Instruction: Generate impression based on medical findings.

Input: Female, 34 years old.Cough evaluate infection. Dermatopolymyositis. Unchanged cardiomegaly and mediastinal widening. Distention of the SVC, thickening of the fissures on the lateral radiograph and pulmonary vascular redistribution consistent with hypervolemia.Dense linear and branching opacities predominantly in the lower zones but also seen in the upper lobes. Trace pleural fluid bilaterally.Intraspinal catheter terminating at approximately the T5/T6 level.

Output: Mild CHF. Lower lung opacities most likely bronchiolitis from aspiration or infection however connective tissue related ILD cannot be entirely ruled out without serial imaging. Recommend follow-up PA and lateral chest radiographs to assess for resolution and if these abnormalities persist then consideration may be given to an ILD protocol thoracic CT. Nonspecific mediastinal widening may indicate lymphadenopathy.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: pulmonary edema History: hypoxia, lethargy Cardiomegaly with pulmonary edema and small pleural effusions, unchanged compared to prior study.Stable retrocardiac atelectasis.Right jugular catheter tip at cavoatrial junction.An NG tube terminates in the stomach.

Output: No significant change in cardiomegaly with pulmonary edema and small effusions. Lines stable.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: evaluate respiratory distress History: as above Improving right-sided predominant interstitial opacities suggestive of edema or aspiration.Moderate cardiomegaly.

Output: Improving opacities suggestive of edema or aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Leiomyosarcoma chest wall status post resection Interval decrease in volume of pleural fluid on the right, now small. Right upper lobe volume loss with cranial retraction of the fissure unchanged. Large lung volumes suggestive of COPD. Mild pulmonary edema. Normal heart size.Apical pleural thickening, right greater than left is unchanged.

Output: Mild pulmonary edema with significant improvement in the volume of pleural fluid on the right.


Instruction: Generate impression based on medical findings.

Input: Male, 45 years old.Reason: hx of MI s/p stents, widened mediastinum? History: chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 51 years old.Reason: cough x 2 weeks, h/o asthma r/o PNA Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Female, 84 years old.Reason: fluid status History: acute stroke Mild cardiomegaly.No specific evidence of infection or edema.

Output: Mild cardiomegaly, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: cough History: cough Volume loss and scarring at the right base consistent with a history of right lower lobe resection.No sign of pneumonia or other acute change.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: 62-year-old male with metastatic disease.Additional history: Prostate cancer. CHEST:LUNGS AND PLEURA: 8 x 8 mm in right middle lobe pulmonary nodule (series 5; image 56), unchanged. Extensive pleural plaques, some calcified, with mild sub-pleural fibrotic changes remainMEDIASTINUM AND HILA: The ascending aorta measures up to 4.8 cm, not significantly change. Small mediastinal lymph nodes are again visualized. Coronary artery calcifications are seen.Small thyroid hypodensities remain.CHEST WALL: Diffuse blastic metastasesABDOMEN:LIVER, BILIARY TRACT: Stable lesion in segment two of the liver with peripheral discontinuous nodular enhancement is compatible with a hemangioma. The previous described lesion in the right lobe of the liver is not well visualized.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructive right lower pole calculus. Stable renal hypodensities, compatible with cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large duodenal diverticulum.BONES, SOFT TISSUES: Diffuse blastic metastasesOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate gland is asymmetrically enlarged and indents the base of the urinary bladder, unchanged.BLADDER: Mild bladder wall thickening remains.LYMPH NODES: Surgical clips along the iliac chainsBOWEL, MESENTERY: Diverticulosis.BONES, SOFT TISSUES: Diffuse blastic metastases, unchangedOTHER: Atherosclerotic disease.

Output: No significant change in the diffuse osseous metastases.


Instruction: Generate impression based on medical findings.

Input: Male 58 years old Reason: cough, DOE. pna? History: as above Cardiomediastinal silhouette is unremarkable.No focal air space opacity or pleural effusion.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 11 years old, with history of neuroblastoma status post stem cell transplant. Evaluate for disease. CHEST:LUNGS AND PLEURA: Streaky linear opacities in the anterior upper lobes, more so on the left, likely represent atelectasis. Dependent atelectasis is also evident at the lung bases. No suspicious nodules or masses. No pleural fluid.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Subcentimeter hypoattenuating focus within the spleen is unchanged. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See below.BONES, SOFT TISSUES: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: A large fecal load is present within the colon, similar to the prior exam.BONES, SOFT TISSUES: No significant abnormality noted

Output: 1.No evidence of recurrent or metastatic disease in the chest, abdomen or pelvis.2.Large colonic fecal load.


Instruction: Generate impression based on medical findings.

Input: Male, 23 years old.Fever, cough, eval for PNA Cardiomediastinal silhouette is unremarkable. Peribronchial thickening compatible with asthma/bronchitis. No pleural effusions or pneumothorax.

Output: Peribronchial thickening compatible with asthma/bronchitis. No specific findings of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Motion degrade sensitivity.Tracheostomy tube and right jugular dialysis catheter unchanged, the latter extends into the right atrium.Persistent small lung volumes with mixed patchy lower zone opacities suggesting edema with no appreciable significant change given differences in technique. No specific superimposed focal findings to suggest additional infection

Output: Persistent findings most consistent with CHF, unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: pneumothorax? History: s/p LUL biopsy Cardiac silhouette remains normal in size and configuration.Low lung volumes with minimal bibasilar atelectasis. Left mid lung nodular density again likely representing solid pulmonary nodule and element of pulmonary hemorrhage status post biopsy. No pneumothorax.

Output: No significant interval changes. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for pleural effusions, pna History: shortness of breath Mild cardiomegaly, unchanged. Mild blunting of the right costophrenic angle suggestive of pleural effusion and possible mild basilar interstitial edema.

Output: Cardiomegaly with probable small effusions and mild interstitial edema.


Instruction: Generate impression based on medical findings.

Input: Age: 20 yearsGender: FemaleReason for Study: Reason: fluid overload History: diminished breath sounds Interval placement of a right central venous catheter with its tip at the SVC/RA junction.The cardiac mediastinal silhouette is unremarkable.The lungs are clear.No pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: assess ETT position History: s/p intubation Unchanged interstitial and airspace opacities consistent with edema.Stable cardiomegaly.ET tube tip approximately 1 cm above the carina.Left jugular catheter tip in left brachiocephalic vein at the midline.An NG tube extends below the lower margin of the image.

Output: Unchanged pulmonary opacities. Low ET tube.


Instruction: Generate impression based on medical findings.

Input: Age: 46 yearsGender: MaleReason for Study: Reason: eval lung fields History: cough, congestion, abd pain Markedly decreased lung volumes.The or mediastinal silhouette is unremarkable.Mild basilar atelectasis.No focal areas of consolidation.No pleural effusions.Evidence of multiple air-fluid levels within loops of bowel in the visualized abdomen

Output: Minimal basilar subsegmental atelectasis. No acute cardiopulmonary abnormality identified.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: Follow-up examination Left subclavian biventricular ICD remains unchanged. Status post median sternotomy, aortic and mitral valve surgery.Status post LVAD, grossly unchanged.Stable cardiac mediastinal silhouette is a some duration. Mild prominent aortic knob remains unchanged.Mildly elevated left hemidiaphragm with interval resolution of previously identified small to moderate left pleural effusion.No pneumothorax.No acute osseous abnormalities.

Output: Interval resolution of previously identified small to moderate sized left pleural effusion. No other significant interval changes.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: lung infiltrate History: Generalized weakness; cough, chills Severe cardiomegaly. Linear bibasilar scarring. No specific radiographic evidence of pulmonary edema. No pleural effusion or pneumothorax. Thoracic scoliosis and degenerative changes.

Output: Cardiomegaly and scarring without specific radiographic evidence of edema.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: s/p lung transplant History: s/p lung transplant No change in consolidation medially in the transplanted left lung base, with a left pleural effusion.Unchanged fibrotic appearing right native lung.

Output: No change in left lower lobe consolidation with a left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Reason: is there a cat p History: harsh hacking cough 4 days Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: Evaluate L pleural effusion vs previous CXR s/p chest tube placement on 11/18 History: Decreased chest tube drainage, SOB Stable small left pleural effusion with left chest tube in place. No pneumothorax.The cardiac contours are partially obscured.Left basilar subsegmental atelectasis, stable from prior.The position of enteric tube and left upper extremity PICC.

Output: Persistent small left pleural effusion with adequate position of left chest tube . No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: r/o infectious etiology History: right side weakness Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

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


Instruction: Generate impression based on medical findings.

Input: Male 11 months old Reason: 11 mo M RSV bronchiolitis, pulmonary HTN, intubated, eval for interval changes VIEW: Chest AP (one view) 2/3/2016 at 0510 hours. Central line coming from the IVC terminates at the right atrium. Right IJ venous access tip is at the SVC. ET tube tip is below thoracic inlet. Feeding tube is transpyloric, tip is not visualized. Unchanged left-sided chest tube.Cardiac silhouette size is normal. Streaky opacities of the right and left upper lobes as well as left-sided subpulmonic pneumothorax are unchanged.

Output: Unchanged focal opacities and left-sided subpulmonic pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old. PICC line from the left arm extending to the area of the left subclavian vein.Bilateral basilar opacity consistent with moderate pleural effusions and underlying atelectasis.

Output: Catheter tip in the left subclavian vein.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: endotracheal tube position, aspiration History: endotracheally intubated Moderate cardiomegaly with a fibrotic native left lung.Mild basilar opacities suggestive of edema on the right are unchanged.Left jugular catheter, tip in left brachiocephalic vein near its junction with the SVC.A Dobbhoff tube extends below the lower margin of the image.Status post cholecystectomy.

Output: Mild basilar edema pattern in the transplanted lung, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 85 years old.Reason: altered mental status, hx dementia History: altered mental status Pacemaker electrode unchanged in position.Blunting of the posterior costophrenic angles is nonspecific. No evidence of edema or pneumothorax. The heart size is normal.

Output: Blunting of the posterior costophrenic angles may be secondary to small pleural effusions, aspiration or atelectasis. Recommend repeat upright PA and lateral radiograph for further evaluation when the patient can tolerate.


Instruction: Generate impression based on medical findings.

Input: Reason: intubated, wheezing History: as above ET tube tip approximately 5 cm above the carina.NG tube tip at the GE junction.Cardiomegaly with bilateral lower zone opacity compatible with resolving edema, atelectasis and small effusions.A more recent radiograph has been interpreted.

Output: Resolving pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: evaluate change in ET placement History: ET tube Endotracheal tube appears to have been advanced slightly. Other lines and tubes are unchanged. Unchanged heart size. Unchanged mediastinal mass. Unchanged patchy left basilar opacity and pleural effusion.

Output: Endotracheal tube has been advanced slightly.


Instruction: Generate impression based on medical findings.

Input: 67-year-old female with fallopian tube cancer. Follow up examination. LUNGS AND PLEURA: Left upper lobe nodule unchanged measuring 0.6 x 0.5 cm (image 58 series 5) from a prior measurement of 0.7 x 0.8 cm. Cluster of other nodules or masses in the right middle lobe also noted yet less pronounced and associated with atelectasis. These are consistent with metastatic disease. No effusions. Some suspected stable scarring within the left base. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: Mild interval improvement of the suspected lung metastatic disease, however this change may represent interval treatment or resolving post inflammatory changes over the past two months.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, 60 years old.Reason: iabp placement, interval exam History: see above Intra-aortic balloon pump marker is in stable position at the proximal descending thoracic aorta. Left univentricular AICD electrodes unchanged.Cardiomegaly is stable. No interval edema. Retrocardiac atelectasis. No pneumothorax.

Output: Stable position AIBP.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: picc line location History: picc line Left upper extremity PICC tip has been repositioned, now extending at least to the SVC/right atrial junction. Enteric tube extends beyond the field of view inferiorly.Stable cardiomediastinal silhouette.Low lung volumes with nonspecific bibasilar opacities greater on the left, unchanged and consistent with atelectasis.No pneumothorax.

Output: PICC tip extending at least to the SVC/right atrial junction.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lung fields History: palpitations, sob Normal heart size with evidence of previous median sternotomy.No significant pulmonary abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: 46-year-old male with metastatic cholangiocarcinoma on chemotherapy. Needs follow up scan. CHEST:LUNGS AND PLEURA: There are numerous bilateral metastatic nodules which have increased in size and number. A reference nodule in the upper right lobe measures 7.5 mm x 7.5 mm (image 43, series 5). A reference nodule in the superior segment of the left lower lobe measures 9.7 mm x 9.1 mm (image 51, series 5). MEDIASTINUM AND HILA: Metastatic lymph nodes are seen in the AP window and paratracheal regions. Right paratracheal reference node measures 1.8 cm x 1.3 cm (image 32, series 4). There is diffuse thickening of the esophageal wall, which is new from the prior study. Additionally, there is a new pericardial effusion.ABDOMEN:LIVER, BILIARY TRACT: There has been interval appearance of new bilobar satellite metastatic lesions. A reference lesion in liver segment 3 measures 1.2 cm x 1.1 cm (image 100, series 4). The dominant mass in the right hepatic lobe measures 7.7 cm x 7.8 cm (image 105, series 4) compared to 4.8 cm x 7.7 cm (image 23, series 6) on the previous study. There is no evidence of biliary ductal dilatation. The right portal vein is not visualized and may be occluded or invaded. This finding was evident on the prior examination.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.LYMPH NODES: There has been interval increase in size of metastatic regional adenopathy, involving the portacaval, periceliac, and portahepatic regionsBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: See belowOTHER: There is new, interval appearance of carcinomatosis. A representative peritoneal nodule measures 9.9 mm x 7.4 mm (image 108, series 4).PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: New, interval appearance of retroperitoneal adenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There are multifocal, destructive bony metastases seen in the acetabulum, left lower rib, and vertebral body. The vertebral body is status post fixation.OTHER: There has been interval placement of caval filter with thrombus seen within the IVC and extending to the external iliac veins bilaterally.

Output: Progression of widespread metastatic disease


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: line placement History: line placement Heart size at least upper normal.No specific evidence of infection or edema.Right jugular catheter, tip in SVC.

Output: Heart size upper normal, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: eval infection History: eval infection Endotracheal tube terminates 2 cm above the carina. A nasogastric tube terminates inferior to the caudal margin of the image.Relatively low lung volumes without evidence of edema or infection. No pneumothorax. The heart size is normal.

Output: Endotracheal tube terminates 2 cm above the carina. No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: fever History: fever Lungs hypoinflated with persistent patchy interstitial and airspace opacity likely atelectasis or edema. No new opacity to suggest pneumonia.

Output: Lungs hypoinflated with persistent patchy interstitial and airspace opacity likely atelectasis or edema. No new opacity to suggest pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: eval for infection History: tachypnea, ams Large lung volumes are consistent with COPD.Heart size upper normal.

Output: COPD, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: ett in place History: ett in place ET tube tip about 8.5 cm above the carina.Nonspecific airspace opacity with pulmonary nodules and pleural effusions, not significantly changed.

Output: No change position of ET tube. No change in pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: eval for RCC recurrence The heart size is normal with a right sided mildly ectatic aortic arch.Small calcified left upper lobe granuloma and hilar lymph nodes again seen.Stable left basilar scarring. No new focal pulmonary opacities.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: infiltrate History: bacteremia Support devices are unchanged in position with mild kinking of the sheath at the right IJ vein.Persistent low lung volumes with diffuse haziness over the majority of the left lung and right base. Ill-defined opacity at the left lower zone suspicious for an effusion. Cardiomegaly is unchanged. No pneumothorax.

Output: Left greater than right pulmonary opacities unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 39 years old.Reason: post-intubation History: post-intubation ET tube tip 4 cm above carina. Persistent hypoinflation with left lower lobe airspace opacity. NG tube tip in stomach. Probable background interstitial lung disease.

Output: ET tube tip 4 cm above carina.


Instruction: Generate impression based on medical findings.

Input: Right thoracotomy Interval removal of 2 right chest tubes with small amount of fluid observed both free flowing and within the major fissure on the right. Underlying right basilar atelectasis without additional abnormality. Left lung specifically essentially clear.Borderline cardiomegaly. Midline sternotomy and CABG clips

Output: Chest tubes removed


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.Chest pain. Secondary pulmonary hypertension. Normal heart size. The central pulmonary vasculature is mildly prominent, as are hilar lymph nodes, unchanged.Calcified mediastinal and hilar lymph nodes and calcified lung nodules, most consistent with healed granulomas.Scoliosis.No pneumothorax or focal airspace opacity.No pleural fluid. Degenerative changes of the spine with desiccated intervertebral disc at T10/T11.Soft tissue fullness in the posterior mediastinum just above the level of the diaphragm, this statistically most likely reflects a hiatal hernia but is a nonspecific finding by plain film.

Output: No acute cardiopulmonary abnormality. Posterior mediastinal mass most likely represents a hiatal hernia or possibly a fluid-filled dilated distal esophageal segment. The possibility of esophageal pathology cannot be excluded by plain film, please correlate for symptoms.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: Evaluate ET tube position. History: See above. ET tube tip 3 cm above carina. NG tube tip in stomach. Venous catheter tip in left brachiocephalic vein.No change in pulmonary appearance demonstrating right-sided edema and small effusion and fibrotic changes in native left lung.

Output: ET tube tip 3 cm above carina.


Instruction: Generate impression based on medical findings.

Input: 71 years old Female. Reason: assess for cause of SOB History: suspect CHF, possible PNA. Had bibasilar crackles, reports some LE edema. No specific evidence of infection. Minimal perihilar interstitial opacity and left retrocardiac opacity appears similar to the prior study. No large pleural effusion or pneumothorax. The cardiac silhouette is a slight prominent. The cardiac pacemaker/defibrillator electrodes are stable in position.

Output: Borderline cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: lung eval History: post op Cardiomegaly with lower lung zone edema, pleural effusions and retrocardiac consolidation the latter progressed.ET tube tip approximately 5 cm above the carina.Right jugular Swan-Ganz catheter, tip directed towards the right pulmonary artery.LVAD and ICD unchanged.Chest tubes are present with no pneumothorax.IABP catheter proximal marker projects over the aortic arch, the introducer unchanged in position.

Output: Unchanged support devices. Increasing left lower lung zone consolidation with stable pleural effusions and basilar edema following LVAD placement.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old. New right jugular catheter extending to the SVC with no pneumothorax or other complications.PICC line tip in the right axillary vein. ICD leads and LVAD unchanged.Small lung volumes with nonspecific basilar opacity compatible with atelectasis and nonspecific consolidation, slightly increased.

Output: New catheter with no complications.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: eval for infiltrate History: sob Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 43 yearsGender: MaleReason for Study: Reason: eval lung fields History: s/p AVR, CABG ET tube has been removed.Remaining support devices unchanged.IABP marker not well visualized however appears to be in the distal descending aorta.Stable cardiac enlargement with perihilar/basilar edema, small pleural effusions, and basilar atelectasis.No new pulmonary opacities identified.

Output: Interval extubation. IVP marker in the distal descending aorta. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: +PPD No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Alcoholic cirrhosis of liver with ascites evaluate for pulmonary edema. Hardware and devices unchanged.Bilateral pleural effusion similar in volume. Interval improvement in edema and atelectasis.The left lower lobe is collapsed with nonvisualization of the distal airway consistent with an endobronchial filling defect.

Output: Improving pulmonary edema and atelectasis. The left lower lobe remains collapsed with cutoff of the proximal left lower lobe bronchus consistent with debris or mucus plug in the airway.


Instruction: Generate impression based on medical findings.

Input: Reason: lung infiltrate History: SOB, chest pain Normal heart size with a moderately tortuous aorta.Markedly under inflated lungs with bronchial thickening and no other gross pulmonary abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 81 years old.Reason: eval lung fields History: weakness Nonspecific basilar interstitial opacities are nonspecific, and could be early edema or aspirated secretions.Reliable evidence of pneumonia.Heart size upper normal.

Output: Nonspecific basilar interstitial opacities which could be edema or aspirated secretions.


Instruction: Generate impression based on medical findings.

Input: Female, 77 years old, short of breath. Evaluate for IPF. LUNGS AND PLEURA: Diffuse interstitial thickening and mild bronchiectasis with evidence of subtle peripheral honeycombing. No significant groundglass opacity. Patchy areas of hypoattenuation probably reflect an underlying perfusion abnormality not changing between inspiration and expiration. No pleural fluid. A few scattered micronodules, some calcified, are nonspecific. Surgical suture lines noted along the right major fissure. MEDIASTINUM AND HILA: The cardiac size is top normal. No pericardial effusion. Within the limits of this noncontrast exam, no pathologically enlarged hilar or mediastinal lymph nodes are seen.CHEST WALL: Surgical clip in the left breast. Asymmetric soft tissue in the left breast along with a prominent left axillary lymph node should be further evaluated with physical examination and/or mammography if clinically indicated.UPPER ABDOMEN: No significant abnormality noted.

Output: 1.Interstitial lung disease compatible with UIP (usual interstitial pneumonia).2.Left breast findings as above.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Reason: s/p left chest tube History: left chest tube Left chest tube placed since the prior study with residual fluid but some reexpansion of the left lower lung zone. Right basilar edema unchanged.Right subclavian catheter tip at right atrial level. Upper abdominal bowel distention.

Output: Left chest tube placement, with some decrease in size of the pleural effusion.


Instruction: Generate impression based on medical findings.

Input: 29-year-old male with testis cancer status post laparoscopic retroperitoneal lymph node dissection CHEST:LUNGS AND PLEURA: Previously measured index right lower lobe nodule is unchanged measuring 3-mm image number 56, series number 4. Other scattered micronodules also unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN: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: Small left retroperitoneal lymph nodes adjacent to the adrenal gland are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Interstitial fibrosis. COPD No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Check device Interval placement of a Swan-Ganz from an inferior approach extending into the right pulmonary outflow tract. A new Impella device is also placed and grossly in the expected locationUnderlying cardiopulmonary appearance is otherwise similar without new additional superimposed focal airspace abnormalities. Right jugular catheter unchanged

Output: Swan-Ganz and Impella device placed


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Reason: intubated, ARDS History: as above Left chest tube unchanged with no pneumothorax.Intense edema like opacities also consistent with ARDS are stable.ET tube about 7 cm above the carina.An esophageal probe is seen in the cervical esophagus region.An NG tube extends below the lower margin of the image.Left jugular catheter, tip still in the left jugular.

Output: Unchanged pulmonary opacities consistent with ARDS.


Instruction: Generate impression based on medical findings.

Input: 48 year old female with productive cough, chills. Rule out pneumonia Faint patchy airspace opacities in the right upper lobe compatible with pneumonia. Bibasilar atelectasis and left lower lung scarring. No pleural effusion or pneumothorax.Cardiomediastinal silhouette is unremarkable.

Output: Findings compatible with right upper lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: Screening tuberculosis. Heart size with a moderately tortuous aorta which may be due to hypertension.No significant pulmonary abnormalities.

Output: Probable hypertension. No sign of infection.


Instruction: Generate impression based on medical findings.

Input: Reason: shunt History: headache SHUNT DEVICE: There is a intracranial shunt catheter exiting through a left parietal burr hole coursing down the lateral subcutaneous tissues of the neck and terminating in the SVC. No evidence of kinks or discontinuities along the course of the catheterSKULL: Focal lucency in the skull seen on the lateral view likely represents a venous lake.CERVICAL SPINE: Surgical clips are seen in the left neck. Reversal of normal cervical lordosis, possibly due to positioning.CHEST: No significant abnormality noted.ABDOMEN: There are 3 orphaned shunt catheters in the abdomen, pelvis and anterior subcutaneous tissues of the upper abdomen. Bowel gas pattern is nonobstructive. Acute angulation at the sacrococcygeal joint may reflect old injury.

Output: Shunt catheter as above without evidence of malfunction.


Instruction: Generate impression based on medical findings.

Input: Age: 91 yearsGender: FemaleReason for Study: Reason: r/o infection History: cold with coughing. afebrile The cardiomediastinal silhouette is unremarkable. Blunting of the right costophrenic angle may represent mild basilar scarring as well Bochdalek hernia noted on prior CT dated 9/23/11.No large pleural effusion or focal areas of consolidation.The left lung is clear.

Output: Right basilar scarring and opacity in the region of the right costophrenic angle most likely secondary to previously demonstrated Bochdalek of hernia. No specific evidence of acute infection.


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: Intubated, eval for ETT placement, lung fields for effusion/infiltrate History: intubated, failed extubation in OR Basilar subsegmental atelectasis or scarring, unchanged.No specific evidence of infection or edema.ET tube tip approximately 2 cm above the carina.An NG tube extends below the lower margin of the image.

Output: Low ET tube. Mild basilar scarring or subsegmental atelectasis, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female 40 years old; Reason: check ogt History: s/p advancement of ogt Patchy airspace disease in the lung with a probable right pleural effusion better evaluated on the chest radiograph.There is gaseous distention of the colon.Enteric tube terminates in the region of the distal gastric body.

Output: 1.Enteric tube terminates in the region of the distal gastric body.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: interval change History: interval change Lines and tubes are unchanged. Endotracheal tube again terminates just above the carina. No new focal lung opacities. Unchanged cardiomegaly. No pneumothorax.

Output: No substantial change.a


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: assess for acute process - presyncope History: assess for acute process - presyncope Cardiomegaly. No evidence of significant edema or focal lung opacity.

Output: Cardiomegaly. Otherwise no acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: r/o pneumothorax s/p chest tube removal History: chest tubes removed Interval decrease in basilar opacities and left lower lung consolidation and effusions.Stable cardiac enlargement and mitral valve repair redemonstrated.Interval removal of bilateral chest tubes. No evidence of pneumothorax. LVAD and ICD devices appear unchanged.Sternotomy wires and surgical clips redemonstrated.

Output: Interval removal of bilateral chest tubes with no evidence of pneumothorax.Interval decrease in bilateral basilar opacities consistent with improving edema and effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 82 years old.Reason: eval position of ett, 2cm out History: ett, 2cm out from reported incisors marking Two right chest tubes with possible right apical pneumothorax, and severe soft tissue emphysema.ET tube tip approximately 3 cm above the carina.A Dobbhoff tube extends below the lower margin of the image.Right jugular catheter, tip in SVC.

Output: Possible right pneumothorax, and severe soft tissue emphysema, none of which have changed.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: CMV pneumonitis History: Po2 decreased slightly, from high 90s to 94% consistently Focal nodule again noted in the upper aspect of the right lung. No new focal lung consolidation. No pleural effusion or pneumothorax. No acute bony abnormality. Patient is status post sternotomy. Diffuse osteopenia, as before.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old.Reason: r/o pneumonia History: SOB, cough, hx COPD No significant cardiopulmonary abnormality.No specific evidence of infection.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Hodgkin's lymphoma. CHEST:LUNGS AND PLEURA: Numerous subcentimeter, spiculated micronodules in both lungs suspicious for metastatic disease. A reference nodule measures 5-mm in the left lower lobe on image number 225, series number 6.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Right axillary adenopathy. A reference lymph node measures 3.7 x 2.1 cm in image number 37, series number 4.Mass in the right chest wall measuring 1.8 x 1.9 cm on image number 83, series number 4.ABDOMEN:LIVER, BILIARY TRACT: Nine by 8mm enhancing mass in the right anterior abdominal wall indenting the liver. No evidence of focal intrahepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Simple appearing left renal cyst.RETROPERITONEUM, LYMPH NODES: Multiple borderline enlarged retroperitoneal lymph nodes. The reference noted in the left there are decreased in measuring 12 by 7 mm on image number 127, series number 4.BOWEL, MESENTERY: Multiple borderline enlarged mesenteric lymph nodes. A reference node measures 11 by 8mm on image number 166, series number 4.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: Right axillary adenopathy. Right chest wall and right anterior abdominal wall enhancing nodules consistent with metastatic disease.Numerous subcentimeter lung nodules suspicious for metastatic disease.Multiple borderline enlarged mesenteric and retroperitoneal lymph nodes as described above.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Persistent postsurgical changes and scarring greater in the apices and upper lungs. Post transplant appearance unchanged with additional minimal scarring both bases. Right jugular single port similar in position with tip projected into the right atrium.

Output: Post transplant surgical changes and scarring without additional new superimposed acute abnormalities


Instruction: Generate impression based on medical findings.

Input: 50 year-old female with metastatic breast cancer. CHEST:LUNGS AND PLEURA: Right-sided pleural effusion is decreased in size. Subcentimeter pulmonary nodules are unchanged. Nodular pleural thickening on the right side has decreased in size but still persists.MEDIASTINUM AND HILA: The pretracheal lymph node is decreased in size.CHEST WALL: Spiculated left breast mass is unchanged.ABDOMEN:LIVER, BILIARY TRACT: Numerous liver metastases are unchanged in number however they are decreased in size. Previously measured reference lesion now measures 8 x 11 mm image number 69, series number 4. The second reference lesion in the right lobe measures 13 x 15 mm image number 81, series number 4.SPLEEN: Splenomegaly is unchanged.PANCREAS: Punctate hypodensities in the tail of the pancreas are unchanged.ADRENAL GLANDS: Right adrenal gland measures 4 x 2.4 cm. Left adrenal gland measures 2.8 x 2.8 cm. There decreased from previous CT however they remain enlarged likely representing metastatic disease.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Confluent retroperitoneal soft tissue density is decreased in size.BOWEL, MESENTERY: Wall thickening involving the entire colon still present but decreasing severity. No bowel obstruction.BONES, SOFT TISSUES: Innumerable foci of bony metastases with a mixed lytic and blastic appearance are unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Leiomyomatous enlarged uterus is unchanged. The adnexa are not well visualized.BLADDER: No significant abnormality noted.LYMPH NODES: Ill-defined soft tissue density extending from confluent retroperitoneal adenopathy like representing pelvic lymph nodes is decreased in size but still persists.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small pelvic ascites is unchanged.

Output: Interval decrease in the right pleural effusion, nodular pleural thickening, pretracheal lymph node, hepatic metastases, adrenal metastases, retroperitoneal and pelvic adenopathy. Bone metastases are unchanged.


Instruction: Generate impression based on medical findings.

Input: 19-year-old male with no past medical history presents with a one day history of frontal headache and pain around the right eye. Patient has had a recent viral upper respiratory infection. Ophthalmologic examination demonstrated scleritis. Family history of sarcoidosis. Normal cardiomediastinal silhouette. No pulmonary or pleural abnormalities.

Output: No acute pulmonary abnormalities. Specifically, no findings to suggest sarcoidosis.


Instruction: Generate impression based on medical findings.

Input: Age: 81 yearsGender: FemaleReason for Study: Reason: eval pneumothorax History: left pneumothorax post biopsy Stable cardiomediastinal silhouette.Left lower lobe consolidation/atelectasis and perihilar opacity similar in appearance to the prior exam.I persistent left pleural effusion/hemothorax.No evidence of a pneumothorax.Right pleural thickening/small effusion.

Output: No evidence of a pneumothorax. Persistent left lower lobe consolidation/atelectasis and left hemothorax.


Instruction: Generate impression based on medical findings.

Input: 19 year-old female with headache, evaluate shunt status SHUNT DEVICE: Left occipital VP shunt exits the skull and courses down the soft tissues of the left neck and anterior chest wall with its tip projecting over the left lower lung.SKULL: Unchanged from the prior exam.CERVICAL SPINE: No significant abnormality noted.CHEST: No significant abnormality noted.

Output: No evidence of discontinuity or kinking of the radiopaque portions of the shunt catheter.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Rule out bladder cancer metastasis status post cystectomy and Indiana pouch. No suspicious pulmonary nodules or masses. A few calcified nodules are unchanged, likely healed granulomas.Normal heart size. Calcified right hilar lymph nodes.Bilateral chest wall prostheses.Please note that chest technique has a limited sensitivity for osseous pathology, within this limitation, no skeletal metastases are identified.

Output: No acute cardiopulmonary abnormality. No signs of pulmonary metastases.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: cardiomegaly History: cardiomegaly Cardiomegaly.No reliable evidence of edema or pneumonia.

Output: Cardiomegaly, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: 87-year-old female with history of strokes, hypertension and shortness of breath and chest pain. Positive d-dimer. Evaluate for PE. PULMONARY ARTERIES: Technically adequate study. Enlarged pulmonary artery suggestive of pulmonary artery hypertension. Multiple granulomas.LUNGS AND PLEURA: Previously described region of focal ground glass opacity in the right middle lobe (image 59, series 7), is unchanged; however, may still be monitored for stability as indolent neoplasm such as bronchoalveolar carcinoma cannot be excluded. Left upper lobe peripheral area of focal nodularity with areas of calcification likely represents postinflammatory changes.MEDIASTINUM AND HILA: Heart is within normal limits without evidence of pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Liver and splenic calcifications secondary to prior granulomatous disease.

Output: 1. No evidence of pulmonary embolus as clinically questioned. 2. Enlarged pulmonary artery suggestive of pulmonary arterial hypertension.3. Right middle lobe ground glass opacity has been stable since 2006 study; however, a longer period of surveillance may be considered due to the indolent nature of certain neoplasms such as bronchoalveolar carcinoma.


Instruction: Generate impression based on medical findings.

Input: Reason: pneumothorax, pleural effusion History: shortness of breath, pneumothorax with chest tube Increased right pneumothorax with the apex of the lung now about 3 cm from the chest wall.Persistent left lower lobe atelectasis. Right chest tube and venous catheter are unchanged.

Output: Increased right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: tracheally intubated, re-eval cardiopulm status History: as above Partially chronic right hemithorax volume loss of the right upper lobe cavity or pleural air collection, unchanged.Interstitial opacities elsewhere could be edema with bilateral pleural thickening or effusions, unchanged.Tracheostomy tube tip approximately 6 above the carina. Left jugular catheter, tip in SVC.A Dobbhoff tube terminates in the stomach.

Output: Unchanged pulmonary abnormalities and support devices.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Reason: chest tube in place History: on oxygen Two right chest tubes with a small right pneumothorax unchanged.Stable basilar opacities.

Output: Stable small right pneumothorax and basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: monitor ET tube History: intubated ET tube tip 5 cm above carina. Other findings stable.

Output: ET tube tip 5 cm above carina.


Instruction: Generate impression based on medical findings.

Input: Female, 26 years old.Status post port placement. Right chest port catheter tip is in the right atrium. Pacemaker leads are unchanged.Heart size is stable. No focal lung opacity, pleural effusion, or pneumothorax.

Output: Right chest port catheter tip is in the right atrium.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: Infiltrates History: fever Mild cardiomegaly. No specific evidence of infection or edema.No pleural effusion. No pneumothorax.

Output: No specific evidence of infection or edema at this time.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old. ET tube is in place with its tip approximately 4 cm above the carina.Bilateral basilar chest tubes unchanged.Status post bilateral lung transplants.Perihilar/basilar interstitial opacities, left retrocardiac consolidation/atelectasis, and bilateral pleural effusions similar to the prior exam.No significant pneumothorax.

Output: Interval intubation with ET tube in satisfactory position. Stable cardiopulmonary appearance with edema, basilar atelectasis, and small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: hx of renal mass evaluate for metastatic disease History: see above 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, 79 years old.Reason: cough post avr History: avr Nodular opacities bilateral lower lobes compatible with nipple shadows. Sternotomy hardware remains well aligned. No evidence of pulmonary edema, pleural effusion or infection. Cardiomegaly is stable.

Output: No edema or infection.


Instruction: Generate impression based on medical findings.

Input: Tachycardia, COPD. Severe emphysema. Patchy opacity in the right upper lobe new from time of prior CT and may reflect aspirated secretions, nonspecific. Minimal basal atelectasis.

Output: Faint right upper lobe opacity most likely represents atelectasis related to focal aspiration, new from prior. Plain film follow-up may be obtained if patient's symptoms worsen to exclude development of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.Reason: eval for cardiomegaly History: palpitations No significant cardiopulmonary abnormality.

Output: No significant abnormality. Heart size normal.


Instruction: Generate impression based on medical findings.

Input: Age: 67 yearsGender: FemaleReason for Study: Reason: evaluate for volume overload, infection History: dyspnea Decreased lung volumes with stable cardiac enlargement.Blunting of the right costophrenic is compatible with a small effusion and/or thickening.No new opacities identified.

Output: Cardiac enlargement unchanged. No specific evidence of edema or infection.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.RFO study No unexpected radiopaque foreign bodies are noted. Specifically, no evidence of a curved needle within the field of view. Tracheostomy is in place. No new focal lung consolidation. Unchanged heart size. No pneumothorax. Mild right-sided subcutaneous emphysema.

Output: No unexpected radiopaque foreign bodies are noted.These findings were discussed by telephone with Dr. Chang, on 3/11/2016 at 8:25 PM.


Instruction: Generate impression based on medical findings.

Input: Female, 37 years old.Reason: repeat History: repeat Interval removal of chest tube. No significant pneumothorax. Right pleural thickening with postsurgical change.. Left lung remains clear.

Output: Postsurgical change in the right hemithorax with no significant pneumothorax. Residual effusion.


Instruction: Generate impression based on medical findings.

Input: Central line placement Interval new right jugular catheter placed with tip extending into the proximal SVC. No immediate postprocedural complication observed on the right side.The underlying cardiopulmonary appearance is otherwise similar with largely interstitial changes and suspected scarring greater both bases as well as a pronounced left apical opacity also unchanged. This latter finding correlates with the CT described mass, please see the alternate report due to greater sensitivity

Output: Right jugular catheter placed without complication


Instruction: Generate impression based on medical findings.

Input: 64 are old female with history of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Right middle lobe, index subcentimeter nodule is unchanged measuring 4 mm in diameter on image number 132, series number 6.. Indexleft lower lobe nodule measures 5 noted in diameter image number 153, series number 6. Other subcentimeter lung nodules are also stable..MEDIASTINUM AND HILA: Stable small mediastinal nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Index lesion in the right lobe is smaller measuring 1.3 x 1.3 cm image number 87, series number 4. Other liver lesions are also less conspicuous and minimally smaller in size.SPLEEN: Hypodense lesion in the spleen measuring 7-mm in diameter image number 74 posters number 4, less conspicuous compared to the previous study.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left nephrectomy. Right kidney is unremarkable. No evidence of recurrence in the left nephrectomy bed.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Wedge deformity of T12 vertebral body is unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Eight decrease in the size and conspicuity of the liver and splenic lesions. Lung nodules are stable.


Instruction: Generate impression based on medical findings.

Input: 74-year-old female with a history of MCL and prostate cancer. Evaluate and compare to previous. CHEST:LUNGS AND PLEURA: Mild dependent changes. Scattered micronodules, unchanged.MEDIASTINUM AND HILA: Small mediastinal nodes in the pre and paratracheal areas are unchanged. Index node in the pretracheal area seen on series 6 image 29 measures 11 x 8 mm mm, unchanged. No new nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Few scattered nonspecific hypodense lesions in the liver, overall unchanged. The lesion in segment 6, subcapsular, along the posterior aspect of the liver, is intermediate density and is not definitely a cyst but is also unchanged. Gallbladder with numerous layering gallstones. No biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Parapelvic cysts on the left, unchanged.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal nodes and aortocaval nodes redemonstrated, unchanged and not significant by size criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Atrophic or surgically absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted. Previously identified small right external iliac lymph node has decreased in size.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.

Output: No significant interval change. No new sites of disease.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Status post right open bilobectomy. Chest tube placement. Right-sided chest tube with tip directed toward the apex and a second projecting over the right base. Right hemithorax subcutaneous emphysema. Right apical pneumothorax with maximal pleural separation from the chest wall of 27 mm. Postoperative volume loss on the right, with a moderate volume of pleural fluid. Basal atelectasis on the left, but no pneumothorax.Hazy opacities in the periphery of the lung reflect known partially calcified pleural lesions.

Output: 27 mm right apical pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: assess ETT placement, shock History: assess ETT placement, shock ET tube tip 5-6 cm above carina. Venous catheter tip in SVC. NG tube tip in stomach.Lungs hypoinflated with stable nonspecific basilar opacities.

Output: ET tube tip 5-6 cm above carina.


Instruction: Generate impression based on medical findings.

Input: Heart failure and IABP check The IABP marker has been advanced, projecting just short of the aortic arch and repositioned at least 5 to 6 cm. No additional cardiopulmonary change. See subsequent reports

Output: IABP repositioning


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.Reason: 44F intubated in MICU, ?ETT and OGT placement, ?diffuse infection progression History: 44F intubated in MICU, ?ETT and OGT placement, ?diffuse infection progression Endotracheal tube terminates 4 cm above carina. Central catheter terminates at the superior caval atrial junction. Nasogastric tube side hole projects inferior to the caudal margin of the image.No significant change in the right greater than left airspace and interstitial opacities. Small pleural effusions, right greater than left. No interval pneumothorax.

Output: Diffuse airspace and interstitial opacities remain stable.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: intubation History: intubated Endotracheal tube tip approximately 3.5 cm from the carina. Enteric tube terminates proximal field-of-view.Extensive subcutaneous emphysema is redemonstrated, limiting evaluation of the lungs.Bilateral upper lobe predominantly interstitial pulmonary opacities again reflect known sarcoidosis, though superimposed acute infection cannot be excluded.Stable cardiomediastinal silhouette.

Output: Extensive subcutaneous emphysema and stable findings of known sarcoidosis, though superimposed acute infection cannot be excluded.


Instruction: Generate impression based on medical findings.

Input: Reason: Pleural effusion History: As above Hazy opacity in the left hemithorax consistent with a moderately large layered out pleural effusion.Normal heart size with moderate tortuosity aorta.

Output: Layered out left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Reason: assess for swan placement, IABP History: as above Swan-Ganz catheter tip in a right lower zone distal branch of the pulmonary artery.Balloon catheter tip in the proximal descending aorta.Filter device in the IVC.No significant pulmonary abnormalities.

Output: Distal location of Swan-Ganz catheter.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: new hd line History: hd line Right subpulmonic effusion with basilar edema and right basilar atelectasis, unchanged.Moderate cardiomegaly noted.Right jugular catheter, tip at SVC/artery junction level.

Output: Pulmonary edema and basilar opacities, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 28 years old.Reason: rule out pna History: cough and chest pain Cardiomediastinal silhouette is within normal limits.No focal airspace consolidation. No pleural effusions.

Output: No acute party pulmonary abnormality. Specifically, no evidence of infection.


Instruction: Generate impression based on medical findings.

Input: 77-year-old male with thyroid cancer No activity is seen in the region of the thyroid bed. Diffuse activity throughout both lungs is compatible with the history of known metastatic thyroid cancer.

Output: 1.Diffuse activity throughout both lungs is consistent with accumulation of recent iodine therapy within the metastatic lesions. 2.No residual activity seen in the thyroid bed.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: Evaluate lung fields History: O2 Requirement Surgical changes of a tracheostomy. Left internal vascular sheath unchanged. ICD with tip unchanged. LVAD in position. Surgical skin staples overlying the midline. Surgical staples overlie the right upper quadrant, consistent with a prior. An inferior vena cava filter is partially imaged. Surgical clips overlie the left axilla.The cardiomediastinal silhouette is apparently magnified but enlarged. Diffuse interstitial opacities are stable. No focal pulmonary opacity to suggest pneumonia. No large pleural effusion. No pneumothorax.

Output: Lines and tubes stable as above. No new superimposed cardiopulmonary disease.


Instruction: Generate impression based on medical findings.

Input: 57 years old Male. Reason: pneumoperitoneum History: abdominal pain. Basilar segmental atelectasis and interstitial changes. The large pleural effusions or pneumothorax. Cardiac silhouette within normal limits. No appreciable pneumothorax. No specific evidence of pneumoperitoneum.

Output: Basilar atelectasis and interstitial changes


Instruction: Generate impression based on medical findings.

Input: Female, 18 years old.Gamma interferon antigen response, evaluate for TB. No significant cardiopulmonary abnormality.No active TB.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: ET tube placement. Interval decrease in lung volumes with development of patchy bilateral areas of atelectasis, probably the result of aspirated secretions.Endotracheal tube tip about 5 cm above the expected level of the carina.

Output: ETT tip about 5 cm above the expected level of the carina.


Instruction: Generate impression based on medical findings.

Input: Pneumothorax, follow-up Extensive bullous emphysema is again observed greater on the right with associated mildly decreased lung volumes. A large hiatal hernia and scarlike changes in both lung bases also greater on the right appear similar.The cardiac and mediastinal contours are grossly within limits due to rotation and given mild left to right shift, unchanged.

Output: Extensive bulla and emphysematous changes unchanged


Instruction: Generate impression based on medical findings.

Input: Device placement Unchanged 2-lead left subclavian ICD, lead tips are in the expected location. No immediate postprocedural complicationsInterval improvement with decreased minimal streaky densities in both lung bases again representing suspected atelectasis and less likely aspiration. No distinct effusions or additional superimposed focal airspace acute abnormality.

Output: Unchanged left subclavian ICD


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: s/p thoracentesis History: s/p thoracentesis Interval slight decrease of the right pleural effusion. The Port-A-Cath is stable in position. The cardiac silhouette cannot be evaluated due to right pleural effusion.

Output: Slight interval decrease of the right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.Chest pain and possible aspiration evaluate for free air or consolidation. Normal heart size. No pleural fluid or pneumothorax. No focal air space opacities.No gross free intraperitoneal air is appreciated.

Output: No acute cardiopulmonary abnormality. No visible free intraperitoneal air.


Instruction: Generate impression based on medical findings.

Input: Reason: Trach History: trach Cardiomegaly with bilateral opacity compatible with edema and small pleural effusions.Cardiopulmonary monitoring and support devices, unchanged.No new findings.

Output: Pulmonary edema and pleural effusions with no acute change.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Status post lung transplant Persistent right apical hydropneumothorax slightly smaller.Postsurgical changes of a right upper lobectomy.Cardiomediastinal silhouette is normal.Emphysematous changes in the left lung.Streaky right basilar opacities likely reflect atelectasis. No new airspace opacity.

Output: Decreased right apical hydropneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: 62M h/o CHF, lung ca s/p resection, dysrhythmias who p/ w CP, SOB History: CP, worsening SOB Cardiac size is unchanged. There is postsurgical changes of the left hilum with left lower lung nodule. There is paramediastinal radiation fibrotic changes of the right hilum. Small pleural effusions. No pneumothorax.

Output: No specific findings to account for pain. Stable appearing radiation reaction and metastasis.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: Eval pneumothorax History: Pneumothorax Support devices unchanged.Persistent right apical pneumothorax measuring approximately 2.3 cm.Stable cardiac enlargement with basilar opacities compatible with atelectasis and probable small effusions.

Output: No change in small right apical pneumothorax. No other interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 24 years old. Trauma Cardiomediastinal silhouette is within normal limits.No focal airspace opacity. No pleural effusions or pneumothorax.No rib fractures within the limits of chest radiograph.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: s/p bronch, Robotic left upper lobectomy History: post-op f/u Left upper lobectomy with volume loss and pleural thickening.No pneumothorax or other complication of bronchoscopy.

Output: Left hemithorax postsurgical volume loss, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: pneumonia History: pneumonia Nonspecific basilar opacities left greater than right, suspicious for infection or aspiration.Tracheostomy tube tip 5 cm above the carina.

Output: Basilar opacities suspicious for infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Chest tube check Right basilar and mediastinal chest tubes, abandoned ICD and Swan Ganz are all unchanged.No clear changes related to the prior pneumoperitoneum, consider dedicated imaging.Mild cardiomegaly and other changes related to recent transplant, unchanged. Suspected basilar atelectasis.

Output: Chest tubes unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: eval for pneumonia History: recent pna Stable cardiomediastinal silhouette.New right basilar opacity. No pleural effusions.

Output: New right basilar opacity suspicious for aspiration/pneumonia.


Instruction: Generate impression based on medical findings.

Input: Dyspnea, history of CHF. Evaluate for pneumonia or pulmonary edema. No focal consolidation or effusion. No evidence of pulmonary edema.Mild cardiomegaly. Intact median sternotomy hardware and mitral valve prosthesis. Chronic midthoracic vertebral body height loss.

Output: No evidence of congestive heart failure.


Instruction: Generate impression based on medical findings.

Input: 72-year-old male with metastatic pancreatic cancer CHEST:LUNGS AND PLEURA: Again noted multiple metastatic nodules in the lungs. Referenced nodule in the lingula measures 11 x 11 mm image number 56, series number 4, not significantly changed. Other spiculated bilateral nodular densities and air space opacities have also not significantly changed.MEDIASTINUM AND HILA: Mediastinal and bilateral hilar adenopathy. Reference precarinal lymph node measures 16 x 14 millimeter on image number 47, series number 4.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Large mass in the pancreatic body and tail measures 9.8 x 5.4 cm in image number 113, series number 4.ADRENAL GLANDS: Left adrenal gland is invaded by the mass. Right adrenal gland is unremarkable.KIDNEYS, URETERS: Bilateral simple appearing cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Reference omental implant is not well visualized on today's study, therefore cannot be measured. Other peritoneal implants are grossly unchanged. Small amount of ascites is unchanged.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: Small amount of ascites. Left common femoral lymph node measures 19 x 17 mm image number 187, series number 4. Not significantly changed from previous study. This may also represent a slightly thickened spermatic cord.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old. SOB. Post-procedure pleuroscopy/thorascopy. Evaluate for pneumothorax/hemothorax/fluidcollection. Interval placement of right chest tube, tip at the apex. No significant pneumothorax. Small amount of subcutaneous emphysema around the chest tube. Small right pleural effusion, decreased from prior. Small left pleural effusion, unchanged. Mild basilar atelectasis and possibly edema.Stable cardiomediastinal silhouette.

Output: Interval placement of right chest tube, tip at apex. Decreased size of right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Age: 80 yearsGender: MaleReason for Study: Reason: evaluate for progression of pneumothorax History: SOB, pneumothorax, diffuse subcutaneous emphysema Left pleural catheter unchanged.Extensive subcutaneous emphysema with moderately large left pneumothorax similar to the prior exam.Again noted is atelectasis in the left lung in the presence of endobronchial valves.

Output: Moderate sized left sided pneumothorax, extensive subcutaneous emphysema, and partial collapse of the left lung unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: pneumonia, pulmonary hemorrhage History: hemoptysis, shortness of breath Mild cardiomegaly with a single lead pacemaker and port catheter unchanged from previous. Mild basilar subsegmental atelectasis and/or scarring. No specific evidence of pulmonary hemorrhage or pneumonia.10 mm nodule in the right lower lung, previously characterized by CT scan and stable since 2010, compatible with a benign etiology.

Output: Cardiomegaly and basilar atelectasis with no acute change.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: evaluate for worsening effusions/edema History: SOB, hypoxia Stable cardiomegaly. Mitral clip is noted.No signs of pulmonary edema.Possible trace right pleural effusion. No pneumothorax.

Output: No evidence of pulmonary edema. Possible trace right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Reason: Worsening pleural or pericardial effusion History: Shortness of breath Heart size about upper normal with moderate bilateral pleural effusions.No significant interval change.

Output: Unchanged heart size and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 22 years old.Cough. Evaluate for pneumonia. The cardiomediastinal silhouette is within normal limits. No focal airspace opacity, significant pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.Reason: is there an infiltrate or edema History: chest pain, hypertension, lupus Stable cardiomegaly. No new opacity or significant pulmonary edema.

Output: No evidence of edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: increased epigastric pain and right shoulder pain x 1 day History: epigastric pain and right shoulder pain Cardiomegaly with basilar interstitial opacities and retrocardiac atelectasis, probably chronic.No specific evidence of infection or edema.No skeletal abnormalities identified.

Output: Cardiomegaly and chronic interstitial opacities, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 29 years old. ET tube with its tip 3 cm above the carina.NG tube with its tip beyond the margin of the image.Right IJ venous catheter placed with its tip in the SVC.No evidence of pneumothorax.Stable cardiomediastinal silhouette.The lungs are clear.

Output: Mild advancement of the ET tube with its tip 3 cm above the carina. Right IJ venous catheter placed without complication. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Reason: ? aspiration afer dobhoff dislodged History: cough Unremarkable cardiac and mediastinal silhouette.Mild elevation of the left hemidiaphragm, unchanged.No significant pulmonary or pleural disease.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Shortness of breath, DOE, LE edema. Normal heart size. Mild elevation of the right hemidiaphragm. No focal airspace opacities, pleural fluid or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 58-year-old female with suspected post transplant lymphoproliferative disorder. Rising EBV titers Evaluation of the solid organs is limited by IV contrast.CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Visualization of the walls of the cardiac chambers suggests anemia.Moderate-sized hiatal hernia. CHEST WALL: Surgical clips are seen in the right axilla and right breast.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Normal in size.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No evidence of disease is seen.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: sob, eval for fluid overload History: sob, eval for fluid overload Moderate cardiomegaly with a tortuous ectatic thoracic aorta.Small bilateral pleural effusions and mild basilar edema. No pneumothorax.

Output: Findings consistent with CHF.


Instruction: Generate impression based on medical findings.

Input: 51-year-old male status exploratory laparotomy, transhiatal esophagectomy, left chest tube, J-tube for GE junction cancer complicated by neck anastomotic leak now presenting with potential right chest pleural effusion Grayscale and Doppler sonography of the right lateral chest demonstrates a large pleural effusion with few septations.

Output: Large right pleural effusion with few septations.


Instruction: Generate impression based on medical findings.

Input: 22-year-old female with history of thyroid cancer status post surgery. Evaluate for areas of uptake. There is increased I-131 activity in the thyroidectomy bed consistent with functioning thyroid tissue. There are no distant areas of I-131 activity to suggest metastatic disease.There is expected faint activity in the liver consistent with metabolized I-131 labeled thyroid hormone. There is also expected I-131 activity in the stomach and urinary bladder.

Output: Functioning thyroidal tissue in the thyroid bed. No functioning more distant metastatic disease is identified.


Instruction: Generate impression based on medical findings.

Input: 41-year-old male with neutropenic fever. Exam is limited by lack of intravenous and oral contrast which limits the exam sensitivity for lesions of the solid organs and bowel. With those limitations, the findings are as follows:CHEST:LUNGS AND PLEURA: There is a new small opacity in the right upper lobe (series 5, image 43). No pleural effusions or other opacities.MEDIASTINUM AND HILA: Right PICC tip is in the axillary vein.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Liver granulomata are again visualized. SPLEEN: Mild splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: New right upper lobe pulmonary opacity, which may represent infectious process.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: pna v infiltrate v interval changes History: sob Study limited by leftward patient rotation. Enteric tube terminates inferiorly off the field-of-view. Left IJ line, unchanged. No substantial change in bibasilar pleural-parenchymal opacities, left greater than right. Probable small pleural effusions. Unchanged heart size. No significant pneumothorax.

Output: Study limited by leftward patient rotation. No substantial change in bibasilar pleural-parenchymal opacities, left greater than right. Probable small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: lung cancer, f/u History: see above Evolving left perihilar radiation reaction.Left hemithorax post radiation and postsurgical volume loss.Right lung unremarkable.

Output: Evolving radiation reaction, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Productive cough, immunosuppressed. Evaluate for pneumonia. Enlargement of the central pulmonary vasculature consistent with pulmonary hypertension, change. Loop recorder device projects over the left chest wall.No pleural fluid or pneumothorax. Left basal scarring and nonspecific hazy opacity.No specific signs of pulmonary edema.Air-fluid level in the transverse colon and small bowel loops, correlate for abdominal symptoms.

Output: Nonspecific hazy basal opacity could potentially reflect very early atypical infection or an atypical presentation of edema; short-term plain film follow-up is suggested. Suggest abdominal radiograph to exclude ileus or other abdominal pathology.


Instruction: Generate impression based on medical findings.

Input: Reason: known RLL abscess; compare to previous for interval change History: cough Persistent right lower lobe cavity consistent with an abscess.Probable slight interval decrease in surrounding opacity, consistent with pneumonia and atelectasis.Moderate cardiomegaly.No new findings.

Output: Persistent right lower lobe abscess with slightly decreased surrounding consolidation.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old, with history of metastatic ocular melanoma. Evaluate for progression of metastatic disease. CHEST:LUNGS AND PLEURA: Scattered bilateral pulmonary nodules suspicious for metastatic disease. The largest measures 10 x 10 mm on image 50, series 5196, in the right perihilar region.No focal consolidation, edema or pleural fluid.MEDIASTINUM AND HILA: A large, heterogeneous left thyroid mass measures 4.2 x 4.3 cm on image 12, series 5195.A right pericardiophrenic lymph node measures 1.1 x 1.3 cm on image 65, series 5195. No other pathologically enlarged hilar or mediastinal lymph nodes are seen.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Numerous hypoattenuating lesions within the liver are compatible with metastatic disease. For reference, a segment 4a lesion measures 6.2 x 6.2 cm on image 87, series 5195.SPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedPANCREAS: Prominent peripancreatic lymph nodes are noted.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymphadenopathy is evident.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Numerous scattered soft tissue nodules are compatible with metastatic disease. The largest arises within the abdominal wall musculature on the right and measures 2.7 x 3.6 cm on axial image 130, series 5195.OTHER: No significant abnormality noted

Output: Widespread metastatic disease as described above.


Instruction: Generate impression based on medical findings.

Input: IntubationVIEW: Chest AP ET tube tip at the level of the thoracic inlet. There are two NG tubes with tips in the stomach. Lower extremity PICC with tip in the right atrium. Cardiothymic silhouette normal. Left chest tube in place. Patchy opacities at the left lower lobe and right upper lobe not significantly changed. No evidence of pneumothorax.

Output: Bilateral patchy lung opacities not significantly change.


Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Reason: r/o infection History: high fever Stellate opacity at the left base compatible with scar. No consolidation or pleural effusion. Pre-medley is stable. Vertebral body endplate changes compatible with sickle cell disease.

Output: No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: r/o pleural effusions vs PNA History: Hypoxemia Increasing basilar opacities suggestive of aspiration.Heart size normal.Status post TIPS.

Output: Increasing basilar opacities suggestive of aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: assess for pulm edema, pneumonia, etiology of worsening O2 requirement History: hypoxia Interval development of probably right lower lobe lung opacity likely representing infection. There is some degree of cardiomegaly with interstitial prominence in left lung base.No pleural effusion. No pneumothorax.

Output: Right basilar opacity likely infection


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Heart failure, evaluate for interval change. Right-sided PICC with tip in distribution of right axilla, unchanged. Right subclavian ICD. Swan-Ganz catheter with tip in the main pulmonary artery.Probable small effusions and mild basilar edema appearing similar to prior.

Output: Right PICC tip in the axilla. Cardiomegaly and mild edema, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Status post LVAD evaluate chest tube position and rule out pneumothorax. Interval removal of right jugular Swan-Ganz catheter. Other hardware and devices similar in position, including a chest tube projecting over the left base.3 mm left apical pneumothorax.Retrocardiac atelectasis and pleural fluid on the left about the same.

Output: 3 mm left apical pneumothorax. Left pleural fluid and retrocardiac opacity most consistent with atelectasis about the same. Swan-Ganz catheter has been removed.


Instruction: Generate impression based on medical findings.

Input: Mitral valve disorder Motion degrades detail.Interval post surgical changes largely involving the right chest with right chest and mediastinal chest tubes. ETT terminates 2 cm above the carina.Swan Ganz extends into the right pulmonary outflow

Output: Post surgical chest tubes without new emergent super imposed new focal findings.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: ACS? r/o pna, ptx History: chest pressure Basilar scarring or subsegmental atelectasis, otherwise unremarkable.No specific evidence of infection or edema.No significant pneumothorax.

Output: Basilar scarring, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Pneumonia status post bronchus evaluate for postprocedural pneumothorax, worsening TRALI versus left lower lobe worsening where saline was injected. Motion artifact degrades image quality. Interval worsening of opacities in the right upper and left lower lobes. Faint groundglass opacities elsewhere are about the same.

Output: Bilateral worsening of opacities. On the left, this may be partially related to bronchoscopy. However, on the right worsening is likely the result of pre-existing process.


Instruction: Generate impression based on medical findings.

Input: 26 year old female with history of non-Hodgkin lymphoma status post stem cell transplant CHEST:LUNGS AND PLEURA: Interval decrease in the amount of left pleural effusion.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Index right axillary lymph node is unchanged measuring 8 mm in diameter on image number 17, series number 3. Other small axillary lymph nodes are also unchanged.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypodense lesion in the lower pole of the right kidney is unchanged. This lesion measures 42 Hounsfield units, does not represent a simple cyst. Further follow-up with ultrasound may be helpful.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Index left inguinal lymph node is unchanged measuring 7-mm in diameter image number 185, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of ascites.

Output: No significant change from previous study other than interval decrease in the size of the left-sided pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Reason: evaluate CHF, pericardial effusion History: see above Cardiomegaly with interstitial changes in the right middle and lower lung fields. Multiple calcified densities are noted in the right upper lobe and the right perihilar region.

Output: Cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Age: 44 yearsGender: FemaleReason for Study: Reason: eval forp na History: productive cough, left sided chest pain 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: Abdominal pain and fever No discrete acute cardiopulmonary abnormality of the minimal basilar previously described atelectasis and/or scarring. Mild scoliosis exaggerates mediastinal contours.No findings to suggest free air under the diaphragm

Output: Minimal pulmonary basilar scarring without superimposed acute abnormality


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: any acute changes? History: Hypoxia Basilar opacities increasing in both bases now also affecting the right, with pleural effusions.Heart size normal.

Output: Increasing basilar opacities suggestive of edema and infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Hypoxia LUNGS AND PLEURA: Complete collapse of right lung with findings consistent with necrotizing pneumonia and extensive right-sided pleural effusion.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: Right lung necrotizing pneumonia on large pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: ETT placement History: ETT Limited examination due to patient's large body habitus, portable technique and lordotic position with significant image blurring.Endotracheal in place with tip 3 cm superior to the carina.Cardiac silhouette is magnified but likely enlarged.Bilateral low lung volumes with element of bronchovascular crowding. Perihilar vascular congestion without frank edema.Bibasilar and retrocardiac opacities likely atelectatic in nature. Trace pleural effusions not excluded. No pneumothorax.

Output: Endotracheal tube tip 3 cm superior to the carina.Bibasilar and retrocardiac opacities likely atelectatic in nature.


Instruction: Generate impression based on medical findings.

Input: Follow-up VATS. Check for pneumothorax Moderate volume loss on the right with elevated diaphragm correlating with recent surgery however other than minimal patchy opacities in the bases representing edema and/or atelectasis, lungs are otherwise clear. The cardiac and mediastinal contours are within limits. Specifically no postprocedural complication such as pneumothorax.

Output: No immediate postprocedural complications


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: CHF vs URI vs RAD History: SOB Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 55-year-old male with 3-cm mass density in the left infrahilar region. CHEST:LUNGS AND PLEURA: A lobulated, left lower lobe mass with internal calcification measures 4.3 x 3.4 cm on axial image 61/139 and is very suspicious for tumor, either metastatic or primary lung malignancy. Left hilar adenopathy is associated with this lesion. A satellite nodule is evident on axial image 52/139. A few scattered micronodules are noted bilaterally. Mild centrilobular emphysema.No pleural effusion.MEDIASTINUM AND HILA: Left hilar adenopathy as above. Small pretracheal and prevascular lymph nodes. Cardiac size is normal with no pericardial effusion.CHEST WALL: Small axillary lymph nodes.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedADRENAL GLANDS: The left adrenal gland is thickened with no discrete mass.KIDNEYS, URETERS: A few, very small hypoattenuating lesions in both kidneys.PANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: The left psoas muscle is atrophic with areas of internal low attenuation of uncertain etiology and clinical significance. Dedicated distal imaging may be considered for further characterization if clinically warranted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Left lower lobe mass with associated adenopathy most likely represents tumor, either metastatic or a primary lung malignancy. Infection is less likely.A preliminary interpretation of this study was communicated to the emergency department by the radiology resident on call. No discrepant findings noted.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.New trach. Respiratory arrest. Interval placement of a tracheostomy tube with tip 4.5 cm above the level of the carina. Central lines are unchanged in position. Bilateral lower lobe aspiration with atelectasis. No pneumothorax. Gastrostomy tube retention device projects over the left upper quadrant.

Output: Appropriate position of tracheostomy tube, no pneumothorax. Bilateral lower lobe aspiration and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 28 years old.Chest pain. Tunneled right central venous catheter tip at the cavoatrial junction. Stable mild cardiomegaly. Low lung volumes with subsegmental atelectasis. Otherwise, no focal airspace opacity, pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 62-year-old male with metastatic colon cancer status post RFA of hepatic lesion on 12/11/09. Evaluate for interval change. CHEST:LUNGS AND PLEURA: Micronodules along fissure on the right series 4 image 50, unchanged from prior exam series 4 image 49 possibly an and pulmonary noted. No new lung nodules. No effusions.MEDIASTINUM AND HILA: No pathologic size nodes. Partial intrathoracic stomach (not a paraesophageal hernia). Coronary artery calcifications.CHEST WALL: Port-A-Cath right chest wall.ABDOMEN:LIVER, BILIARY TRACT: No new sites of disease.Lesion that underwent RFA on the border of segment 5/6 as a larger near fluid density area caudally probably representing changes related to RFA. Along cephallic margin is more intermediate density seen on series 3 image 100 to measure 3.6 x 2.4-cm (also see coronal 60/110) which is less specific and concerning for residual tumor. No evidence of hepatic or portal vein thrombus. No biliary dilatation. Cholelithiasis, unchanged. Small nodes in the porta hepatis unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild right hydroureter, unchanged.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal, portacaval and periportal nodes, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder wall thickening. Foley catheter. Posterior wall of the bladder performed in infused to the presacral soft tissue unchanged from prior.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes. Left lower quadrant colostomy with parastomal hernia, nonobstructive. Parastomal hernia contains both large and small intestine. Diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Postsurgical changes and soft tissue thickening in the presacral space could represent postsurgical change. As before, the urinary bladder is tented and he is this area.

Output: Expected postsurgical changes. Changes in liver consistent with RFA and possible residual tumor should be followed. Nonobstructive parastomal hernia. Stable postsurgical changes in the presacral space. Numerous other findings as above.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.History of HIV with worsening cough and shortness of breath, evaluate for pneumonia Low lung volumes. Patchy bilateral airspace opacities similar in distribution to the prior exam. Heart size is top normal.

Output: Patchy bilateral airspace opacities similar in the supervision of the prior exam. Findings are suggestive of aspiration or infection, such as pneumocystis pneumonia in this patient with HIV.


Instruction: Generate impression based on medical findings.

Input: Reason: assess for PNA, other acute abnormalities History: neutropenic fever (pt with h/o DLBCL s/p SCT) Elevation of the left hemidiaphragm and mild scarlike opacity in the left upper lobe, decreased compared to previous.Right jugular catheter is extending to the SVC.No sign of pneumonia.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: h/o Type I/II respiratory failure with COPD and OSA, now extubated and on BiPAP History: dyspnea Cardiomegaly and patchy opacities consistent with acute edema or aspiration, unchanged.Small pleural effusions noted.Right jugular catheter poorly visualized but probably still terminates in the SVC.

Output: Unchanged pulmonary opacities and small pleural effusions with cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: Pre-Kidney evaluation, end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax.

Output: No acute cardiopulmonary process is identified.


Instruction: Generate impression based on medical findings.

Input: Reason: ? pneumonia after recent hemopneumothorax History: fever Unremarkable cardiac and mediastinal silhouette. Moderate right pneumothorax with the apex of the lung about 2 cm from the chest wall.Pleural opacity compatible with a history of hemothorax. Moderate effusion/hemothorax at the right base.

Output: Moderate right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 62-year-old male with colorectal cancer CHEST:LUNGS AND PLEURA: No change in the nodule measuring 8mm abducting the right fissure on image number 56, series number 5.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Presacral soft tissue density encasing the rectum and containing small amount of air is unchanged. This may represent scarring, however, neoplasm cannot be excluded.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No significant change from previous CT.