA: Multiple pulmonary nodules demonstrate interval growth. No new nodules can be identified. Reference nodule (image 48, series 4) now measures 21 mm x 21 mm, previously, measuring 18 mm x 19 mm. Other enlarging nodules in both lungs (image 51, series 4) measures 15 mm x 12 mm previously measured 13 mm x 12 mm and (image 51, series 4) now measures 12 mm x 11 mm, previously, measuring 10 mm x 9 mm.MEDIASTINUM AND HILA: Prior CABG with extensive calcification of the coronary arteries.No hilar or mediastinal lymphadenopathy. Cardiac size is normal without evidence of a pericardial effusionCHEST WALL: Tracheostomy.UPPER ABDOMEN: Lithiasis.

Output: Interval increase in size of numerous pulmonary metastases. No new sites of disease identified.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: pt with pl effusion History: metastatic breast cancer Enlarging right peri-hilar mass with a persistent right pleural effusion.No specific evidence of superimposed pneumonia.

Output: Unchanged right pleural effusion with an enlarging right hilar mass.


Instruction: Generate impression based on medical findings.

Input: Male, 21 years old.Fever question infiltrates. Right sided Midline catheter tip at the SVC.Low lung volumes. Fine granular opacities in the lower lung zones could reflect interstitial pneumonia or other process, nonspecific. Other basilar opacities most likely reflect atelectasis.

Output: Fine interstitial abnormality nonspecific and could reflect viral pneumonia or other interstitial process.


Instruction: Generate impression based on medical findings.

Input: Male, 20 years old.Reason: 20M hx testicular cancer. Evaluate for metastatic disease. History: as above No evidence of metastatic disease.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: Cp History: above No significant cardiopulmonary abnormality.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 15-year-old female with Ewing's sarcoma and history of pleural effusion.VIEW: Chest AP (one view) 12/28/2016 1620 Left chest port terminates in the SVC. Unchanged large right chest wall mass and adjacent bone changes are again demonstrated. No pleural effusion or pneumothorax. The cardiothymic silhouette is within normal limits.

Output: Resolution of right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: COPD, increased SOB History: short of breath Persistent basilar opacities suggestive of subsegmental atelectasis with underlying scarring, possibly aspiration related.Heart size normal.

Output: Persistent basilar opacities suggestive of aspiration and/or scarring.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: check pulmonary status History: check pulmonary status Mild basilar edema and increased retrocardiac atelectasis possibly from aspiration.An NG tube terminates in the stomach.A Dobbhoff tube extends below the lower margin of the image.ET tube tip approximately 4 cm above the carina.

Output: New mild basilar edema and increased retrocardiac atelectasis, likely from aspirated secretions or mucous plugging.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: chest pain History: chest pain Borderline family with vascular congestion and mild edema are findings representing fluid overload.Right hemodialysis catheter with tip in right atrium. No pneumothorax. No pleural effusion.

Output: Fluid overload


Instruction: Generate impression based on medical findings.

Input: Age: 43 yearsGender: FemaleReason for Study: Reason: line replacement History: adjusting central line Right IJ venous catheter has been repositioned with tip now in the SVC.Stable cardiomediastinal silhouette.No new pulmonary opacities.

Output: ] Right IJ venous catheter repositioned with its tip now in the SVC.


Instruction: Generate impression based on medical findings.

Input: 44-year-old female with history of lung cancer CHEST:LUNGS AND PLEURA: Small left-sided pleural effusion. Volume loss involving the left hemithorax with areas of scarring. Left lower lobe, irregular soft tissue density likely represents a combination of patient's lung cancer and atelectasis. Irregular thickening of the left-sided pleura with patchy calcifications. Atelectasis of the left lower lobe.MEDIASTINUM AND HILA: Left hilar soft tissue density measuring 1.9 x 1.9 cm on image number 31, series number 3 which may represent a lymph node.Left-sided port catheter with its tip in the in the superior SVC.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: 7-mm hypodense lesion in the right lobe liver image number 70, series number 3.2.4 x 1.5 cm hypodense lesion in the right lower liver in image number 100, series number 3. This lesion cannot to optimally characterize on this single phase CT. MRI of the liver may be helpful for further evaluation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Para-aortic adenopathy measuring 1.2 x 1 cm image number 118, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Abdomen two stripe is dilated. Correlation with patient's menstrual cycle is recommended.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic left iliac bone lesion, nonspecific.OTHER: Small amount of free fluid.

Output: Ill-defined soft tissue density involving the left lower lobe that cannot be differentiated from the surrounding atelectasis and scarring likely representing patient's known lung cancer. Left hilar adenopathy. Left-sided pleural effusion.Small, Indeterminate liver lesions. Further evaluation with MRI of the liver may be helpful, if clinically indicated.Nonspecific para-aortic adenopathy.Dilated endometrial stripe. Further evaluation with pelvic ultrasound and correlation with menstrual cycle is recommended.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: Eval for pneumothorax History: S/P L and R Pleural tube removal Left PICC terminates in the upper left hemithorax. Mediastinal drains again noted. No large pneumothorax. Patchy bibasilar opacities. Unchanged heart size.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 51-year-old male with history of duodenal GIST. CHEST:LUNGS AND PLEURA: Punctate nodule in the right upper lobe is stable from 7/08 and is most likely benign (series 4; image 19).MEDIASTINUM AND HILA: Subcentimeter mediastinal nodes are stable, not pathologically enlarged by CT criteria.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cholecystectomy clips.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: A exophytic lesion in the upper pole of the right kidney is most likely a cyst, unchangedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Surgical clip adjacent to the fourth portion of the duodenum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No significant change. No evidence of disease.


Instruction: Generate impression based on medical findings.

Input: Hypertension and left-sided burning chest pain. No acute cardiopulmonary abnormality.Persistent mild left cardiac contour suggestive of prominent apical appendage.

Output: No acute disease


Instruction: Generate impression based on medical findings.

Input: Renal cell cancer CHEST:LUNGS AND PLEURA: No significant abnormality.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.A small hiatal hernia is seen.ABDOMEN:LIVER, BILIARY TRACT: Innumerable hepatic lesions are again identified, consistent with metastasis. The reference lesion in segment 4 AA is unchanged (series 6, image 76), measuring 12 x 11 mm (previously 14 x 11 mm). Diffuse fatty infiltration is again noted. A surgical defect is noted along segments 8/5.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right nephrectomy. Cyst in the midpole of the left kidney is stableRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Stable disease.


Instruction: Generate impression based on medical findings.

Input: Female, 84 years old.Reason: chest pain History: as above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: progression of opacity History: AMS Right central venous catheter tip is in the left atrium. Cardiomediastinal silhouette is unchanged. Tortuous aorta. No pleural effusion or pneumothorax. Previously noted left upper lobe opacity and diffuse reticular opacities are no longer seen. No focal pulmonary opacities.

Output: No specific evidence for infection.


Instruction: Generate impression based on medical findings.

Input: Reason: chest pain, eval mediastiunum History: CP Normal heart size and mediastinal contours.Small lung volumes with no significant abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: LVAD and cough. Left subclavian ICD, valve prosthesis, sternotomy hardware and an LVAD are unchanged; the far left sternal screw is partially retracted from the plate device.Cardiomegaly, similar to prior.The lungs are clear. Lung volumes are low normal. No evidence of pulmonary edema.

Output: No acute pulmonary abnormality. Cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: 74-year-old male with history of prostate cancer CHEST:LUNGS AND PLEURA: Bilateral numerous lung nodules consistent with metastatic disease. An index lesion in the right lower lobe measures 6 mm in image number 64, series number 4.MEDIASTINUM AND HILA: Mediastinal adenopathy. Index prevascular lymph node measures two by 1.3 cm in image number 37, series number 3. Small pericardial effusion.CHEST WALL: Heterogeneous, sclerotic bone lesions consistent with metastatic disease. There is also paravertebral soft tissue and on some of the upper thoracic vertebral bodies and lower thoracic vertebral bodies compatible with metastatic disease.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodense lesion in the left lobe cannot the optimally characterized due to lack of IV contrast on image number 98, series number 3. Another subcentimeter lesion in the left lobe is on image number 105, series number 3.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypodense lesions in both kidneys. They cannot the optimally characterized as a lack of IV contrast. There is also a hyperdense lesion measuring 12 mm on image number 116, series number 3 arising from the midportion of the left lobe. Lack of IV contrast limits optimal evaluation of these lesions. Renal cell carcinoma cannot be entirely excluded.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse, heterogeneous sclerotic lesions throughout the vertebral bodies which may be compatible with metastatic disease. A large lytic lesion L3 vertebral body.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Significantly enlarged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Limited study due to lack of IV contrast. Bone metastases as described above.Bilateral lung metastases.Mediastinal adenopathy.Trace pericardial effusionLeft renal hyperdense lesion, indeterminate, renal cell carcinoma cannot be excluded. Further evaluation with contrast-enhanced CT, MRI or ultrasound is recommended.Indeterminate small hypodense lesions in the liver


Instruction: Generate impression based on medical findings.

Input: 72 years old female with history of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Again noted innumerable bilateral pulmonary nodules consistent with metastatic disease. Index right middle lobe nodule measures 2.3-cm in diameter image number 55, series number 5, minimally enlarged compared to previous study. Index lesion in the left lower lobe measures 1.5 by 1.1-cm in image number 74, series number 5, again minimally enlarged compared to previous study.MEDIASTINUM AND HILA: Nonspecific hypodense focus within the left thyroid lobe is unchanged measuring 2.5-cm in image number 11, series number 3. Other scattered borderline enlarged mediastinal lymph nodes are also unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis with relative high density fluid in the gallbladder, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Large mass in the region of the pancreatic head measures 7.4 x 6.3 cm image number 109, series number 3, not significantly changed compared to previous study. Smaller lesion in the pancreatic body best seen on image number 98, series number 3 is also unchanged.ADRENAL GLANDS: Nodule in the right adrenal gland is unchanged measuring 1.5-cm on image number 93, series number 3.KIDNEYS, URETERS: Multiple hyperdense and soft tissue densely left kidney are incompletely characterized but not significant changed in size from prior. Largest lesion in the inferior pole of the left kidney measures 3.2-cm image number 130, series number 3.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Minimal interval increase in the size of the bilateral innumerable metastatic lung lesions.Peripancreatic/pancreatic metastatic lesions are unchanged.Indeterminate left renal lesions and right adrenal lesion are also stable.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Reason: new afib eval History: new afib Cardiomegaly and emphysema.No specific evidence of infection or edema.Left PICC, tip in SVC.Left axillary calcified node or joint body.

Output: Cardiomegaly and emphysema, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.ILD with chest pain evaluate for infiltrate. History of dermatomyositis per pathology report. Interval progression of interstitial abnormality, and now with numerous poorly defined nodular densities measuring up to 8mm in size. Lung volumes remain low normal. Normal heart size.

Output: Interval progression of interstitial lung disease now with diffuse nodular opacities. Recommend correlation with ILD protocol chest CT to exclude development of acute interstitial pneumonitis or , in the appropriate clinical context, opportunistic infection.


Instruction: Generate impression based on medical findings.

Input: Female 57 years old Reason: s/p esophagectomy; check Left Chest Tube Placement History: s/p esophagectomy; check Left Chest Tube Placement Right central venous catheter tip in the SVC. NG tube tip is at the diaphragmatic hiatus. A left-sided chest tube is present with its tip positioned inferiorly.Cardiomediastinal silhouette is within normal limits. Minimal retrocardiac atelectasis. Subcutaneous emphysema is noted in the left axilla.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: sob and wheezing on exam, eval for PNA or aspiration History: as above No significant cardiopulmonary abnormality.Left subclavian ICD, leads unchanged in position.

Output: No significant abnormality. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Reason: intubation History: intubation Endotracheal tube terminates 3 cm above the carina. The remaining support devices are unchanged.Persistent low lung volumes with moderate layering pleural effusions and edema-like opacities throughout the lungs. No pneumothorax.

Output: No change in the pulmonary edema with basilar atelectasis and moderate layering pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 76 years old.Reason: look for interval change in pneumothorax History: a Small left apical pneumothorax remains. Otherwise, no substantial change in left-sided pleural-parenchymal opacities. Unchanged heart size.

Output: Stable small left apical pneumothorax. Remaining findings are unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: hypoxia, dyspnea, concern for PNA History: as above Enlarging right pleural effusion.No new mediastinal lymphadenopathy and right lower lobe atelectasis from bronchial obstruction.Heart size normal.

Output: No evidence of new pneumonia. Unchanged right lower lobe postobstructive consolidation, an enlarging right pleural effusion and extensive mediastinal lymphadenopathy.


Instruction: Generate impression based on medical findings.

Input: 61-year-old male with mesothelioma. Please evaluate for disease as baseline prior to chemotherapy. CHEST:LUNGS AND PLEURA: Circumferential left sided pleural thickening, volumen loss, and loculated effusion compatible the patient's history of mesothelioma. Reference measurements as follows:At the left apex (series 3, image 21): 12 mm at the two o'clock position; 15 mm at the 6 o'clock positionAt the level of the aortic arch (series 3, image 34): 26 mm at the 5 o'clock position; 26 mm at the 10 o'clock positionAt the level of the IVC/RA junction (series 3, image 73): 20 mm at the 9 clock position; 14 mm at the 5 o'clock positionThe pleural thickening extends into the left supraclavicular space, best seen on series 80248, coronal image 41. Additionally it abuts the entire mediastinal surface with probable pericardial invasion (series 3, image 58). The pleural thickening also extends inferiorly into the costophrenic sulcus to the level of the spleen; please note that diaphragmatic invasion cannot be excluded on the basis of this examination. There is also chest wall invasion in the left lateral mid thorax right series 3, image 66).Multiple solid and ground glass pulmonary nodules are seen in the right lung, which may represent metastatic foci. No pleural nodularity is noted on the right.MEDIASTINUM AND HILA: A left paratracheal node measures 1.5 cm. No other enlarged mediastinal lymph nodes are identified. Heart size normal without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Well-defined low density lesions in the right hepatic lobe likely represent cysts. Multiple other subcentimeter low-density lesions are also seen and are too small to characterize. Cholecystectomy clips.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cysts. Enhancement of the left proximal ureter and renal pelvis is nonspecific but may be seen in patient's with infection.RETROPERITONEUM, LYMPH NODES: Small lymph nodes are seen in the upper abdomen.BOWEL, MESENTERY: Surgical suture line is seen near the splenic flexure of the large bowel.BONES, SOFT TISSUES: No significant abnormality noted.

Output: 1. Left pleural thickening and loculated pleural effusion compatible patient's history of mesothelioma with reference measurements as above. There is associated invasion into left chest wall and left supraclavicular region as well.2. Multiple < 1cm right sided pulmonary nodules may represent metastatic foci.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: 69F with MM s/p SCT with neutropenic fever. History: neutropenic fever, r/o signs of pulm infection Elevated right hemidiaphragm with a smaller atelectasis or scarring but no consolidation, effusion, or interstitial edema. Heart size within normal limits. Right central line has been placed in the interval with tip over the SVC and no pneumothorax.

Output: No acute cardiopulmonary abnormality. No pneumothorax post right central line placement, tip over the SVC.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: picc line pulled back on accident, pls comment on location of tip. History: as above PICC line now with tip in the peripheral subclavian vein. AICD device with leads in unchanged position.Cardiomediastinal silhouette is unchanged.No abnormal pulmonary opacities. No pleural effusions.

Output: PICC line now with tip in the peripheral subclavian vein. No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: eval lung fields History: cp, sob No acute cardiopulmonary abnormality.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: eval lung fields History: cp Heart size normal.Lungs clear.No pneumothorax. No pleural effusion.

Output: No specific evidence of infection or edema


Instruction: Generate impression based on medical findings.

Input: 45-year-old male with history of HIV CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Nonspecific mildly enlarged bilateral axillary lymph nodes. An index left axillary node measures 1.8 x 1.3 cm on image number 37, series number 3.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Nonspecific, mildly enlarged axillary lymph nodes.


Instruction: Generate impression based on medical findings.

Input: 62-year-old male, rule out pneumonia. Heart size is within normal limits.No focal pulmonary opacity or pleural effusion.Elevation of the left hemidiaphragm is noted.

Output: No specific evidence of pneumonia. Elevation of the left hemidiaphragm suggesting diaphragmatic dysfunction.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Reason: eval pulm edema History: hypoxia Basilar pulmonary opacities suggestion of edema and atelectasis are stable, with small pleural effusions left larger than right.Left PICC, tip pulled back house projected over the SVC.Median sternotomy for CABG.

Output: Right PICC repositioned. Stable pulmonary opacities and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 85 years old.Reason: Eval HF History: CHF NG tube tip in stomach.Lungs hypoinflated. No change in diffuse nonspecific interstitial opacity, possibly due to edema with underlying emphysema. Known pulmonary nodules were better seen on prior CT.

Output: No change in diffuse nonspecific interstitial opacity, possibly due to edema with underlying emphysema.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o pulmonary edema History: seizure, poss eclampsia Bilateral lower lobe airspace opacity, nonspecific but suggestive of aspiration.Pulmonary edema is considered less likely based on the appearance and distribution.Possible small right pleural effusion.

Output: Lower lobe air space opacities suggestive of aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: hypoxia History: desaturation Enteric tube beyond the field-of-view.The cardiac silhouette is enlarged but stable.There are no focal pulmonary opacities or large pleural effusions. Previously seen basilar opacities are near completely resolved.

Output: Cardiomegaly with resolving atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: baseline pulm status given hypoxia History: requiring O2 POD2 Bilateral lower lobe opacities which could represent both atelectasis and/or aspiration.Cardiomediastinal silhouette within normal limits. Mid and upper lung zones are clear. No pleural effusion. No pneumothorax.

Output: Basilar opacities representing atelectasis and/or aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: Pleural effusions History: Pleural effusions Left ICD device is unchanged. Right jugular catheter with tip in the SVC. Right PICC with tip in SVC.Interval improvement in the right-sided pleural effusion. Decrease in basilar edema.Cardiomediastinal silhouette appears unremarkable.

Output: Interval decrease in edema and right-sided effusion. Devices stable as above.


Instruction: Generate impression based on medical findings.

Input: Cough No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: Pre-operative evaluation The heart is normal in size.Lung volumes are normal. No abnormal focal lung parenchymal opacities.Blunting of the right posterior costophrenic angle of indeterminate nature, possibly representing scarring.Minimal degenerative changes of the thoracic spine.

Output: No abnormal radiographic findings to preclude surgical procedure.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old. ET tube and Dobbhoff tube unchanged.New right IJ Swan-Ganz with its tip in the pulmonary artery.Stable cardiomediastinal silhouette.Bilateral pleural effusions with perihilar opacities and basilar atelectasis similar in appearance to the prior exam.

Output: Interval placement of a right IJ Swan-Ganz with its tip in the pulmonary artery. Stable cardiopulmonary appearance with pleural effusions and bilateral pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Reason: extubated in micu, eval for interval change History: leukocytosis Interval extubation.NG tube tip in the stomach.Catheter tip in the SVC.Partial resolution of bilateral nonspecific pulmonary opacities with residual basilar atelectasis and a small left pleural effusion.

Output: Partial resolution of diffuse pulmonary opacity, with residual basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: 50 year-old female with metastatic breast cancer, now with hypoxia. Rule out PE. PULMONARY ARTERIES: No evidence of PE.LUNGS AND PLEURA: Interval increase in the right pleural effusion with areas of loculation. Right chest tube is present in unchanged position.Unchanged left pleural effusion.Marked worsening of the airspace disease bilaterally, left greater than right.Peribronchial thickening bilaterally.MEDIASTINUM AND HILA: Mild cardiomegaly with small pericardial effusion, unchanged.CHEST WALL: Multiple calcified micronodules are noted in right breast tissues.UPPER ABDOMEN: No significant abnormality noted on this very limited view of the abdomen.

Output: 1. No evidence of PE.2. Interval worsening of right pleural effusion now with areas of loculation and bilateral air space disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: 40 year-old female with autoimmune hemolytic anemia with new night sweats, weight loss, wheezing. The infection the lymphadenopathy. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Small nodes not pathologic by size criteria.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Splenomegaly to 15.1 cm as seen on coronal image 47/115 slightly more prominent on the prior exam when the spleen measured 13.2 cm on coronal image 35/96. Note that the accessory spleen is also increased in size and measures about 2.2 cm in diameter and coronal image 75/115 with on the prior exam it measured 1.6 cm on coronal image 5/96.Wedge-shaped hypoattenuating infarct is decreased in size. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Sub-centimeter hyperattenuating foci too small to characterize likely cysts and unchanged.RETROPERITONEUM, LYMPH NODES: Shotty portacaval and retroperitoneal nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Prominent left ovary possibly due to a hypoattenuating lesion consistent with a cyst. Right ovary is normal. Uterus normal.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Increase in size of spleen. Probable right adnexal cyst.Other findings as above.


Instruction: Generate impression based on medical findings.

Input: Age: 57 yearsGender: MaleReason for Study: Reason: chf History: sob There are decreased lung volumes with mild to moderate cardiac enlargement.Nonspecific basilar opacities are compatible with atelectasis.No focal areas of consolidation.No pleural effusions.

Output: Mild cardiac enlargement without specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: 19-year-old male with respiratory distress and oxygen requirement.VIEW: Chest AP (one view) 11/22/2015, 2003 Right PICC and left chest port with tips in the right atrium. Cardiothymic silhouette is normal. No new focal pulmonary opacities. No pleural effusion or pneumothorax.Mild thickening of the partially visualized transverse colon.

Output: No focal pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Reason: confirm ett History: confirm ett ET tube tip approximately 3 cm above the carina.NG tube tip in the gastric fundus.Moderate cardiomegaly.Small lung volumes with basilar subsegmental atelectasis, not significantly changed allowing for projection.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Status post resection for renal cell cancer with end-stage renal disease CHEST:LUNGS AND PLEURA: Linear atelectasis in the right lung base. Lungs are otherwise unremarkable.MEDIASTINUM AND HILA: Thyroid gland is enlarged with multiple heterogeneous nodules. Mild cardiomegaly and mild pericardial thickening.CHEST WALL: Small bilateral axillary lymph nodes.ABDOMEN:LIVER, BILIARY TRACT: The liver is enlarged and enhances heterogeneously. Particularly posterior segment of the right lobe near the dome demonstrates heterogeneous enhancement. Small amount of fluid is present around the liver near the dome. A focal lesion enhancing in the early phase is not well seen on the delayed phase images. This focal area measures 12 x 13 mm. Ill-defined heterogeneous areas are seen in the bilateral lobes, most prominent in the right lobe. In addition there are small subcentimeter lesions in the liver which are too small to accurate characterize. Simple cyst in the left lobe. No biliary dilatation. Mild periportal edema is present.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The patient is status post right nephrectomy. Left kidney content is numerous cysts. 3.6 x 2.9 cm soft tissue density lesion in the left lower pole is suspicious for a solid lesion. In addition there are multiple other hyperdense foci on these postcontrast images in the left kidney. Further evaluation of these lesions with a dedicated renal mass protocol CT is recommended.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy. A reference node measures 17 x 13 mm image number 62/96 on series number 7.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right inguinal collection measuring 2.7 x 2.6 cm.OTHER: Small amount of free fluid in the pelvis.

Output: Heterogeneous enhancement of the liver and mild periportal edema. Small indeterminate hepatic lesions. Given the patent vessels and mild cardiomegaly the etiology of this heterogeneous perfusion is not certain. Due to patient's elevated creatinine, the patient is not a candidate for a contrast enhanced MR.Suspicious lesion for another renal cell carcinoma in the left kidney. Dedicated renal mass protocol CT is recommended.Retroperitoneal adenopathy suspicious for metastatic disease.Right inguinal collection which may be secondary to recent iatrogenic procedure.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Reason: daily CCU CXR History: s/p IABP removal Interval extubation.Cardiomegaly with bilateral opacity compatible with edema, effusions and calcified pleural plaques. Other devices unchanged.

Output: Interval extubation and removal of aortic balloon. No other interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.COPD, history of lung cancer, productive cough Left hemithorax volume loss. Right hilar fullness is likely vascular in etiology and decrease in the prior exam. No specific evidence of infection, edema, or pleural effusions.

Output: Left hemithorax volume loss without evidence of infection or mass.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Reason: Positive ppd History: none Normal cardiomediastinal silhouette. No pulmonary opacity, pleural effusions or pneumothorax.

Output: No evidence of active TB.


Instruction: Generate impression based on medical findings.

Input: Male, 86 years old.Reason: chest pain History: chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 69-year-old male with malignant pleural mesothelioma status post-pleurectomy/decortication. CHEST:LUNGS AND PLEURA: Significant interval decrease in the nodular pleural thickening seen on recent PET/CT from 7/2010 with residual scarring and atelectasis at the left base. Given the lack of IV contrast on prior PET/CT, comparison measurements were not made to that study.1] main pulmonary artery (series 4, image 37): No measurable disease at any position. 2] aortic root (series 4, image 46): No measurable disease.3] left costophrenic angle (series 5, image 62): No measurable disease.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Moderate calcifications of the LAD with mild to moderate calcifications of the proximal left circumflex artery.CHEST WALL: Nondisplaced fracture of the left sixth rib is new since the PET/CT scan from 7/6/2010. Left chest wall Port-A-Cath with tip near the SVC/RA junction.ABDOMEN: LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Small loculated and possibly subcapsular fluid collection is seen at the posterolateral aspect of the spleen (series 4, image 74).PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the spine.

Output: 1. Significant interval decrease in the nodular pleural thickening in the left hemithorax with residual postsurgical scarring and atelectasis at the left lung base. 2. Small, loculated and possibly subcapsular fluid collection at the posterolateral aspect of the spleen. It is of uncertain significance but measures near water density and likely does not represent hemorrhage.3. Nondisplaced fracture of the left sixth rib is new since the PET/CT scan.


Instruction: Generate impression based on medical findings.

Input: Male, 27 years old.Reason: eval for effusion History: dialysis, uremia Heart size upper normal.No specific evidence of infection or edema.No sizable effusion.

Output: Heart size upper normal, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Syncope at dialysis, meets SIRS criteria. No focal airspace opacities, pleural fluid or pneumothorax. No specific evidence of pulmonary edema.

Output: No visible signs of pneumonia or edema. No acute pulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Patient presented with shortness of breath, currently on chemotherapy for myelodysplastic syndrome, evaluate for lung infiltrate. Cardiomediastinal silhouette is unremarkable. Mild bibasilar subsegmental atelectasis appears similar to the prior exam. There is an abnormal progression of left perihilar/suprahilar opacity, which may indicate atelectasis with a superimposed focal pneumonia. No pleural effusion or pneumothorax are identified.

Output: Interval increase in a left suprahilar and perihilar opacity, which may indicate atelectasis with superimposed pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: congestion History: congestion Cardiomegaly status post sternotomy.No specific evidence of infection or edema.

Output: Cardiomegaly, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: r/o mass vs PNA History: fevers of unknown origin, cough Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 43 yearsGender: MaleReason for Study: Reason: exam History: tamponade s/p pericardial window in recent heart txp Left PICC line with its tip in the left axilla.Right IJ Swan-Ganz with its tip in the pulmonary artery.Chest/mediastinal tubes in place without evidence of a pneumothorax. Sternotomy redo with the sternotomy intact.Retained ICD wire in the left subclavian vein.Pericardial drain noted.There is moderate cardiac enlargement and nonspecific basilar opacities compatible with atelectasis and small effusions.

Output: Postoperative chest without complications.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old. Left PICC line with its tip in the SVC.Right upper lobe nodule and right hilar lymphadenopathy increased in size since the prior exam.Scarring at the left lung base.No pleural effusions.

Output: Left PICC line with its tip in the SVC. Right upper lobe mass and right hilar lymphadenopathy increased in size from prior exam.


Instruction: Generate impression based on medical findings.

Input: 80 year-old female with history of lung cancer status post two cycles of chemotherapy. Please compare with previous study. Evaluate treatment response. CHEST:LUNGS AND PLEURA: Reference right lower lobe mass measures 39 x 30 mm (series 3, image 77 ) and is stable since prior study accounting for differences in technique.Multiple micronodules are again seen predominantly in the upper lobes. Right middle lobe ground glass opacity appears similar to prior study.MEDIASTINUM AND HILA: Confluent right hilar and mediastinal lymphadenopathy (predominately subcarinal) has decreased. The confluent right hilar adenopathy encasing the right main bronchus is again difficult to measure. Reference prevascular lymph node measures 18 x 13 mm (series 3, image 38); previously measuring 18 x 19 mm.Heart size normal without pericardial effusion.Significant coronary artery calcifications. Low density material in the right atrial appendage (series 3, image 58) is difficult to evaluate and may be followed on subsequent studies.Interval resolution of previously seen pulmonary emboli in the left lower lobe pulmonary artery branches.Intramural thrombus is again seen in the proximal descending thoracic aorta (grossly stable).CHEST WALL: No significant abnormality noted. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Marked atherosclerotic disease of the aorta and branch vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: IVC filter in expected location.

Output: 1. Stable right lower lobe mass with decreased hilar and mediastinal lymphadenopathy.2. Stable upper lobe micronodules.3. Low-density material in the right atrial appendage is difficult to evaluate and may be artifactual in etiology. This finding may be followed on subsequent studies.4. Interval resolution of previously seen pulmonary emboli in left lower lobe pulmonary artery branches.


Instruction: Generate impression based on medical findings.

Input: Dyspnea on exertion. History of non-small cell lung cancer Extensive fibrotic reticular changes are observed greater both bases and bilaterally similar to the recent chest CT. Superimposed emphysema with minimal basilar bronchiectasis is observed. No discrete superimposed new airspace abnormality. Again no discrete nodules or masses, however the CT described and evaluated right middle lobe paramediastinal mass is difficult to discern by plain film. Please correlate with the more sensitive chest CT.Cardiac and mediastinal contours are within limits

Output: Poor evaluation and delineation of the recently described right hilar right middle lobe nodular mass. No interval new acute cardiopulmonary abnormalities


Instruction: Generate impression based on medical findings.

Input: ETT check ETT remains 4 cm above the carina. NG coiled in the proximal stomach.Cardiopulmonary appearance is also similar with diffuse patchy confluent airspace opacities in all 4 quadrants with mild relative sparing of the right lower lung and more focally in the mid left lung. No new distinct superimposed focal airspace process Cardiac and mediastinal contours again remain within limits

Output: ETT unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: please evaluate post thoracentesis History: increased O2 requirement Pleural effusions and basilar atelectasis unchanged.No significant pneumothorax.

Output: No pneumothorax following thoracentesis.


Instruction: Generate impression based on medical findings.

Input: Reason: R/o Blood clots History: shortness of breath Enlarged central pulmonary arteries, consistent with pulmonary hypertension, with a lobulated appearance in the right hilum likely secondary to vascular structures, unchanged since the previous radiograph.No acute pulmonary abnormalities or other significant interval change.

Output: Pulmonary hypertension consistent with a previous diagnosis of chronic pulmonary embolism, with no acute change.


Instruction: Generate impression based on medical findings.

Input: 72-year-old male with metastatic melanoma CHEST:LUNGS AND PLEURA: A few subcentimeter nodules are identified in both lungs, unchanged. The reference left lower lobe nodule measures 5 mm (series 4; image 85), unchanged in size. MEDIASTINUM AND HILA: A surgical clip is seen in the previous location of the enlarged left supraclavicular lymph node. A right hilar lymph node measures 12 x 10 cm, not significantly changed (series 3; image 45). Calcified mediastinal nodes are again evident.CHEST WALL: Gynecomastia, unchanged.ABDOMEN:LIVER, BILIARY TRACT: The lesion in segment two of the liver is stableSPLEEN: Calcified splenic granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypodense renal lesions, likely cysts, are stable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable mild aneurysmal dilatation of the infrarenal abdominal aorta.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate gland is enlarged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Interval excision of the left supraclavicular lymph node. Otherwise, stable examination.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: eval PICC placement History: RUE picc Right upper extremity PICC tip terminates in the SVC.No focal lung opacity, pleural effusion, or pneumothorax. The heart size is normal.Partially imaged abdominal drain and surgical skin staples.

Output: Right upper extremity PICC terminates in the SVC.


Instruction: Generate impression based on medical findings.

Input: Male, 81 years old.Reason: swan pulled back 1cm Swan-Ganz catheter has been pulled back and terminate within the interlobar pulmonary artery. Cardiac leads, unchanged. Mild pulmonary edema pattern, unchanged. No substantial change in bibasilar pleural-parenchymal opacities. Unchanged cardiomegaly. No large pleural effusion or pneumothorax.

Output: Swan-Ganz catheter has been pulled back and terminate within the interlobar pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: Left posterior rib pain No consolidations, pleural effusions, or pneumothorax. No displaced rib fractures. However, chest radiograph not sensitive in this respect.No soft tissue abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: 59-year-old male with asthma. No focal airspace opacities, pleural effusions or pneumothorax. Normal cardiomediastinal silhouette.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: r/o pneumonia, effusions History: SOB, cirrhosis, fever Small lung volumes with minimal basilar atelectasis and a small left pleural effusion.Heart size normal.Prior PICC removed.

Output: Small left pleural effusion with small lung volumes and minimal basilar atelectasis. No reliable evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.Reason: r/o acute process History: chest pain Mild cardiomegaly.No specific evidence of infection or edema, prior edema resolved.Right subclavian catheter, tip in SVC.

Output: Cardiomegaly, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath Moderate bilateral pleural effusions and overlying basilar opacities are unchanged.No significant pneumothorax.Right jugular catheter, tip in SVC.

Output: Unchanged pleural effusions and pulmonary opacities. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 68-year-old male with history of cough. Evaluate for pneumonia. Chronic-appearing basilar predominant interstitial opacities compatible with interstitial lung disease, not significantly changed when compared to the prior study. No superimposed opacity to suggest infection.Cardiomediastinal silhouette is unchanged.

Output: Chronic interstitial lung disease without superimposed pulmonary process.