Instruction: Generate impression based on medical findings.

Input: Age: 63 yearsGender: FemaleReason for Study: Reason: CHF with ICD in place History: volume overload There is moderate/marked cardiac enlargement with atherosclerotic changes of the aorta.Left-sided ICD with single lead within the right ventricle.Right central venous catheter with its tip in the SVC.Lungs are clear.No pleural effusions.

Output: Cardiomegaly without specific evidence of pulmonary edema or pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Reason: interval change History: interval change Tracheostomy tube, venous catheter and chest tubes unchanged.Bilateral nonspecific airspace opacity compatible with edema and atelectasis.Bilateral pleural effusions, greater on the left.No pneumothorax or other acute change.

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


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: evaluate for infiltrate History: cough. No focal air space opacity.No pneumothorax, pulmonary edema, or significant pleural effusion.Cardiomegaly is increased from the previous exam.

Output: No specific evidence of acute infection. Increased cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: dyspnea History: dyspnea Unchanged PICC. Low lung volumes makes detailed cardiopulmonary assessment difficult. Increased retrocardiac opacity, likely atelectasis. Unchanged cardiomegaly. Small right pleural effusion. No pneumothorax.

Output: Low lung volumes makes detailed cardiopulmonary assessment difficult. Increased retrocardiac basilar opacities, likely atelectasis or aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 29 years old. Reason: s/p cardiac arrest with leukocytosis, r/o PNA. also confirm ETT History: leukocytosis Lines and tubes are unchanged. No new focal lung opacity. No large pleural effusion or pneumothorax. Unchanged heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Reason: Rule out PNA History: Cough, SOB No significant cardiopulmonary abnormality.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 56 yearsGender: FemaleReason for Study: Reason: s/p L thora, eval for ptx History: see above No decrease lung volumes with stable cardiac mediastinal silhouette.Significant interval improvement in the perihilar/basilar opacities, particularly on the left.Dobbhoff tube with its tip beyond the margin of the image.Right PICC line with its tip in the SVC.No evidence of a pneumothorax post thoracentesis.

Output: Significant interval improvement in the pulmonary opacities and left pleural effusion. No evidence of a pneumothorax post thoracentesis.


Instruction: Generate impression based on medical findings.

Input: Male, 87 years old.Reason: evaluate for infection/effusion History: new A-fib, hypotension Basilar interstitial opacities possible edema or aspirated secretions, accentuated by underinflation artifact.Mild cardiomegaly with tortuous aorta.Bilateral ureteral stents noted.

Output: Basilar interstitial opacities suggestive of edema or aspirated secretions.


Instruction: Generate impression based on medical findings.

Input: Female, 32 years old.Reason: quinton placement, eval for ptx History: quinton placement Right IJ central venous catheter present with tip in SVC.The cardiomediastinal silhouette is unremarkable.Lungs are clear.No evidence of pleural effusion or pneumothorax.

Output: No cardiopulmonary abnormalities and no evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Reason: s/p ICD History: S/P ICD Interval placement of left chest ICD, with lead near the cardiac apex.Stable cardiomediastinal silhouette.No new focal air space abnormality. No significant pleural effusions. No pneumothorax.

Output: Interval placement of left chest ICD without complication or new acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.History of bilateral pleural effusions. Tracheostomy and enteric tube are unchanged. Interval removal of right central venous catheter. Layering bilateral pleural effusions and basilar atelectasis, appearing similar to the prior study. The cardiomediastinal silhouette is stable.

Output: Stable bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: Swan positioning History: as above Left-sided ICD unchanged.Left IJ Swan-Ganz with its catheter tip in the left pulmonary artery.Decreased lung volumes with stable cardiomegaly.No new pulmonary opacities identified.

Output: Mild retraction of the Swan-Ganz catheter with its tip now in the left pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: 71-year-old male metastatic sarcoma on chemotherapy. Please evaluate. CHEST:LUNGS AND PLEURA: Stable micronodules involve the right upper lobe, right middle lobe and lingula. No new nodules. No effusions.MEDIASTINUM AND HILA: Small not pathologically enlarged nodes unchanged. Clear artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN: The exam is not sensitive for detecting lesions in the solid organs due to the lack of intravenous contrast. Given that limitation, the following observations are made.LIVER, BILIARY TRACT: Index lesion in the lateral segment of left lobe, 7.4 x 5.7 cm, series 3 image 93. Previously measured 7 x 5.8 cm.Index lesion right lobe of liver,14.6 x 10.9 cm, series 3 image 95. Previously 14.9 x 11.8 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Some of the renal lesions measures slightly higher than water density but are unchanged in size. In particular the lesion and the lateral aspect of the left lower pole is higher than water density. Indeterminate nature on this noncontrast scan as were the two prior CT scans.RETROPERITONEUM, LYMPH NODES: Atherosclerotic changes. No aneurysm. Shotty nodes not pathologic in size.BOWEL, MESENTERY: Hazy soft tissue density in the mesenteric root with panniculitis like appearance slightly more prominent on today's exam but is present dating back to July 6, 2009. Bowel is normal except for colonic diverticulosis. No evidence of ascites.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: Diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Atherosclerotic changes iliac vasculature no evidence of aneurysm.

Output: Measurements as above. No new sites of disease. Stable micronodules in the lungs. There some of the lesions in the kidneys are cysts some are higher than fluid density and indeterminate.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: evaluate cardiopulmonary fields History: chest pain Mild cardiomegaly.No significant pulmonary or pleural abnormality.

Output: Cardiomegaly, but no acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 22 years old.Cough and fever evaluate for pneumonia. Left lower lobe airspace opacity consistent with pneumonia.Normal heart size.Right lung is clear.

Output: Left lower lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: 18-year-old female with fever and cough. Evaluate for pneumonia. Cardiac silhouette is normal.Mild peribronchial thickening.No abnormal focal airspace opacity.Pleural spaces are clear.

Output: Mild peribronchial thickening suggestive of reactive airway disease versus bronchitis.


Instruction: Generate impression based on medical findings.

Input: Female, 38 years old.Cough. Cardiomegaly with underlying atelectasis/consolidation. No new focal opacity to suggest acute infection. No reliable evidence of pulmonary edema. No large pleural effusion is evident. No evidence of pneumothorax. Right AICD in place, unchanged.

Output: Cardiomegaly without evidence of acute infection or pulmonary edema.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, 53 years old.Reason: eval RIJ position History: as above Small lung volumes.No specific evidence of infection or edema.Chronic appearing eventration right hemidiaphragm.Right jugular catheter, tip in SVC.Spinal stabilization hardware, an IVC filter and cholecystectomy clips are noted.

Output: Small lung volume, otherwise unremarkable. Right jugular catheter, tip in SVC.


Instruction: Generate impression based on medical findings.

Input: Chest pain Moderate nonspecific cardiomegaly without additional mediastinal contour abnormality.Lungs remain clear. Persistently and mildly decreased in lung volumeInterval placement of right jugular dialysis catheter terminating in the mid SVC

Output: Right jugular dialysis catheter placed


Instruction: Generate impression based on medical findings.

Input: Male, 39 years old.Reason: IABP placement History: IABP placement IABP superior margin terminates approximately 1.8 cm from the top of the aortic arch. Other iatrogenic devices are unchanged. No new focal lung consolidation. No pleural effusion or pneumothorax. Marked cardiomegaly again noted.

Output: IABP superior margin terminates approximately 1.8 cm from the top of the aortic arch.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p thora assess for PTX, improvement in effusion History: s/p thora Right retrohilar mass compatible with focal pleural thickening or lymphadenopathy.Moderate bilateral pleural effusions with underlying atelectasis.Nodular pleural thickening in the right hemithorax, previously confirmed by CT scan, compatible with mesothelioma.No pneumothorax.

Output: Right pleural mesothelioma with pleural effusions and basilar atelectasis. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Gastric cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Sub-centimeter, subtle indeterminate hypodensities in the liver are unchanged from previous CT. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left hydronephrosis with delayed nephrogram and dilated right ureter. Underlying etiology is not certain but could be the retroperitoneal soft tissue encasing the distal ureter.RETROPERITONEUM, LYMPH NODES: Soft tissue infiltration of the paraceliac peripancreatic, porta hepatis, and around the IMA have increased.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: The uterus is unremarkable. Both ovaries are enlarged with soft tissue densities which may represent metastatic disease.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: Small amount of ascites.

Output: Interval increase in the retroperitoneal metastatic disease extending along the aorta. Enlarged ovaries with soft tissue nodules likely representing metastatic disease. Ascites is also suspicious for peritoneal carcinomatosis.New left-sided hydroureter and hydronephrosis likely caused by retroperitoneal metastatic disease.These findings were discussed with the clinical team at the time of dictation.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: Pre kidney transplant evaluation/end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: Pre-Kidney Transplant Normal heart size. Unremarkable mediastinal silhouette.Flattening of the diaphragms raising possibility of COPD/emphysema.No focal pulmonary opacities, pneumothorax, or pleural effusions. Fine surgical clips projected over left upper lung zone.

Output: Normal heart size. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Reason: eval lung fields History: sob, cp The lungs and pleural spaces are clear. Heart size is within limits of normal.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old. Near syncope Cardiomediastinal silhouette is within normal limits.No focal airspace opacity. No pleural effusions or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: pulmonary edema History: shortness of breath Cardiomegaly with pulmonary edema. Pleural effusions stable to increased. Support hardware unchanged.

Output: Cardiomegaly with pulmonary edema. Pleural effusions stable to increased.


Instruction: Generate impression based on medical findings.

Input: Weakness Interval improvement with near complete clearance of the small to moderate right effusion. No additional cardiopulmonary abnormality observed other than persistent mildly decreased lung volumes.

Output: Right effusion nearly resolved


Instruction: Generate impression based on medical findings.

Input: 61-year-old male with likely gastric cancer. Evaluate for metastatic disease. CHEST:LUNGS AND PLEURA: Bilateral pleural effusions and dependent atelectasis.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: Multiple borderline enlarged retroperitoneal lymph nodes suspicious for metastatic disease.BOWEL, MESENTERY: Wall thickening of the gastric antrum causing gastric of the obstruction and dilatation of the esophagus. Peritoneal soft tissue and significant amount of ascites suspicious for peritoneal carcinomatosis.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: Ascites.

Output: Antral wall thickening consistent with patient known history of gastric cancer. Peritoneal carcinomatosis and significant ascites.Bilateral small pleural effusions. Gastric outlet obstruction. Small retroperitoneal lymph nodes suspicious for metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Reason: post op, eval lung fields History: s/p CABG Chest tubes unchanged with a minimal left apical pneumothorax.Nonspecific basilar opacity consistent with atelectasis, consolidation and effusions.Interval removal of a right jugular catheter.No new findings.

Output: Minimal left apical pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Post tube. Interval placement of endotracheal tube with distal tip positioned approximately 2 cm above the carina. Interval placement of nasogastric tube with distal tip and sidehole in the left upper quadrant.Mild cardiomegaly. Mild pulmonary vascular congestion. Improved aeration at left base. No large pleural effusion, or large pneumothorax.

Output: Satisfactory positioning of endotracheal tube and nasogastric tube. Improvement of airspace disease previously noted at left base.


Instruction: Generate impression based on medical findings.

Input: 83 year old male s/p TECAB. Stable cardiomediastinal silhouette. Interval improvement of left pleural effusion/thickening.

Output: Interval improvement of left pleural effusion/thickening.


Instruction: Generate impression based on medical findings.

Input: Female, 90 years old.Reason: cough History: weakness Right axillary surgical clips noted.Mild cardiomegaly.No pleural effusions or pneumothorax.No focal opacities.

Output: No acute cardiopulmonary abnormality noted.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: Eval for PNA, volume overload History: SOB Layering right pleural fluid collection unchanged. Diffuse pulmonary opacities about the same.Interval clearance of left retrocardiac atelectasis.

Output: Improving atelectasis. Unchanged pleural fluid and diffuse pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: assess for change in pleural effusion, ETT position, chest tube position History: s/p intubation and chest tube placement for R sided empyema Feeding tube has been advanced slightly. Endotracheal tube, unchanged. Right-sided chest remains in place. Mild diffuse prominent opacities, unchanged. Moderate size right pleural effusion, as before. Unchanged heart size. No pneumothorax.

Output: Lines and tubes, as above. Persistent pulmonary edema. No change in right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: nodule left lung History: none No significant pneumothorax.Median sternotomy for CABG with mild cardiomegaly.

Output: No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: f/u form previous History: MG patient Right lower lobe consolidation and atelectasis, slightly improved.Mild left basilar atelectasis.NG tube tip in the gastric antrum.

Output: Persistent basilar opacities consistent with atelectasis and consolidation, likely secondary to aspirated secretions.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.History of mesothelioma. Postop. Left-sided chest tubes remain in place. Left basilar pleuroparenchymal opacity, not substantially changed. Unchanged cardiomegaly. No new focal pleural parenchymal opacity in the right hemithorax. No significant pneumothorax.

Output: Lines and tubes, as above. Left basilar pleuroparenchymal opacity, not substantially changed.


Instruction: Generate impression based on medical findings.

Input: Cough and sputum. Dyspnea Mild COPD changes with flattened diaphragms. Minimal basilar streaky densities suggesting atelectasis and/or scarring, serial imaging will be needed to confirm. No distinct superimposed focal airspace process. No effusionsCardiac and mediastinal contours significant for moderate tortuosity of the aorta

Output: COPD changes with suspected minimal basilar scarring and/or atelectasis. Serial imaging will be needed to confirm


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: hx of L flank rhabdomyosarcoma s/p surgery and RT History: none Stable kyphosis with loss of height of several vertebral bodies secondary to compression fractures. No visible pulmonary nodules. Heart size is normal.

Output: Stable compression fracture mid thoracic vertebral bodies. No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 58 yearsGender: MaleReason for Study: Reason: sob History: sob Moderately decreased lung volumes.The cardiomediastinal silhouette is unremarkable.Mild basilar subsegmental atelectasis.No focal airspace opacities.No large pleural effusions.

Output: No interval change without acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.IABP position. IABP marker is approximately 4.6 cm from the level of the aortic arch. Sternotomy wires, left AICD and right central venous catheter in place, unchanged. No findings to suggest acute infection or pulmonary edema. Cardiomegaly, appearing similar to the prior study.

Output: IABP marker is approximately 4.6 cm from the level of the aortic arch.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: SeizuresVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) Right parietooccipital approach ventriculostomy tube has its tip to the left of midline in the middle cranial fossa. Strata valve is set at performance level of 2.0. Distal tubing continues along the right neck and chest. Caudal tip is in the right mid abdomen. No discontinuity is identified. Bowel loops are not displaced from the caudal tip. Cardiothymic silhouette normal. No focal lung opacity. Moderate amount of fecal burden.

Output: No evidence of the extracranial shunt malfunction.


Instruction: Generate impression based on medical findings.

Input: 75-year-old female with significant weight loss CHEST:LUNGS AND PLEURA: 7 x 6 mm nodule in the right upper lobe on image number 20, series number 6. Another similar nodule is seen on image number 24, series number 6.MEDIASTINUM AND HILA: Nonenlarged pretracheal lymph node image number 20, series number 4.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: 2.5 by 2-cm round mass likely arising from the left adrenal gland. This lesion cannot be optimally characterized by this CT. MRI of the adrenal gland is recommended for further evaluation.KIDNEYS, URETERS: Nonspecific bilateral hypodense lesions in the kidneys, too small to acutely characterizable most likely benign. Scarring in the upper pole of the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ascending colon is not well opacified. Some areas of wall thickening may be secondary to transient peristalsis , however, further evaluation with colonoscopy may be helpful.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: Nonspecific right upper lobe nodules. Follow-up chest CT in 6 months is recommended.Left adrenal mass. Further evaluation with adrenal MRI is recommended.Colonoscopy is recommended for further evaluation of the ascending colon.


Instruction: Generate impression based on medical findings.

Input: Age: 50 yearsGender: FemaleReason for Study: Reason: sepsis of unknown origin History: sepsis of unknown origin The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Suspicion for interstitial lung disease in a patient with new diagnosis of pulmonary hypertension. Shortness of breath, volume overload. LUNGS AND PLEURA: Markedly enlarged main pulmonary artery, measuring 4.9 cm (image number 39, series number 3). Mosaic attenuation pattern with demonstration of areas of air trapping bilaterally. Mild bronchial wall thickening. Small bilateral pleural effusions or pleural thickening. Basilar scarring and dependent atelectasis. No evidence of interstitial lung disease.MEDIASTINUM AND HILA: Moderately severe cardiomegaly. Small to moderate amount of pericardial effusion/thickening. Moderate calcifications along coronary arteries. Mediastinal lymphadenopathy with the largest precarinal lymph node measuring 25 x 17 mm (image number 35, series number 3). CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Calcified and aneurysmal dilatation of splenic artery.

Output: 1. Markedly enlarged pulmonary artery and mosaic attenuation pattern, compatible with pulmonary hypertension.2. Cardiomegaly, pericardial effusion/ thickening, small pleural effusion and/or thickening.3. No evidence of interstitial lung disease.


Instruction: Generate impression based on medical findings.

Input: Esophageal cancer Postsurgical changes and scarring largely involving the right lung base unchanged. Specifically no new findings to support recurrence or new abnormality.Old scattered granuloma with other lungs are otherwise clear

Output: Postsurgical scarring without evidence of disease recurrence


Instruction: Generate impression based on medical findings.

Input: Female, 82 years old.Reason: s/p DC-PM implant --> r/o pneumothorax and evaluate lead positions History: as above Mild basilar subsegmental atelectasis.Left subclavian dual-chamber pacemaker placement, leads in appropriate positions without complication.

Output: No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 88 years old.Evaluate for aspiration and/or pneumonia. Extensive pleural calcification bilaterally limiting characterization of the lung parenchyma.Low lung volumes. No visible signs of pneumonia or aspiration.Right PICC extends into the azygos arch.Left subclavian dual-chamber pacemaker unchanged in position.Carotid calcifications in the neck.

Output: No specific signs of pneumonia or aspiration. Pleural calcifications compatible with prior asbestos exposure. Right PICC extends into the azygos arch.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Reason: assess ETT placement History: new intubation Low ET tube, at the level of the carina.Small lung volumes.Right jugular catheter, tip in SVC.

Output: Low ET tube, at the level of the carina.


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.Reason: subcutaneous emphysema History: right sided chest pain, swelling Unchanged minimal right pneumothorax with right chest tube and severe soft tissue emphysema.The underlying lungs appear unremarkable.Heart size normal.

Output: No change in very small right pneumothorax with right chest tube, with severe soft tissue emphysema.


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.Reason: r/o infection. Hx: stem cell transplant with relapsed AML. Recent aspiration PNA History: febrile No significant cardiopulmonary abnormality.No specific evidence of infection or aspiration.A Dobbhoff tube terminates in the stomach.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 21 years old.Reason: patient with port, in altercation where port was pulled on while accessed. Assess integrity History: port pulled at Right midlung scarring.Right jugular catheter, tip in SVC, unchanged.

Output: No change in catheter position.


Instruction: Generate impression based on medical findings.

Input: ETT check ETT remains 4 cm above the carina. NG, right PICC line overall cardiopulmonary appearance is significant for mild improving aeration and volumes, specifically left lower lobe

Output: ETT unchanged


Instruction: Generate impression based on medical findings.

Input: 57-year-old male with history of cough. Evaluate for infection. Again seen are extensive changes related to sarcoidosis of perihilar, left upper, and bibasilar interstitial fibrotic changes as well as apical bullae and scattered areas of bronchiectasis. No evidence to suggest acute exacerbation or superimposed infection. No pleural effusions or pneumothorax.The cardiomediastinal silhouette is unchanged.

Output: Extensive changes compatible with pulmonary sarcoid not significantly changed when compared to the prior study. No radiographic evidence of superimposed infection.


Instruction: Generate impression based on medical findings.

Input: 4-year-old male with history of leukemia and histiocytosis; evaluate lung masses CHEST:LUNGS AND PLEURA: The anterior mediastinal mass in the left hemithorax measures approximately 8.3 x 4.7 cm in the axial plane (series 4, image 29), previously measuring approximately 8.4 x 5.9 cm. Central low density regions likely represent areas of necrosis. Innumerable lung nodules are also again seen scattered throughout both lungs of varying sizes, the larger ones of which appear slightly smaller when compared to prior study. MEDIASTINUM AND HILA: Confluent mediastinal and bilateral hilar lymphadenopathy is identified. Conglomerate of subcarinal lymph nodes measures 4.1 x 1.6 cm (series 4, axial image 31), previously measuring 4.3 x 2.4 cm. Heart size remains normal without evidence of pericardial effusion.CHEST WALL: Double lumen Port-A-Cath is again seen a left chest wall with tip at the SVC/RA junction. UPPER ABDOMEN: Previously seen metastatic disease in the liver is partially visualized (series 4, image 66). No other significant abnormality is seen in the partially visualized abdomen.

Output: 1. Slight decrease in the size of anterior mediastinal mass with central areas of necrosis.2. Innumerable nodules in both lungs of varying sizes as above.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Reason: s/p open LLL lobectomy for stage IIIA lung cancer History: s/p open LLL lobectomy for stage IIIA lung cancer Two left apical chest tubes remain unchanged.Cardiac silhouette is again enlarged.Low lung volumes with likely mild interstitial edema in the setting of interstitial fibrotic changes. Mild bibasilar atelectasis and small pleural effusions. No pneumothorax.

Output: Postoperative changes as above including bibasilar atelectasis and trace pleural effusions. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: pulmonary edema? History: chest pain, shortness of breath Minimal scarring or subsegmental atelectasis left lower lobe, improved.No specific evidence of infection or edema.Heart size normal.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female 4 years old Reason: cough for greater than 4 weeks History: cough, runny noseVIEWS: Chest AP/lateral (two views) 10/2/2015, 1402 Left chest port tip in the SVC.Cardiomediastinal silhouette is normal. No focal airspace opacity, pleural effusion or pneumothorax.

Output: No pneumonia.


Instruction: Generate impression based on medical findings.

Input: 3 year-old male status post trauma. ABDOMEN:LUNG BASES: No pulmonary opacity or pleural effusion is noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: A small amount of free intraperitoneal fluid is seen in the right lower quadrant.PELVIS:BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: A partially visualized fracture fragment in the soft tissues of the left thigh is consistent with the left femoral fracture.No other fractures are noted. No significant soft tissue abnormality is noted.OTHER: A small amount of free fluid is seen in the deep pelvis.

Output: .1.Small amount of free fluid in the right lower quadrant and deep pelvis is nonspecific. No other abnormality is noted in the abdomen or pelvis.2.Partially visualized left femoral fracture fragment.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Chest pain, evaluate for pneumonia Hypoinflated lungs without evidence of acute abnormality. The cardiac silhouette is normal.

Output: No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: rule out ILD, cavitary lesions History: none Status post median sternotomy for CABG.No other significant abnormality.Heart size and mediastinal contours unremarkable.No significant pulmonary or pleural abnormality.

Output: Status post median sternotomy, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Female 34 years old Reason: Rule out PNA History: Asthma exacerbation. No focal air space opacity.Large lung volumes compatible with obstructive airway disease. Mild wall thickening.Cardiomediastinal silhouette is unremarkable.

Output: Large lung volumes and bronchial wall thickening compatible with asthma. No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: 52-year-old male with diagnosis colon cancer CHEST:LUNGS AND PLEURA: Nonspecific subcentimeter 91 image number 22, series number 5 in the right upper lobe. Other scattered subcentimeter nodules are also present in both lungs. Another index nodule measures 1.1 x 0.7 cm on image number 62, series number 5 in the right lower lobe.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: There are multiple lymph nodes within the sigmoid mesocolon. The index node measures 1.6 x 1.2 cm on image number 182, series number 3. Mild wall thickening is noted within the sigmoid colon in that area. This may represent patient's known history of colon cancer. Correlation with colonoscopy findings is recommended.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Nonspecific, scattered bilateral small lung nodules.Mild wall thickening of the sigmoid colon associated with adenopathy in the sigmoid mesocolon. Correlation with patient's colonoscopy findings is recommended.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: assess placement of ETT History: intubated Endotracheal tube terminates 6 cm from the carina. New apparent cardiac lead appears to terminate within the expected location of the RVOT. Unchanged port catheter. Marked improvement in interstitial pulmonary edema and pleural effusions. Improvement in heart size, now normal. No pneumothorax.

Output: Marked improvement in pulmonary edema and pleural effusions. New apparent cardiac lead appears to terminate within the expected location of the RVOT.


Instruction: Generate impression based on medical findings.

Input: Female, 92 years old.Reason: fever, eval for aspiration History: fever Mild cardiomegaly, unchanged. Tortuous aorta with atherosclerotic calcifications.No focal airspace opacity, pleural effusion, or pneumothorax.Age indeterminant compression fractures of the lower thoracic vertebral bodies. IVC filter is noted.

Output: Stable mild cardiomegaly. No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: Swan position History: As above Heart size upper normal. No significant pulmonary or pleural abnormality.Right jugular Swan-Ganz catheter tip in right interlobar pulmonary artery.Left subclavian ICD, leads unchanged in position.

Output: Swan-Ganz catheter tip in right interlobar pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: cardiopulmonary process History: weakness, some subjective fever Stable marked cardiac enlargement.Interval improvement in left retrocardiac opacity.No new lung opacities.No pneumothorax. No pleural effusion.

Output: Stable cardiac enlargement with interval improvement in the left retrocardiac opacity.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: chest t pain. Eval for edema History: as above Motion heavily degrades sensitivity.Marked nonspecific cardiomegaly without definite additional new cardiopulmonary abnormality. Mild perihilar changes again suggest early edema and overall improvement again is observed since 12/6/2016. Probable small effusionsUnchanged 3-lead left subclavian ICD. Right jugular Swan-Ganz removed

Output: Swan-Ganz removed I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Female, 31 years old.Reason: ? Pneumothorax or other abnormality to account for her CP and SOB History: Left sided Cp with SOB. H/O asthma. No URI symptoms. No fever Cardiomediastinal silhouette is normal in size.No focal airspace opacity, pleural effusion or pneumothorax.

Output: No acute cardiopulmonary findings.


Instruction: Generate impression based on medical findings.

Input: Reason: Lumbar peritoneal shunt, please do chest/ abdomen x-ray, skull is not needed for this shunt series. Please make sure the valve is visible directly so a setting can be determined. History: abd pain, possible shunt failure/broken SHUNT DEVICE: Lumbar spinal peritoneal shunt tip at the level of T12 courses inferiorly and exits spinal canal at the level of L2, at which point it joins a T type connector. Tubing then loops in the soft tissue of the lower back posterior to the spine and joins a second connector before extending along the right flank to the pressure valve. Notch on the pressure valve points to approximately 50 mm of water, best seen on image time marked 16:22:54. The tubing then continues along the anterior abdominal wall and enters the pelvis where it terminates. Portions of the tubing near the connectors are relatively radiolucent and difficult to evaluate, but we see no definite discontinuity.Pump device at the right lower quadrant enters spinal canal at the level of T12 and courses cranially to lower cervical spine. Additional tubing is noted overlying the lower cervical spine. Additional tubing overlies the right neck, anterior chest wall, and enters abdomen and terminates anterior to the L3 vertebral body. Mild anterior wedging of the T12 vertebral body similar to prior study and likely not related to current complaint.CHEST: Lungs are underinflated but clear.ABDOMEN: Nonobstructive bowel gas pattern.

Output: Shunt device as described above. Portions of the tubings are radiolucent but we see no definite discontinuity. Pressure valve notch points to approximately 50 mm of water as above.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: r/o infection History: chronic cough No significant cardiopulmonary abnormality.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 23 years old.Reason: testicular cancer History: testicular cancer Prior wedge resection with diminished adjacent opacity.No new findings, the lungs otherwise unremarkable.Unremarkable mediastinal contours and cardiac silhouette.

Output: Continued improvement in surgical site with no new findings.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Status post LVAD POD #2. Hardware and devices similar in position. A portion of the left upper lobe is obscured by the pulse generator and cannot be assessed.Bronchial wall thickening and hazy opacity in the left lung unchanged. Improving atelectasis left base.

Output: Improving atelectasis. Stable device position.


Instruction: Generate impression based on medical findings.

Input: 66-year-old male with history of COPD exacerbation. Bilateral endobronchial valves are present. Extensive bilateral interstitial opacities compatible with scarring. Severe emphysema. Large left upper and lower lobe bullae.

Output: Severe emphysema and chronic scarring appearing similar to prior.


Instruction: Generate impression based on medical findings.

Input: Male, 45 years old.Reason: annual eval for transplant History: cough Median sternotomy for heart transplant.Heart size normal.No significant pulmonary or pleural abnormality.

Output: Status post heart transplant, without any significant findings.


Instruction: Generate impression based on medical findings.

Input: Male, 26 years old.Reason: Pt is a 26 yo male w/ hx of DLBCL s/p chemo; pre-asct evaluation History: evaluate Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Right jugular catheter, tip in SVC.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: 74M hx cystectomy/ileal conduit, now s/p nephroureterectomy c/b persistent O2 requirement. Evaluate for volume status and aspiration History: as above Increase in left basilar opacity, likely atelectasis. Large diaphragmatic hernia. Small right pleural effusion or pleural thickening with right basilar opacity, unchanged. No pneumothorax. Unchanged heart size.

Output: Increase in left basilar opacity, likely atelectasis. Persistent right pleural effusion or thickening with right basilar atelectasis and/or consolidated lung.


Instruction: Generate impression based on medical findings.

Input: Male, 85 years old.Right scapula pain and dizziness. Loop recorder device projects over the left chest wall. Right apical scarring. The cardiomediastinal silhouette is unchanged. Calcified left upper lobe granuloma and calcified lymph nodes again noted. There is persistent elevation of the left hemidiaphragm with left basilar atelectasis. No focal airspace opacity, significant pleural effusion, or pneumothorax. No rib fractures identified.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 24 years old.Reason: ACS History: chest pain, SOB 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: PneumoniaVIEW: Chest AP 3/2/15 Left upper extremity PICC with tip in the right atrium. Cardiothymic silhouette normal. Patchy opacities in the right lower lobe and left lower lobe not significantly changed. There is a small left pneumothorax minimally improved. There is subcutaneous emphysema in the left lateral chest wall.

Output: Left pneumothorax minimally improved from prior study.


Instruction: Generate impression based on medical findings.

Input: Chest tubes removed Interval right jugular sheath and bilateral chest tubes have been removed without evidence of interval complication. Specifically no new pneumothorax. Small residual effusions and questionable cardiomegaly with decreased lung volumes. See subsequent report

Output: Chest tubes removed


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.History of emphysema with increased productive cough, evaluate for pneumonia. Unremarkable cardiomediastinal silhouette.Large lung volumes compatible with COPD/emphysema. Lower lung bronchial wall thickening which can be seen with bronchitis.Mild chronic blunting of the costophrenic angles without new focal opacitiesOld healed rib fractures.

Output: COPD/emphysema without acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: LLL pneumonia? History: Fever and rales on left Mild left lower lobe airspace opacity, confirmed on both PA and lateral views, consistent with pneumonia.Unremarkable cardiac and mediastinal silhouette. No other significant findings.

Output: Left lower lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 22 years old.Reason: chest pain History: chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: r/o PTX, fluid overload History: pleuritic chest pain Improvement in prior pulmonary opacities suggestive of edema.Minimal basilar subsegmental atelectasis or scarring.Heart size normal.Right jugular catheter tip at right atrial level.

Output: Improvement in prior opacities with only residual scarring or subsegmental atelectasis. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Cough and flank pain. Decreased lung volumes likely due to poor inspiration. Left basilar opacity compatible with consolidation/atelectasis.Cardiomegaly and aortic arch calcifications.

Output: Poor inspiration with mild left basilar consolidation/atelectasis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Female, 51 years old.Reason: chest tubes History: chest tubes Unchanged right chest tube with no pneumothorax.Right hemithorax postsurgical volume loss with foci of atelectasis or scarring bilaterally.

Output: No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old. Single lateral view demonstrates NG tube with side-port at GE junction, 2 right-sided chest tubes, central venous catheter.No unexpected radiopaque foreign objects identified.Mild basilar atelectasis.

Output: Intraoperative exam demonstrates no evidence of an RFO.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: s/p AVR History: s/p AVR Small lung volumes.Mild cardiomegaly status post aortic valve replacement.Left subclavian pacemaker, leads unchanged in position.

Output: Small but unremarkable appearing lungs following aortic valve replacement, with resolution of prior atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 93 years old.Reason: evaluate for pulmonary edema in 93yo pt with known lung mass, COPD and CHF History: LE edema, SOB Right upper lobe mass has increased in size compared to prior. Tortuosity and enlargement of the thoracic aorta better characterized on recent cross-sectional imaging. Small right pleural effusion without pulmonary edema. Cardiomegaly unchanged. No pneumothorax.

Output: No evidence of edema. Small right pleural effusion stable cardiomegaly. Right upper lobe mass has increased in size.


Instruction: Generate impression based on medical findings.

Input: 64-year-old female presents with a FUO. Evaluate for airspace disease. There is been interval removal of a left-sided central venous catheter. Surgical anchor projects over the right humeral head. Partially visualized catheter projects over the upper abdomen.There is been interval resolution of diffuse pulmonary opacities. No pleural effusion or pneumothorax.

Output: No acute pulmonary abnormality. Interval resolution of previously seen pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Reason: cough History: cough Large left pleural effusion has recently characterized by CT suggestive of empyema, with underlying subsegmental atelectasis.An air-fluid level visible on the upright radiograph is no longer evident due to portable technique and a nonhorizontal x-ray beam.

Output: Large left pleural effusion with no acute change.


Instruction: Generate impression based on medical findings.

Input: Age: 58 yearsGender: MaleReason for Study: Reason: impella History: impella ET tube, enteric tube, and impella device unchanged.Right IJ Swan-Ganz catheter with its tip within the right descending pulmonary artery.Stable cardiomediastinal silhouette.Perihilar/basilar edema and pleural effusions similar in appearance to the prior exam.

Output: Right IJ Swan-Ganz has been advanced with its tip now within the distal right descending pulmonary artery. Pulmonary edema and pleural effusions again identified.


Instruction: Generate impression based on medical findings.

Input: Age: 74 yearsGender: FemaleReason for Study: Reason: SOB in HF History: SOB in HF Stable cardiac enlargement with mild perihilar/basilar interstitial opacities suggestive of edema.Bilateral pleural thickening and basilar atelectasis similar to the prior exam.No new focal areas of consolidation.Surgical clips identified in the right axillary region.

Output: Cardiomegaly with bilateral pleural thickening/effusions and basilar atelectasis similar to the prior exam. Interstitial opacity suggestive of mild edema.


Instruction: Generate impression based on medical findings.

Input: Reason: AM CXR History: AM CXR . Post inflammatory pulmonary fibrosis. Left chest tube in place with a moderate left pneumothorax, increased compared to previous.Bronchial valves in the left perihilar region, unchanged.Diffuse chronic interstitial disease, unchanged.

Output: Increased left pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 57 year old male with a history of PTC. Evaluate for recurrence. LUNGS AND PLEURA: Multiple micronodules are present bilaterally. Although some of these are stable since 4/20/2009, some have slightly increased in size. For example a 4-mm nodule in the right lower lobe (209/320) which is been marked on both the MIP and high-resolution series was not present in 2009, measured 2 mm in 2010 and measures 4 mm in diameter on the current scan. Given the clinical history, this is highly suspicious for a metastasis.MEDIASTINUM AND HILA: No significant lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Bilateral renal cysts.

Output: Interval slight increase in the size of several micronodules, at least one of which is new since 2009, suspicious for metastases.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: infection History: altered mental status Heart size upper normal.No specific evidence of infection or edema.

Output: Heart size upper normal, otherwise unremarkable without evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath and pneumothorax Cardiopulmonary appearance appears similar with bilateral apical loculated pneumothoraces greater on the right previously described. Superimposed atelectasis without additional superimposed change. See subsequent report

Output: Bilateral loculated apical pneumothoraces, unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: s/p LVAD History: s/p LVAD Left subclavian ICD and an LVAD are in place. Sternal hardware appears in alignment. Mediastinal drains and left chest tube unchanged in position. Right jugular Swan-Ganz catheter can be followed to the proximal right main pulmonary artery. Valve prosthesis.Patient is rotated, cardiomegaly is similar.Large layering left pleural fluid collection with atelectasis. No evidence of pulmonary edema. Small to moderate volume of pleural fluid on the right.

Output: Line position stable. No change in cardiopulmonary findings.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: possible aspiration History: possible aspiration/pulm edema Enteric tube and mediastinal tubes unchanged.The right IJ introducer has been removed.Right PICC line with its tip in the right axilla.Stable cardiomediastinal silhouette.Mixed airspace and interstitial opacities, more prominent on the right, as well as pleural effusions similar in appearance to the prior exam.No new opacities identified.

Output: Pulmonary opacities and pleural effusions without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.AML, pancytopenia Left PICC is unchanged. No significant pulmonary or pleural abnormalities. The cardiac silhouette is unremarkable.

Output: No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: s/p dobhoff History: dysphagia Enteric tube tip in stomach. Right pleural effusion slightly improved. Patchy right-sided opacity likely due to pneumonia, unchanged. Improved aeration of left lower lobe.

Output: Enteric tube tip in stomach.


Instruction: Generate impression based on medical findings.

Input: Age: 59 yearsGender: MaleReason for Study: Reason: edema History: sob, doe, history of hfpef Stable cardiac enlargement.No focal areas of consolidation.Nonspecific perihilar and basilar interstitial opacities with bronchial wall thickening similar to the prior exam.No large pleural effusions.

Output: Mild nonspecific interstitial opacities and bronchial wall thickening similar to the prior exam may reflect minimal edema. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: eval ett History: intubated Small lung volumes with pleural effusions and interstitial opacities.Retrocardiac consolidation has improved.ET tube tip approximately 5 cm above the carina.Right jugular catheter, tip in SVC.

Output: Pleural effusions and pulmonary opacities, improved in the left base.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: continued O2 requirements History: continued O2 requirements Stable position of central line. No pneumothorax.Persistent effusions with basilar atelectasis, right greater than left. Unchanged.

Output: No significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 34 years old.Chest pain and some SOB. History of CHF. Unchanged cardiomegaly. No evidence of pulmonary edema. No pleural fluid. The lungs are clear.

Output: Cardiomegaly but no evidence of pulmonary edema or other acute pulmonary pathology.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.History of pneumothorax. Right chest tube unchanged in position.Right subcutaneous emphysema unchanged. Minimal right apical pneumothorax unchanged since most recent prior study.Cardiac silhouette unchanged in size.

Output: Minimal right apical pneumothorax and subcutaneous emphysema without acute interval change.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Changes consistent with pulmonary hypertension without additional acute cardiopulmonary abnormalityRight jugular catheter remains projected into the mid to proximal SVC

Output: No acute change


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: eval for outpatient rehab History: necessary for outpatient rehab Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Tortuous descending aorta, but consistent with age.Cholecystectomy clips.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.ET tube position. History of hypoxemia. ET tube is 3 cm superior from the carina in stable position. An enteric tube projects below the diaphragm with tip at the fundus of the stomach. No focal airspace opacities or areas of consolidation. The pleural effusions or pneumothorax. Small metallic linear opacity projecting over the right mid lung is again present and is external to the patient.

Output: ET tube is in stable position.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: evaluate for TB History: history of latent TB The heart size is within normal limits. Tortuous thoracic aorta. No focal pulmonary opacities, pleural effusion, or pneumothorax. No specific evidence of tuberculosis. Surgical clips in the right upper abdomen.

Output: No specific evidence of intrathoracic TB.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: Reason: eval for pneumonia History: hypotension, septic shock, s/p pericardiocentesis New pericardial drainage catheter in place. Catheter tip in the SVC.Small pleural effusions.No sign of pneumonia or other acute change.

Output: Small pleural effusions and no acute change.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o dz process History: productive cough, weakness, chills Severe cardiomegaly with pulmonary vascular distribution.Status post median sternotomy with an aortic valve bioprosthesis..Chronic bronchial thickening and interstitial opacity in the lower lung zones, not significantly changed from previous.No reliable evidence of pneumonia.

Output: Cardiomegaly and possible mild CHF. No specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: post extubation, dyspnea History: shortness of breath No significant cardiopulmonary abnormality.Status post extubation and NG tube removal.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: effusion/infiltrate, VAD positioning History: new LVAD, RH failure Swan-Ganz catheter terminates within the proximal aspect of the right atrium. Other iatrogenic devices are unchanged. Persistent patchy bibasilar opacities. Small left pleural effusion again noted. Unchanged cardiomegaly. No pneumothorax.

Output: Swan-Ganz catheter has been pulled back and terminates within the proximal right pulmonary artery. Otherwise no substantial difference.


Instruction: Generate impression based on medical findings.

Input: Male, 89 years old.Weakness evaluate for pneumonia. Pleural calcifications.Normal heart size.Unchanged nodular opacities in the upper lobes, which are most likely pleural plaques seen en face. No signs of edema or specific evidence of pneumonia.

Output: No specific evidence of pneumonia. Pleural plaques suggest prior asbestos exposure.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Shortness of breath, wheezing. There is no focal consolidation, pleural effusion or pneumothorax.Cardiac and mediastinal contours are within normal limits for size.The bones and upper abdomen are unremarkable.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: Post thoracentesis, r/o pneumothorax History: None, post thoracentesis No significant pneumothorax status post thoracentesis. Small right pleural effusion slightly improved. Adjacent subsegmental atelectasis. Left basilar scarring.

Output: Improving right pleural effusion with adjacent subsegmental atelectasis. No evidence of pneumothorax status post thoracentesis.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: trach History: Seizures Small left pleural effusion with patchy subsegmental atelectasis, unchanged.NG tube removed.Tracheostomy tube tip approximately 4 cm above the carina.

Output: Tracheostomy tube tip approximately 4 cm above the carina. Stable basilar subsegmental atelectasis.


Instruction: Generate impression based on medical findings.

Input: Connective soft tissue sarcoma of the lower leg, check for malignancy A new 14 mm nodule is observed in the mid left lung, not clearly observed on the lateral projection. No definite additional focal airspace abnormalities observed other than persistent questionable scarring in the right lung base. Follow-up imaging including CT is needed.Cardiomediastinal contours are within limitsDr. Haydon contacted

Output: New nodular opacity in the left midlung. Specifically the size and appearance being new since December is most concerning for possible infection in the appropriate setting, however metastatic disease cannot entirely be excluded without follow up axial CT imaging.


Instruction: Generate impression based on medical findings.

Input: Reason: ptx History: ptx, sp chest tube placement Left chest tube in place with a minimal residual apical pneumothorax.No other significant abnormalities.

Output: Minimal left pneumothorax, unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: R/o pna History: above Unremarkable cardiac and mediastinal silhouette. Eventration of the anterior right hemidiaphragm.No sign of pneumonia.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Shortness of breath. Hypoxemia with metastatic prostate cancer and pulmonary embolism. Moderate to severe diffuse predominantly interstitial opacities are stable. Right central line has been removed. No pneumothorax.

Output: No pneumothorax post right central line removal. Otherwise stable diffuse interstitial pattern which may reflect infection or edema superimposed on COPD.


Instruction: Generate impression based on medical findings.

Input: Male, 47 years old.Reason: Hemothorax History: Hemothorax Marked cardiomegaly, unchanged.Left greater than right basilar opacities and left hemothorax, similar to prior. No pneumothorax.Right IJ tip is at the level of the distal SVC. Left chest tube unchanged in position.Above average stool burden is partially imaged.

Output: Left greater than right basilar opacities and left hemothorax, similar to prior. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Female; 75 years old. Reason: eval for response to tx Hx of GIST tumor on chemotherapy CHEST:LUNGS AND PLEURA: Basilar scarring, similar to prior. Lingular micronodule (series 5 image 42), not imaged on priors.MEDIASTINUM AND HILA: Coronary and valvular calcifications. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Heterogeneous, early enhancing mass in the right hepatic lobe (series 7, image 32) measures 3.8 x 2.4 cm (previously 3.6 x 2.5 cm), not significantly changed. Subcentimeter enhancing focus in the left hepatic lobe (series 7 image 28) is also unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter lesions in the bilateral kidneys, too small to characterize.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: Absent. BLADDER: No significant abnormality noted.LYMPH NODES: Mild inguinal adenopathy, not significantly changed.BOWEL, MESENTERY: No evidence of obstruction.BONES, SOFT TISSUES: Heterotopic bone adjacent to the left acetabulum again noted.OTHER: Interval decrease in size of large heterogeneous mass occupying the majority of the pelvis, measuring 16 x 9.5 cm (previously 20 x 10 cm (series 8 image 138).Anasarca.

Output: Interval decrease size of large pelvic mass. Stable liver lesions.


Instruction: Generate impression based on medical findings.

Input: Reason: cp History: cp Moderate cardiomegaly with no evidence of CHF.Moderate herniation No acute abnormalities. of the lung between the fifth and sixth right ribs into the lateral chest wall at the site of an apparent previous surgical incision.This has increased since previous radiographs.

Output: Increased right lung herniation. No acute findings.


Instruction: Generate impression based on medical findings.

Input: 60 year-old female history of cholangiocarcinoma CHEST:LUNGS AND PLEURA: Again noted multiple pulmonary metastatic lesions. Index lesion in the right middle lobe now measures two . 2 x 1.7 cm on image number 49, series number 7, increased in size compared to previous study. Second index lesion in the right lower lobe now measures 7-mm in diameter in image number 54, series number 7, increased in size compared the previous study. Biapical scarring.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Again noted biloba or numerous metastatic lesions. Index lesion in the left lobe measures 6.6 x 4 .7 cm on image number 95, series number 7, not significantly changed in size. However, all of the other metastatic lesions have significantly increased in size. For comparison an index lesion on image number 113, series number 7 now measures 3 x 2.7 cm. Previously it was measuring 1.3 x 1.3 cm on image number 109, series number 3. There are also new metastatic liver lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Reference peripancreatic lymph node now measures one .2 x 1.3 cm image number 106, series number 7, increased in size compared to previous study. Other peripancreatic and retroperitoneal nodes also significantly increased in size.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified fibroid is unchanged.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: Small amount of ascites.

Output: Interval progression of disease with interval increase in the size and number of hepatic metastases, size of lung metastases and retroperitoneal metastatic adenopathy.


Instruction: Generate impression based on medical findings.

Input: Age: 57 yearsGender: MaleReason for Study: Reason: S/P OHT History: OHT The cardiomediastinal silhouette is unremarkable.Persistent elevation of the right hemidiaphragm.No new pulmonary opacities identified.No pleural effusions.Median sternotomy is intact.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: ILD, worsening respiratory status. Low lung volumes with diffuse interstitial lung disease about the same. No visible pneumomediastinum or pneumothorax.No new visible abnormalities.

Output: Extensive chronic appearing interstitial lung disease. No conclusive new abnormalities by plain film technique.


Instruction: Generate impression based on medical findings.

Input: Chest pain No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Shortness of breath New small lung volumes, possibly related to semiupright portable technique. Underlying mild to moderate nonspecific cardiomegaly with superimposed scattered calcified lymph nodes with patchy bilateral basilar opacities. This latter finding is nonspecific and although possibly atelectasis, aspiration or even infection cannot entirely be excluded without serial imaging.Single lead left subclavian ICD unchangedDiffuse skeletal hyperostosis and scoliosis

Output: Nonspecific basilar changes suggesting aspiration, atelectasis or even potentially infection. Serial imaging will be helpful to differentiate


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: evaluate for pulmonary edema History: dyspnea, chest pressure, PMH CHF Stable cardiomediastinal silhouette.Lungs clear.Low lung volumes. No pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 34 year old female with history of Hodgkin's lymphoma. Status post 4 cycles ABVD chemotherapy, completed in 5/17/07. Restaging. CHEST:Lungs and Pleura: No significant abnormality noted.Mediastinum and Hila: Right paratracheal node is stable in size measuring 1.7 x 0.9 cm (image 24/212).Chest Wall: Bilateral breast implants.ABDOMEN:Liver, Biliary Tract: Hepatomegaly, measuring 21.3 cm. Heterogeneous attenuation within the posterior segment right lobe liver is unchanged in appearance.Spleen: No significant abnormality noted.Kidneys, Ureters: No significant abnormality noted.Adrenal Glands: No significant abnormality noted.Pancreas: 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, Adnexae:Myomatous uterus is stable.Bladder: No significant abnormality noted.Lymph Nodes: No significant abnormality noted.Bowel, Mesentery: No significant abnormality noted.Bones, Soft Tissues: No significant abnormality noted.Other: No significant abnormality noted.

Output: Stable right paratracheal node. No significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Status post thoracentesis. Evaluate for pneumothorax. No evidence of pneumothorax.Diffuse bilateral pulmonary opacities, mildly improved on the left. Mildly improved moderate-sized left pleural effusion.Unchanged cardiomegaly.

Output: No pneumothorax. Mildly improved left pulmonary opacities and pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Stage II a nonseminomatous testicular cancer follow-up. Normal heart size. Posterior costophrenic angle blunting unchanged. No visible suspicious pulmonary nodules, masses or lymphadenopathy.Retroperitoneal dissection clips project over the upper abdomen.

Output: No acute pulmonary abnormality. No visible signs of pulmonary metastases by plain film technique.


Instruction: Generate impression based on medical findings.

Input: Female, 85 years old.Reason: r/o infection History: cough Moderate cardiomegaly.Mild basilar scarring and pleural thickening.No specific evidence of infection or edema.Left subclavian pacemaker, leads unchanged in position.Right jugular catheter, tip in SVC.

Output: Cardiomegaly and chronic abnormalities but no reliable evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Reason: pna? L sided wkness History: stroke Unremarkable cardiac and mediastinal silhouette. Mild scarring at the right base, unchanged.No sign of pneumonia or other acute findings.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: changed swan position History: sob Left hemithorax opacification and right basilar opacities with right Pleurx catheter pleural effusion, unchanged.Right jugular Swan-Ganz catheter tip in right pulmonary artery.Right jugular catheter tip at SVC/RA junction level.

Output: Right jugular Swan-Ganz catheter tip in right pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: free air? History: abd pain No evidence of free air under the diaphragm.Heart size upper normal. Lungs clear.No pneumothorax. No pleural effusion.

Output: No evidence of free air or acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: Pneumonia History: Productive cough Cardiothoracic ratio appears normal. Prominent central pulmonary vasculature, unchanged. Right upper lobe paramediastinal opacity now projecting over the right clavicular head present on prior radiographs and unchanged, unclear etiology.Bronchial wall thickening, minimal peribronchial opacity and atelectasis in the right middle lobe and lingula, but no conclusive pneumonia.

Output: 1. Dense opacity projecting over the right paramediastinal region unchanged from prior radiographs dating back to 8/20/2015 and may be in the chest wall soft tissues or less likely in the lung. Recommend PA and lateral chest radiographs when feasible for further localization in addition to correlation with physical examination.2. Bronchial wall thickening, atelectasis and peribronchial opacity in the right middle lobe and lingula, present to some extent previously and may reflect acute exacerbation of chronic bronchitis or recurrent aspiration. This can be reassessed on the follow-up PA and lateral films to exclude development of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: Eval for effusion atelectasis - worsening consolidation History: Increasing O2 reqirements Persistent diffuse bilateral opacity, septal lines, and trace bilateral effusions consistent with the findings on recent CT examination of pulmonary edema on a background of COPD.Cardiomegaly, unchanged. LVAD, left AICD, right orphaned AICD leads, right PICC in place, unchanged.

Output: Persistent diffuse bilateral opacities, suggestive of pulmonary edema on a background of COPD.


Instruction: Generate impression based on medical findings.

Input: Male, 47 years old.Reason: Pre kidney transplant evaluation/end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: Pre-Kidney transplant The heart size is normal. The lungs are clear. No focal pulmonary opacities, pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormality. No evidence of cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: 20 year old male with shortness of breath. Evaluate for mediastinal massVIEWS: Chest PA/lateral (two views) 2/16/2015 Cardiac silhouette is normal. No focal pulmonary opacities. No pleural effusion or pneumothorax. No evidence of lymphadenopathy.

Output: Normal examination.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o pna History: congestion, left facial droop Unremarkable cardiac and mediastinal silhouette. Mild scarring or atelectasis at the left base.No sign of pneumonia.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 32 years old.Reason: Evaluate for air, recent EGD with back pain, epigatric pain History: abd pain, back pain The heart size is normal.The lungs are clear. No pneumothorax or pneumomediastinum.

Output: No acute cardiopulmonary abnormality. Stable exam without interval change.


Instruction: Generate impression based on medical findings.

Input: Cough Persistent moderate cardiomegaly with small lung volumes, bilateral moderate pleural effusions and diffuse 4 quadrant nonspecific changes suggesting patchy consolidation, edema versus atelectasis.

Output: No significant change


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: evaluate mediastinum History: ecg changes, r side weakness Focal subsegmental scarring or atelectasis in the mid aspect the left lung. No focal lung consolidation or evidence of overt left-sided heart failure. No large pleural effusion or pneumothorax. Normal heart size. Surgical clips noted at the gastroesophageal junction.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Age: 24 yearsGender: MaleReason for Study: Reason: trach, lung fields History: trach Support devices including vertebral stabilization hardware unchanged.Markedly decreased lung volumes with stable cardiac enlargement.Hazy opacity over the right hemithorax compatible with layering of pleural effusion.Basilar atelectasis similar to the prior exam.

Output: Support device unchanged. Stable cardiopulmonary appearance with markedly decreased lung volumes, pleural effusions, right greater than left, and basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 31 years old.Fever and hypoxia evaluate for infiltrate. Interval retraction of dual-lumen catheter from an IVC approach, distal catheter tip projects over the suprahepatic IVC and the more proximal catheter tip projects over the right atrium. Sternotomy hardware with probable osseous nonunion.Interval increase in left pleural fluid volume and development of adjacent atelectasis/consolidation in the left lower lobe.Chronic pleural thickening and pleural fluid on the right is similar to prior. Pulmonary vascular redistribution and metastatic calcification related to end-stage renal disease again seen.

Output: Increase in left pleural fluid and atelectasis/consolidation. This is nonspecific but in the appropriate clinical context could be due to infection in the underlying lung or pleural space. Interval retraction of IVC catheter which terminates in the low right atrium/suprahepatic IVC.


Instruction: Generate impression based on medical findings.

Input: 63 years old Male. Reason: intubated; confirm ETT location History: as above. ET tube and NG tube are stable in position. Right jugular catheter was removed.Patchy bilateral mainly perihilar and lower zone opacities suggestive of aspiration, unchanged.

Output: Bilateral patchy opacities, suggestive of aspiration, unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: et tube check History: intubated ET tube tip 4 cm above carina. NG tube tip in stomach. No new pulmonary opacity.

Output: ET tube tip 4 cm above carina.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Shortness of breath. The cardiomediastinal silhouette is within normal limits. Low lung volumes without focal airspace opacity, pleural effusion, or pneumothorax.

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


Instruction: Generate impression based on medical findings.

Input: Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath No pneumothorax.Streaky airspace opacity at the right base, increased since the most recent previous exam, which may be related to infection or aspiration.However the appearance was similar on earlier exam from 5/13/2015 which could be related to recurrent aspiration and atelectasis.Unremarkable cardiac and mediastinal silhouette.

Output: Nonspecific opacity at the right base with a component of atelectasis, increased over the past 6 days, possibly related to infection, aspiration or embolism.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old. Reason: Swan History: Swan Swan-Ganz catheter has been pulled back and now terminates in the right pulmonary artery. Unchanged IJ catheter. Unchanged basilar opacities and pleural effusions. Cardiomegaly again noted. No pneumothorax.

Output: Swan-Ganz catheter has been pulled back and now terminates in the right pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: Sclerosing mesenteritis. 3.4 x 2.4 cm opacity in the left lung base abutting the pleura. Please assess for changes. CHEST:LUNGS AND PLEURA: Previously described 3.4 x 2.4 cm masslike lesion abutting the pleura in the left lung base associated with linear atelectasis is unchanged from previous CT. Pleural-based lingular nodular density is 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: No significant abnormality noted.BOWEL, MESENTERY: Previously described mesenteric mass is are again identified. More superior and lateral mass is slightly smaller now measures 6.6 x 3.7 cm in image number 126/214. The second more inferior mass is also slightly smaller and measures 4.2 x 1.9 cm on image number 134/214.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 change in the previously described left lower lobe soft tissue density which represent atelectasis. Further follow-up is recommended to ensure stability.Slight interval decrease in the size of the previously described mesenteric masses.


Instruction: Generate impression based on medical findings.

Input: Female 49 years old Reason: Forty-Nine Morbidly obese Female Under Going Gastric Surgery. Pre-op CXR. History: Forty-Nine Morbidly obese Female Under Going Gastric Surgery. Pre-op CXR. Heart size upper limits of normal.No focal airspace opacities.No significant pleural effusions or pneumothorax.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Weakness, malaise and fatigue. Normal heart size. Atherosclerotic calcification of the thoracic aorta at the level of the arch. No focal airspace opacities, pleural fluid or pneumothorax.

Output: No acute cardiopulmonary abnormality. Atherosclerotic calcifications.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Neutropenic fever. Right jugular central line similar in position, just above the azygos arch level.Normal heart size.No focal airspace opacities, pleural fluid or pneumothorax.

Output: No specific signs of pneumonia.


Instruction: Generate impression based on medical findings.

Input: NJ tube adjustment, evaluate.VIEW: Abdomen AP (one view) 11/16/2016, 1008 hours. Enteric tube tip loops distally in the stomach, with the tip in the antropyloric region. Right femoral venous access tip is in the area of the common iliac vein. Disorganized nonspecific bowel gas pattern is identified. Soft tissue thickening of the left chest and abdominal wall is again noted. No pneumoperitoneum is identified.

Output: Enteric tube tip terminates in the antropyloric stomach.


Instruction: Generate impression based on medical findings.

Input: Age: 74 yearsGender: MaleReason for Study: Reason: s/p right upper lobectomy for lung cancer, screening History: None Volume loss in the right lung compatible with prior right upper lobectomy.Cardiomediastinal silhouette is unremarkable.Small left upper lobe nodule similar to that seen on recent CT dated 8/21/2015Left apical pleural parenchymal fibrosis.No pleural effusions.

Output: Left upper lobe nodule as noted on recent CT dated 8/21/2015. No acute abnormalities identified.


Instruction: Generate impression based on medical findings.

Input: 61-year-old male with sarcoma CHEST:LUNGS AND PLEURA: No significant change in the multiple bilateral pulmonary nodules. No new nodules are seen. Index right middle lobe lesion measures 16 by 12 mm, previously 15 x 10 mm when remeasured (series 4; image 53)MEDIASTINUM AND HILA: The ascending aorta is ectatic, unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: 2-mm hypodensity in segment two of the liver is stable. (series 3; image 75). Hypodensity adjacent to the gallbladder fossa (series 3; image 90) is unchanged and may represent focal fatty infiltration. Cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild-moderate atherosclerotic plaque affecting the infrarenal abdominal aorta.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: L5 pars defects. Benign-appearing lesion in the left femoral head is unchanged.OTHER: No significant abnormality noted

Output: Hepatic hypodensities, described above, stable from 4/20/09. No significant change in the pulmonary nodules.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: Chest pain History: chest pain Ill-defined opacity projecting over the anterior left sixth rib may be artifactual. Recommend repeat PA radiograph with nipple markers for further evaluation. No evidence of edema or infection. The cardiomediastinal silhouette is unremarkable. Blunting of the posterior costophrenic angles may be secondary to scarring or trace pleural effusion. No pneumothorax.

Output: Ill-defined nodularity anterior left sixth rib may be artifactual. Recommend repeat PA radiograph with nipple markers. No evidence of acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 70 yearsGender: MaleReason for Study: Reason: eval lung fields History: s/p LVAD Support devices unchanged.Stable cardiac enlargement.Basilar atelectasis and small effusions similar to the prior exam.No new pulmonary opacities identified.No evidence of pneumothorax.Median sternotomy now noted.

Output: Support devices unchanged. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 18 years old.Reason: 18M pmh pleuritic CP History: CP No acute cardiopulmonary abnormality.

Output: No acute cardiopulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: Radical thymectomy Recurrent streaky patchy opacities in the right lung again similar to prior exam to slightly progressed. Although possibly edema, the appearance and similarity to prior studies is nonspecific. Closer serial imaging and/or possibly CT evaluation should be considered if there is concern for infection.Left lung remains clear. Cardiac and mediastinal contours are otherwise within limitsMidline sternotomy and right jugular single port unchanged.

Output: Persistent and/or recurrent mid right lung mixed opacities involving the inferior aspect of the right upper lobe and both of the right middle and lower lobes.


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.History of sickle cell disease with pleuritic left chest pain and shortness of breath. Spinal immobilization hardware and osseous changes of sickle cell disease are unchanged.The heart size is upper limits of normal but unchanged.Streaky basilar opacities appear similar to the prior studies and are compatible with subsegmental atelectasis. There is no focal airspace opacity, pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: ett placement History: ett placement Worsening pulmonary opacities suggestive of edema, with stable pleural effusions and left lower lobe consolidation.ET tube tip approximately 5 cm above the carina.An NG tube terminates in the stomach.

Output: Worsening pulmonary opacities suggestive of edema. ET tube tip approximately 5 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Reason: shortness of breath History: shortness of breath Increase interstitial markings are suggestive of edema with large upper lobe bulla right greater than left.Heart size normal.No large pleural effusions.Right jugular catheter tip in SVC/RA junction region.

Output: Increase interstitial markings with underlying bullous disease, suggestive of edema but the plaque of pleural effusions raise the question of atypical infection or drug reaction.


Instruction: Generate impression based on medical findings.

Input: Reason: patient with ADHF, edema, check placement of lines History: SOB, orthopnea Swan-Ganz catheter tip in the right descending pulmonary artery. ICD leads and venous catheter unchanged.Mild perihilar interstitial opacity compatible with edema.

Output: Probable mild interstitial edema


Instruction: Generate impression based on medical findings.

Input: 65-year-old female with history of metastatic liposarcoma, two cycles of chemotherapy assess response CHEST:LUNGS AND PLEURA: Previously described left lower nodule has minimally reduced in size measuring 17 x 17 mm on image number 40, series number 4. Second reference lesion in right lower lobe nodule is unchanged in size and now measures 13 x 10 mm on image number 41, series number 4. A no new lesions identified.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Heterogeneously enhancing soft tissue tumor appears to originate within the intrahepatic IVC, extends superiorly to SVC and inferiorly just before the bifurcation. Interval new finding of extension of tumor into the right hepatic vein, coronal, image 52. The tumor also likely extends to the bilateral renal veins. No significant change in the size and extension of disease. The size of the lesion just superior to the renal veins measures 3.8 x 4 cm (image 86, series 3). Multiple collaterals are identified in the anterior abdominal wall, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Again noted tumor thrombus extending from the level of the bifurcation of the IVC to the superior SVC. Extension of the tumor appears to have increased, now seen within the right hepatic vein (image 68, series 3, and coronal plane image 52). Previously measured mass involving the left psoas muscle has also increased in size and now measures 5.5 x 4.9 cm on image number 127, series number 4, minimally increased. The low attenuation loculated collection inferior to left psoas mass best seen on image 122, series 3, measures 2.5 x 2 .2 cm, approximately unchanged in comparison with prior study. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes involving the entire lumbar vertebral body as well as the sacrum. Metallic orthopedic hardware. Laminectomy defects involving the lumber vertebral bodies. Posterior paravertebral areas cannot be well seen due tometallic hardware. 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: See discussion aboveOTHER: No significant abnormality noted.

Output: Mixed response.1. Minimal reduction in size of left lung mass.2. Interval extension of tumor in the IVC into the right hepatic vein.3. Interval increase in size of left psoas masses.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p chest tube History: s/p chest tube Chest tube directed medially at the right base with a very small loculated basilar pneumothorax. Underlying nonspecific opacity compatible with effusion, consolidation and atelectasis.Mild atelectasis or scarring at the left base, unchanged.Port catheter with tip in the SVC.

Output: Chest tube with right pleural effusion and probably a very small pneumothorax, unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: Pleural effusion secondary to pancreatitis/pancreatic pseudocyst status post CT placement. Please assess interval change. History: As above Bilateral pleural effusions with underlying atelectasis.Right chest tube in place with no significant pneumothorax.

Output: Pleural effusions and atelectasis with no significant change.


Instruction: Generate impression based on medical findings.

Input: 60 year-old female evaluate for colonic mass CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted. Duplicated ureters on the left side.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: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: Left obturator adenopathy measuring 12 x 11 mm image number 115, series number 4. It is also possible that this may represent the left ovary. Correlation with clinical history is recommended.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Possible pelvic lymph node versus left ovary. Correlation with clinical history, if necessary with transvaginal pelvic ultrasound may be helpful if further characterization of this lesion is clinically indicated.Patient's known colonic mass is not visualized on the CT scan.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: S/p cardiac surgery, pneumonia, left CT History: asx Left chest tube with no pneumothorax. Unchanged pulmonary opacities.Stable tubes and devices.

Output: No significant pneumothorax. Unchanged tubes and devices, as well as pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 87 years old.Reason: evaluate TLC placement History: see above Right IJ central venous catheter tip in the superior vena cava.Unchanged moderate to severe cardiomegaly.Mild basilar interstitial edema and pleural effusions, improving.Large left lateral lower lung herniation, present since 2014.Left subclavian pacemaker, leads unchanged in position.Dilated stomach without visible bowel markings, correlate with abdominal radiograph.

Output: Right IJ central venous catheter tip in the superior vena cava. Dilated stomach without visible bowel markings, correlate with abdominal radiograph.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, 77 years old.Reason: mesothelioma History: mesothelioma Left-sided volume loss with left inferior pleural thickening. Resolution of previous loculated air collections in the left infralateral chest wall. Leftward mediastinal shift with normal heart size. Right lung is well aerated; no right pleural effusion is present.

Output: Resolution of previous gas collections in the left infralateral chest wall. Small loculated pleural effusions with pleural thickening and left sided volume loss.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: pneumonia, cardiomegaly, effusion History: hx of ESRD, CAD, CHF. 4 days productive cough, chills, malaise, missed dialysis sessions. Cardiomegaly, with streaky basilar opacities questionably edema.No evidence of infection.Coronary stents.Upper abdominal surgical clips.Left upper extremity stool or stent.

Output: Small lung volumes with possible basilar edema, but no sign of infection.


Instruction: Generate impression based on medical findings.

Input: History of sarcoidosis, now with cough and fever Persistent mildly decreased lung volumes without distinct superimposed acute cardiopulmonary new air space abnormalities, however please correlate with pending PE CT given greater sensitivity. Diffuse lymphadenopathy grossly unchanged without with known underlying sarcoidosis.

Output: No distinct superimposed acute new abnormality superimposed upon findings compatible with known sarcoid


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Oxygen requirement. "Status post SOB". Diffuse interstitial opacity and vascular unsharpness suggestive of edema, minimally worse. Hardware and devices similar in position.

Output: Moderate pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: HF vs COPD History: diminished breath sounds Moderate cardiomegaly with pulmonary vascular redistribution.No significant pulmonary or pleural abnormality.No specific evidence of infection or edema.

Output: Moderate cardiomegaly without acute edema or pneumonia. No evidence of COPD.


Instruction: Generate impression based on medical findings.

Input: Age: 25 yearsGender: MaleReason for Study: Reason: eval for pulmonary edema, effusions, PNA History: SOB, wheezing, cough, increased DOE for 5 days Stable marked cardiac enlargement.Perihilar interstitial opacities similar to the prior exam and compatible with edema.Right basilar opacity may represent infection or aspiration.No large pleural effusions.

Output: No significant interval change in the cardiomegaly and mild interstitial edema. Right basilar opacity suggestive aspiration or infection.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: PTX resolved, CT now clamped History: PTX Right apical chest tube is unchanged. Loop recorder again in place.Stably enlarged cardiac silhouette.Remonstration of bilateral pulmonary opacities suggestive of edema or atypical infection. Significant interval increase in size of right apical pneumothorax.

Output: Significant interval increase in size in right apical pneumothorax.