Instruction: Generate impression based on medical findings.

Input: 30 year old male with chest pain, cocaine use No focal airspace opacities. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Fever Minimal basilar interstitial changes largely in the right lung base, possibly old and chronic. No definite superimposed acute airspace abnormality however serial imaging may be helpful if suspicion remains high. Mildly decreased lung volumes persist.Borderline cardiomegaly. Mediastinal contours are within limitsInterval removal of the right jugular catheter

Output: Mild basilar opacities, presumably and most consistent with chronic interstitial change.


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: ETT and PNA eval History: intubated, PNA Patchy left basilar atelectasis and bilateral basilar edema, unchanged.Small pleural effusions are present.A Dobbhoff tube extends below the lower margin of the image.Left subclavian catheter, tip in SVC.ET tube tip 7 cm above the carina.

Output: High ET tube. Stable basilar opacities and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: 57-year-old female with history of piriform sinus cancer status post CRT. Evaluate for disease. CHEST:LUNGS AND PLEURA: Postsurgical changes from left upper lobectomy, similar to multiple prior studies. Scattered micronodules, unchanged. No suspicious nodules, masses, or pleural effusion.Mild centrilobular emphysema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Moderate coronary calcifications.CHEST WALL: Right chest port catheter with catheter tip in proximal SVC. UPPER ABDOMEN: Left renal cyst.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Male, 90 years old.Reason: eval dobhoff tube placement History: new dobhoff Streaky atelectasis left lung base periphery, the lungs otherwise unremarkable.No specific evidence of infection or edema.Left subclavian pacemaker, leads unchanged in position.A Dobbhoff tube terminates in the stomach.

Output: No acute abnormality. A Dobbhoff tube terminates in the stomach.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: 51M with chest pain and SOB, eval for infiltrates or mediastinal abnormalities History: chest pain The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions. Moderate degenerative changes in the thoracic spine.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Status post pacemaker extraction. Pacemaker apparatus has been removed. Stable diffuse pulmonary opacities and focal right apical and retrocardiac opacities. Pleural effusions again noted. Unchanged heart size. No pneumothorax.

Output: Interval extraction of pacemaker apparatus. No pneumothorax. No substantial difference, otherwise, compared to previous study.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: SOB History: as above Interstitial and airspace opacities consistent with acute pulmonary edema with small pleural effusions and moderate cardiomegaly.A bullet fragment is projected over the right peritracheal region.

Output: Pulmonary edema with pleural effusions consistent with CHF.


Instruction: Generate impression based on medical findings.

Input: Reason: R/O effusion History: as above Small lung volumes with basilar opacity greater on the right consistent with atelectasis and effusions, not significantly changed since the previous day but increased since 2/25/2015.No new findings.

Output: Pleural effusions and atelectasis, increased over the past 3 days.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: indeterminate quant gold; r/o tb History: testing for indet gold prior to biologic therapy Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Large patient body habitus. Diffuse idiopathic skeletal hyperostosis.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: ETT and IABP check IVP marker remains within the aortic arch. Mediastinal chest tubes, ETT and Dobbhoff are all otherwise unchanged. Supportive drain overlying the left axilla is also similar position with overlying surgical clips.Cardiopulmonary appearance is also similar with retrocardiac opacities representing suspected compression atelectasis, however partial consolidation cannot be excluded. Small suspected bilateral effusions.

Output: Chest tubes unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: eval fluid overload History: SOB, weakness Pacemaker unchanged. Right shoulder arthroplasty.Cardiomegaly but no new opacity to suggest pneumonia. No evidence of edema.

Output: Cardiomegaly but no new opacity to suggest pneumonia. No evidence of edema.


Instruction: Generate impression based on medical findings.

Input: Female, 22 years old.Reason: eval for new infiltrate or signs of acute chest History: sickle cell pt, recent dz of PE, with CP Moderate cardiomegaly again noted. Otherwise, no substantial difference compared to the study. No new focal lung consolidation.

Output: No substantial change compared to previous study.


Instruction: Generate impression based on medical findings.

Input: Reason: infiltrate History: intubated ET tube tip approximately 3 cm above the carina.Bilateral venous catheters unchanged.Bilateral pleural effusions, larger on the right, with underlying atelectasis.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Age: 76 yearsGender: MaleReason for Study: Reason: eval ETT, lung fields History: s/p CABG Left-sided pacemaker unchanged.ET tube with its tip approximately 3 cm above the carina.Right IJ Swan-Ganz with its tip in the pulmonary artery.Chest/mediastinal tubes in place without evidence of a significant pneumothorax.Stable cardiomediastinal silhouette.Lungs are clear.No pleural effusions.Median sternotomy is noted.

Output: Postoperative chest without complication.


Instruction: Generate impression based on medical findings.

Input: Evaluate lungs, abdomen, pelvis and pancreas for neoplasm. CHEST:LUNGS AND PLEURA: Emphysema. Right lower lobe bronchiectatic changes.MEDIASTINUM AND HILA: 18 x 14 mm round hypodense lesion in the pre-carinal area, which represent an enlarged lymph node. Fluid attenuating lesion adjacent to the main pulmonary artery measuring 2.3 x 1.9 cm extending to the aortic root may be extension of the pericardial fluid. Trace amount of pericardial fluid is present.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hepatic lesion, too small to accurate characterize but likely benign. Distal common bile duct is not well seen, however, no evidence of intrahepatic or proximal common bile duct dilatation. Incidentally noted is an approximately 50% stenosis at the proximal celiac trunk with mild poststenotic dilatation which may be secondary to compression by the median arcuate ligament versus atherosclerosis.SPLEEN: No significant abnormality notedPANCREAS: Entire pancreatic duct is dilated with more cystic appearance in the head measuring up to 3-cm in diameter. This appearance is consistent with main duct type I PMN. Local vessels are patent without evidence of tumor invasion. No definite soft tissue component within the significantly dilated pancreatic duct.ADRENAL GLANDS: Small right adrenal nodule consistent with adenoma.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right inguinal hernia containing nonobstructive bowel loops.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate gland is enlarged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Round sclerotic focus in the left iliac bone.OTHER: No significant abnormality noted

Output: Findings consistent with main duct type intrapancreatic mucinous neoplasm. There is small amount of pericardial effusion likely extending into the mediastinum.Precarinal round lesion which may represent adenopathy versus fluid in the precarinal recess of the pericardium. Follow-up imaging is recommended.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: evaluate SG catheter History: see above Unchanged interstitial edema and right pleural effusion.Right jugular Swan-Ganz catheter tip directed towards the right interlobar pulmonary artery.Left jugular catheter tip at cavoatrial junction.

Output: Unchanged edema, right pleural effusion and support devices.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: eval for PNA History: neutropenic fever Right dual-lumen port remains accessed.Stable postoperative changes on the right without new opacity to suggest pneumonia.

Output: No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: pneumonia History: pna A small caliber are enteric tube projects over the thoracic midline and terminates in the left upper abdomen.No significant change in the left lower lobe pneumonia with moderate left and small right pleural effusions. Right lower zone opacities slightly increased.

Output: Bilateral lower lobe pneumonia, larger on the left, with associated pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Coughing and lung cancer history Persistent near complete opacification of the right lung with only minimal right upper lobe aeration observed. Larger effusion extending into the apex is again observed with associated air bronchograms representing partial consolidation of the underlying collapsed right lung. Near-complete compression of the right mainstem bronchus appearance correlates with recent CT.Left lung remains clear.

Output: Stable appearing near complete opacification of the right hemithorax from a known hilar mass and near complete compression of the airway and compressing effusion


Instruction: Generate impression based on medical findings.

Input: 51-year-old female with history of colon cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Bilateral nonenlarged axillary lymph nodes.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: Left kidney is severely hydronephrotic with a dilated ureter which can be traced down to the pelvis where it is compressed by an 5.9 x 2.6 cm mass in the left lower quadrant on image number 160, series number 3.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Cystic tubular lesion in the left adnexa which may represent dilated ureter versus hydrosalpinx. Right ovary is not visualized. Uterus is unremarkable. Round soft tissue density involving the rectal stump adjacent to the anastomosis may represent residual tumor versus unopacified collapsed bowel loop. Further evaluation with endoscopy is recommended.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large pelvic mass causing left-sided hydronephrosis as described in the abdomen part of the report.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Large pelvic mass likely representing recurrent tumor causing severe left-sided hydronephrosis. Endoscopy is recommended to evaluate the residual rectum.Left adnexal cystic tubular structure which may represent a dilated left ureter versus hydrosalpinx.


Instruction: Generate impression based on medical findings.

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

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


Instruction: Generate impression based on medical findings.

Input: Male, 31 years old.Reason: eval pna History: LUQ pain, cough, congestion Cardiomediastinal silhouette is normal. No specific evidence of infection or edema. No pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Sepsis, evaluate for infiltrate. History of breast cancer with known metastatic disease to the chest. Left chest wall port, tip at the SVC/right junction.Increasing mediastinal adenopathy with enlarged azygos node.Increasing pulmonary nodules compatible with metastatic disease.No pleural effusion or pneumothorax.

Output: 1.No evidence of infection.2.Interval increase in metastatic pulmonary nodules and mediastinal lymphadenopathy.


Instruction: Generate impression based on medical findings.

Input: Swan-Ganz check Large diffuse layered right pleural effusion with a smaller fluid collection of the left with cardiomegaly and underlying diffuse edema.ICD, Swan-Ganz and Dobbhoff are all otherwise unchanged, the latter extends beyond the inferior edge of the image

Output: Swan-Ganz unchanged


Instruction: Generate impression based on medical findings.

Input: Pulmonary edema Motion degrade sensitivity. Persistent small to moderate pleural effusions with nonspecific patchy streaky densities in both bases likely atelectasis, however aspiration or mild edema again cannot be excluded. Borderline cardiomegalyETT remains under advanced with side port seen just at or above the GE junction.

Output: Probable atelectasis with probable mild edema


Instruction: Generate impression based on medical findings.

Input: 56-year-old male with colorectal cancer on chemotherapy. CHEST:LUNGS AND PLEURA: A few subcentimeter nodular opacities are seen, unchanged. No pleural effusions.MEDIASTINUM AND HILA: Small hypodense thyroid nodule. Superior mediastinal adenopathy has decreased, measuring 11 x 7 mm (series 4; image 21), previously 22 x 12 mm.CHEST WALL: The right-sided port terminates in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Punctate hepatic hypodensities are stable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The right kidney demonstrates several low attenuation lesions, stable.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy has improved, with the reference node in the para-aortic region measuring 6 x 7 mm (series 4; image 135), previously 16 x 13 mm.BOWEL, MESENTERY: Ileocolic anastomosis without evidence of obstruction.Mesenteric soft tissue mass anterior to the duodenum has also decreased in size, measuring 2.7 x 1.5 cm (series 4; image 132), previously 3.2 x 2.0 cm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate gland is enlarged and indents the base of the urinary bladder.BLADDER: No significant abnormality notedLYMPH NODES: Right external iliac lymph node has decreased in size. Ill-defined soft tissue anterior to the proximal right external iliac artery has also decreased in size.BOWEL, MESENTERY: 2.3 x 1.2 cm soft tissue mass superior to the prostate gland and possibly involving the seminal vesicles has decreased in size (series 4; image 196), previously 2.6 x 2.0 cm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Decrease in size of adenopathy and scattered peritoneal lesions.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: r/o CHF exacerbation History: abdominal swelling Moderate cardiomegaly, similar to prior.Minimal right basilar subsegmental atelectasis. No focal airspace opacity, pneumothorax or large pleural effusion.Right ICD with lead unchanged in position.

Output: Stable cardiomegaly without definite evidence of edema.


Instruction: Generate impression based on medical findings.

Input: Male, 86 years old.Reason: lung CA, thoracentesis 4/23. Increasing shortness of breath. Status of pleural fluid. History: shortness of breath Enlarging left pleural effusion with left basilar consolidation.Right lung unremarkable.

Output: Enlarging left pleural effusion compressing the left lung base.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Reason: intubation - ET placement History: ET placement Perihilar edema like opacities with a right pleural effusion consistent with CHF.ET tube tip within 2 cm of the carina.

Output: Low ET tube. Unchanged pulmonary opacities and right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 78 years old.Reason: SOB History: As above Persistent pulmonary edema with bilateral pleural effusions. Venous catheter unchanged.

Output: Persistent pulmonary edema with bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: 51-year-old male with history of right chest port placement. Right chest port with tip in the SVC. NG tube tip projecting over the proximal gastric body with the sidehole in the distal esophagus. No evidence of pneumothorax. Small right pleural effusion with associated subsegmental atelectasis.

Output: Right chest port with tip in the SVC. NG tube tip projecting over the proximal gastric body with sidehole in the distal esophagus. Consider advancing NG tube. No evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: s/p ett adjustment History: see above Lines and tubes are unchanged. Diffuse left greater than right pleural-parenchymal opacities again noted. Unchanged heart size. No definite pneumothorax.

Output: Diffuse left greater than right pleural-parenchymal opacities again noted.


Instruction: Generate impression based on medical findings.

Input: 4 months old ex 35 week twin with left sided peritonsillar cellulitis and phlegmon now with vomiting with PO. Question worsening swelling. Examination demonstrates diffuse mucosal swelling along left side oropharynx, hypopharynx, larynx and subglottic airways with narrowing of the airway and trachea. There has been an interval development of low-attenuation lesion with rim enhancement measuring 0.8 x 1.3 cm on axial image 61 of series 3 and extending in the craniocaudal dimension for a distance of 3.8-cm as measured on sagittal image 48 from the level of the nasopharynx superiorly to the level of the larynx inferiorly. This lesion is consistent with an abscess. The left epiglottis, vallecula, piriform sinuses are effaced. Extensive cervical lymphadenopathy is noted in the posterior triangles and jugulodigastric regions bilaterally, left more than right.Limited view of of the lung apices demonstrates a right apical consolidation which has markedly progressed compared to prior and most likely represent pneumonia, dedicated chest imaging is recommended for further evaluation.

Output: 1. Interval development of a large left parapharyngeal abscess causing compromise of the upper airway. 2. Diffuse bilateral posterior triangle lymphadenopathy, left more prominent than right.3. Interval progression of right lung apical consolidation suggestive of pneumonia. Dedicated chest imaging is recommended for further evaluation.


Instruction: Generate impression based on medical findings.

Input: 60 years old Female. Reason: eval for PTX s/p chest tube History: chest tube in place. Stable basilar opacities and pleural effusions. Cardiac silhouette is normal. The mediastinal drain, right PICC line and enteric tube are stable in position.

Output: Stable basilar opacities and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.Assess chylothorax. The left-sided pleural effusion is not significantly changed in size. Adjacent consolidation/atelectasis. The right lung is clear. Normal cardiomediastinal silhouette.

Output: No significant change in left-sided pleural effusion with adjacent consolidation/atelectasis.


Instruction: Generate impression based on medical findings.

Input: 73-year-old female with elevated WBC count and streaky pulmonary opacity seen on CT. Cardiac silhouette is unremarkable. A retrocardiac opacity is seen superior to the left major fissure on lateral projection which corresponds to calcified node seen on prior CT. Additional opacity seen inferior to this corresponds to the opacity seen on CT and could represent aspiration or infection. No pneumothorax or pleural effusion is present.

Output: Left lower lobe opacity suggestive of infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old. Right jugular catheter tip in the SVC.No pneumothorax or other complications.Cardiomegaly, ICD leads, pleural effusions and atelectasis, slightly increased though accentuated by under inflation.

Output: New catheter with no complications.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: Hx of haplo/cord SCT. Now with fevers, orthopnea, chest congestion and sore throat. Rule out infection History: fever, chest congestion New focal pulmonary opacities are visualized in the right lung base and a smaller one in the left lung base.No pleural effusion or pneumothorax. Right middle lobe atelectasis. The cardiomediastinal silhouette is within normal limits. Slightly ectatic descending thoracic aorta. Unchanged calcified hilar granulomas.

Output: New pulmonary opacities in the right lung base and left lung base especially fungal pneumonia.


Instruction: Generate impression based on medical findings.

Input: Age: 72 yearsGender: FemaleReason for Study: Reason: et tube placement History: et tube placement ET tube with its tip at the orifice of the right mainstem bronchus.NG tube with its tip in the stomach.Decreased lung volumes with stable cardiomediastinal silhouette.Elevation of the left hemidiaphragm.No new pulmonary opacities noted.

Output: ET tube tip at the orifice the right mainstem bronchus. Recommend repositioning..


Instruction: Generate impression based on medical findings.

Input: Male, 26 years old.Fever and shortness of breath. Low lung volumes. Persistent basilar opacities possibly from aspirated secretions or mucous plugging, appearing similar to the prior study. NG tube tip terminates beyond the caudal aspect of the film beyond the GE junction. Right jugular catheter projects at the level of the SVC.

Output: No significant interval change in basilar opacities suspicious for aspirated secretions or mucous plugging.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, 50 years old.Reason: new intermittent chest pain, Hx: R breast cancer currently undergoing chemotherapy History: chest pain Right breast spacer. Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Port catheter terminates in the superior aspect of the RA.

Output: Clear lungs. Right breast soft tissue spacer again noted.


Instruction: Generate impression based on medical findings.

Input: Reason: chest pain, shortness of breath. hx COPD History: chest pain, SOB, hx COPD Unremarkable cardiac and mediastinal silhouette. Status post left upper lobectomy.Large hypovascular lungs, consistent with COPD.No sign of pneumonia or other acute change.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female; 80 years old. Reason: Eval for worsening effusions History: CHF MR Requiring more Oxygen Stable ICD.Stable cardiomegaly.No significant interval change in low lung volumes and lower lung zone opacities suggestive of edema, pleural effusions, and atelectasis.

Output: Stable findings suggestive of moderate CHF.


Instruction: Generate impression based on medical findings.

Input: Male, 46 years old.Reason: Intubated, hx mucous plugging, eval pulmonary status History: Intubated, hx mucous plugging, eval pulmonary status ET tube tip 5-6 cm above carina. Enteric tube extends beyond the field-of-view of study. Jugular and subclavian venous catheters are unchanged.Lungs are hypoinflated. Increased left lower lobe opacity likely due to aspiration or atelectasis. Other findings are stable.

Output: Increased left lower lobe opacity likely due to aspiration or atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: pna? History: trach, sob Mild to moderate cardiomegaly.New retrocardiac left lower lobe airspace opacity consistent with pneumonia.Mediastinal mass and known pulmonary nodules.Left subclavian pacemaker, leads unchanged in position. Tracheostomy tube unchanged.

Output: Known metastatic disease. New left lower lobe pneumonia or aspiration.


Instruction: Generate impression based on medical findings.

Input: Age: 93 yearsGender: FemaleReason for Study: Reason: nausea, congestion , eval for pneumonia History: nausea, congestion, eval for pneumonia Stable cardiomediastinal silhouette.No focal areas of consolidation.No pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p pleurectomy History: - Interval removal of one of 2 right chest use.Very small residual apical pneumothorax.Nonspecific pulmonary opacities unchanged from previous.

Output: Small right apical pneumothorax with chest tube in place.


Instruction: Generate impression based on medical findings.

Input: Male, 39 years old.Left pleural effusion. Large retrocardiac opacity with large left pleural effusion stable to minimally improved from previous. Right lung remains clear. Cardiomegaly again noted. Right jugular catheter tip over the RA. NG tube in the stomach. ET tube 5 cm above the carina. No pneumothorax.

Output: Large left retrocardiac opacity with effusion stable to minimally improved. Other findings and devices stable.


Instruction: Generate impression based on medical findings.

Input: Age: 76 yearsGender: MaleReason for Study: Reason: history urothelial cancer status post right nephroureterectomy in past, assess for recurrence History: history urothelial cancer status post right nephroureterectomy in past, assess for recurrence Stable cardiomediastinal silhouette with evidence of a prior sternotomy and CABG.The lungs are clear. No pleural effusions.Degenerative changes in thoracic spine

Output: No acute cardiopulmonary abnormalites identified without interval change. No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Acute kidney failure. Check tracheostomy tube Tracheostomy tube remains unchanged, tip is thought to terminate 3 cm from the carina however the tip and overlying thoracic spine fixation hardware superimposed, decreasing sensitivity. No new gross abnormality and the bilateral jugular catheters otherwise appear similar.Pronounced decreased lung volumes with near complete obscuration of the left lung by an enlarged cardiac silhouette and patient rotation, similar to prior exams. Underlying compression atelectasis and or consolidation of the left lower lobe cannot be excluded

Output: Tracheostomy tube appears grossly unchanged, see the limitations described


Instruction: Generate impression based on medical findings.

Input: Age: 55 yearsGender: MaleReason for Study: Reason: eval lung fields History: s/p MVR Support devices unchanged.Stable cardiomediastinal silhouette.Interval improvement in the right-sided pulmonary edema and associated right pleural effusion.No evidence of a pneumothorax.

Output: Support devices unchanged. Interval improvement in right-sided edema .


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Reason: type a dissection History: type a dissection Widening of the superior mediastinum again noted. Iatrogenic devices are unchanged. No pneumothorax. Skinfold overlies the upper left hemithorax. Mild bibasilar subsegmental atelectasis or scarring again noted.

Output: No substantial difference compared to last study.


Instruction: Generate impression based on medical findings.

Input: Check for CHF. Dyspnea on exertion No acute pulmonary abnormalities. Calcified granuloma observed in the left lung base.Cardiac silhouette is within limits, however mild tortuosity of aorta with atherosclerotic disease is observed

Output: Granulomatous disease exposure without superimposed acute cardiopulmonary abnormalities


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: Pt is a 66 yo male w/ hx of MCL; pre-sct evaluation History: eval Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Right subclavian catheter, tip in SVC.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 82 years old.ETT placement. ETT 7 cm above the carina. Left jugular catheter at the SVC/artery junction. NGT sidehole just below the GE junction.Cardiomegaly. Atherosclerotic calcification at the aortic arch. Apparent mediastinal widening may be exaggerated by portable technique and patient rotation, nonspecific

Output: ETT 7 cm above carina.


Instruction: Generate impression based on medical findings.

Input: Evaluate for obstruction, history of constipation and vomiting Right upper quadrant drainage percutaneous biliary drain and surgical clips. Overlying artifact seen in right-sided abdomen. No evidence of bowel obstruction. Curvilinear hyperdensity in right hemipelvis presumably related to vascular calcifications.

Output: Nonobstructive bowel gas pattern.Curvilinear hyperdensity in right hemipelvis presumably related to vascular calcifications.


Instruction: Generate impression based on medical findings.

Input: Reason: progression of PNA History: L chest pain/cough Airspace opacities in the left lung have partially cleared since the previous radiograph with residual areas of subsegmental atelectasis, compatible with resolving pneumonia.No new findings.

Output: Partial resolution of left upper lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Reason: Evaluate PICC line History: PICC Increased basilar opacities with persistent pleural effusions.Mild cardiomegaly.New right PICC, courses cephalad into the jugular and above the upper margin of the image.

Output: 1. Worsening basilar opacities.2. Malpositioned right PICC, coursing into the neck and above the upper margin of the image. The service was text paged regarding this pager 6229.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Reason: sob History: sob Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: assess ETT placement History: as above Cardiomegaly.Mild retrocardiac opacity unchanged.Right jugular Swan-Ganz catheter, tip in right interlobar pulmonary artery.Left subclavian ICD, leads unchanged in position.NG tube, tip above the diaphragm.ET tube tip approximately 3 cm above the carina.IABP catheter proximal marker projects over the aortic arch.

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


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.Reason: r/o mets History: none Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No evidence of metastases.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 69 year-old female with hypertension admitted with angioedema presenting with atrial fibrillation with rapid ventricular rate. Assess for PE. PULMONARY ARTERY: No evidence of PE. The subsegmental arteries are poorly evaluated, however.LUNGS AND PLEURA: Interval development of patchy ground glass opacities as well as bibasilar right greater than left consolidation with trace left pleural effusion. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Normal cardiac size. No pericardial effusions. No significant mediastinal lymphadenopathy. Atherosclerotic calcifications of the aorta and its branches.CHEST WALL: No significant axillary lymphadenopathy. Degenerative changes. Tracheostomy tube tip at the level of the thoracic inlet. Small amount of tracheal debris noted below the tracheostomy tube.UPPER ABDOMEN: No significant abnormality.

Output: 1. No PE.2. Right greater than left basilar consolidation. This is most likely due to pneumonia or aspiration. The additional areas of ground glass opacity may be secondary to an extension of the infection or superimposed edema.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Reason: infection History: cough Lungs and pleural spaces are clear. Multilevel degenerative changes of the thoracic spine. The heart size is normal.

Output: No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: eval lung fields History: s/p MVR, TVR, CABG, IABP Lines and tubes are unchanged. Bibasilar opacities, left greater than right again noted. Mild pulmonary edema, unchanged. No significant pneumothorax. Unchanged cardiomegaly.

Output: Lines and tubes are unchanged. Bibasilar opacities, left greater than right again noted. Mild pulmonary edema, unchanged. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 96 years old.Disorientation question pneumonia. Mild cardiomegaly with a highly tortuous thoracic aorta. No focal airspace opacity or pneumothorax. Mild blunting of the costophrenic angles may be secondary to scarring or a trace amount of pleural fluid. Mild thoracic kyphosis.

Output: Cardiomegaly and tortuous thoracic aorta. No acute pulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 94 years old.Reason: infection? History: productive cough Study limited by leftward patient rotation. Patchy right basilar opacity. Subsegmental atelectasis or scarring left lung base. Heart size likely at the upper limit of normal. Aortic calcification consistent with atherosclerosis. Status post right shoulder surgery. No pneumothorax.

Output: Study limited by patient rotation. Mild patchy right basilar opacity which could represent early aspiration or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Cough with sputum. Small scarlike opacity at the posterior costophrenic angle. Lungs are otherwise clear without consolidation, effusion, or edema. Interval removal of right central line without pneumothorax. Heart size normal.

Output: No acute cardiopulmonary abnormality. Interval removal of right central line without pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 50 year-old male with history of renal cell carcinoma. Assess for progression. CHEST:LUNGS AND PLEURA: Stable right lobe metastatic nodules. Right middle lobe nodule is best seen on series 4, axial image 41/116 and measures 2.7 cm x 3.2 cm. Right lower lobe peripheral nodule is best seen on the series 4, axial image 61/116 and measures 2.9 cm x 2.5 cm. No new nodules are 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: Surgical clips in the left nephrectomy site.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No other significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: 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 other significant abnormality noted.

Output: Stable right lung metastatic nodules.


Instruction: Generate impression based on medical findings.

Input: 60 years old Female. Reason: ett History: 4143. Patchy edema-like opacities with retrocardiac consolidation, not significantly changed.A Dobbhoff tube extends below the lower margin of the image.An NG tube extends below the lower margin of the image.Right jugular catheter, tip in SVC.ET tube tip approximately 5 cm above the carina.

Output: Unchanged pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: Please evaluate for pneumothorax s/p left sided pacemaker insertion History: left sided pacemaker Interval removal of the temporary pacer wire with placement of left pacemaker device with leads in the right atrium and high in the right ventricle directed towards the pulmonary outflow tract, however this could be confirmed with a lateral view. ETT and enteric tube removed. Status post TAVR. Stable cardiomediastinal silhouette with heavily calcified aortic arch.Low lung volumes. Small bilateral pleural effusions and underlying atelectasis/consolidation. Stable interstitial opacities are consistent with mild interstitial edema.No pneumothorax.

Output: Status post left pacemaker insertion with leads in the right atrium and probably the proximal right ventricle. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: goh History: goh Endotracheal tube terminates 4 cm above the carina. Nasogastric tube is unchanged in position.Lungs and pleural spaces remain clear. Cardiomediastinal silhouette is unremarkable.

Output: Endotracheal tube remains in stable position.


Instruction: Generate impression based on medical findings.

Input: Reason: post intubation and bronch History: L side obstruction ET tube tip approximately 3 cm above the carina.Other devices unchanged.Partial reexpansion of the left lung with partial residual atelectasis.Diffuse bilateral airspace opacity compatible with edema with a moderate left effusion.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Reason: perforated esophagus History: back pain, sob Left chest tube in place with no pneumothorax.Small lung volumes with basilar atelectasis and effusions.A more recent radiograph has been interpreted.

Output: Bilateral pleural effusions and basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 38 years old.Reason: eval for ptx, mass, effusion, etc History: right sided CP for 2 days, BP 180/120 No focal lung opacity, pleural effusion, or pneumothorax. The heart size is normal.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old."PVD and rhabdo". Tubes and lines similar in position, no pneumothorax. Bronchial wall thickening and diffuse interstitial opacities continue to slightly worsened. Blunting of the left cardiophrenic angle is new. Subsegmental atelectasis bilaterally in the lower lungs slightly worse. Hazy right upper lobe airspace opacities new, though part of the opacity can be attributed to tubing overlying the chest wall..

Output: Worsening atelectasis, probably due to aspirated secretions. Hazy opacity suggestive of bronchiolitis and pneumonitis, likely related to aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 86 years old.Shortness breath x3 days. Left-sided ICD is unchanged. Stable cardiomediastinal silhouette. Extensive calcified mediastinal lymph nodes are again seen and compatible with history of cervical diagnosis. Basilar predominant chronic appearing interstitial opacities are again noted and less conspicuous compared to prior examination. No focal airspace opacity, pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 77 years old.Reason: Eval for dissection History: Hypertensive emergency Complete left hemithorax opacification with volume loss either from bronchial obstruction or pneumonectomy.Right lung unremarkable.The mediastinum cannot be assessed secondary to the left hemithorax opacification.

Output: Complete left hemithorax opacification either from pneumonectomy or complete atelectasis, making detection of aortic abnormalities impossible.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.New hypoxia. Tracheostomy tube in place with tip 4.5 cm above the carina. Cardiac size unchanged. Low lung volumes with small bilateral pleural effusions. Right basilar bronchial wall thickening appears similar compared to prior examination.

Output: Low lung volumes with small bilateral pleural effusions and right basilar bronchial wall thickening, which may be related to aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 30 years old.Reason: Pre-Op TRANSPLANT baseline assessment History: Pre-Op TRANSPLANT The cardiomediastinal silhouette is normal.There are no focal pulmonary opacities or pleural effusions.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Fever No cardiopulmonary abnormality observed. Unchanged right and left vascular access.

Output: No acute disease


Instruction: Generate impression based on medical findings.

Input: Reason: assess for pna History: intubated ET tube tip approximately 3 cm above the carina.NG tube tip in the stomach.Mild left basilar opacity compatible with atelectasis and aspirated secretions.

Output: Mild basilar opacity compatible with aspirated secretions but no specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: 77-year-old male with RCC status post surgery evaluate for disease.No IV contrast please CHEST:LUNGS AND PLEURA: Centrilobular emphysematous changes. Micronodules unchanged. Extensive calcified pleural plaques in the left chest unchanged.MEDIASTINUM AND HILA: Small nodes not pathologic by size criteria. Granuloma right hilum. Postsurgical changes sternotomy and coronary surgery. Mediastinal shift to the left. Prominent mediastinal and pericardial fat.CHEST WALL: Postsurgical changes.ABDOMEN: The exam is not sensitive for detecting lesions in the solid organs due to the lack of IV contrast. Given that limitation, the following observations are made.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted. Granuloma.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrectomy. Irregular residual soft tissue density in the nephrectomy bed can be followed. It is very irregular not easily amenable to measurement.Exophytic small lesion off the left lower pole slightly higher than fluid density, unchanged from the prior exams.RETROPERITONEUM, LYMPH NODES: No pathologic size nodes. Previously seen large mass on the right has been resected. Mild atherosclerotic changes aorta and iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall. No free or loculated fluid.OTHER: 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: Postsurgical changes right nephrectomy bed can be followed. Probable atypical cyst exophytic off lower pole left kidney, unchanged. Postsurgical changes chest. Calcified pleural plaques.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: eval balloon pump and PA cath position History: IABP and PA cath The proximal intra-aortic balloon marker is located at the distal transverse arch. The distal marker is located at the level of L2/L3. The right IJ Swan-Ganz catheter is directed toward the right pulmonary artery. The remaining support devices are unchanged in position.Persistent cardiomegaly with retrocardiac atelectasis. Increasing perihilar opacities of mild edema. Trace pleural effusions. No pneumothorax.

Output: Perihilar opacities slightly increased of mild edema. Intra-aortic balloon proximal marker at the distal transverse arch.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p esophagectomy, ARDS History: s/p esophagectomy, ARDS ET tube tip approximately 3 cm above the carina.Catheter tip in the SVC.NG tube tip projected over the lower mediastinum.Chest tube in place with no visible pneumothorax.Diffuse mainly interstitial opacity suggestive of edema and/or ARDS without significant change.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Congenital diaphragmatic herniaVIEW: Chest AP and abdomen AP Left lower extremity PICC with tip in the IVC at the T11 level. Endotracheal tube tip is at the thoracic inlet. Enteric tube tip is below the left hemidiaphragm. Umbilical venous catheter tip is in the right chest. Umbilical arterial catheter tip at the T7 level and displaced to the left. Urinary catheter in place.Cardiothymic silhouette size cannot be evaluated. Right hemithorax is completely opacified. A few gas-filled bowel loops are present in the right lateral lower hemithorax. A crescent-shaped lucency is present in the medial upper portion of the right hemithorax. Leftward mediastinal shift noted. Paucity of bowel gas within the abdomen.

Output: Right diaphragmatic hernia not significantly changed.


Instruction: Generate impression based on medical findings.

Input: Endometrial stromal sarcoma. Interval PICC placement. Minimal streaky bibasilar opacities compatible with atelectasis. Interval removal of two Port-A-Caths. Interval placement of right PICC line with tip in the SVC. No pneumothorax. Persistent decreased lung volumes. Previously documented metastatic pulmonary nodules in the right lung are not definitively visualized on this study.

Output: Bibasilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Age: 62 yearsGender: MaleReason for Study: Reason: eval ETT, lung fields History: s/p lead placement ET tube with its tip 4 cm is above the carina.Right IJ Swan-Ganz with its tip in the pulmonary artery.Chest/mediastinal tubes in place without evidence of a pneumothorax.IABP marker in the distal aortic arch.The cardiomediastinal silhouette is unremarkable.Left basilar opacities compatible with atelectasis.Median sternotomy intact.

Output: Postoperative chest without complications.


Instruction: Generate impression based on medical findings.

Input: IABP check All chest tubes, Swan-Ganz, ETT and IABP are all unchanged. The latter extends 5 cm below the aortic archPersistent decreased lung volumes with mixed interstitial and airspace changes in both bases greater on the left. Suspected atelectasis, however mild edema with cardiomegaly again must be suggested

Output: Unchanged ETT


Instruction: Generate impression based on medical findings.

Input: 33-year-old male with history of dyspnea and fever. Again seen are bilateral basilar predominant opacities with septal lines compatible with edema. Right upper and lower lobe airspace opacity have slightly increased. Small right pleural effusion.

Output: Worsening bilateral pulmonary opacities concerning for edema and/or infection.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: Interval change in pulmonary opacities, ET tube placement History: remains on ventilator, s/p dialysis with fluid removal Small lung volumes with unchanged pulmonary opacities and pleural effusion/pleural thickening. ET tube tip approximately 5 cm above the carina.An NG tube extends below the lower margin of the image.Right jugular catheter, tip in SVC.

Output: ET tube tip approximately 5 cm above the carina, repositioned.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: assess left pneumo History: CT on left recently placed with residual Pneumothorax. reassess Apically directed bilateral chest tubes are seen. The patient is intubated with ET tube tip above the carina. ECMO cannulae are seen. A left internal jugular catheter is unchanged in position with tip in the brachiocephalic vein.The cardiomediastinal silhouette is stable.The left pneumothorax has resolved, but there is some residual consolidation of the left lung base. Diffuse interstitial opacities are seen bilaterally. A right pneumothorax appears larger than the prior examination.

Output: 1.Left pneumothorax resolved.2.Increasing right pneumothorax with chest tube in place.


Instruction: Generate impression based on medical findings.

Input: Age: 70 yearsGender: MaleReason for Study: Reason: assess for heart failure History: SOB Atrial flutter Left-sided ICD unchanged.Stable cardiac enlargement with prominence of the central pulmonary vasculature.No focal airspace opacities.Minimal blunting of the right costophrenic angle may represent a small effusion and/or pleural thickening.No significant pulmonary edema.Median sternotomy is intact with evidence of a prior CABG.

Output: Stable cardiac enlargement without evidence of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: intubated History: see above Endotracheal tube in place with tip 4.4 cm superior to the carina. Enteric tube in place with tip overlying the gastric antrum. Partially visualized tubing overlying the left hemiabdomen.Cardiac silhouette is normal in size.Bilateral low lung volumes with mild bibasilar atelectasis. Left lateral costophrenic angle is not entirely included in the study. No definite pneumothorax.

Output: As described above.


Instruction: Generate impression based on medical findings.

Input: Age: 45 yearsGender: FemaleReason for Study: Reason: desaturations History: destruation Right central venous catheter with its tip in the SVC.New consolidation involving the right middle lower lobes compatible with infection and/or aspiration.Left basilar opacities compatible with subsegmental atelectasis.

Output: New right basilar consolidation and airspace opacity compatible with infection and/or aspiration.


Instruction: Generate impression based on medical findings.

Input: Hemoptysis Essentially unchanged cardiopulmonary appearance with a persistent left basilar opacity and moderate left effusion. Small right effusion cannot be excluded. Prominent azygos suggesting increasing circulating volumesRight jugular catheter extends into the upper SVC

Output: Left basilar suspected atelectasis with persistent effusions


Instruction: Generate impression based on medical findings.

Input: Reason: s/p OLT, Check Pulmonary Status History: s/p OLT, Check Pulmonary Status Interval extubation.Basilar opacity, greater on the left, compatible with nonspecific consolidation and atelectasis, unchanged.Left jugular catheter with tip in the right atrium.

Output: Nonspecific basilar atelectasis and consolidation with no acute change.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.PICC placement. Right upper extremity PICC terminates at the SVC level. Other tubes and lines unchanged. Pleural fluid and atelectasis bilaterally, right greater than left, about the same.

Output: Right PICC tip at the SVC.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: sob, vomiting, eval for aspiration PNA History: sob, vomiting, eval for aspiration PNA Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male 22 years old Reason: evaluate for infiltrate History: cough, fever A bullet is present in the soft tissues of the anterior chest wall just inferior to the xiphoid process. Additional small metallic fragments are present posterior right lower chest wall.The cardiomediastinal silhouette is normal.No abnormal pulmonary opacity, pleural effusion or pneumothorax.

Output: Metallic foreign bodies as above. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: 7 years old female with screening for respiratory tuberculosis. The cardiothymic silhouette is normal. No focal lung opacity, pleural effusion, or pneumothorax.

Output: Normal examination. No radiographic evidence of tuberculosis.


Instruction: Generate impression based on medical findings.

Input: Reason: CP History: above Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female 39 years old. Reason: Is there acute chest? History: Sickle cell. Chest pain. SOB. Cardiomegaly, which appears to have improved since prior study. No specific evidence of infection or edema.Cholecystectomy clips are noted in the right upper.

Output: Cardiomegaly without evidence of acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 100 years old.Reason: fever workup History: fever Mild cardiomegaly with tortuous and calcified aorta, findings which are stable.Bibasilar opacities likely represent subsegmental atelectasis or scarring are also unchanged.No pneumothorax. No pleural effusion.

Output: Stable cardiopulmonary findings with no specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for pneumonia History: weakness, recent chemotherapy Port catheter with its tip in the SVC.No significant cardiopulmonary abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Evaluate shortness of breath. Moderate pleural effusions, similar to prior. Mild pulmonary edema. Unchanged cardiomegaly. Sternotomy wires with fragmentation of the lowermost wire present previously.

Output: Mild CHF.


Instruction: Generate impression based on medical findings.

Input: Dobbhoff placement Dobbhoff tube placed with tip projected in the mid gastric lumen. Unchanged right subclavian ICD, tip extends into the right atrium.Marked motion degrades sensitivity, however interval increasing bilateral effusions and pulmonary changes suggesting marked CHF. See subsequent report

Output: Dobbhoff tube placement


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: Please eval for acute pulm findings History: asthma exacerbation Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: hypoxia post CT removal, s/p esophagectomy History: hypoxia Left chest tube removed with a small left apical pneumothorax.Unchanged pleural effusions and basilar opacities.NG tube unchanged, the side port at the hemidiaphragm level.

Output: Small left apical pneumothorax following left chest tube removal.


Instruction: Generate impression based on medical findings.

Input: Reason: fall History: fall Mild cardiomegaly and mild left lower lobe subsegmental atelectasis.No sign of pneumothorax or fracture.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.CLL status post stem-cell transplant now with neutropenic fever. Right central line tip projects over the SVC. No significant pneumothorax. Right basal scarring. Coarse appearance of the lung interstitium with a fine micronodular pattern beyond the resolution of characterization by plain film.

Output: Subtle change in appearance of the lung interstitium. Suggest correlation with reduced dose unenhanced thoracic CT to exclude opportunistic pneumonia.


Instruction: Generate impression based on medical findings.

Input: History of weakness, evaluate for pneumonia.VIEWS: Chest PA/lateral (two views) 12/29/2015 Right chest port with tip in the right atrium.Cardiothymic silhouette is normal.Mild peribronchial thickening is present. No focal pulmonary opacities, pneumothorax, or pleural effusions.

Output: Airway hyperreactivity/bronchiolitis pattern.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: Malignant neoplasm of lower lobe of right lung ?? History: Malignant neoplasm of lower lobe of right lung ?? The cardiac and mediastinal contours are within normal limits.Surgical plates or tight the mediastinum.Status post right lower lobe resection. No new abnormal focal lung parenchymal opacities.Persistent small right pleural effusion, slightly decreased in size from prior. Suggestion of associated pleural thickening.The left pleural space is within normal limits.No osseous lesions are present.

Output: Status post right lower lobe resection. Persistent although improving small residual right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 27 years old.Reason: Evaluation for cardiopulmonary abnormalities History: Kidney Donor Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 25 years old.Shortness of breath question pneumonia. Normal heart size. No pneumothorax or visible pleural fluid. Mild subsegmental atelectasis in the posterior lower lobes. No focal airspace opacity.

Output: Mild subsegmental atelectasis. No signs of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Reason: eval for pna History: rising temp, new leukocytosis Small pleural effusions and basilar atelectasis likely accompanied by edema.Heart size upper normal.

Output: Nonspecific basilar opacities which could be edema although focal consolidation in the left retrocardiac region raises the possibility of infection.


Instruction: Generate impression based on medical findings.

Input: 7-month-old male postop cardiac patientVIEW: Chest AP (one view) 01/16/15 Right internal jugular central venous catheter tip is in the superior vena cava. Epicardial pacing leads and right-sided chest tube is unchanged in position. Cardiothymic silhouette is enlarged. No pleural effusion or pneumothorax. Unchanged perihilar and right basilar opacity.

Output: Mild pulmonary edema is unchanged.


Instruction: Generate impression based on medical findings.

Input: History of intermittent fusion and current shortness of breath Interval near complete resolution of previously described small effusions with a small fluid collection persisting on the right. Residual or recurrent minimal basilar streaky densities suggesting atelectasis and possibly scarring. Persistent yet currently mild though overall improving cardiomegaly.

Output: Improving basilar nonspecific patchy opacities and small fluid collections


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: eval lung fields History: s/p CABG, MVR, trach Tracheostomy. Enteric tube terminates beyond the field-of-view. Epicardial pacing wires are noted. Sternotomy fixation intact.No significant interval change in mild pulmonary edema and small bilateral effusions.No pneumothorax.Stable cardiomediastinal silhouette.

Output: No significant interval change in mild pulmonary edema and small bilateral effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old. Status post esophageal perforation. Evaluate stent position. Venous catheter, esophageal stent, and left chest tube, unchanged.Basilar opacities consistent with pleural effusions and atelectasis, unchanged.

Output: Stable positioning of esophageal stent without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: clavicle fracture History: pain, SOB Normal cardiac and mediastinal contours.Borderline low lung volumes.No pneumothorax, focal opacities, or pleural effusions. No displaced osseous fracture, though chest radiograph is insensitive for fracture detection.

Output: No evidence of clavicle or rib fracture; 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: Persistent oxygen requirement. Question of aspiration pneumonia. Low normal lung volumes. Dobbhoff tube sidehole remains at the level of the diaphragm, suggest advancement. Left jugular catheter tip at the SVC. Abdominal staples.Bilateral diffuse airspace opacities with decrease in groundglass component and increase in nodularity, most pronounced in the left lower and right upper lobes.

Output: Worsening pulmonary opacities consistent with aspiration and infection.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Reason: CHF exacerbation? History: as above Chronic appearing basilar interstitial opacities. Minimal pleural effusions. No pneumothorax. Severe cardiomegaly is unchanged. Surgical clips project over the upper mediastinum.

Output: Chronic basilar opacities, possibly chronic edema, and minimal pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.History of chest pain shortness of breath. The cardiomediastinal silhouette is obscured.Extensive, bilateral interstitial opacities with architectural distortion are unchanged from the prior examinations. There are no new focal areas of consolidation.

Output: Extensive, chronic pulmonary opacities and architectural distortion compatible with history of sarcoid. No new focal areas of consolidation.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old. Support devices are unchanged in position.Cardiomegaly unchanged. Diffuse pulmonary opacities, retrocardiac consolidation and pleural effusions stable. No pneumothorax

Output: No significant interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Postoperative day #1. Status post MVR. Evaluate lungs. Cardiomegaly with mild bibasilar opacities are stable. ET tube is 3 cm above the carina. Right jugular catheter tip in the RV outflow tract. Mediastinal drain is noted. No pneumothorax. Left ICD grossly intact. Left ventricular assist device is also noted.

Output: Cardiomegaly with small bibasilar opacities may reflect aspiration, stable.


Instruction: Generate impression based on medical findings.

Input: Reason: AMS in cirhosis History: SOB Small lung volumes with mild basilar atelectasis.No specific evidence of pneumonia or CHF.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: 69 year-old female, nodular calcified densities on recent chest x-ray. Please note that this noncontrast examination is insensitive for the detection of solid organ pathology.LUNGS AND PLEURA: No evidence of suspicious nodules or masses. No focal consolidation, edema or pleural fluid.MEDIASTINUM AND HILA: The cardiac size is normal. No pericardial fluid. No pathologically enlarged hilar or mediastinal lymph nodes. The left lobe of the thyroid is enlarged measuring 3.7 x 3.2 cm in axial image 26/106 causing rightward deviation and transverse narrowing of the adjacent trachea to approximately 1.6 cm.CHEST WALL: Subchondral cyst within the right humeral head, probably degenerative, correlates with the abnormality seen on recent prior chest film. Scattered small axillary lymph nodes are noted which contain benign-appearing fatty hila.UPPER ABDOMEN: Hypodense lesion in the dome of the liver measures 1.4 x 1.3 cm on axial image 94/106 and is incompletely evaluated on this noncontrast examination.

Output: 1.No pulmonary or osseous abnormality is seen to correlate with the nodular opacities reported on the recent prior chest film.2.Enlarged left lobe of the thyroid causing mass effect on the trachea as above. Please note CT cannot differentiate benign from non-benign causes of thyroid pathology and further management should be on a clinical basis.3.Scattered small axillary lymph nodes.4.Nonspecific liver hypodense lesion, too small to characterize by noncontrast CT as above.


Instruction: Generate impression based on medical findings.

Input: Male, 84 years old.Cough, AMS. Evaluate for pneumonia. Unchanged bibasilar atelectasis. No focal pulmonary opacities to suggest infection. No pleural effusions or pneumothorax.Cardiomediastinal silhouette is within normal limits.

Output: Unchanged bibasilar atelectasis. No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: 57-year-old male. Renal cell cancer, status post left nephrectomy. Evaluate disease status. CHEST: LUNGS AND PLEURA: Bilateral emphysematous changes bilaterally. MEDIASTINUM AND HILA: Nonenlarged mediastinal lymph nodes are stable. CHEST WALL: No significant abnormality noted ABDOMEN: LIVER, BILIARY TRACT: Subtle hyperdense lesions with the largest measuring less than 1 cm in the liver are faintly seen, unchanged since the prior exam. The lesion near the dome, best seen on image number 71/232 is not significantly changed from CT dated 12/19/2005. Other similar lesions were seen on the 1/26/08 exam, but not on the current study. These are too small to actually characterize and may represent perfusion differences. No definite evidence of metastases. SPLEEN: No significant abnormality noted PANCREAS: No significant abnormality noted ADRENAL GLANDS: Right adrenal gland is unremarkable. KIDNEYS, URETERS: Right kidney is unremarkable. No evidence of recurrent disease in the left nephrectomy bed. 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: PROSTATE, SEMINAL VESICLES: 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: Stable examination. No evidence of metastases.


Instruction: Generate impression based on medical findings.

Input: Lung transplant Persistent bilateral pleural effusions greater on the left with interval resolution of previously observed mild small hydropneumothorax. Underlying atelectasis and edema remains moderate and unchanged. A gastric tube, NG tube, Dobbhoff and right jugular catheters are all otherwise similar.Cardiac and mediastinal contours are otherwise within limits.

Output: Interval resolution of previously observed small hydropneumothoraces, persistent effusions


Instruction: Generate impression based on medical findings.

Input: Female, 38 years old. Right jugular catheter extending to the area of the SVC with no pneumothorax or other complications.Cardiomegaly and basilar subsegmental atelectasis, new since previous.

Output: New catheter with no complications.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Reason: Pneumonia, effusion, cardiomegaly, widened mediastinum History: Chest Pain No significant cardiopulmonary abnormality.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: ET tube placement History: MICU Small lung volumes with chronic appearing interstitial opacities likely fibrosis.Mild cardiomegaly.ET tube tip approximately 2 cm above the carina.An NG tube terminates in the stomach.Despite the NG tube there is marked gas distention of the stomach.

Output: ET tube tip approximately 2 cm above the carina. Interstitial opacities likely fibrosis. Marked gas distention of the stomach.


Instruction: Generate impression based on medical findings.

Input: Reason: 63Yrs old M with MDS s/p MUD stem cell transplant. New cough with wheezing and fever. Eval for pneumonia vs other infection. History: cough, fever, wheezing, h/o immuncompromise Unremarkable cardiac and mediastinal silhouette. Focal streaky opacity at the left base with partial obscuration of the left hemidiaphragm on the lateral view, compatible with infection and atelectasis.No other significant findings.

Output: New left lower lobe opacity, nonspecific but compatible with pneumonia in the appropriate clinical setting.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Acute stroke, ESRD, CHF. Interval removal of previously seen central line.Normal heart size. No mediastinal widening.Diffuse dense and nodular opacities present since 2011 most likely reflect granulomas.Mild central bronchial wall thickening and vascular unsharpness suggestive of hypervolemia, but there is only minimal interstitial thickening. Mild atelectasis in the lingula.

Output: Mild hypervolemia.


Instruction: Generate impression based on medical findings.

Input: Age: 32 yearsGender: MaleReason for Study: Reason: leukocytosis, eval for infiltrate History: see above Enteric tube with its tip beyond the margin of the image. Left upper quadrant drainage tube redemonstrated.Interval clearing of the pleural effusions and basilar atelectasis.No focal air space opacities or pleural effusions identified on this exam.

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


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: eval for SOB History: CP, SOB The cardiomediastinal silhouette is within normal limits. The lungs are clear of interstitial and air space opacities. No pleural effusions.No pneumothorax. Median sternotomy intact.

Output: No acute cardiopulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Hypoxemia question pneumothorax. Question deep sulcus on prior x-ray. Tubes and lines unchanged. Diffuse airspace opacities with slight improvement allowing for limitations of significant artifact from an overlying warming blanket.Lucency in the left hemithorax is felt most likely to represent artifact. This can be confirmed by a follow-up examination after removal of warming blanket, sheeting and other external fabric from this area of the patient.

Output: Limited exam, no conclusive pneumothorax. Diffuse airspace opacities appear to be slightly improving.


Instruction: Generate impression based on medical findings.

Input: Age: 58 yearsGender: MaleReason for Study: Reason: post intub History: post intubation ET tube is been placed with its tip in the right mainstem bronchus.There is subsequent left lung atelectasis as well as accompanying pleural effusion.Interstitial opacities throughout the right lung compatible with edema.

Output: ET tube with its tip well within the right mainstem bronchus and resulting left lung atelectasis. Subsequent imaging demonstrates appropriate repositioning with improved aeration in the left lung.


Instruction: Generate impression based on medical findings.

Input: 79 year-old female with shortness of breath. Evaluate right lung fluid collection CHEST:LUNGS AND PLEURA: Heterogeneously enhancing, infiltrative mass seen occupying the majority of the right lower lobe. It obliterates the right intermediate bronchus with associated lower lobe atelectasis. There is a large right pleural effusion as well, which compresses the right upper lobe. The mass extends into the mediastinum with probable involvement of the subcarinal lymph nodes.MEDIASTINUM AND HILA: Significant subcarinal lymphadenopathy from infiltrating right lung mass. Definitive measurements are not possible given the infiltrative nature of the probable tumor.Heart size normal without pericardial effusion. Moderate vascular calcifications affect the right coronary, left circumflex, and LAD arteries.CHEST WALL: No significant abnormality noted. UPPER ABDOMEN: Multiple, heterogeneously enhancing lesions in the liver of varying sizes likely represent metastatic disease. The liver is only partially visualized but one of the larger lesions (series 3, image 82) measures 2.4 x 2.7 cm.Nonspecific left adrenal nodule.

Output: Findings highly suspicious for primary lung cancer with hepatic metastases. Large right pleural effusion with probable loculation. Nonspecific left adrenal nodule.


Instruction: Generate impression based on medical findings.

Input: Male, 38 years old.Right shoulder gunshot wound. Evaluate for retained bullet in pneumothorax. The cardiomediastinal silhouette is within normal limits. No focal airspace opacity, significant pleural effusion, or pneumothorax. There is a questionable focus of subcutaneous emphysema projected over the body of the scapula. Recommend correlation with dedicated shoulder radiographs. No radiopaque foreign objects.

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: Male, 39 years old.Reason: IABP placement History: IABP placement IABP marker in the proximal descending thoracic aorta. Swan-Ganz catheter tip in right pulmonary artery. ICD unchanged.Stable cardiomegaly with no significant pulmonary edema.

Output: IABP marker in the proximal descending thoracic aorta.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: Evaluate lung fields for pna, aspiration, effusions and ETT placement History: Hx of ILD with recurrent asp pna and pleural effusions, hypoxic Endotracheal tube tip is 4 cm from the carina. Left central venous catheter tip is at the brachiocephalic confluence, unchanged. Low lung volumes. Slight interval increase in basilar interstitial opacities consistent with edema and possible aspiration. Questionable new airspace opacity at the right lung base could represent pneumonia or acute exacerbation of the underlying interstitial process described on CT dated 11/22/2015. No pleural effusions. No pneumothorax.

Output: Endotracheal tube tip is 4 cm from the carina.Slight interval increase in basilar interstitial opacities consistent with edema and possible aspiration. Questionable new airspace opacity at the right lung base could represent pneumonia or acute exacerbation of the underlying interstitial process described on CT dated 11/22/2015 and demonstrated on multiple interval radiographs. If further imaging evaluation is clinically indicated, CT of the chest could be considered.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: ET tube placement History: ET tube in place Mild cardiomegaly.Small lung volumes with nonspecific basilar opacities suggestive of subsegmental atelectasis.Distended azygos vein.ET tube tip approximately 5 cm above the carina.

Output: Acro ET5


Instruction: Generate impression based on medical findings.

Input: 62 year-old female with lung transplant, chest discomfort post hitting her chest against the car door No focal airspace opacities. Blunting of the right costophrenic angle unchanged may be due to small pleural effusion or thickening. No pneumothorax. Cardiomediastinal silhouette is unremarkable. No displaced rib fractures.

Output: No interval change in cardiopulmonary appearance. No specific evidence of displaced rib fracture or pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.Reason: infiltrate vs pneumo vs atelectassi History: pleuritic cp Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. Status post cholecystectomy.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Male, 32 years old.Reason: upper respiratory infection History: see above Small lung volumes with mild basilar atelectasis on the right.Heart size near upper normal.Extensive gaseous distention of the stomach is noted and an NG tube may be advisable.

Output: Small lung volumes with right basilar subsegmental atelectasis. Extensive gaseous distention of the stomach noted.


Instruction: Generate impression based on medical findings.

Input: Chest pain Scattered biapical scarring and granuloma without superimposed new acute cardiopulmonary canal. Mild COPD changes

Output: COPD with superimposed granulomatous disease. No acute abnormalities


Instruction: Generate impression based on medical findings.

Input: 49-year-old female with history breast cancer, cancer, and thymoma status post resection, chemo radiotherapy. CHEST:LUNGS AND PLEURA: Micronodules bilaterally are unchanged. Reference right middle lobe nodule (series 6, image 54) measures 6 x 5 mm (stable). No suspicious nodules, masses, or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.Large hiatal hernia.CHEST WALL: Breast implants.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Heart failure Mediastinal and bilateral basilar chest tubes, cannula and right jugular catheter are all unchanged. No appreciable significant pneumothoracesUnderlying cardiopulmonary appearance is also similar with scattered nonspecific patchy mixed opacities with moderate effusions

Output: Chest tubes are unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Reason: s/p ECMO placement History: na New ECMO cannula from below overlying the RA/SVC junction. Venous catheters ET tube and enteric tube stable.Diffuse airspace and interstitial opacity is stable. Loculated left pneumothorax is stable.

Output: New ECMO cannula from below overlying the RA/SVC junction.


Instruction: Generate impression based on medical findings.

Input: Female, 81 years old.Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath Moderate right pleural effusion unchanged with right basilar consolidation.Right pleural drain placed.No significant pneumothorax.Mild atelectasis left lung base.

Output: Right pleural drain placed, with a persistent right pleural effusion and overlying consolidation. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old. Reason: eval lung fields History: chest pain Mild bibasilar subsegmental scarring or atelectasis. Probably mild left-sided pleural scarring. Oblong opacity in the mid aspect the left lung with associated punctate metallic opacities which may represent sequela of previous trauma. Mild cardiomegaly. Postsurgical changes in the upper abdomen.

Output: Oblong opacity in the mid aspect the left lung with associated punctate metallic opacities which may represent sequela of previous trauma. Correlation with chest CT is suggested if clinically indicated.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: assess PICC line placement History: not working despite TPA use to de-clot There has been interval removal of the left-sided tunneled PICC line with interval placement of a triple-lumen central line, the tip in the projection of the azygos vein/superior vena cava.No pneumothorax.Heart size normal.Lungs clear.

Output: 1 replacement of left-sided line with a triple-lumen central venous catheter, the tip in projection of the azygos/superior Vena cava.2. No specific evidence of infection or edema


Instruction: Generate impression based on medical findings.

Input: Male, 38 years old.Reason: evaluate for pneumonia History: hypoxia, wheezing, cough Subtle nodular interstitial opacities.No pleural effusions or evidence of infection.Unremarkable mediastinal contours and cardiac silhouette.

Output: Mild basilar interstitial opacities which could be edema or bronchiolitis.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: IABP eval History: IABP Heart size upper normal.No specific evidence of infection or edema.IABP catheter proximal marker 3 cm below the top of the aortic arch.Left subclavian ICD, leads unchanged in position.LAD stent.

Output: IABP catheter proximal marker 3 cm below the top of the aortic arch.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for acute chest History: sob, VOC pain x1 day Mild cardiomegaly and vascular redistribution consistent with chronic anemia. Skeletal findings consistent with sickle cell disease.Port catheter with its tip in the SVC.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: 52-year-old male with HIV, Kaposi's sarcoma, and DVT found to have patchy airspace opacity in left lower lung on chest x-ray. Want to evaluate for Kaposi's. CHEST:LUNGS AND PLEURA: Small bibasilar (left greater than right) peribronchiolar nodular opacities with adjacent septal and pleural thickening. Right basilar pleural thickening is noted as well. No suspicious nodules or masses identified.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.CHEST WALL: No significant abnormality noted. UPPER ABDOMEN: No significant abnormality noted.

Output: Nonspecific left greater than right lower lobe nodular opacities. Bibasilar pleural thickening is noted as well. Please correlate for immune reconstitution syndrome and opportunistic infection; also please correlate with findings on bronchoscopy if clinically appropriate.


Instruction: Generate impression based on medical findings.

Input: 62-year-old male with history of colon cancer CHEST:LUNGS AND PLEURA: Reference left lower lobe nodule measures 8 x 6 mm image number 61, series number 4, not significantly changed from previous study. Right-sided pleural effusion has resolved. Other bilateral nodules are also not significantly changed. Soft and demonstrate central cavitation.MEDIASTINUM AND HILA: The tip of the right port catheter is in the SVC and there is redundancy in the catheter.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Index segment 8 lesion measures 3 by 1.4 cm on image number 77, series number 3, not significantly changed from previous study. Other ill-defined hypodense lesions throughout the liver are also unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral simple appearing cysts unchanged.RETROPERITONEUM, LYMPH NODES: Reference portacaval lymph node measures 4 x 1.2 cm on image number 95, series number 3. No significant change. IVC filter is in place.BOWEL, MESENTERY: Nonobstructing small bowel loops herniated through the ventral hernia are unchanged.BONES, SOFT TISSUES: Sclerotic lesion at the L3 vertebral body has slightly increased in size.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No significant change from previous CT other than slight increase in the size of the sclerotic lesion in the L3 vertebral body


Instruction: Generate impression based on medical findings.

Input: Male, 22 years old.Reason: intubated History: now intubated ET tube tip approximately 5 cm above the carina.Enteric tube traversing the esophagus.Bilateral lower zone patchy airspace opacities, highly suggestive of aspiration pneumonia.

Output: Extensive bilateral aspiration.


Instruction: Generate impression based on medical findings.

Input: Testicular cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM 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: Index aortocaval lymph node measures 6 mm in diameter image number 130, series number 3, slightly smaller compared to previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Subcentimeter aortocaval lymph node is minimally smaller.


Instruction: Generate impression based on medical findings.

Input: Check pleural effusion Interval right basilar chest tube placed, tip projects towards midline. Marked interval decrease size of the Naumann mild to moderate right pleural effusion. Underlying focal opacity with preservation of clear right upper and left lungs.Cardiac and mediastinal contours otherwise remain within limits given scoliosis and mild rotation

Output: Right chest tube placed


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Reason: eval for infection History: increased somnolence Scarlike nodular opacities noted, unchanged on the left and improved on the right.COPD.Heart size upper normal.Left subclavian pacemaker, leads unchanged in position.

Output: Scarlike opacities. COPD. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: comparison History: intubated Endotracheal tube tip approximately 3 cm above the carina. Enteric tube looped in stomach with tip projecting over the gastric antrum.No significant change in left retrocardiac opacity and probable small pleural effusions. No pneumothorax. The heart size is stable.

Output: Endotracheal tube tip approximately 3 cm above the carina, unchanged.


Instruction: Generate impression based on medical findings.

Input: Age: 38 yearsGender: FemaleReason for Study: Reason: ro worsening pulm edema History: hypoxia with positive fluid balance Left-sided ICD and right IJ venous catheter unchanged.Swan-Ganz catheter has been removed.Stable marked cardiac enlargement with prominence of the central pulmonary vasculature.The diffuse interstitial and airspace opacities compatible with edema similar in appearance prior exam.Left retrocardiac consolidation/atelectasis redemonstrated.No new pulmonary opacities identified.

Output: Interval removal of Swan-Ganz catheter. Cardiomegaly and pulmonary opacities compatible with edema without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Reason: Evaluate for source of fever History: fever Basilar opacities compatible with atelectasis and small pleural effusions, not significantly changed.The differential diagnosis includes aspiration and infection.

Output: Basilar atelectasis and small pleural effusions without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Reason: syncope workup History: above Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. Diffuse idiopathic skeletal hyperostosis.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o disease process History: productive cough, bodyahces Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for pnx History: hypoxic ET tube tip approximately 3 cm above the carina.Right jugular catheter tip in the SVC. Feeding tube tip in the stomach.Extensive atelectasis and consolidation in the right lung with a right upper lobe cavity, not significantly changed.Severe emphysema on the left with multiple bronchial valves in place.No pneumothorax or other acute change.

Output: Extensive abnormalities with no acute change.


Instruction: Generate impression based on medical findings.

Input: Dyspnea Motion degrades sensitivity.No acute cardiopulmonary abnormality preserved in this limited evaluation. Mild chronic appearing interstitial changes are observed with scattered calcified granuloma greater on the right. Prosthetic right aortic valve. Midline sternotomy

Output: No discrete acute cardiopulmonary abnormality within the limitations described


Instruction: Generate impression based on medical findings.

Input: Male, 40 years old.Reason: hx of chf, chest pain sob History: chest pain, sob Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 30 years old.Reason: ro PNA History: cough, shortness of breath The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax.Subtle left basilar opacity, likely atelectasis.

Output: Subtle left basilar atelectasis without specific evidence of infection or failure.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: eval opacities History: decreased mental status, large mucous plug Mild cardiomegaly.No focal airspace abnormality. No large effusions.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: Tachypnea History: as above Feeding tube is looped within the stomach. No new focal pleural parenchymal opacity. No large pleural effusion or pneumothorax. Unchanged heart size.

Output: No focal lung consolidation or evidence of overt left-sided heart failure.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: Shortness of breath Lines and tubes are unchanged. No substantial change in bibasilar pleural-parenchymal opacities. Unchanged cardiomegaly. Probable small pleural effusions, as before. No pneumothorax. Newly apparent curvilinear lucencies overlying the upper left hemithorax which can be reevaluated on imaging follow-up.

Output: No substantial change in bibasilar pleural-parenchymal opacities. Probable small pleural effusions, as before. Newly apparent curvilinear lucencies overlying the upper left hemithorax which can be reevaluated on imaging follow-up.


Instruction: Generate impression based on medical findings.

Input: Reason: Swan placement History: None Swan-Ganz catheter tip in the right main pulmonary artery.Normal heart size and no sign of pulmonary edema. Status post median sternotomy with intact sternal fixation devices.

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


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: s/p pleurectomy, decortication History: shortness of breath Right sided chest tubes again noted. Small right-sided pneumothorax with right-sided subcutaneous emphysema again noted. Unchanged port catheter. Patchy bibasilar opacities, unchanged. Unchanged cardiomegaly.

Output: Right sided chest tubes again noted. Small right-sided pneumothorax with right-sided subcutaneous emphysema again noted.


Instruction: Generate impression based on medical findings.

Input: 37-year-old male with history of bilateral lung transplants now with abdominal distention and increasing lactate levels. Please evaluate bilateral lungs as well as evaluate for bowel ischemia. CHEST:LUNGS AND PLEURA: Bilateral pleural effusions, left greater than right, with associated compressive atelectasis as well as patchy opacities in bilateral lower lobes which have progressed on comparison to previous exam with groundglass opacities up to the level of the apices bilaterally.MEDIASTINUM AND HILA: New pericardial effusion.ET tube tip is appropriately located above the carina.CHEST WALL: Central venous catheter tip is noted to be at the cavoatrial junction. ABDOMEN:LIVER, BILIARY TRACT: Nodular liver contour compatible with cirrhosis. Significant atrophy of the liver on comparison to previous exam with patchy attenuation. Decreased caliber of the IVC as well as the portal vein, both of which remain patent. However patchy areas of hypoattenuation in the region of poorly visualized hepatic veins are most consistent with hepatic vein thrombosis.SPLEEN: Splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered areas of hypoattenuation in bilateral kidneys, concerning for areas of infarction (for example on series 4, image 128/240). Embolic etiology is on the differential.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse mucosal enhancement as well as dilatation of the colon. No evidence of ischemic bowel, free air, or perforation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: NG tube is curved within the stomach with tip located at the gastric fundus.Increased ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Foley catheter in place.LYMPH NODES: No significant pelvic lymphadenopathy.BOWEL, MESENTERY: Diffuse fatty infiltration of the rectum and colonic wall, which may be due to long-standing colitis.Rectal tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Bilateral fat containing inguinal hernias, right greater than left. Right inguinal hernia sac contains increased amount of free fluid on comparison to previous exam (best seen on coronal image 63/110).Left femoral central venous catheter is noted.

Output: 1.Patchy areas of hypoattenuation is noted in the liver, especially in the region of poorly visualized hepatic veins. As described above, this is concerning for hepatic vein thrombosis.2.Hypoattenuating foci in bilateral kidneys consistent with areas of infarction given the time frame in which they evolved; possibly due to emboli.3.Bilateral pleural effusions with associated atelectasis. Worsening patchy opacities in bilateral lower lobes with groundglass opacification up to the level of the apices bilaterally.4.Diffuse colonic wall thickening and interval dilatation with no evidence of ischemia, perforation, or free air.5.Increasing ascites.6.New pericardial effusion.7.Bilateral internal hernias with increasing fluid in both hernia sacs.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Fever. Evaluate for infiltrates. Unchanged low lung volumes. No focal pulmonary opacities to suggest infection. Bilateral pulmonary nodules better appreciated on recent CT. No pleural effusion or pneumothorax.Cardiomediastinal silhouette within normal limits.Right chest wall port, tip in SVC. Gastrostomy tube projecting over the left upper quadrant.

Output: No focal pulmonary opacities to suggest infection.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Patient with history of transient ischemic attack and cerebral infarction, evaluate. Cardiomediastinal silhouette is normal. No focal airspace opacity, pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: 52 yo F w/ shortness of breath, wheezing, eval for pulmonary infiltrate 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: Stroke Left basilar atelectasis without distinct additional cardiopulmonary abnormality

Output: Atelectasis


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.History: Pulmonary Langerhans Cell Histiocytosis. Bilateral pneumothoraces Bilateral chest tubes unchanged in position.Severe cystic lung disease and diffuse reticular opacification, consistent with PLCH. Bilateral pneumothoraces with no significant interval change.

Output: No significant interval change in bilateral pneumothoraces