Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Shortness of breath, pleural effusion Left pleural thickening, pleural effusion, and adjacent atelectasis/consolidation is again noted and minimally improved. Nodular opacity left lower lung zone is better delineated on the current study. Interval removal of left pleural drain.No pneumothorax. Cardiomediastinal silhouette is normal.

Output: Left pleural thickening, pleural effusion, and adjacent atelectasis/consolidation is minimally improved.


Instruction: Generate impression based on medical findings.

Input: Reason: Respiratory distress, eval for PNA vs CHF, likely COPD exac though History: Shortness of breath Cardiomegaly with a markedly tortuous aorta.Small lung volumes with basilar opacities suggestive of subsegmental atelectasis.Mild blunting of the costophrenic angles may be due to scarring or atelectasis.No reliable evidence of pulmonary edema or pneumonia.

Output: Cardiomegaly and basilar atelectasis but no reliable evidence of pneumonia or pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: 8 year-old male with history of peritesticular rhabdomyosarcoma. Evaluate for metastasis. LUNGS AND PLEURA: The lungs are clear. No pleural effusion. No nodules or masses seen.MEDIASTINUM AND HILA: No hilar lymphadenopathy is seen. The heart is of normal size.CHEST WALL: Normal.UPPER ABDOMEN: Normal. No malrotation.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old.Reason: chest pain History: chest pain No significant cardiopulmonary abnormality.Bilateral shoulder prostheses.Cholecystectomy clips.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old.Reason: Swan-Ganz catheter placement History: CHF Swan-Ganz catheter terminates within the RPA. IABP metallic marker again projects over the aortic arch. ICD lead, unchanged. Low lung volumes with no substantial difference in mild bibasilar opacities without evidence of pneumothorax. Question of small pleural effusions. Unchanged cardiomegaly.

Output: Low lung volumes. Bibasilar opacities and small pleural effusions again noted.


Instruction: Generate impression based on medical findings.

Input: 79 year-old male with mesothelioma on chemotherapy. LUNGS AND PLEURA: Centrilobular emphysema is unchanged. Bilateral pleural effusions are also unchanged. Pleural reference measurements are as follows:1.Aortic arch level, 9 o'clock (image 25/95): 4 mm (unchanged from prior).2.Right pulmonary artery level, 10 o'clock (image 44/95): 7 mm (unchanged from prior).3.Left atrium level, 11 o'clock (image 51/95): 18 mm (unchanged from prior).Circumferential right pleural thickening predominately along the anterolateral and posterior surfaces is not significantly changed.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged. Cardiac size is normal with no pericardial effusion. Small cystic lesion within the right thyroid.CHEST WALL: Sclerotic focus within an upper thoracic vertebral body likely represents an infarct. Degenerative changes affect the spine.UPPER ABDOMEN: A small amount of peri-splenic ascites is incompletely evaluated but appears to have decreased in the interval.

Output: Stable right pleural thickening with reference measurements as above. Slight decrease in ascites with other stable findings as above.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: iabp placement History: iabp placement IABP marker unchanged. Left-sided AICD with leads unchanged.Stable mild cardiomegaly. No focal air space opacities, pleural effusions, or pneumothorax.

Output: No interval change


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old.Evaluate IABP placement The tip of the intra-aortic balloon pump is at the superior aspect of the left mainstem bronchus, and the proximal one third of the descending thoracic aorta. Advancement is recommended. The left univentricular AICD electrode emains in stable position.Persistent cardiomegaly without evidence of edema or interval pleural effusion. No pneumothorax.

Output: Intra-aortic balloon pump tip is slightly low, advancement by 2 cm is recommended.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: ETT History: ETT Basilar atelectasis unchanged suggestive of aspirated secretions or mucous plugging.The patient's neck obscures the right apex.ET tube tip approximately 4 cm above the carina.An NG tube extends below the lower margin of the image.

Output: Unchanged basilar atelectasis which may be from aspirated secretions or mucous plugging. ET tube tip approximately 4 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Reason: cp History: cp Cardiomegaly with small pleural effusions and nonspecific basilar atelectasis.No reliable evidence of infection or edema.

Output: Cardiomegaly with small pleural effusions and nonspecific basilar subsegmental atelectasis. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: 45-year-old male with new onset right upper quadrant pain any shortness of breath. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted. Specifically, no perihepatic or peridiaphragmatic fluid collections.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple left renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild submucosal fat deposition is seen the terminal ileum, which can be seen with chronic inflammation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No evidence of hepatic mass. No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: eval lung fields History: s/p MVR Interval extubation. Other lines and tubes, unchanged. Decrease in lung volumes. Increased diffuse pulmonary opacity. Question of small pleural effusions. No pneumothorax. Unchanged heart size.

Output: Interval extubation with lower lung volumes. Increased diffuse pulmonary opacities consistent with pulmonary edema and/or atelectasis. Small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: eval for effusions, CHF History: as above Study limited by leftward patient rotation. Trend toward worsening in diffuse pulmonary opacities. Pleural effusions, likely. Unchanged cardiomegaly. No pneumothorax. Enteric tube extends inferiorly off the field-of-view.

Output: Trend toward worsening in diffuse pulmonary opacities, likely pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: 80 y/o female with swan History: swan Swan-Ganz catheter looped in the right atrium and terminating in the right pulmonary artery, unchanged.No focal airspace opacity, pleural effusion, or pneumothorax.Moderate cardiomegaly.

Output: Again noted Swan-Ganz catheter looped in the right atrium, with tip in main pulmonary artery. No other interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.SOB and chest pain assess for signs of heart failure. No signs of CHF. Mild elevation of the right hemidiaphragm. Normal heart size.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: post CV surg, r/o pneumo / effusion History: post CV surg Median sternotomy with chest tubes but no pneumothorax.Unchanged basilar atelectasis with decreased lung volumes.Stable small pleural effusions.Status post extubation.Right jugular Swan-Ganz catheter, tip in right main pulmonary artery.

Output: No pneumothorax. Decreased inflation following extubation, otherwise unchanged with basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Chest pain Interval removal of right jugular sheath without complicationResolving an improvement in the overall extensive mixed airspace and largely interstitial abnormality without new superimposed focal airspace findings. Small effusions and borderline cardiomegalyMidline sternotomy

Output: Right jugular sheath removed with partially resolving suspected CHF


Instruction: Generate impression based on medical findings.

Input: Female, 84 years old.Reason: ? Infiltrate Recent Viral URI History: Cough Left chest pacemaker with leads unchanged. Cardiomediastinal silhouette is enlarged but unchanged. No specific evidence of edema. Right basilar bronchiectasis and interstitial opacities mildly increased compared to the prior exam. Linear scarring bilaterally. No specific evidence of infection. No pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.ETT inserted, airway compromise. ETT 4.5 cm above the level of the carina. Nasogastric tube looped in the stomach. Low lung volumes with elevation of the right hemidiaphragm. No focal pulmonary opacities. The main pulmonary artery appears enlarged, lymphadenopathy is less likely. Left upper lobe nodule.

Output: ETT 4.5 cm above carina. Left upper lobe nodule.


Instruction: Generate impression based on medical findings.

Input: Male 52 years old. Reason: re-eval consolidation noted on CXR 10/9 History: sob. Right-sided PICC terminates at the lateral aspect of the right subclavian vein near the axilla.Cardiomediastinal silhouette is within normal limits.Low lung volumes with bilateral pleural effusions and basilar atelectasis. Interval increase in perihilar nodular opacities compatible with aspiration/edema.

Output: Interval increase in perihilar nodular opacities compatible with aspiration/edema.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: assess PA catheter placement History: PA catheter in place Left-sided PICC appears to terminate in the azygos vein. Consider correlation with PA and lateral radiograph. Swan-Ganz catheter terminates in the RPA. Defibrillator lead terminates in the expected location of the RV. Moderate cardiomegaly. No new focal lung consolidation. No large pleural effusion or pneumothorax.

Output: Left-sided PICC appears to terminate in the azygos vein. Moderate cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: 75% TBSA burn; trach on vent History: hypercarbia Diffuse edema like pattern also consistent with ARDS, unchanged.Tracheostomy tube tip approximately 5 cm above the carina.A Dobbhoff tube extends below the lower margin of the image.Left jugular catheter tip in left brachiocephalic vein.

Output: Unchanged pulmonary opacities suggestive of ARDS.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: sob, productive cough History: sob Left lower lobe consolidation and left pleural effusion, progressed compared with prior study.Elsewhere, the lungs are unremarkable.The heart is moderately enlarged.

Output: Worsening left basilar opacity with pleural fluid consistent with infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 27 years old.Reason: edema? infection? History: syncope Small lung volumes.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: CAD. Preop CABG. Chest pain. Normal heart size. Central pulmonary vasculature upper normal in caliber. No focal airspace opacities, pleural fluid or pneumothorax area no evidence of pulmonary edema or pneumonia.Vascular calcification in the expected location of the carotid arteries bilaterally.

Output: No acute pulmonary abnormality. Severe carotid vascular calcifications in the neck bilaterally; this area may be further assessed with carotid duplex if clinically warranted.


Instruction: Generate impression based on medical findings.

Input: Male, 19 years old. Assess for infection. Normal cardiomediastinal silhouette.No abnormal pulmonary opacity, pleural effusion or pneumothorax.

Output: No evidence of pneumonia. No significant interval change.


Instruction: Generate impression based on medical findings.

Input: Age: 48 yearsGender: FemaleReason for Study: Reason: s/p thoracoscpy for left pleural effusion History: s/p thoracoscopy Left Pleurx catheter unchanged.Interval clearing of subcutaneous emphysema along the left lateral chest wall.No evidence of a pneumothorax.Stable cardiomediastinal silhouette.

Output: Persistent bilateral pleural effusions with loculation on the left.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Mitral valve insufficiency. Cardiomegaly with interstitial and pleural abnormality suggesting CHF, stable. ET tube is 7 cm above the carina. NG tube tip in the proximal stomach with the side port again near the GE junction. Chest drainage catheters again noted without measurable pneumothorax. Other tubes and lines are stable.

Output: CHF pattern, stable. ET tube 7 cm above the carina. NG-tube side port near the GE junction, stable.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: evaluate lung fields History: hx of pulmonary edema, inability to wean from vent Pleural effusions with pulmonary edema and basilar opacities are stable. Tracheostomy tube and venous catheter unchanged.

Output: No change in pulmonary edema, basilar opacity, and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.Chest tube removal evaluate pneumothorax. Severe emphysema. Left chest tube unchanged in position allowing for differences in patient orientation. The left apical hydropneumothorax is similar in size, approximately 19 mm. Minimal right hydropneumothorax, less than 5 mm in the costophrenic angle. Right cardiophrenic angle opacity nonspecific and unchanged.

Output: The right lung remains well expanded with only trace pneumothorax. Persistent left hydropneumothorax without significant change.


Instruction: Generate impression based on medical findings.

Input: 76-year-old male with desaturation status post wedge. Interval intubation with the tracheal tube tip 6 cm above the carina. Left apical chest tube unchanged.Small sub-5 mm left apical pneumothorax is better seen on subsequent study. Possible small left pleural effusion. Otherwise persistent small lung volumes with no significant interval change in left lung opacity and bibasilar subsegmental atelectasis.

Output: Interval intubation. Small left apical pneumothorax is better seen on subsequent study, otherwise no significant interval change in cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: 69-year-old male with metastatic prostate cancer, status post two cycles of investigational treatment, evaluation of disease CHEST:LUNGS AND PLEURA: Scattered micronodules unchanged.Minimal dependent bi-basilar atelectasisMEDIASTINUM AND HILA: Multiple enlarged lymph nodes identified in the subcarinal, prevascular, aortopulmonary window and hilar region, mostly unchanged. Index right hilar lymph node is slightly enlarged measuring 1.1 x 1.4 cm in image number 42, series number 3, unchanged. Mild interval increase in size of a pretracheal lymph node which is a new referenced measurement, measures 1.1 x 0.9 cm (image 27 comes series 3), previously measured 5 x 5 mm.CHEST WALL: Metastatic left scapular, posterior left 7th rib, T7, vertebral body and sternal lesions are unchanged.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: Index aortocaval reference node is unchanged measuring 7 by 5 mm on image number 122, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in the size and density of some of the sclerotic bone metastases involving the pelvic bones and lumbar vertebral bodies.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Interval increase in the size and density of some of the sclerotic bone metastases involving the pelvic bones and lumbar vertebral bodies, especially, L2, L3, vertebral body.OTHER: No significant abnormality noted

Output: Interval increase in the size and density of some of the sclerotic bone metastases involving the pelvic bones and lumbar vertebral bodies.Minimal interval increase in the size of the right pretracheal lymph nodeStable right hilar lymph node


Instruction: Generate impression based on medical findings.

Input: Age: 73 yearsGender: FemaleReason for Study: Reason: evaluation of right 7th rib fx History: as above Mild cardiac enlargement.Decreased lung volumes with mild basilar atelectasis.No evidence of a pneumothorax.No obvious rib fracture identified.Interval bilateral shoulder arthroplasties.

Output: No obvious rib fracture noted. Dedicated rib views are more sensitive. Mild basilar subsegmental atelectasis more pronounced on the left.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Status post fall. Chest pain. The lungs are clear without consolidation, effusion, or significant edema. No pneumothorax. No acute fractures identified. Surgical clips seen over the left upper abdomen.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 65-year-old male with history of renal cell carcinoma CHEST:LUNGS AND PLEURA: Left upper lobe nodulemeasures 1.7 x 1.6 cm on image number 35 series number 3, not significantly changed from previous study.Left lower lobe mass measures 1.2 by 0.9 cm on image number 69, series number 5, slightly smaller. Most of the other subcentimeter nodules are unchanged, although the nodule in the right upper lobe, basilar image number 26 has slightly increased in size.MEDIASTINUM AND HILA: Small mediastinal nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Small nonspecific hypodense lesions in the liver and presumed hemangioma near the dome of the liver on image number 72, series number 3 a unchanged. No new lesions in the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy. No evidence of recurrence. Right kidney is unremarkable.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: Enlarged prostate gland, unchanged.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: Mixed interval changes in the size of the lung nodules as described above. No evidence of recurrence of metastatic disease in the abdomen and pelvis.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: pna History: cough Mild cardiomegaly with pulmonary vascular redistribution.No specific evidence of infection or edema.No large pleural effusions.

Output: Mild cardiomegaly, otherwise unremarkable. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: s/p Port access AVR , ct out today r/o pnemothorax and pleural effusion History: s/p chest tube removal Mild improvement in right basilar opacity. Left discoid atelectasis unchanged. No other interval changes seen.

Output: Mild improvement in the right basilar opacity. Left basilar discoid is unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: et tube placement History: extubated ET tube tip approximately 3 cm above the carina. Left jugular catheter unchanged.Small lung volumes with diffuse nonspecific interstitial and airspace opacity, not significantly changed.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Cough, fevers and chills for 4 days, possible COPD. Evaluate for pneumonia. Chronic scarring and volume loss in the right lung, with elevation of the right hemidiaphragm and numerous metallic pellets overlying the thorax. Mild scarring on the left. Diminished vascularity of the lung parenchyma is suggestive of COPD/emphysema and is unchanged. No focal airspace opacity to suggest pneumonia.

Output: No signs of pneumonia. Scarring and volume loss in the right hemithorax is chronic. Hypovascularity suggestive of COPD/emphysema.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Reason: eval IABP placement History: IABP in place No significant pulmonary or pleural abnormality.Heart size normal.IABP catheter proximal marker 4 cm below the top of the aortic arch.Left PICC, tip in the SVC.

Output: IABP catheter proximal marker 4 cm below the top of the aortic arch.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lung fields History: sob, weakness, fever Extensive right lower lobe airspace opacity and probable pleural effusion. Mild airspace opacity at the left base with a component of atelectasis.Unremarkable cardiac and mediastinal silhouette.

Output: New nonspecific basilar airspace opacities compatible with pneumonia, possibly secondary to aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: s/p RL lobectomy History: s/p RL lobectomy Patient status post right lower lobectomy. 2 right-sided chest tubes noted. No definite pneumothorax. Small amount of right-sided subcutaneous emphysema noted. Right-sided pleural thickening versus pleural effusion, unchanged. Left lung remains clear. Mild rightward mediastinal shift. Unchanged heart size.

Output: Expected postoperative appearance status post right lower lobe.


Instruction: Generate impression based on medical findings.

Input: Age: 26 yearsGender: FemaleReason for Study: Reason: r/o cardiopulm process History: chest pain, back pain The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.Calcified hilar lymph nodes compatible with a prior granulomatous disease.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: 56-year-old male with history of cough and shortness of breath. Evaluate for pneumonia. LVAD and other support devices are unchanged. Severe cardiomegaly, unchanged. There is mild pulmonary vascular redistribution, equivocal edema.

Output: Severe cardiomegaly and mild pulmonary vascular redistribution, equivocal edema. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 73 yearsGender: FemaleReason for Study: Reason: S/p dual-chamber pacemaker History: None Left-sided pacemaker has been placed with lead wires and right atrial appendage and right ventricle.Cardiomediastinal silhouette is unremarkable.The lungs are clear.No pleural effusions.No pneumothorax.

Output: Interval placement of a left-sided pacemaker without complications.


Instruction: Generate impression based on medical findings.

Input: Reason: Fever, chills History: As above Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.Venous catheters extending to the SVC.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 55 yearsGender: FemaleReason for Study: Reason: eval for pulmonary edema History: ARDS Support devices unchanged.Stable cardiomediastinal silhouette.Diffuse interstitial opacities, left greater than right, similar appearance to the prior exams.No new pulmonary opacities identified.

Output: Support devices unchanged. Diffuse interstitial pulmonary opacities similar in appearance to the prior exam and compatible with edema superimposed on underlying emphysema.


Instruction: Generate impression based on medical findings.

Input: Pain in right shoulder and chest Large right effusion with underlying compression atelectasis as well as a small left fluid collection. Lungs are otherwise essentially clear, however abnormality within the right middle and lower lobes difficult to exclude due to collapse.Cardiac and mediastinal contours are grossly within limitsExtensive splenic arterial calcifications

Output: Unexplained large right pleural effusion with underlying compression atelectasis. Follow-up serial or CT imaging should be considered to ensure clearance and absence of an underlying secondary process.


Instruction: Generate impression based on medical findings.

Input: Reason: infiltrate History: PMH of sickle cell p/w chest pain Mild cardiomegaly with vascular redistribution.No acute abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Reason: hx of sarcoid, here w worsening exertional dyspnea History: above Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Mild cardiomegaly.

Output: No acute cardiopulmonary process on radiography. Mild cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: ptx History: ptx No significant pneumothorax.Improving right basilar opacities and pleural effusion.No new findings.

Output: No significant pneumothorax. Improving right basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Reason: known LLL pneumonia, evaluate for progression History: new "hot flashes"/chills Partial clearing of dense lingular and bilateral lower lobe airspace opacities, compatible with the clinical history of pneumonia.No new findings.

Output: Partial resolution of airspace opacities compatible with pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old. Reason: 2 weeks s/p lap chole with complaint of right sided mid back inspiratory pain and abnormal breath sounds. Please eval for pneumonia or pleural effusion History: abnormal breath sounds Mild cardiomegaly with enlargement left atrium. Tortuous thoracic aorta is again seen. Left basilar scarring or atelectasis. No new focal opacity, pleural effusion, or pneumothorax. Postsurgical changes in the left chest wall, unchanged. Left humeral head and surgical anchors, unchanged. No visible evidence of intraperitoneal free air.

Output: Cardiomegaly without acute pulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 40 years old.Reason: pneumonia History: pneumonia Moderate cardiomegaly.Worsening interstitial and airspace opacities consistent with edema or atypical infection.Tracheostomy tube tip approximately 6 above the carina.Right jugular catheter tip at RA level.Gastrostomy tube.

Output: Worsening pulmonary opacities more consistent with edema than infection.


Instruction: Generate impression based on medical findings.

Input: Chest pain and knee pain. Lupus Knee: Mild osteoarthritis without superimposed acute abnormality. A well-defined punctate calcification is observed in the lateral soft tissues, possibly related to an old healed MCL injury. Soft tissues unremarkableChest: Mild right basilar scarring without new superimposed acute cardiopulmonary abnormality

Output: Unchanged chest scarring and no distinct superimposed acute knee osseous abnormality. See details provided


Instruction: Generate impression based on medical findings.

Input: Nonspecific Pruritus Minimal scarlike changes observed in the mid right lung in both apices, yet without additional superimposed acute cardiopulmonary malady. Mild COPD changes are suspected.Borderline cardiomegaly with mild tortuosity of the aorta and atherosclerotic diseasePartially visualized IVC filter

Output: Mild COPD with suspected minimal scarring. No acute pulmonary disease


Instruction: Generate impression based on medical findings.

Input: Age: 67 yearsGender: FemaleReason for Study: Reason: rule out pneumonia History: short of breath, cough Stable cardiomediastinal silhouette.The lungs are clear.No pleural effusions. Moderate scoliosis of the thoracic spine.

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


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.IABP position. IABP marker unchanged in position projecting over the descending portion of the aortic arch. Interval placement of a Dobbhoff tube with tip just beyond the GE junction. Other monitoring and support devices unchanged in position. Elevation of the right hemidiaphragm unchanged. No focal air space opacities or signs of pulmonary edema.

Output: Dobbhoff tube tip just beyond the GE junction and may be advanced.


Instruction: Generate impression based on medical findings.

Input: Age: 21 yearsGender: MaleReason for Study: Reason: PNA? History: shorntess of breath 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: Permacath pain No fluid collection surrounding the catheter. Ovoid hypoechoic foci medial to the catheter likely represent reactive lymph nodes measuring up to 1.6 cm.

Output: Limited exam without evidence of fluid collections surrounding the catheter.


Instruction: Generate impression based on medical findings.

Input: Female, 85 years old.Reason: SOB, evaluate for effusions History: as above Retrocardiac opacity could be resolving consolidation or conceivably a hiatal hernia.No sizable pleural effusions.Heart size normal.Left PICC, tip in the SVC.Spinal stimulator device unchanged.

Output: Nonspecific retrocardiac opacity could be resolving consolidation or possibly hiatal hernia.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: location of ETT History: s/p intubation New ET tube, the tip 3 cm above the carina.Unchanged basilar opacities and pleural effusions.

Output: ET tube tip approximately 3 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: 57 yo post op patient with some hypoxia History: hypoxia Right upper lobe subsegmental atelectasis.Elsewhere, the lungs are unremarkable.Heart size normal.

Output: New right upper lobe subsegmental atelectasis, which may be from aspirated secretions or mucous plugging.


Instruction: Generate impression based on medical findings.

Input: Age: 71 yearsGender: MaleReason for Study: Reason: new admit with GIB and hypoxia, assess for pathology History: as above Left-sided ICD in caliber and unchanged.Stable cardiac enlargement.Chronic appearing interstitial opacities at the lung bases.No new pulmonary opacities identified.No large pleural effusions.

Output: Support devices unchanged. No acute abnormality identified.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: eval for edema/infiltrate History: shortness of breath Cardiomegaly with moderate interstitial opacities suggestive of edema with small pleural effusions.No specific evidence of infection.

Output: CHF with pulmonary edema and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 99 years old.Fatigue and abnormal breath sounds. Stable cardiomediastinal silhouette with cardiomegaly and calcified tortuous aorta.No focal airspace opacity, pleural effusions or pneumothorax.

Output: No acute cardiopulmonary abnormality or significant interval change.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: Female, 57 years old.Reason: r/o infiltrate History: crackles on exam Cardiomediastinal silhouette is normal. No specific evidence of infection or edema. No large pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormality without interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 32 years old.Reason: Rule out R pneumothorax History: s/p R IJ TLC placed No right internal jugular catheter identified. No focal air space opacity, large pleural effusion, or pneumothorax is identified.The cardiomediastinal silhouette is normal. Free intraperitoneal air in the right upper quadrant with surgical drain in place is presumably postoperative.

Output: 1.No right internal jugular catheter identified. No pneumothorax.2.Free intraperitoneal air is presumably postoperative and clinical correlation is recommended.


Instruction: Generate impression based on medical findings.

Input: 54-year-old male with shortness of breath and tachycardia. Cardiomediastinal silhouette is at the upper limits of normal with tortuosity of the aorta.No pneumothorax, pleural effusion, or consolidation.Scoliosis and degenerative osseous changes.

Output: Cardiomegaly. No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: Evaluate lung fields History: sob Cardiac size unchanged. There has been interval increase in right pleural effusion. Right greater than left patchy bibasilar opacities also appear increased. No pneumothorax

Output: Interval increase in right pleural effusion and right greater than left patchy bibasilar opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: rule ou atelectasis, pneumonia History: rising WBC Lungs hypoinflated with basilar atelectasis, unchanged.

Output: Lungs hypoinflated with basilar atelectasis, unchanged.


Instruction: Generate impression based on medical findings.

Input: Age: 55 yearsGender: FemaleReason for Study: Reason: r/o pneumonia History: URI symptoms with LLL crackle Stable cardiomediastinal silhouette.Markedly decreased lung volumes with basilar scarring/discoid atelectasis similar to the prior exam.No new pulmonary opacities identified.Again noted is severe kyphosis and marked anterior wedging of multiple midthoracic vertebrae.

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


Instruction: Generate impression based on medical findings.

Input: Female, 81 years old.Reason: AS, CHF History: SOB, chest discomfort Cardiomegaly with basilar edema, consolidation and pleural effusions.Right PICC, tip at SVC/RA junction level.

Output: Cardiomegaly with pulmonary opacities and pleural effusions consistent with CHF, although superimposed infection is in the differential diagnosis given the degree of consolidation.


Instruction: Generate impression based on medical findings.

Input: 78-year-old male with mesothelioma. LUNGS AND PLEURA: Nodular pleural thickening in the right hemithorax is without significant change, compatible with mesothelioma.Reference soft tissue lesions are as follows: 1. At the level of the aortic arch (series 3 image 32): 13mm at the one o'clock position, unchanged. 11 mm at the 3 o'clock position, unchanged.2. At the level of the aortopulmonary window (series 3 image 37): 9 mm at 3 o'clock, unchanged.3. At the level of the aortic valve on (series 3 image 60): 16 mm at the two o'clock, unchanged. 16 mm at the 3 o'clock position, unchanged. Multiple small right pulmonary nodules, unchanged from prior. Many of these are in the fissures and likely represent intrapulmonary lymph nodes. No new lesions.Right basilar pleural calcifications, similar to prior.Subtle nodular opacity of the left basilar pleura anteriorly, unchanged.MEDIASTINUM AND HILA: Extensive coronary artery calcifications. No pericardial effusion. Multiple subcentimeter mediastinal lymph nodes, unchanged. CHEST WALL: Right chest port with tip at the SVC/RA junction. Postoperative changes of the right hemithorax. Nodular opacities in the right posterolateral chest wall, similar to prior, suggestive of extrapleural metastatic disease.UPPER ABDOMEN: Cholelithiasis. Small right Bochdalek hernia, unchanged. Left renal cyst, unchanged. Moderate vascular calcifications of the abdominal aorta and its branches.

Output: No significant interval progression of disease.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Hypoxia evaluate lines, tubes and devices. ETT tip 4.5 cm above the level of the carina. Dobbhoff tube looped in the stomach. Left jugular catheter tip in the projection of the left brachiocephalic vein to the right of midline.Lung volumes remain low.Multifocal airspace opacities about the same. Atelectasis on the right is increasing.Unable to exclude small pleural effusions.

Output: Worsening pulmonary opacities and atelectasis suspicious for aspiration and infection. ETT tip 4.5 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Bladder cancer No cardiopulmonary acute abnormalities, mild COPD changes

Output: Mild COPD without superimposed acute abnormality


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: Eval IABP placement History: None IABP marker projects over the proximal descending thoracic aorta at the level of T5/T6. temporary pacemaker device which now projects over a branch of the coronary sinus.Patchy opacity in the medial aspect of the left base is slightly improved compared to prior.No pneumothorax.

Output: Support devices in stable position. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Age: 79 yearsGender: FemaleReason for Study: Reason: Is there a lobular PNA? History: SOB Right-sided ICD unchanged.Stable cardiac enlargement with atherosclerotic changes of the aorta.Right basilar scarring/atelectasis and right pleural effusion similar to the prior exam.No focal areas of consolidation.

Output: No interval change. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Gallbladder CA and right pleural effusion with unsuccessful thoracentesis in the past now with worsening SOB. Right jugular chest port tip at the SVC.Right basilar pleural thickening associated atelectasis, about the same. Moderate volume of pleural fluid on the left also with associated atelectasis has increased.

Output: New left pleural fluid collection with worsening atelectasis. Atelectasis and pleural thickening on the right is unchanged.


Instruction: Generate impression based on medical findings.

Input: 57-year-old female with cervical cancer. Pre-carinal lymph node/colonic implant CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: 16 x 10 mm lymph node at the carina (series 3 comment is 31), unchanged. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: 12 x 9 mm enhancing focus in segment 4 (series 3, image 79)SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst.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: The endometrial cavity is fluid-filled. A 2.4 x 2.0 x 3.1 cm fluid collection is seen within the cervix (series 3 image 173)-surrounding enhancement may be due to enhancing cervical mucosa. Numerous polypoid uterine masses are again visualized with scattered calcifications, suggestive of fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: Reference left external iliac lymph node has decreased in size, measuring 6 x 4 mm, previously measuring 13 x 10 mm (series 3 comment at 160)BOWEL, MESENTERY: The previously described implant along the distal sigmoid colon is no longer seen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Unchanged mediastinal adenopathy with decrease in size of the reference pelvic lymph node. Resolution of the rectosigmoid serosal lesion.New small enhancing hepatic lesion-please correlate with PETCTFluid collection in the cervical canal, suggestive of obstruction due to tumor and/or radiation therapy changes. Please correlate clinically to exclude infection.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: sob/cp History: above Right atrial appendage lead is more inferiorly oriented than study from 2015 but is unchanged compared to 4/2016. Other cardiac leads are unchanged. No focal lung consolidation or evidence of overt left-sided heart failure. Unchanged heart size. No large pleural effusion or pneumothorax.

Output: No acute cardiopulmonary process on radiography.Right atrial appendage lead is more inferiorly oriented than study from 2015 but is unchanged compared to 4/2016. Follow-up with EP cardiology is suggested. This unexpected finding was directly discussed with Dr. Barron from the emergency room at 8:16 AM on 9/14/2016.


Instruction: Generate impression based on medical findings.

Input: Bacteremia, evaluate for evidence of infection. Right jugular catheter tip at the SVC. No pneumothorax. No focal airspace opacities. Subsegmental atelectasis at the lung bases, right greater than left. Unchanged mild cardiomegaly. No specific evidence of pulmonary edema.

Output: No specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Reason: S/p bronch with biopsies, r/o PTX History: LTxp, s/p bronch w/ biopsies Extensive bilateral pulmonary and pleural abnormalities as previously described without significant change.No pneumothorax.

Output: Pulmonary and pleural abnormalities with no acute change.


Instruction: Generate impression based on medical findings.

Input: Male, 19 years old.Reason: eval for pathology History: malaise Cardiomediastinal silhouette is are unremarkable. No focal airspace opacity, pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: 54 year old female with history of lung cancer. Status post two cycles of chemotherapy and radiation therapy. Reevaluate. CHEST:LUNGS AND PLEURA: Upper lobe predominant centrilobular emphysema and small apical bullae. No suspicious pulmonary nodules or masses identified.MEDIASTINUM AND HILA: Interval decrease in right paratracheal lymphadenopathy (series 4, image 38), measuring 2.8 x 3.1 cm; previously measuring 4.2 x 4.9 cm.Heart size normal without pericardial effusion.Right thyroid nodule.CHEST WALL: The bones are severely demineralized, unchanged.ABDOMEN: LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Punctate hypoattenuating foci in the spleen are too small to characterize.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cysts bilaterally. Nonobstructing right renal stones.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease of the aorta and iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: The bones are severely demineralized and could represent metabolic disease, unchanged.

Output: 1. Interval decrease in the size of right paratracheal lymphadenopathy.2. Severe osteopenia, may represent sequela of metabolic disease.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Reason: r/o pna History: sob, 56M on home O2 2L, PMH copd, no f/c v/d but pt poor historian Cardiomediastinal silhouette is normal in size and configuration.COPD changes.Focal right apical opacity with apparent tethering and rightward displacement of the anterior junction line. Bibasilar pleural thickening with associated subpleural scarring. Nipple shadows project over the mid lung regions.

Output: 1.Asymmetric focal right apical opacity may relate to scarring but space occupying process/mass cannot be entirely excluded. Consider CT chest for further evaluation as clinically warranted.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Rule out foreign body, previously reported history of malignant neoplasm of the ovary Endotracheal tube terminates 3 cm superior to carina. The cuff is mildly overinflated. Right port catheter terminates at the central superior vena cava. Esophageal temperature probe in the midesophagus. Nasogastric tube side hole is positioned in the stomach. Minimal postoperative pneumoperitoneum.Retrocardiac atelectasis and consolidation. Heart size upper limits normal. No pneumothorax. No evidence of radiopaque foreign body. These findings were discussed by telephone with Dr. Lee, the attending surgeon, on 3/23/15 at 5:54 p.m.

Output: No evidence of radiopaque foreign body.


Instruction: Generate impression based on medical findings.

Input: Male, 29 years old.Reason: r/o PNA, rib fracture History: left sided intermittent chest pain Heart size normal.Lungs clear.No pneumothorax. No pleural effusion. No obvious rib fracture.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Presents with syncope and collapse. Repeat exam due to artifact. Normal cardiac silhouette. Mild elevation of the right hemidiaphragm. No focal airspace opacity or pleural effusion. Calcified hilar lymph nodes are compatible with healed granulomatous disease. Unchanged goiter. Severe vascular calcifications, including in the distribution of the carotid arteries.

Output: No acute cardiopulmonary abnormality or significant interval change. Severe vascular calcifications, including in the distribution of the carotid arteries.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, 63 years old.Reason: Needs prior to V/Q scan History: Needs prior to V/Q scan There are multiple osseous lucencies and rib deformities.There is hardware within the lower thoracic spine.Mild cardiomegaly.Metastatic nodules seen on chest CT are not visualized on this radiograph.

Output: Mild cardiomegaly and skeletal metastases with no significant change. No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 32 years old Male. Reason: interval change History: ecmo. There is interval worsening of the bilateral interstitial changes as compared with the prior study. The support devices are stable in position. Stable right and left small pleural effusions. There is no evidence of pneumothorax.

Output: Apparent interval increase of the interstitial changes.


Instruction: Generate impression based on medical findings.

Input: Age: 62 yearsGender: FemaleReason for Study: Reason: Interval change in pulm opacities, change in size of gastric bubble, new pneumothorax? History: s/p removal of apical chest tube; s/p bilateral lung transplant One of the 2 left-sided chest tubes has been removed. Left subclavian catheter unchanged.Volume loss in the right lung with right pleural thickening/effusion similar to the prior exam.Interstitial opacities in left lung including septal lines compatible with edema.No evidence of a pneumothorax.Subcutaneous emphysema noted along the left lateral chest wall.

Output: Removal of one of the 2 left-sided chest tubes. No significant pneumothorax identified. Interval increase in interstitial edema within the left lung.


Instruction: Generate impression based on medical findings.

Input: Male, 76 years old.Reason: eval PICC line position History: PICC Right PICC tip in right brachiocephalic vein. NG tube tip in stomach.

Output: Right PICC tip in right brachiocephalic vein.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o infection History: cough Unremarkable cardiac and mediastinal silhouette. Small calcified nodules compatible with previous infection and pleural thickening with possible calcification on the right.Focal opacity projected over the right anterior sixth rib is compatible with superimposed ribs, thickened bronchi and vascular structures.No specific evidence of pneumonia.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: 58-day-old female status post central line placement, evaluate position.VIEW: Chest AP (one view) 1/17/2015, 00:09 Endotracheal tube tip below the thoracic inlet and above the carina. Left chest tube with tip in the superior sulcus, position unchanged. Left upper extremity PICC with tip in the superior vena cava.Improved left basilar opacity. Small right pleural effusion evident, but no pneumothorax is seen. The cardiothymic silhouette is normal.

Output: Improved left basilar opacity and persistent small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: evaluate pleural effusion History: decreased breath sounds Changes of a prior median sternotomy. Surgical clips project over the mediastinum. Aortic valve replacement noted.The cardiomediastinal silhouette is normal. No pulmonary opacity, no pleural effusion, no pneumothorax. Interval resolution of bibasilar atelectasis and pleural effusions.

Output: No acute cardiopulmonary disease.


Instruction: Generate impression based on medical findings.

Input: 36-year-old male with infected pancreatic pseudocyst. Status post drainage. Left chest diffusion. Please evaluate abdomen and pelvis for fluid. CHEST:LUNGS AND PLEURA: Minimal left-sided pleural effusion. Air within the left pleural cavity may be secondary to recent tap. Bilateral dependent atelectasis. Left-sided pleural effusion has decreased in size.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: The mild intra-and extrahepatic biliary dilatation which has slightly increased compared to previous CT. No focal hepatic lesions. Small perihepatic collection is unchanged.SPLEEN: No change in the splenic infarct or parasplenic loculated gas fluid collection. Percutaneous drains unchanged in position.PANCREAS: Stable cyst gastrostomy. No change in the small collection adjacent to the pancreatic tail. Enhancement of the pancreas is unremarkable except for a small segment in the proximal body.ADRENAL 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: Interval decrease in the amount of the left-sided pleural effusion.Minimal increase in the amount of biliary dilatation. Otherwise no significant change in the abdomen findings.


Instruction: Generate impression based on medical findings.

Input: Female, 91 years old.Reason: weakness History: weakness Left basilar nodular opacity corresponding to presumed rounded atelectasis seen on CT, the lungs otherwise unremarkable.No specific evidence of infection or edema.Unremarkable mediastinal contours and cardiac silhouette.

Output: Stable left based benign-appearing nodule. No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for effusions History: intubated status ET tube tip approximately 2 cm above the carina.Catheter tip in the SVC.Small lung volumes with bilateral streaky opacities compatible with atelectasis, slightly improved compared to previous. Possible small pleural effusions.

Output: Small lung volumes with areas of atelectasis and possible small effusions.


Instruction: Generate impression based on medical findings.

Input: 74-year-old male with history of metastatic renal cell cancer. CHEST:LUNGS AND PLEURA: Stable centrilobular and paraseptal emphysema. Via apical scarring is unchanged.MEDIASTINUM AND HILA: Enlarged pulmonary arteries likely secondary to prominent arterial hypertension. Aneurysm involving the descending and descending thoracic aorta is unchanged. The descending aorta measures 5.2-cm descending aorta measures 6.2-cm in largest diameter. There is a focal aneurysm at the distal descending aorta.Previously measured pretracheal node and AP lymph node another lymph nodes are stable in size and appearance.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable hypodense lesions in the liver. Cholelithiasis is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Presumed left renal cyst is unchanged. Lack of IV contrast limits evaluation of solid lesions in the left kidney.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: Stable destructive lesion involving the right iliac wing. Stable lucencies in the left iliac wing.OTHER: No significant abnormality noted

Output: Large, Diffuse and focal aneurysms involving the thoracic aorta. No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Female, 29 years old.Reason: r/o infection/abnormality History: pain with inspiration at left posterior and anterior areas No pleural effusion or pneumothorax. Query left hilar nodular opacity. Cardiomediastinal silhouette is normal.

Output: No acute cardiopulmonary abnormality.Query left hilar nodular opacity. Consider repeat imaging in 8 weeks to re-evaluate this area or comparison to previous imaging.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Reason: rule out pneumonia History: cough Prior basilar opacities have resolved except for residual scarring or subsegmental atelectasis.No specific evidence of infection or failure.Heart size normal.Prior right jugular catheter removed.

Output: Near resolution of prior opacities with no current evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 46 years old.Reason: CT History: CT No change in position of chest tube. No evidence of significant pneumothorax. Venous catheters unchanged. Interval extubation. Improved aeration of right base. No new opacity.

Output: No change in position of chest tube. No evidence of significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: S/p AVR, MVR History: CT removed Left IJ sheath has been removed. Mediastinal drains and left basilar chest tube noted. Cardiac leads, unchanged. Patchy bibasilar pleural-parenchymal opacities again noted. No new focal pleural parenchymal opacity. No pneumothorax.

Output: Patchy bibasilar pleural-parenchymal opacities again noted. No new focal pleural parenchymal opacity. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 20-year-old male with history of end-stage renal disease, antiphospholipid antibody syndrome, lupus. Complains of hemoptysis. Evaluate for pneumonia. Stable cardiomegaly.Mild diffuse groundglass opacity.Chronic diffuse pulmonary nodular opacities stable.Stable small pleural effusions.

Output: Mild diffuse groundglass opacity which may reflect pulmonary edema or pulmonary hemorrhage.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: 52-year-old female status post esophagectomy and EGD with dilation. Enteric tube traverses the dilated conduit with its tip projecting over the left upper quadrant of the abdomen.Additional enteric tube is noted with its side-port in the distal neoesophagus.Interval removal of right chest tube with persistent minimal apical pneumothorax.Persistent large air collection projects over the mediastinum, similar in appearance to the prior exam; this is at least partially related to a dilated gastric conduit, although extraluminal air cannot be excluded.Low lung volumes with nonspecific basilar opacities compatible with atelectasis and pleural effusions.

Output: Persistent large air collection projecting over the mediastinum. This is at least partially related to a dilated gastric conduit, although extraluminal air cannot be excluded and CT chest would be of value if clinically indicated.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: Shortness of breath The heart size is at the upper limit of normal. Streaky retrocardiac opacity, suggestive of subsegmental atelectasis and peribronchial thickening. No large pleural effusion or pneumothorax.

Output: Basilar subsegmental atelectasis.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: Female, 74 years old.Reason: rule out chest metastasis History: hx of renal cell carcinoma and bladder ca Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No evidence of metastases.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old. Swan-Ganz catheter has been removed.Left IJ venous catheter with its tip in the left innominate.Right IJ venous catheter with its tip in the SVC.Right-sided ICD unchanged.ET tube with its tip 3 cm above the carina.Stable marked cardiac enlargement with basilar opacities, right greater than left, compatible with atelectasis/edema and small effusion.No new pulmonary opacities.No pneumothorax.

Output: Interval removal of a Swan-Ganz catheter and placement of a new left IJ venous catheter. Stable cardiopulmonary appearance with cardiomegaly and right basilar opacity.


Instruction: Generate impression based on medical findings.

Input: Check for pneumothorax. Following biopsy No immediate postprocedural complication. Diffuse patchy and somewhat confluent nodular opacities and masses are observed bilaterally but greater on the left with associated airspace component also on the left possibly representing edema or hemorrhage.Left subclavian port unchanged

Output: Unchanged cardiopulmonary appearance, specifically no postprocedural postbiopsy complication.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: shortness of breath and wheezing History: sob, wheezing Ill-defined nodular opacity above the minor fissure on the right could represent bronchiolitis, and there is right upper lobe bronchial wall thickening. Elsewhere, the lungs are unremarkable.Heart size normal.

Output: Possible right upper lobe bronchiolitis with bronchial wall thickening.


Instruction: Generate impression based on medical findings.

Input: Female, 20 years old.Reason: ? PTx History: chest pain Postsurgical changes related to left upper lobe pneumonectomy.The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormal. No pneumothorax is identified.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: pre OLT eval History: HBV, cirrhosis, coronary calcification Right pleural effusion larger than before, occupying nearly 1/2 of the right hemithorax volume compressing the right lower lobe.Moderate cardiomegaly.Left lung unremarkable.

Output: New large right subpulmonic pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: CHF s/p LVAD, eval hardware, eval for pulm edema History: as above Moderate cardiomegaly, slightly increased from the prior exam.Low lung volumes. Increased interstitial opacities and vascular redistribution. No large pleural effusion or pneumothorax.Interval placement of a central venous catheter with its tip is in the SVC. Postsurgical changes of median sternotomy. Left-sided ICD with leads intact. LVAD in place. Surgical clips project over the right axilla.

Output: Mild pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: possible lung infxn History: inc white count Right IJ central venous catheter terminates at the superior atriocaval junction. A left internal jugular double-lumen central venous catheter terminates at the confluence of the brachiocephalic veins. Single lumen left central venous catheter terminates at the superior atriocaval junction. Tracheostomy tube is notedPatchy bilateral nodular opacities are similar in distribution to the prior exam, slightly increased in left lung base. Small bilateral pleural effusions are unchanged. No pneumothorax. The heart size is stable.

Output: Diffuse nodular patchy opacities with mildly increased left retrocardiac opacity which may reflect aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: s/p VATS LUL. Assess lung expansion and effusion History: s/p VATS LUL. Assess lung expansion and effusion Two left chest tubes unchanged, with resolution of prior pneumothorax.Postsurgical left hemithorax volume loss.Small right pleural effusion.

Output: Resolution of prior left pneumothorax.


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 extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: No significant abnormality of the extra cardiovascular portions on this limited examination.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Reason: s/p trach History: SOB Feeding tube terminates within the stomach and could be advanced clinically indicated. Tracheostomy remains in place. No new focal lung consolidation. Patchy left basilar opacities again noted. Unchanged heart size. No acute bony abnormality.

Output: Feeding tube terminates in the stomach and could be advanced if clinically indicated. Patchy left basilar opacities again noted.


Instruction: Generate impression based on medical findings.

Input: Female, 43 years old.Reason: assess for fluid overload History: Shortness of breath Low lung volumes. Stable cardiac enlargement. No new airspace or interstitial opacities. No pleural effusions. No pneumothorax.

Output: No interval change


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old. IABP appears to be at the level of the aortic knob.Stable line position.No change in lung opacities.

Output: No change in lung opacities. IABP BX level of the aortic knob.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: assess for infection History: mildly altered, undergoing chemo RT so immunosuppressed and leukocytosis on admission Large lung volumes consistent with COPD.Heart size normal.No specific evidence of infection or edema.Right jugular catheter, tip in SVC.

Output: COPD, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.History: Breast cancer. Symptoms: Cough, dyspnea. Stable cardiomediastinal silhouette, mild cardiomegaly.Bibasilar streaky opacities, possible with atelectasis/scarring, stable in appearance.Blunting of the bilateral cardiophrenic angles, compatible with small pleural effusions or scarring.Right arthroplasty. Marked deformity of the left humeral head.

Output: Stable mild cardiomegaly and basilar atelectasis/scarring. No evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: hypoxia, eval for underlying PNA, pt now s/p volume removal with HD History: hypoxia Significant improvement in pulmonary opacities with residual disease on the right. Heart size upper normal, status post sternotomy for CABG.Right jugular catheter, tip at SVC/artery junction level.

Output: Significant improvement in pulmonary opacities with no new findings.


Instruction: Generate impression based on medical findings.

Input: Age: 62 yearsGender: MaleReason for Study: Reason: interval change History: interval change Right-sided chest tube, NG tube, and right Port-A-Cath unchanged.No pneumothorax identified.Decreased lung volumes with stable cardiomediastinal silhouette.Mild basilar atelectasis.No new pulmonary opacities identified.

Output: No interval change with mild basilar atelectasis. No pneumothorax identified.


Instruction: Generate impression based on medical findings.

Input: Female, 89 years old.Syncope and history of sarcoidosis. Calcified mediastinal and hilar lymph nodes compatible with granulomatous disease.No focal airspace opacity, pleural effusions or pneumothorax.Normal cardiac silhouette size.Scoliosis.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 39 years old.Reason: sob History: sob Interval increase in large right pleural effusion.No change in scarring or atelectasis seen in the left lung. Cardiac silhouette unchanged.

Output: Interval increase in large right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Reason: sob History: sob Moderate to severe cardiomegaly.Unchanged pulmonary opacities and pleural effusions.Left subclavian catheter, tip in SVC.Right subclavian dual chamber pacemaker, leads unchanged in position.

Output: Pulmonary opacities and pleural effusions consistent with CHF/hypervolemia, unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 84 years old.Reason: infiltrates History: dyspnea Unchanged basilar opacities suggestive of edema and/or aspiration, left worse than right.Small right pleural effusion unchanged.

Output: Stable basilar opacities suggestive of edema and/or aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Chest pain evaluation. No focal airspace opacity, pleural effusion, or pneumothorax.The cardiomediastinal silhouette is within normal limits.

Output: No acute cardiopulmonary process. 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: Age: 32 yearsGender: MaleReason for Study: Reason: ecmo, s/p lung txp History: ecmo, s/p lung txp ET tube has been removed.Dobbhoff tube with its tip beyond the margin of the image.Right central venous catheter with its tip in the SVC.ECMO catheter extending to the right atrium.Stable cardiomediastinal silhouette.Mild nonspecific basilar opacities with small effusionsNo new pulmonary opacities noted.

Output: Support devices unchanged including ECMO catheter. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Age: 26 yearsGender: FemaleReason for Study: Reason: eval for pathology History: CP 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: Male, 68 years old.Status post cardiac arrest. Fever. Left IJ catheter terminates at the confluence of the brachiocephalic veins. Tracheostomy tube tip approximately 6 cm from the carina. Enteric tube projects beyond the film. Stable cardiomegaly. No focal pulmonary opacity, large pleural effusion, or pneumothorax.

Output: No acute pulmonary process..


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Perforation of esophagus, ETT placement. No endotracheal tube is identified.Extensive pneumomediastinum and subcutaneous emphysema bilaterally.No pneumothorax.Moderate to large layering left pleural fluid collection. Mild to moderate pulmonary edema. Nonspecific basal opacities and atelectasis, possibly the result of prior aspiration.

Output: Extensive pneumomediastinum and subcutaneous emphysema. Left pleural fluid collection, pulmonary edema and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.Pneumonia. Coarse breath sounds. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal.

Output: No acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: Female, 26 years old.Prekidney transplant, evaluate cardiomegaly, rule out infiltrates Cardiomegaly, unchanged. No specific evidence of infection or edema. Small bilateral pleural effusions. Right IJ dual-lumen catheter tip can't the cavoatrial junction.

Output: Cardiomegaly with small bilateral pleural effusions. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Unstable angina Mediastinal and left basilar chest tubes are unchanged. No associated significant pneumothorax. Swan-Ganz extends in the right ulnar outflow tract.Moderate cardiomegaly with diffuse cardiopulmonary changes are similar largely perihilar edema-like changes with relative sparing of the right lung base

Output: Chest tubes unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.History of COPD, wheezing, AMS, evaluate for pneumonia. Mildly hyperinflated lungs with peribronchial cuffing compatible with emphysematous changes better seen on CT. The right middle lobe pulmonary nodule is again noted, unchanged in appearance. There is increased airspace opacification in the right lung base. The heart size is within normal limits. Metallic catheter tip projects over the right hemiabdomen.

Output: Increased opacification in the right lower lobe may represent a developing bronchopneumonia without evidence of consolidation.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Endocarditis. Status post MVR POD 1 Tubes and lines unchanged in position. The sidehole of one of the right upper chest tubes projects outside the bony thorax overlying the right chest wall soft tissues. No significant pneumothorax. Small volume of laterally loculated pleural fluid on the right unchanged. Mild atelectasis, but no specific signs of pulmonary edema.

Output: No acute change. Sidehole of a right upper chest tubes projects over the right chest wall soft tissues, outside of the bony thorax.


Instruction: Generate impression based on medical findings.

Input: Age: 42 yearsGender: FemaleReason for Study: Reason: trauma, mvc History: trauma mvc The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: 67 years old Male. Reason: ADHF History: ADHF. The cardiac and mediastinal silhouette is enlarged. There is no evidence of acute infiltrate, pleural effusion or pneumothorax. The left AICD are stable in position.

Output: Cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: 84-year-old male history of metastatic renal cancer to the liver. Assess for disease progression. Lack of IV contrast limits evaluation of solid organs and vasculature.CHEST:LUNGS AND PLEURA: Bilateral punctate micronodules are unchanged. No new or suspicious nodules are noted.Azygos fissure is also unchanged.MEDIASTINUM AND HILA: No mediastinal lymphadenopathy. Heavy coronary artery calcifications are noted. Minimal pericardial fluid is unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Cystic mass in the head of the pancreas is unchanged and measures 2.4 x 3.3 cm (series 3, image 109). Also, nodularity of the pancreatic tail is unchanged when compared to studies dating back to 2010.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Patient is status post left nephrectomy without evidence of local recurrence. Multiple lesions in the right kidney are unchanged and consistent with high density cysts.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta are noted.BOWEL, MESENTERY: There is stable mild prominence of the mesenteric fat, suggesting panniculitis. BONES, SOFT TISSUES: There is a deformity of the left iliac ring, which is unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mesenteric panniculitis appearing similar to the prior study.BONES, SOFT TISSUES: Unchanged deformity of the left iliac ring. Degenerative disease affect the lumbar spine.OTHER: No significant abnormality noted

Output: 1.No evidence of recurrence or metastatic disease.2.Stable pulmonary micronodules.3.Stable right kidney lesions, consistent with hyperdense cysts.4.Stable cystic pancreatic head mass and stable nodularity of the pancreatic tail.5.Stable mesenteric panniculitis.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: assess for iabp placement History: sp iabp IABP marker in proximal descending thoracic aorta. Other findings stable.

Output: IABP marker in proximal descending thoracic aorta.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: Preop TECAB History: Preop TECAB The heart is normal in size.Lung volumes are normal. No abnormal focal lung parenchymal opacities.The pleural spaces and visualized bones are within normal limits.The pleural spaces

Output: Chest radiograph within normal limits.


Instruction: Generate impression based on medical findings.

Input: Male, 82 years old.Reason: re-eval consolidation / edema History: desaturation ,distress NG tube tip in stomach. Tubing external to the patient overlies the neck and upper chest.Persistent nonspecific pulmonary opacities, likely edema possibly with superimposed infection, unchanged.

Output: Persistent nonspecific pulmonary opacities, likely edema possibly with superimposed infection, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: chest congestion and cough History: 62Yrs female with newly diagnosed T3N3 hpv negative supraglottic squamous cell carcinoma, s/p induction chemotherapy with carboplatin/taxol followed by 5/5 cycles of TFHx completed on 3/25/16. Left chest port with tip in the SVC. No focal pulmonary opacity. No pleural effusion or pneumothorax. No specific evidence of infection or edema.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: SOB, sickle cell disease, prior to transplant History: SOB Heart size about upper normal with increased upper zone blood flow compatible with sickle cell disease.Venous catheters extending to the SVC/RA junction.Streaky basilar opacity consistent with subsegmental atelectasis, increased compared to previous.

Output: Increased basilar subsegmental atelectasis and no other significant change.


Instruction: Generate impression based on medical findings.

Input: Reason: cough and dyspnea in ovarian cancer pt History: see above Bilateral diffuse reticular and nodular opacities mainly in the lower lobes, suspicious for lymphangitic spread of tumor.Bilateral pleural effusions, larger on the right.Hilar and mediastinal lymphadenopathy, confirmed on a previous CT scan.Tumor nodule indenting the medial aspect of the gastric air shadow.

Output: Findings suggestive of lymphangitic spread of tumor with pleural effusions.


Instruction: Generate impression based on medical findings.

Input: 64-year-old male with pelvic fluid collection status post IR drainage now with cyclic fevers and leukocytosis. Assess fluid collection. CHEST:The lack of intravenous contrast limits exam sensitivity for detection of lesions of the solid organs and bowel. With those limitations, the findings are as follows:Motion artifact limits the sensitivity of the examination.LUNGS AND PLEURA: Dependent atelectasis, greater on the right.MEDIASTINUM AND HILA: Endotracheal tube tip is above the carina. A right Port-A-Cath with tip in the SVC. Left PICC with tip in the SVC.The heart size is normal. There is no pericardial effusion.CHEST WALL: Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Unchanged hypodensity in the left lobe of the liverSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Abdominal aortic atherosclerotic calcifications.BOWEL, MESENTERY: Enteric tube tip is in the body of the stomach. The small bowel loop dilatation is still evident but has improved from previous examination. The large bowel remains decompressed.BONES, SOFT TISSUES: Postsurgical changes in anterior bowel wall with open wound. Degenerative changes of thoracic spine.OTHER: Left lower quadrant abdominal drain in unchanged position.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: Post surgical changes of neobladder with no evidence of complication. Foley catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Enteric tube tip is in the body of the stomach. The small bowel loop dilatation is still evident but has improved from previous examination. The large bowel remains decompressed.Rectal tube has been removed.BONES, SOFT TISSUES: Degenerative changes of lumbar spine. Bulky ossification involving the left iliac extending toward the left greater tuberosity, unchanged.OTHER: The pelvic fluid collection measures 4.8 x 6.6 x 9.3 cm with adjacent fat stranding (series 3, image 169), previously measuring 6 x 8 x 10 cm. There is a pigtail drainage catheter with its tip in communication with the fluid collection. There is a layering component of the fluid collection (Series 3, image 159). A smaller abscess is again seen in the right paracolic gutter (Series 3, Image 149).

Output: 1. Slight interval improvement of pelvic fluid collection with pelvic drain in communication with fluid collection. Stable right paracolic gutter fluid collection. No new fluid collections.2. Improved small bowel obstruction.


Instruction: Generate impression based on medical findings.

Input: 50 years old Male. Reason: eval for volume overload History: dyspnea, tachypnea, volume resuscitation. The tip of the left upper extremity PICC line projects over the junction of the right brachiocephalic vein and SVC. Small lung volumes with basilar linear densities.

Output: The tip of the left upper extremity PICC line projecting over the junction of the right brachiocephalic vein and SVC


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Syncope evaluate pneumonia, volume. Cardiomegaly, tortuous thoracic cord and enlargement of the central pulmonary vasculature. Vascular unsharpness suggests mild CHF. No signs of pneumonia.

Output: Mild hypervolemia. Enlargement of the central pulmonary vasculature may indicate pulmonary hypertension.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Shortness of breath. Normal heart size.No significant pulmonary or pleural disease.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Reason: Bowel obstruction Chest: Postsurgical changes in the right midlung following wedge resection. Stable emphysematous changes with underlying mild chronic interstitial changes. New left midlung and near atelectasis. Displacement of the azygoesophageal recess represents the dilated esophagus with a new air-fluid level. Bilateral breast implants. No subphrenic free air.Abdomen: Retained contrast is again seen throughout the colon, which remains dilated without significant interval change. There has been some interval decrease in opacification of the bowel loops in the pelvis and the previous area of narrowing is not definitely seen. No free intraperitoneal air. Calcified uterine fibroid.

Output: No significant interval change in colonic distention, remaining suspicious for distal obstruction. No free intraperitoneal air.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Central line placement. Right jugular catheter tip at the level of the superior cavoatrial junction. Dependent atelectasis bilaterally, new in the right upper lobe. No pneumothorax.

Output: Right jugular catheter tip near the superior cavoatrial junction, no pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Cough Persistent mildly decreased lung volumes with minimal basilar atelectasis or scarring, greater on the left, unchanged. No suspicious new focal abnormalities

Output: Minimal scarring and atelectasis


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: ? Volume overload History: SOB Support devices are unchanged in position. There is evidence of prior coronary arterial stenting.No evidence of pulmonary edema or significant pleural effusion. The heart size is within limits of normal. No pneumothorax.

Output: Stable position of support devices without interval pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 24 years old.Fever and cough. The cardiomediastinal silhouette is within normal limits. No focal airspace opacity, significant pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormality.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: Female, 76 years old.Reason: tachycardia, congestion, desatting in postop patient History: tachycardia, congestion, desatting in postop pt Lungs hypoinflated. No acute cardiopulmonary abnormality.

Output: Lungs hypoinflated. No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 82 years old.Fluid overload versus infection. Cough. Exam limited by patient motion. Vascular unsharpness at least partially artifactual but mild pulmonary edema cannot be entirely excluded. Subsegmental atelectasis or scarring in the bases, mild. Cardiomegaly and mediastinal widening about the same. The azygos arch and superior vena cava appeared dilated, suggesting hypervolemia. Unable to accurately assess caliber of the aorta given patient rotation.

Output: Exam limited by motion. Basilar subsegmental atelectasis or scarring. Unable to exclude mild pulmonary edema or aspiration. If the patient remains symptomatic, follow-up chest radiograph is suggested, preferably with PA and lateral technique. Signs of hypervolemia. Unable to exclude vascular pathology such as dilatation of the aorta due to patient rotation and limitations of study.


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.Reason: r/o acute cardiopulm process History: CP and SOB There is a streaky right basilar opacity which likely represents subsegmental atelectasis or scarring. The remaining lungs are clear of airspace or interstitial opacities.Cardiomediastinal silhouette is unremarkable. No evidence of pneumothorax. No pleural effusion.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 30 years, Male. Reason: Rule out perforation History: LLQ abd pain following colonscopy The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax.Mild gaseous distention of small and large bowel, which could be related to insufflation from recent colonoscopy versus developing ileus. No evidence of pneumoperitoneum. Biliary stent is noted.

Output: No evidence of pneumoperitoneum. If there is continued clinical concern for pneumoperitoneum, left lateral decubitus radiograph can be obtained.


Instruction: Generate impression based on medical findings.

Input: Lung transplant check, chest pain Persistent moderate right pleural effusion with layering and decreased overall lung volumes bilaterally greater on the right. Atelectasis and questionable partial minimal edema in both bases exam would be more sensitive with increased upright positioning and follow-up serial imagingBorderline cardiomegaly without additional definite mediastinal contour abnormalityClamshell sternotomy and surgical clips overlie both hilar regions

Output: Post transplant surgical changes with bilateral pleural effusions greater on the right with underlying atelectasis.


Instruction: Generate impression based on medical findings.

Input: Age: 68 yearsGender: MaleReason for Study: Reason: 68yr old male with history of MM; pre-auto sct evaluation History: evaluate Cardiac size is normal.Left paravertebral mass in the region of the left fourth costovertebral junction as noted on prior CT.Innumerable osteolytic lesions throughout the visualized chest not as well-seen as on recent CT.The lungs are clear.No pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified. Left paravertebral mass with associated vertebral and rib destruction as well as multiple osteolytic lesions compatible with multiple myeloma not as well-seen as on recent CT.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: r/o PNA History: cough No new opacity to suggest pneumonia. Linear scarring or atelectasis on the left as on prior.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: post op vad History: post op vad Basilar opacities suggestive of edema and atelectasis with pleural effusions, unchanged.Stable tubes and devices.

Output: Basilar opacities and pleural effusions unchanged since the most recent radiograph.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Evaluate IABP location. Acidosis, average patient. Low position of IABP marker, projecting over the descending thoracic aorta just above the level of the left hemidiaphragm, approximately at the T9 level. Interval extubation. Other hardware and devices unchanged.Patchy basal atelectasis bilaterally with probable loculated fluid entering the fissure on the left.

Output: Low position of IABP marker, approximately at the T9 level.


Instruction: Generate impression based on medical findings.

Input: Reason: ARDS, evaluate PICC line placement and ETT History: ARDS ET tube tip approximately 3 cm above the carina.PICC line tip in the area of the SVC though not clearly visible.Cardiomegaly with bilateral nonspecific patchy airspace and interstitial opacity compatible with infection.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Cough. Evaluate for abnormality. No focal pulmonary opacities, pleural effusions, or pneumothorax.Cardiomediastinal silhouette is within normal limits.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: eval for PNA History: sob, chest pain Clear lungs. Mild bronchial wall thickening. No pleural effusion or pneumothorax. No acute bony abnormality. Heart size at the upper limit of normal.

Output: Mild bronchial wall thickening which may represent asthma or bronchitis.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Crackles on exam rule out hypervolemia. Right jugular catheter can be followed to the SVC. Sternotomy hardware appears in alignment. Chronic elevation of the right hemidiaphragm. Adjacent compressive atelectasis appears slightly worse and there is an enlarging pleural fluid collection.New pleural or extrapleural dense opacity on the left overlying the scapula may reflect loculated fluid.

Output: Pleural effusions consistent with hypervolemia. Worsening atelectasis.


Instruction: Generate impression based on medical findings.

Input: Cough Interval marked improvement with near complete resolution of the right upper lobe focal air space process concerning for pneumonia described previously. Lungs currently clear other than minimal right basilar changes suggesting minimal atelectasis and/or scarring. Left lung clear.The cardiac and mediastinal contours are within limits

Output: Marked interval improvement and near complete resolution of the focal right upper lobe air space process suspicious for pneumonia


Instruction: Generate impression based on medical findings.

Input: Respiratory failure and chest tube placement.VIEW: Chest AP (one view) 12/25/16, 0705 A right chest tube has been placed. Residual hyperlucency is seen laterally and inferiorly.The right lung is reexpanding and moderate hazy opacity with air bronchograms is seen. Left lower lobe opacity with air bronchograms has increased. Cardiothymic silhouette is normal.Endotracheal tube tip is between thoracic inlet and carina. Enteric tube tip is in gastric body. Right jugular line has its tip in superior vena cava.

Output: Decrease in size of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 47 yearsGender: MaleReason for Study: Reason: Evaluate ETT, lung fields History: s/p arrest ET tube and NG tube unchanged.Marked cardiac enlargement with prominence of the central pulmonary vasculature.Perihilar opacities compatible with edema.Left retrocardiac consolidation/atelectasis similar to the prior exam.

Output: Support devices unchanged. Marked cardiac enlargement with evidence of CHF.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Cough and chest congestion rule out pneumonia. Left base opacity seen previously likely represents pericardial fat pad.No focal air space opacities. Minimal blunting of the posterior costophrenic angles is chronic. Calcified granulomas right lung.

Output: No signs of pneumonia or other acute pulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 51 years old.Reason: shortness of breath History: shortness of breath Exam is markedly limited by patient body habitus.Marked cardiomegaly.Decreased lung volumes.

Output: Marked cardiomegaly and decreased lung volumes. Refer to same day chest CT for further details.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for new infiltrates History: chest pain, increased productive cough Bilateral basilar predominant chronic interstitial disease with extensive lower zone fibrosis, better demonstrated on previous CT scans dating from 6/4/2014.No specific evidence of pneumonia or other acute process no interstitial disease may have progressed.A CT scan is recommended for further evaluation.

Output: Severe chronic interstitial disease which may have increased compared to previous CT scans.


Instruction: Generate impression based on medical findings.

Input: Age: 74 yearsGender: MaleReason for Study: Reason: S/P LVAD, Eval for infection vs. edema History: SOB Left-sided ICD and LVAD unchanged.Right-sided lead wires redemonstrated.Stable cardiac enlargement.Increasing interstitial opacities throughout both lungs compatible with worsening edema superimposed on residual lung fibrosis.No large pleural effusions.

Output: Interval increase in interstitial opacities compatible with edema superimposed on underlying ILD.


Instruction: Generate impression based on medical findings.

Input: Female, 91 years old.Shortness of breath. Recent intubation. Persistent global enlargement of the cardiac silhouette. Assessment of the mediastinum is limited by rotation.Bilateral perihilar heterogeneous and consolidative opacities are minimally improved, likely representing resolving pulmonary edema. Attention on follow-up.Possible small bilateral pleural effusions. No pneumothorax.ET tube terminating approximately 3 cm above the carina. Enteric tube coursing below the diaphragm.

Output: Slightly improved alveolar pulmonary edema.Adequate position of support apparatus.


Instruction: Generate impression based on medical findings.

Input: Female, 83 years old, with known lung cancer status post resection. LUNGS AND PLEURA: Severe, diffuse centrilobular emphysema. Postoperative change status post resection of a lingular mass. Nodular soft tissue density along the suture line measures 1.5 x 1.2 cm on axial image 40/100 and may reflect postoperative change, but continued surveillance is recommended to exclude recurrent disease.Biapical scarring, unchanged. Scattered pulmonary micronodules, most of which are unchanged with the exception of a new right upper lobe micronodule (axial image 46/100).MEDIASTINUM AND HILA: Right hilar reference node measures 1.3 x 1.1 cm on axial image 44/100, smaller when compared to 1.4 x 1.6 on the prior exam. Paraesophageal lymph node measures 1.4 x 0.9 cm on axial image 48/100, unchanged.The cardiac size is normal. Small pericardial effusion. Extensive aortic and coronary artery calcifications.CHEST WALL: Asymmetry of the breast tissues compatible with right mastectomy.UPPER ABDOMEN: No significant abnormality noted.

Output: Postoperative change in the lingula with nodular soft tissue adjacent to the surgical site. Continued surveillance is recommended to exclude residual or recurrent disease.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Localized swelling, mass or lump, trunk. 22 mm left apical pneumothorax, previously 18 mm.Moderate pleural effusions with basal atelectasis. Left retrocardiac atelectasis/consolidation, slightly worse. Near complete resolution of pulmonary edema.Mediastinal drain has been removed. The stomach is no longer distended with air and apparent lucency in the upper abdomen has resolved.

Output: Left apical pneumothorax is larger, now 22 mm. Pleural fluid, atelectasis and left basal consolidation about the same.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: Post thoracentesis, evaluate for pneumothorax History: Evaluate for pneumothorax Previous catheter projecting over the right upper abdominal quadrant is no longer visualized. There is a metallic biliary stent right of midline.Relatively low lung volumes with basilar opacities of atelectasis. Heart size unchanged. No pneumothorax. Trace pleural effusions.

Output: Trace pleural effusions and basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Reason: s/p cardiac surgery, intubated History: intubated Cardiomegaly with unchanged pulmonary opacities in pleural effusions.Marked gaseous distention of the stomach unchanged.ET tube tip 5 cm above the carina.An NG tube extends below the lower margin of the image.

Output: Unchanged pulmonary opacities and marked gastric distention.


Instruction: Generate impression based on medical findings.

Input: 25 year-old woman with history of right-sided neck pain and headache. SHUNT DEVICE: Intracranial shunt catheter is seen with tip in the right middle cranial fossa. The shunt catheter exits the skull via a right occipital burr hole and courses down the soft tissues of the right lateral neck and anterior chest wall, entering the abdomen with tip coiled in the pelvis. Portions of the shunt device are radiolucent and cannot be evaluated. An additional, lumboperitoneal shunt catheter is seen with tip at L1, entering the abdomen with catheter tubing coiled in the right upper quadrant. Portions of this shunt device are also radiolucent and cannot be evaluated. There is no evidence of discontinuity or kink.SKULL: No significant abnormality noted.CERVICAL SPINE: The cervicothoracic junction is not well visualized on the lateral view due to overlying anatomy, otherwise the cervical spine appears normal.CHEST: No focal air space opacities. The cardiomediastinal silhouette appears normal.ABDOMEN: Nonobstructive bowel gas pattern.

Output: Intracranial and lumboperitoneal shunt catheters without evidence of complication.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: Eval for Effusion and Atelectasis History: S/P CABG Hx of LV dysfunction Interval removal of right IJ Swan-Ganz catheter. Sternotomy hardware remains well aligned. Subxiphoid surgical staples remain in place.Heart size remains enlarged. Trace right pleural effusion. No pneumothorax.

Output: No complication following Swan-Ganz catheter removal.