Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: eval for edema History: chf Mild leftward patient rotation. No focal lung consolidation. Moderate cardiomegaly. Status post sternotomy. No pleural effusion or pneumothorax. Large patient body habitus.

Output: No acute cardiopulmonary process on radiography though the study is limited by large patient body habitus.


Instruction: Generate impression based on medical findings.

Input: Age: 75 yearsGender: MaleReason for Study: Reason: syncope History: syncope Left PICC line with its tip in the SVC.Decreased lung volumes with stable cardiomediastinal silhouette.No new pulmonary opacities identified.No large pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: 61 years, Male. Reason: NGT position NG tube coiled in gastric body with tip in the antropyloric region. Diffuse dilatation of small bowel loops is compatible with severe generalized ileus. Midline surgical staples are noted. Left pleural effusion; please see same day chest radiograph for additional details.

Output: 1.NG tube coiled in gastric body with tip in the antropyloric region.2.Severe generalized ileus.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: aspiration pneumonia History: aspiration pneumonia Rightward patient rotation. Low lung volumes. Patchy left basilar opacity. Question mild cardiomegaly. No pneumothorax.

Output: Patchy left basilar opacity which may represent atelectasis and/or consolidated lung. Query mild cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: copd exacerbation? Fluid overload? History: sob Query new hazy opacities throughout the lungs without focal lung consolidation. No large pleural effusion or pneumothorax. Moderate cardiomegaly again noted.

Output: Query new hazy opacities throughout the lungs without focal lung consolidation which could represent mild edema, atypical infection, or inflammatory lung disease.


Instruction: Generate impression based on medical findings.

Input: 44-year-old male with renal cell carcinoma (bx 6/22 showed clear cell) on chemotherapy evaluate for disease progression and appropriateness of nephrectomy. CHEST:LUNGS AND PLEURA: There is a oval-shaped, spiculated lung mass in the right middle lobe, measuring 2.2 cm by 2.8 cm on axial image 34/89, series 4.MEDIASTINUM AND HILA: Multiple borderline enlarged lymph nodes are noted in the mediastinum. Heart size normal without pericardial effusion.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: There is lobulated, exophytic, heterogeneous mass in the upper pole of the left kidney, measuring 11 cm by 10 cm (axial image 94/206, series 3), and involving the pararenal fascia.There is also an infiltrating, heterogeneous mass lesion affecting both the upper and lower poles of the right kidney. The mass in the upper lobe measures 7.1 cm x 3.5 cm on coronal image 59/98, series 80244. There is heterogeneous thrombus within the main right renal vein that appears similar to the tumor mass, consistent with a tumor thrombus. The tumor thrombus extends into the IVC, causing focal dilatation.There is no involvement of the collecting system or any evidence of hydronephrosis.In the lower pole of the left kidney, there is a hypodense lesion that is too small to characterize.RETROPERITONEUM, LYMPH NODES: Multiple and large retroperitoneal lymph nodes are again seen. The reference left renal peri-hilar node is stable and measures 2.4 x 1.6 on axial image 105/206, series 3, compared to 2.5 cm x 1.5 cm on the prior study. The reference para-aortic node measures 2.0 cm x 1.6 cm on axial image 109/206, series 3, compared to 2.0 cm x 18 cm on the prior study. Several enlarged retrocrural lymph nodes are also seen at the reference lesion measuring 1.2 cm x 1.5 cm on axial image 60/26, series 3.BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: Degenerative changes of the spine are noted with bilateral bone islands in the iliac bones of the pelvis.OTHER:No other significant abnormality noted.d.PELVIS:PROSTATE, SEMINAL VESICLES:No significant abnormality noted.d.BLADDER:No significant abnormality noted.d.LYMPH NODES:No pelvic lymphadenopathy noted.d.BOWEL, MESENTERY:No significant abnormality noted.d.BONES, SOFT TISSUES:No significant abnormality noted.d.OTHER:No other significant abnormality noted.d.

Output: 1. Stable bilateral renal masses with tumor thrombus within the left renal vein and extending into the infrahepatic IVC 2. Right middle lobe spiculated mass is concerning for metastatic disease given patient's known history of renal cell carcinoma (bx left kidney 6/09 showed clear cell carcinoma)3.Stable mediastinal retrocural and retroperitoneal adenopathy


Instruction: Generate impression based on medical findings.

Input: 54 year old female with pain upon inspiration, evaluate for pneumonia. No focal airspace opacities. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable.

Output: No acute cardiopulmonary abnormalities. No specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: placed a 2nd chest tube for remaining pneumothorax 2nd right chest tube directed towards apex. NG tube in the stomach. Endotracheal tube tip 4 cm above the carina. Venous catheter unchanged.Right apical pneumothorax has improved. Stable cardiac silhouette. Diffuse pulmonary opacities have improved. No large effusions.

Output: Right apical pneumothorax improved.


Instruction: Generate impression based on medical findings.

Input: Age: 76 yearsGender: MaleReason for Study: Reason: Central Line History: central line Right IJ venous catheter is in place with its tip in the SVC.No evidence of pneumothorax.Stable cardiomediastinal silhouette.Persistent elevation right hemidiaphragm and probable small right pleural effusion.

Output: Interval placement right IJ venous catheter without complication. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Reason: cardiomegaly, rib frx, pneumonia, effusion History: midline subcostal pain reproducible on exam x 5 days. Normal heart size with a mildly tortuous aorta.Pleural or extrapleural nodule at the periphery of the right upper lobe, measuring approximately 15 x 30mm, not appreciably changed over the past 7 months. This is most likely benign, such as a pleural lipoma, and unrelated to the patient's symptoms. However a CT scan is recommended for further evaluation unless previous radiographs can be obtained from elsewhere to confirm stability over a longer period.No other significant pulmonary abnormalities.

Output: Right upper lobe pleural or subpleural nodule, for which a contrast enhanced CT scan is recommended. The discrepancy was communicated with the ED.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: status post right atrial lead extraction and CIED upgrade to CRT-D (implant of RA lead and LV CS lead) --> r/o pneumothorax and evaluate lead positions History: as above Median sternotomy, heart size normal.Left subclavian biventricular ICD, leads in appropriate positions, upgraded since the prior study.No significant pneumothorax.

Output: Left ICD upgrade, without pneumothorax or other complication.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: 64M w/ ECMO cannulas Multiple ECMO cannulas unchanged position. Left subclavian sheath and catheter at the left lung base, unchanged.Stable cardiomediastinal silhouette. Mixed interstitial and airspace opacities throughout both lungs, slightly increased in the right mid and lower lung. Previously noted left base pneumothorax difficult to visualize.

Output: Slight interval increase in airspace opacities in the right mid and lower lung, consistent with worsening pulmonary edema. Stable support devices.


Instruction: Generate impression based on medical findings.

Input: 61-year-old female, intubated, sedated postop day 1. Line check. Patient with history of burns status post debridement of the upper and lower extremity on 6/2/2016. Tracheostomy tube tip 6 cm above the carina. A surgical staple in the left midlung is again seen.Improved aeration of the lungs with mild residual perihilar interstitial opacities. Peripheral right midlung nodule corresponds to the right lower lobe nodule seen on recent CT study. No new focal airspace opacity. No significant pleural effusions. No pneumothorax. Normal cardiomediastinal silhouette.

Output: 1. Improved aeration of the lungs likely improving edema/atelectasis.2. Right lower lobe nodule corresponds to that seen on recent CT study.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Check pulmonary status. Exam limited by chest wall deformity and resultant architectural distortion as well as spinal stabilization rods obscuring the midline. Tracheostomy tube is present and terminates above the level of the carina. No pneumothorax. Increased opacity projecting over the right hemithorax may be secondary to layering pleural fluid. Septal occluder device.

Output: Markedly limited exam with low lung volumes and suspected pleural effusions. Ultrasound may be of use for confirmation of pleural fluid. Assessment for pulmonary edema is markedly limited, but none is observed in the aerated portion of the left upper lobe.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Reason: Pneumothorax; Post device placement in EP Lab History: Post device placement in EP Lab Small right pleural effusion and basilar subsegmental atelectasis.Heart size normal, with coronary stents. No pneumothorax following recent left subclavian ICD placement.

Output: No significant pneumothorax. Left subclavian ICD, leads unchanged in position.


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Reason: shortness of breath Septal thickening and basilar opacities with small pleural effusions. Mild cardiomegaly. No pneumothorax. Feeding tube extends inferiorly off the field-of-view. Aortic atherosclerosis. Lumbar spinal fusion hardware, incompletely visualized. Staples overlie the left upper aspect of the abdomen. Surgical screw noted in the left shoulder.

Output: Congestive heart failure.


Instruction: Generate impression based on medical findings.

Input: Postthoracentesis Tracheostomy tube unchanged without interval new cardiopulmonary abnormalities. Bilateral pleural effusions greater on the right with underlying atelectasis, the right fluid collection may be slightly smaller however difficult to confirm with patient in the semiupright position. Please see subsequent reportRight PICC line extends into the proximal SVC

Output: . Gastric tube unchanged and no immediate postprocedural complication


Instruction: Generate impression based on medical findings.

Input: Reason: eval pna History: cough, sob Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 28 years old.Reason: clavicular frx rib frx History: rt pain Right IJ port catheter with tip overlying the SVC.Cardiac silhouette is normal in size.Low lung volumes with bronchovascular crowding and element of interstitial prominence suggesting mild edema. Small to moderate left pleural effusion with passive atelectasis. Minimal right basilar atelectasis and trace pleural effusion also present. No pneumothorax.No evidence of displaced rib or clavicular fracture on limited chest radiography.

Output: 1.Moderate left pleural effusion with associated atelectasis.2.Low lung volumes with mild interstitial edema pattern.3.No evidence of displaced rib or clavicular fracture on limited chest radiography. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: pna? History: leukocytosis Cardiac silhouette is obscured on the left.Moderate to large left-sided pleural effusion with underlying atelectasis. Mild right basilar atelectasis.Remote right sixth rib fracture deformity. No acute osseous changes.

Output: Moderate to large left pleural effusion with underlying atelectasis better demonstrated on visualized lung bases on CT abdomen and pelvis obtained the same day earlier.


Instruction: Generate impression based on medical findings.

Input: Age: 66 yearsGender: FemaleReason for Study: Reason: 7/28/15 Right thoracoscopic lung biopsy History: none Interval removal of a right-sided chest tube.No significant pneumothorax.Decreased lung volumes with right basilar opacity compatible with small effusion and atelectasis.Stable cardiac enlargement.Predominantly peripheral interstitial opacities compatible with fibrosis.

Output: Interval removal of right-sided chest tube. No significant pneumothorax identified. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: eval lung fields History: eval lung fields Cardiomegaly with a right pleural effusion and basilar subsegmental atelectasis suggestive of CHF, gradually improving over the last two days.Median sternotomy.IABP catheter proximal marker just below the top of the aortic arch.Left PICC, tip in the SVC.

Output: Gradually improving right pleural effusion and nonspecific basilar atelectasis with moderate cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: 26 years old Male. Reason: Evaluate for interval change and pulmonary edema History: SOB. Nonspecific opacities are seen in the bilateral mid and lower lungs are stable, which may represent infection, aspiration or edema. The cardiac silhouette is normal. The feeding tube has been removed. The NG tube is in position. The tip of the right IJ catheter projects over the SVC.

Output: Stable bilateral airspace opacities, which may represent infection or aspiration or edema. Suggest follow-up.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.History of chronic cough. The cardiomediastinal silhouette is normal.No focal pulmonary opacities or pleural effusions.Azygos pseudolobe noted.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Status post Pleurx placement assess for pneumothorax or other acute changes. Left Pleurx catheter tip projects over the lateral costophrenic angle. Left hydropneumothorax with decrease in pneumothorax component and slight increase in pleural fluid volume. No pneumothorax on the right. Right chest port unchanged in position. Loculated pleural fluid on the right about the same. Diffuse interstitial and airspace opacities bilaterally; opacities in the periphery of the right lung are becoming confluent with increasing volume loss at the base.

Output: Slowly improving left pneumothorax, now with maximal pleural separation from the chest wall about 6 mm at the apex. Worsening atelectasis and confluent airspace opacities on the right. Other findings without significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 78 years old.Reason: Chest pain Elevation of right hemidiaphragm again noted. No new focal pleural parenchymal opacity. Biapical pleural-parenchymal scarring again noted. Normal heart size. Aortic atherosclerosis, as before. Status post cholecystectomy. Diffuse osteopenia with mild multilevel thoracic compression deformities again noted.

Output: Elevation of right hemidiaphragm again noted. No new focal pleural parenchymal opacity. Biapical pleural-parenchymal scarring again noted.Diffuse osteopenia with mild multilevel thoracic compression deformities again noted.


Instruction: Generate impression based on medical findings.

Input: 60 year old female with weakness, evaluate for mass. No focal air space opacities.No pleural effusion or pneumothorax.Cardiomediastinal silhouette is unremarkable.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Reason: pleaural effusion History: desat, inc O2 requirement Unchanged enlargement of the cardiomediastinal silhouette with dense aortic arch and mitral annular calcifications. Interval increase in bilateral left greater than right pleural effusions with underlying consolidation/atelectasis. Patchy perihilar airspace opacities have also increased since the prior exam. No pneumothorax.Multiple healed right-sided rib fractures. Right base peripherally calcified lesion is unchanged. Suture material noted in the right mid abdomen.

Output: Interval increase in patchy perihilar opacities and pleural effusions, consistent with worsening pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 36 years old.Reason: sharp chest pain History: sharp chest pain Minimal basilar scarring or subsegmental atelectasis with small lung volumes.No other significant pulmonary or pleural abnormality.Unremarkable mediastinal contours and cardiac silhouette.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 89 years old.Enteric tube. Enteric tube extends inferiorly to at least the mid aspect of the stomach. Probable drain overlies the left upper aspect of the abdomen, incompletely visualized. Cardiac leads terminate in expected location of the right atrium and right ventricle. Low lung volumes makes detailed cardiopulmonary assessment difficult. Patchy left basilar opacity, likely atelectasis. No large pleural effusion or pneumothorax. Normal heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Female, 43 years old. Heart size normal. Lungs clear. No pleural effusion. No pneumothorax.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: ET tube placement. Interval advancement of endotracheal tube with tip 3 cm above the level of the carina. ECMO cannulae, LVAD, Swan-Ganz catheter and chest tubes and mediastinal drains similar in position. Surgical lap pads project over the mediastinum.Complete opacification of the left hemithorax unchanged. Rib crowding on the left consistent with volume loss.Patchy interstitial and airspace opacities in the right hemithorax are stable.

Output: No acute change in pulmonary appearance. ETT has been advanced with tip now 3 cm above the level of the carina.


Instruction: Generate impression based on medical findings.

Input: Male, 45 years old.Reason: ptx? pna? History: chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: intubated, OGT. pls assess placement of lines History: intubated, OGT Endotracheal tube remains in right mainstem bronchus.Other lines unchanged in position. Nasogastric tube coiled within the gastric body.Interval progression of left lower lobe atelectasis.No pneumothorax.

Output: 1. Right mainstem bronchus intubation. Requires repositioning.2. Left lower lobe atelectasis


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: Increasing O2 requirement History: SOB, tachypnea Improvement in lung volumes. Patchy bibasilar opacities and right pleural effusion or thickening again noted. Large diaphragmatic hernia, unchanged. No pneumothorax.

Output: Improvement in lung volumes without substantial difference compared to last study.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.PKD here for bilateral nephrectomy with wheezing. Right jugular catheter tip at the SVC/RA junction. Normal heart size. New ill-defined air space opacity in the left upper lobe overlying the anterior tip of the left second rib. Compressive atelectasis overlying the elevated right hemidiaphragm and atelectasis or scarring at the left lung base is unchanged.

Output: Small focal left upper lobe airspace opacity may represent pneumonia. In the absence of clinical signs of infection, differential considerations include aspiration pneumonitis however in the adult population a non- benign lesion cannot be excluded without serial plain film follow-up to complete radiographic resolution, which is recommended. If the abnormality does not resolve in 6 weeks, then a thoracic CT may be obtained for further characterization.


Instruction: Generate impression based on medical findings.

Input: Reason: pna History: cough fever sob Mainly interstitial opacity in the left lower lung, compatible with infection, possibly atypical. No other significant findings.

Output: Abnormal mainly interstitial opacity in the left lower lung, compatible with infection, including mycoplasma and viral etiologies.


Instruction: Generate impression based on medical findings.

Input: Age: 61 yearsGender: MaleReason for Study: Reason: SOB History: sob The cardiac mediastinal silhouette is unremarkable.Postsurgical changes of the left lower lung zone similar in appearance to prior exams.No new pulmonary opacities identified.No pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Reason: h/o heart disease, has SOB History: sob Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: difficulty swallowing History: as above No pleural effusion or pneumothorax. Right chest port terminates in the atriocaval junction. Large lung volumes and flattening of the diaphragms consistent with chronic obstructive disease. There is anterior deviation of the trachea with an air-fluid level visualized in the fluid-filled dilated upper esophagus on lateral films. Left posterior base airspace opacities compatible with atelectasis/aspiration.

Output: Anterior deviation of the trachea with air-fluid level visualized in the upper esophagus. These findings are concerning for esophageal mass or stricture, possibly at the level of the aortic arch. Follow-up CT is recommended for further evaluation. Left lower lobe opacities suspicious for aspiration pneumonitis/bronchiolitis and may be a result of the high fluid level in the esophagus.


Instruction: Generate impression based on medical findings.

Input: Female, 37 years old. Reason: any pulm abnormality History: chest pain, low risk Cardiomediastinal silhouette is unremarkable. No focal pulmonary opacity, pleural effusion, or pneumothorax.

Output: No significant cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 76 years old.Reason: SOB, h/o systolic HF, suspected pulmonary edema History: SOB Mild to moderate cardiomegaly with a right pleural effusion and subtle basilar edema.No specific evidence of infection.

Output: CHF with subtle pulmonary edema and a right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Reason: Pre-Kidney evaluation, end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: baseline eval pre kidney tx Heart size about upper normal.No sign of pulmonary edema or other acute abnormalities.

Output: Heart size about upper normal with no acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for pulmonary edema History: chf Moderate cardiomegaly withICD lead and venous catheter unchanged. Lower zone opacity, greater on the right, consistent with edema and pleural effusion.Moderate right superior mediastinal widening, decreased from previous.No new findings.

Output: Findings consistent with CHF with no acute change.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old. ET tube unchanged.NG tube with its tip in the region of the GE junction.Right IJ venous catheter placed with its tip in the SVC.No evidence of pneumothorax.Stable cardiomediastinal silhouette.Mild chronic interstitial opacities.No new pulmonary opacities noted.

Output: Interval placement of a right IJ venous catheter without complication. ET tube unchanged. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: 62 year-old female with a chronic cough. Evaluate for hypersensitivity pneumonitis LUNGS AND PLEURA: Scarring is identified at the left lung base. There is no evidence of interstitial lung disease, air trapping, or groundglass opacities. No pleural effusions are present.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Mild diffuse degenerative changes within the dorsal spineUPPER ABDOMEN: No significant abnormality noted.

Output: Normal CT of the chest except for mild focal scarring at the left lung base. No evidence of interstitial lung disease or hypersensitivity pneumonitis.


Instruction: Generate impression based on medical findings.

Input: 46-year-old male with history of hepatitis C now with hypoxemia. ET tube tip advanced, now 4 cm above the carina. Right subclavian central line tip overlying the cavoatrial junction. Interval placement of right IJ central line with its tip overlying the cavoatrial junction. Interval placement of enteric tube with its tip out the field of view.Low lung volumes with effacement of cardiac borders.Probable left basilar atelectasis.No large pleural effusions or pneumothorax.

Output: ET tube tip 4 cm above the carina. Probable left basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 47 years old.Worsening hypoxia Right chest wall Port-A-Cath tip is at the superior cavoatrial junction. Enteric tube tip courses below the field of view. Surgical clips in the left axilla. Sclerosis bilateral humeral heads may represent metastasis.Cardiomediastinal silhouette is normal.New left basilar opacity compatible with pleural effusion and consolidation. No focal airspace opacities in the right lung. No pneumothorax.

Output: New left basilar opacity compatible with pleural effusion and consolidation.


Instruction: Generate impression based on medical findings.

Input: Male, 45 years old.Chest pain, atrial flutter, CHF evaluate for fluid overload. Unchanged cardiomegaly. No pleural fluid or specific signs of pulmonary edema. No focal airspace opacities.

Output: Cardiomegaly, but no evidence of pulmonary edema or pleural fluid.


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.Reason: r/o infection History: dizziness, loss of balance Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Stable mild cardiomegaly.

Output: Clear lungs. Mild cardiomegaly, as before.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: swan placement History: swan Swan-Ganz catheter tip in the right main pulmonary artery.ICD leads unchanged.Small lung volumes with moderate cardiomegaly and mild basilar atelectasis.

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


Instruction: Generate impression based on medical findings.

Input: 68-year-old male with history of prostate cancer CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged.MEDIASTINUM AND HILA: Reference right hilar lymph node measures 9 x 5 Moores on image number 44, series number 3, smaller compared to previous study.CHEST WALL: Left scapular metastatic focus has increased in size compared to previous study.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Aortocaval reference lymph nodes is stable measuring 7 x 7 mm image number 119, series number 4. Other retroperitoneal lymph nodes are also stable.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in the size of the some of the previously seen metastatic lesions.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cholecystectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Stable multifocal sclerotic foci in the pelvic bones.OTHER: No significant abnormality noted

Output: Interval increase in the size of some of the sclerotic bone lesions. No other significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: eval for pulmonary edema History: dyspnea Severe multichamber cardiomegaly status post aortic and mitral valve replacement and tricuspid annuloplasty.No specific evidence of infection or edema.

Output: Severe cardiomegaly without edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Age: 47 yearsGender: MaleReason for Study: Reason: Soft tissue sarcoma of the elbow, evaluate for metastasis History: above The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Left pneumothorax.VIEW: Chest AP (one view) 10/10/16, 1312 Left chest tube remains in place. No pneumothorax is seen. No focal lung opacity is present. Cardiothymic silhouette is normal.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 47 yearsGender: FemaleReason for Study: Reason: r/o cardiac abnormality History: chest pain The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.History: Shortness of breath. Rule out pneumonia. No focal airspace opacities. No pneumothorax. No pleural effusions. The heart is within normal limits. VP shunt tubing projects over the right side of the chest/abdomen.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: s/p cardiac arrest History: s/p cardiac arrest Dense airspace opacities left greater than right.An ET tube is seen in the deep in the right main bronchus, subsequently repositioned.Right jugular catheter, tip in SVC.A surgical drain is projected over the right side of the chest, probably in the soft tissues. No significant pneumothorax.IVC filter and gastrostomy tube are noted.

Output: New dense airspace opacities. ET tube tip deep in the right main bronchus.


Instruction: Generate impression based on medical findings.

Input: 75-year-old female with history of right breast cancer CHEST:LUNGS AND PLEURA: Right-sided pleural effusion is slightly increased. No new nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Interval increase in the size of the right breast mass lesion. The lesion now measures 5.4 x 4.7 cm on image number 45, series number 6. Bilateral borderline enlarged axillary lymph nodes are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter cystic lesions in the liver are unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable bilateral nonobstructing subcentimeter stones.RETROPERITONEUM, LYMPH NODES: Index leftpara-aortic lymph node measures 10 x 8 mm on image number 108, series number 6, not significantly changed from previous study.BOWEL, MESENTERY: Stomach, duodenum and proximal small bowel segments are dilated. Distal small bowel segments are decompressed. The transition point is in the right lower quadrant. This is not significantly changed from previous study and indicates and distal small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Bilateral ovaries are unremarkable. Uterus is not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Minimal interval increase in the size of the left-sided pleural effusion.Minimal interval increase in the size of the right chest wall mass. Axillary nodes are unchanged.Distal small bowel obstruction is unchanged.Bilateral nephrolithiasis is unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: Infiltrates History: fever Chronic appearing elevation left hemidiaphragm with overlying subsegmental atelectasis.Elsewhere, the lungs are unremarkable.Small lung volumes.Right jugular catheter, tip in SVC.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath Patchy right basilar opacities and possible right pleural effusion unchanged.No pneumothorax.Emphysematous left lung.

Output: No significant pneumothorax. Unchanged right-sided opacities.


Instruction: Generate impression based on medical findings.

Input: 51-year-old male with history of LVAD with chest pain and shortness of breath LVAD and ICD leads unchanged in position. Median sternotomy hardware noted.Stable cardiomegaly .Left pleural effusion/thickening without interval change .No evidence of pneumothorax.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: EmpyemaVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Right-sided chest tube in place. Patchy opacities at the right lower lobe increased from prior study. There is a small right-sided pleural effusion also minimally increased from prior study. Minimal opacities at the left lower lobe. There is minimal subcutaneous emphysema in the right lateral chest wall.

Output: Right lower lobe opacity and right-sided pleural effusion minimally increased from prior study.


Instruction: Generate impression based on medical findings.

Input: Reason: is there pul edema History: hypertension, sob Normal heart size with a tortuous aorta compatible with systemic hypertension.No significant pulmonary or pleural abnormalities and no change.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Reason: R/o PNA History: Leukocytosis No significant cardiopulmonary abnormality.

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


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.Reason: swan placement History: swan placement Cardiomegaly status post sternotomy.No specific evidence of infection or edema.Unchanged support devices.

Output: Cardiomegaly. Unchanged support devices.


Instruction: Generate impression based on medical findings.

Input: 19-year-old male with hypercalcemia rule out lymphadenopathy and granulomatous disease. 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: Bilateral multiple punctate stones without evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Bilateral nephrolithiasis without evidence of hydronephrosis, otherwise unremarkable CT.


Instruction: Generate impression based on medical findings.

Input: Hilar adenopathy. No history of sarcoid. LUNGS AND PLEURA: Small subpleural opacity at right upper chest posteriorly, along with a few nodular opacities which are mostly associated with fissures and could represent intrapulmonary lymph nodes.No significant interstitial or air space opacities. No pleural fluid seen.MEDIASTINUM AND HILA: Without the use of intravascular contrast, evaluation is limited. Multiple enlarged hilar and mediastinal nodes.CHEST WALL: No significant abnormality noted.

Output: Bilateral hilar and mediastinal adenopathy along with a few parenchymal findings as above, with no change in at least the bilateral hilar findings when compared to previous radiographs. Once again possibilities include sarcoidosis or other granulomatous or reactive lymphadenopathy. Time course of findings (and if there has been no treatment for these findings) favors a benign etiology.


Instruction: Generate impression based on medical findings.

Input: 57-year-old female status post Dobbhoff placement. Dobbhoff tube tip coiled and terminates in the gastric body. Overlying drains and wires again noted. Please refer to recent chest radiograph for findings related to the chest.Paucity of bowel gas.

Output: Dobbhoff tube tip coiled and terminates in the gastric body.


Instruction: Generate impression based on medical findings.

Input: Age: 43 yearsGender: MaleReason for Study: Reason: hemoptysis History: hemoptysis The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Age: 56 yearsGender: MaleReason for Study: Reason: patient w L CT in place History: L chest tube in place, s/p VATs left lower lobectomy 2. Left apically directed chest tubes unchanged.Left apical pneumothorax better visualized than on prior exam and now demonstrating a 19 mm separation from the chest wall.Subcutaneous emphysema noted along left lateral chest wall.Stable cardiomediastinal silhouette with evidence of a mitral valve repair.Interstitial opacities in both lungs suggestive of edema.

Output: Persistent left apical pneumothorax increased in size from the prior exam. Increasing interstitial opacities suggestive of edema.


Instruction: Generate impression based on medical findings.

Input: Reason: eval worsening respiratory function History: tachypnea Diffuse coarse chronic interstitial opacity unchanged.Focal airspace opacity in the right lower and middle lobe area, not significantly changed from immediate previous radiographs, suspicious for superimposed infection.No new findings.

Output: Chronic interstitial disease and possible right lower zone pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: eval infection History: fever Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No specific evidence of infection.Right jugular catheter, tip in SVC.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: 62 yo F with relapsed ALL and neutropenic fever, increasing shortness of breath and hypoxia, eval for volume overload other interval change History: see above Interval progression of bilateral interstitial and airspace opacities. No change in degree of cardiac enlargement. No significant pleural effusion or pneumothorax.Stable central venous catheter.

Output: Significant interval progression of bilateral interstitial and airspace opacities. This can likely represent a combination of both infection and edema.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Presenting with fever. No pneumothorax or pleural effusion. The cardiomediastinal silhouette is within normal limits. There is an airspace opacity with air bronchograms located in the left midlung, nonspecific but compatible with pneumonia.

Output: Large airspace opacity in the left mid lung is nonspecific, but consistent with pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Chest pain. Shortness of breath. Unremarkable cardiomediastinal silhouette.Mild bibasilar subsegmental atelectasis/scarring, without specific evidence of infection or edema.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female 52 years old Reason: infiltrate History: persistent cough Cardiomediastinal silhouette is unremarkable. No focal airspace opacity, pneumothorax or pleural effusion.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: ? Pneumonia vs. Radiation pneumonitis History: Reported fever, persistent cough Increased consolidation at the right lung base obscuring previously noted right basilar nodule/mass. Mild subsegmental scarring or atelectasis noted at the left lung base. No large pleural effusion or pneumothorax. Unchanged cardiac leads. Normal heart size. No pneumothorax.

Output: Increased right basilar consolidation consistent with pneumonia, aspiration, or radiation pneumonitis.


Instruction: Generate impression based on medical findings.

Input: Reason: hx of leukemia here with fever. History: fever, nausea vomiting Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.Mild volume loss in the left hemithorax, unchanged.Catheter tip in the SVC.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: A-fib, CHF History: A-fib, CHF Sternotomy hardware remains well aligned.Cardiomegaly is unchanged. Perihilar opacities of atelectasis with basilar predominant interstitial edema, mild. No pneumothorax.

Output: Cardiomegaly with mild basilar edema.


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old. Catheter tip in the SVC.Cardiomegaly and ICD lead unchanged.Pulmonary vascular redistribution but no sign of pulmonary edema or infection.

Output: New catheter with no complications.


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.Pleural effusion. Sternotomy hardware and surgical clips noted.Inferior approach venous catheter tip in the right ventricle.Unchanged mild cardiomegaly. Stable cardiomediastinal silhouette.Multifocal opacities compatible with pneumonia, improved from the initial chest CT on 8/14/2015.Moderate bilateral pleural effusions, similar to prior.

Output: Improving multifocal opacities compatible with infection. Stable pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.SOB question pneumothorax. Normal heart size. No pneumothorax or pleural fluid.Mild bronchial wall thickening.No focal airspace opacity.

Output: No pneumothorax. Mild bronchial wall thickening.


Instruction: Generate impression based on medical findings.

Input: Age: 38 yearsGender: MaleReason for Study: Reason: eval atelectasis vs infiltrate vs effision History: leukemia Left PICC line with its tip in the left innominate.The cardiomediastinal silhouette is unremarkable.The lungs are clear.No pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Female, 26 years old.Reason: Acute Chest ro History: neck pain Subtle basilar opacities, not reliable evidence of infection or infarction.Heart size upper normal.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Sepsis. Known Pseudomonas in sputum culture. Right internal jugular line with tip terminating at the right atrium. Tracheostomy in place. Low lung volumes. Right lower and middle lobe consolidations are unchanged from prior. Left perihilar and retrocardiac opacities are similar to prior. No pleural effusion or pneumothorax. The cardiomediastinal silhouette is at the upper limits of normal.IVC filter and right upper quadrant cholecystostomy tube.

Output: Unchanged bilateral perihilar, and lower lobe opacities, may represent multifocal pneumonia given positive sputum culture. Component of pulmonary edema cannot be excluded.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, 79 years old.Reason: eval lung fields History: palpitations Leftward patient rotation. Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. Surgical clips in the neck.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Male, 36 years old.Reason: Chest pain History: Chest pain Lungs and pleural spaces are clear. Cardiomediastinal silhouette is unremarkable.

Output: No evidence of edema or infection. Heart size normal.


Instruction: Generate impression based on medical findings.

Input: Reason: interval change History: interval change Small lung volumes with nonspecific basilar opacity compatible with atelectasis and consolidation. Chest tube extending to the right apex with no significant pneumothorax.No new findings.

Output: Postoperative findings and basilar airspace opacity without significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.History of asthma, now with cough and chills evaluate for pneumonia. Stable mild cardiac enlargement.Mild perihilar bronchial wall thickening which can be seen with asthma.No specific evidence of infection or edema.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female 63 years old Reason: rule out pneumothorax after L subclavian line placement History: none Right central venous catheter tip in the SVC. Left subclavian central venous catheter is at the cavoatrial junction.Cardiomediastinal silhouette is unremarkable. No focal opacity, significant pneumothorax, or pleural effusion is identified.

Output: No significant pneumothorax identified.


Instruction: Generate impression based on medical findings.

Input: 25-year-old female requesting second opinion for interstitial lung disease, diagnosed at an outside hospital. History of cough and shortness of breath. LUNGS AND PLEURA: Subpleural reticular opacities with microcystic honeycombing are noted in both lungs. In upper lung zones, these findings are more prominent anteriorly. In the lower lung zones, findings are prominent in the lung bases. Staples are noted in the left lower lobe, from prior biopsy. Pleural thickening on the right. No pleural effusion.MEDIASTINUM AND HILA: No lymphadenopathy. Mild dilatation is seen in the mid and lower thoracic esophagus.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: 1. Subpleural reticular opacities with microcystic honeycombing, more prominent in anterior upper lung zones and lung bases. Dilated esophagus. The findings are suggestive of connective tissue disease, such as scleroderma.


Instruction: Generate impression based on medical findings.

Input: Female, 36 years old.With a history of rectal adenocarcinoma and recently discovered left lower lobe nodule status post wedge resection. Persistent minimal left apical pneumothorax. No pleural effusion. Left Port-A-Cath with tip in the right atrium. Bibasilar atelectasis.

Output: Persistent minimal left apical pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: legionella pna, recent ARDS, esrd, evaluate pulmonary edema History: hypervolemia Interval removal of enteric tube. Venous catheter tip in SVC.Stable to slightly improved nonspecific basilar consolidation and atelectasis. No significant pulmonary edema.

Output: Stable to slightly improved nonspecific basilar consolidation and atelectasis. No significant pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male 68 years old Reason: LUL collapse, evaluation for improvement History: SOB, hypoxia Increased opacity left upper lobe consistent with consolidation and atelectasis likely related to proximal bronchial obstruction.Right-sided pulmonary nodules and masses unchanged.Surgical clips and sternotomy hardware unchanged.

Output: Increased opacity left upper lobe consistent with consolidation and atelectasis likely related to proximal bronchial obstruction.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: eval for infitrate/edema History: shortness of breath Large lung volumes with bronchial wall thickening, suggestive of emphysematous change. No acute consolidation is identified. No pneumothorax. Cardiac silhouette and mediastinal contours are within normal limits. Scarring is noted at both lung apices.

Output: No interval change with no acute cardiopulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Cough, rule out pneumonia The heart size is normal. No specific evidence of infection, edema, or effusions.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 81 yearsGender: FemaleReason for Study: Reason: post op, eval ETT, lung fields History: s/p AVR ET tube with its tip 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.Right PICC line with its tip in the SVC. Decreased lung volumes with mild cardiac enlargement.Basilar opacities are compatible with pleural effusions and atelectasis/edema.Median sternotomy intact.

Output: Postoperative chest without evidence of complications.


Instruction: Generate impression based on medical findings.

Input: 63 year old male with stage I non-small cell lung cancer with new right upper lobe nodule. CHEST:LUNGS AND PLEURA: Postoperative findings of superior segment right lower lobe resection. Soft tissue nodule in the proximity of the surgical bed (series 5 image 66) measures 10 x 10 mm (previously 13 x 11) favors scar etiology given lack of PET activity.Left basilar pleural calcifications with posterior curvilinear opacity is similar to prior likely representing atelectasis or scarring. Nonspecific left upper lobe pleural based nodule (series 5 image 33) is similar in size, measuring 11 x 5 mm (previously 10 x 6 mm).Mild centrilobular emphysema. Right apical and left basilar scarring, unchanged. No new lesions. No pleural effusion.MEDIASTINUM AND HILA: Moderate to severe left and right coronary artery calcifications. No cardiomegaly or pericardial effusion.No lymphadenopathyCHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple nonspecific bilateral hypoattenuating lesions are unchanged. Few of these lesions are compatible with simple renal cysts, others are indeterminate. Referenced cyst in the inferior pole of the right kidney (series 4 image 131), unchanged. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Previously identified suspicious lesion adjacent to right lung surgical bed, likely represents scar given lack of growth and recent PET findings. Indeterminate lesion in left lung, unchanged. No new lesions or evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: pneumonia, pulmonary edema History: shortness of breath Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Unchanged pectus excavatum.

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


Instruction: Generate impression based on medical findings.

Input: 52 F. Generalized weakness. Question pneumonia. Cardiomediastinal silhouette is normal.Lungs are clear without focal pulmonary consolidation or pleural effusion.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old.Mitral valve disorder status post cardiac surgery. Low endotracheal tube with tip less than 15-mm above the level of the carina. Right chest tube tip projects over the medial thorax and a cardiophrenic angle region. Two catheters project over the right thoracic inlet in the region of the jugular vein.No pneumothorax.Valvular prosthesis.Contour abnormality of the lateral aspect of the aortic arch unchanged and may correlate to prominent aortic isthmus, please refer to separately reported CT of the chest recently performed.

Output: No pneumothorax. Low endotracheal tube.


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.Reason: ards progression History: sepsis Bilateral pleural effusions and left lower lobe consolidation are unchanged.ET tube tip 7 cm above the carina.An NG tube extends below the lower margin of the image.Right PICC, tip in the SVC.Left subclavian catheter removed.

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


Instruction: Generate impression based on medical findings.

Input: Reason: flash pulm edema History: worsening SOB ET tube tip approximately 4 cm above the carina.Cardiomegaly with bilateral mainly lower zone airspace opacity, unchanged.NG tube tip in stomach.

Output: Bilateral lower zone airspace opacity, compatible with acute pulmonary edema, or aspiration, slightly improved. ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: 27-year-old female with shortness of breath. Evaluate for pneumonia or effusion. Cardiac silhouette is normal.No abnormal focal airspace opacity.No pneumothorax or pleural effusion.

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


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: 63 y/o h/o CLL undergoing chemotherapy, developed pleural effusions, now with worsening SOB. Please eval for effusion, infection History: h/o pleural effusions, now with worsening SOB Persistent moderate left and small right pleural effusions, partially loculated. These opacities favor edema with atelectasis. No interval pneumothorax. Cardiac silhouette is obscured.

Output: Persistent left greater than right pleural effusions with basilar opacities favoring edema with atelectasis. Associated infection is a consideration.


Instruction: Generate impression based on medical findings.

Input: Female, 81 years old.Reason: sob History: sob Stable position of support apparatus, including enteric tube terminating above the diaphragm and with sidehole overlying the mid esophagus. Recommend advancement.Very limited assessment of the cardiomediastinum, lungs and pleural spaces due to patient's position and body habitus.Suggestion of persistent right pleural effusion.

Output: Limited assessment of the lungs and cardiomediastinum. Suggestion of right pleural effusion.Recommend advancement of enteric tube which terminates above the diaphragm.


Instruction: Generate impression based on medical findings.

Input: Age: 27 yearsGender: MaleReason for Study: Reason: s/p PICC History: s/p PICC The cardiac mediastinal silhouette is unremarkable.Minimal scarring in the right midlung.No focal airspace opacities.No pleural effusions.Right PICC line with its tip extending across the midline into the left innominate vein.

Output: No acute cardiopulmonary abnormalities are identified. Right PICC line extending into the left innominate vein.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Cough evaluate for infiltrate or pulmonary edema. Irregular pleural thickening at the right apex unchanged since 2014. Patchy small nodular opacities right upper lobe also appear chronic. Chronic volume loss at the lung bases. Persistent nodular opacity at the right base poorly visualized but not conclusively changed.Faint nodularity of the lung parenchyma in the lower zones new from previous. Mild cardiomegaly. Tortuous thoracic aorta. Mild posterior costophrenic angle blunting may reflect trace pleural fluid or pleural thickening.Right mastectomy with chest wall dissection clips.

Output: Chronic abnormalities in the right hemithorax not significantly changed since 2014 and may reflect post therapeutic findings patient received radiation therapy to the right hemithorax. No specific signs of pulmonary edema or convincing evidence of pneumonia, though the patient could have either bronchiolitis or lymphangitic tumor spread at the bases.


Instruction: Generate impression based on medical findings.

Input: 70 year-old female with history of laryngeal cancer, status post radiation and resection; lung cancer status post surgery/RT/chemo. CHEST:LUNGS AND PLEURA: Status post right upper lobe resection. Micronodule in left major fissure is unchanged, likely representing an intrapulmonary lymph node. No pleural effusion.MEDIASTINUM AND HILA: Stable postoperative findings of right hilum. Left hilar calcifications, unchanged. Multiple small mediastinal lymph nodes are similar in size. No cardiomegaly or pleural effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Irregular dilatation of the pancreatic duct in the body/tail is unchanged. No discrete mass identified.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. Postoperative findings unchanged.


Instruction: Generate impression based on medical findings.

Input: 61-year-old female with history of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Previous described nodular opacities in the left upper lobe are unchanged. Calcified granulomas in the right lower lobe are also unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left nephrectomy. No evidence of recurrent disease. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small paramedical hernia containing nonobstructed transverse colon segments.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Female, 34 years old.Reason: IABP placement History: IABP placement Intra-aortic balloon pump has been slightly inferiorly displaced, now projecting over the left mainstem bronchus. The remaining support devices are unchanged in position.Severe cardiomegaly persists. Possible trace pleural effusions with mild vascular redistribution. No frank pulmonary edema or pneumothorax.

Output: Intra-aortic balloon pump tip projects of the left mainstem bronchus, slightly inferiorly retracted as compared to prior.


Instruction: Generate impression based on medical findings.

Input: 37 year old female with fever, cp. Evaluate for infiltrate. Fracture sternotomy wires and curved metallic opacity in the right midlung unchanged. No focal airspace opacities. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable.

Output: No acute cardiopulmonary abnormalities. No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Reason: r/o pneumonia, pe, pleural effusions History: sob, hx of prostate cancer Chronic changes in the lung bases with likely residual left pleural effusion. The mid and upper lung zones are clear.Stable position of left subclavian dual lumen chest port.The cardiomediastinal silhouette is within normal limits.

Output: Chronic changes lung bases residual left pleural effusion. No other apparent acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate R sided ptx History: R sided ptx Small residual right pneumothorax laterally and inferiorly with a pleural drain projected over the right lung base.Small lung volumes with diffuse chronic interstitial disease, better characterized by recent CT scan.

Output: Small residual right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: Pt w/ AML (neutropenic) now w/ fever History: fever PICC has been pulled back and now terminates at the junction of the left brachiocephalic vein and SVC. No new focal pleural parenchymal opacity. No large pleural effusion or pneumothorax. Unchanged heart size.

Output: No acute cardiopulmonary process on radiography. PICC has been pulled back slightly.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: Pt with Sezary's disease on romedepsin now with worsening cough and sinus congestion- History: Pt with Sezary's disease on romedepsin The cardiomediastinal silhouette is normal. No pulmonary opacity, no pleural effusion, no pneumothorax.

Output: No acute cardiopulmonary disease.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: possible infectious process? History: new tachypnea, borderline fever Diffuse pulmonary opacities again noted. Question of small left pleural effusion, as before. No definite pneumothorax. Unchanged cardiomegaly. Left IJ line terminates in the superior aspect of the SVC. Enteric tube extends inferiorly off the field-of-view.

Output: Lines and tubes, as above. Diffuse pulmonary opacities again noted which certainly could represent pulmonary infection though pulmonary edema seems more likely. Question small left pleural effusion, as before.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Reason: Pre op transplant baseline History: Pre op transplant Calcified nodes consistent with healed granulomatous disease. No acute cardiopulmonary abnormality. Multiple peripheral vascular stents are present

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 20 years old.Reason: worsening R sided PTX? History: known R sided PTX with recent clamping of chest tube The Dobbhoff tube has been removed from the lung without complication.Stable small right apical pneumothorax with a right chest tube unchanged. Left lower lobe consolidation and pleural effusions bilaterally stable.Tracheostomy tube tip approximately 4 cm above the carina.Left PICC, tip in the SVC.

Output: Dobbhoff tube removed from the airways. Stable small right apical pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 82 years old.Reason: pna? History: hypoxia on RA, no prior O2 requirement, concern for slight AMS x 2 days Elevated right hemidiaphragm with adjacent compressive atelectasis.Mild scarring or atelectasis left base.Costophrenic angle blunting may represent scarring.No focal opacities or pleural effusions.No pneumothorax.

Output: No evidence of pneumonia; elevated right hemidiaphragm of unclear etiology or chronicity.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: desaturationVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left upper extremity PICC with tip at the confluence of the brachiocephalic veins. There are two chest tubes on the right and two chest tubes on the left. Cardiothymic silhouette normal. Bilateral pneumothoraces are present. There is moderate amount of pneumomediastinum and subcutaneous emphysema at the supraclavicular regions bilaterally. There is also subcutaneous emphysema at the lateral chest walls bilaterally.

Output: Bilateral pneumothoraces are present right greater than left.


Instruction: Generate impression based on medical findings.

Input: History of cough and shortness of breath. COPD patient. LUNGS AND PLEURA: Severe and diffusely distributed central lobular emphysema and increased lung volumes. Interval resolution and no significant residual nodular density in the right lower lower lobe (image 75 series 7). Current appearance suggests confluent vessels and possibly minimal post inflammatory scarring. No superimposed nodules or masses. No effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: Extensive severe central lobular emphysema. Resolution of the small right lower lobe nodular opacity.


Instruction: Generate impression based on medical findings.

Input: 59 year-old female history of cough. Right lower lobe pulmonary opacities compatible with infection. Probable small right pleural effusion. Mild cardiomegaly appearing similar to prior. Evidence of prior sternotomy. No pneumothorax. Equivocal background edema.

Output: Right lower lobe pneumonia. Follow up to resolution is recommended given the patient's age.


Instruction: Generate impression based on medical findings.

Input: 75-year-old male with history of burn CHEST:LUNGS AND PLEURA: Biapical scarring. Follow-up imaging is recommended to exclude possibility of carcinoma arising from these scars.Endotracheal tube is in place.Trace bilateral pleural effusions.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Simple right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate gland is enlarged. There is heterogeneous enhancement in the left peripheral zone suspicious for prostate carcinoma.BLADDER: Bladder wall is thickened.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Biapical scarring. Follow-up with CT imaging is recommended to exclude possible to carcinoma.Heterogeneous left-sided prostate suspicious for prostate carcinoma.Wall thickening of the bladder.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: 59yr old female with history of MM; pre-auto sct evaluation History: evaluate 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: Male, 76 years old.High oxygen requirement of indeterminate nature. Persistent moderate right pleural effusion.Partially obscured bilateral solid lead pulmonary nodules previously characterized encrustation limiting.Poorly defined gray lung heterogeneous opacities are stable from prior, with limited assessment of the right lung secondary to pleural fluid. No new abnormal focal lung parenchymal opacities to suggest pneumonia or pulmonary edema.No pneumothorax.Stable position of the right IJ port venous catheter overlying the right atrium.

Output: Assessment of the right lung is limited by moderate right pleural effusion. Within these limitations, no radiographic findings to suggest pneumonia or pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: chest tube placement History: s/p right VATS robotic wedge resection Interval placement of a right chest tube that is directed to the apex. Small amount of subcutaneous emphysema at the chest tube entry site inferolateral wall. No significant pneumothorax. The pleural spaces are clear. The cardiomediastinal silhouette is unremarkable.

Output: No pneumothorax. Right apically directed chest tube.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: Placement of PICC History: as above Moderate cardiomegaly.No specific evidence of infection or edema.Right PICC, tip in axillary region.Left subclavian ICD, leads unchanged in position.

Output: Right PICC, tip in axillary region. The configuration suggests that it is caught in a branch vessel as the course has become serpiginous.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: lung eval History: sob Lungs hypoinflated with basilar edema and atelectasis and probable small effusions, unchanged. Dobbhoff extends beyond the field of view study.

Output: Lungs hypoinflated with basilar edema and atelectasis and probable small effusions, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: eval for edema History: sob Left base better aerated. No evidence of significant pulmonary edema.

Output: Left base better aerated. No evidence of significant pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: rsv + bilateral pleural effusions assess stability History: bilateraly pleural effusions Small lung volumes with bilateral nonspecific basilar air space opacity, suggestive of aspiration and infection. Very small pleural effusions unchanged.Dual-lumen power port with its tip in the SVC.

Output: Very small pleural effusions unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: PNA? History: hypoxemia No change in bilateral pulmonary opacities compatible with pneumonia and bilateral pleural effusions

Output: No change in pulmonary opacities and effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 43 years old.Reason: infectious work-up History: SIRS Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No specific evidence of infection.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 24 years old.Reason: eval for acute chest syndrome History: chest pain, sickle cell Heart size upper normal with mild redistribution of the pulmonary blood flow.No evidence of infection or infarction.Cholecystectomy clips and evidence of autosplenectomy noted.

Output: Sickle cell disease, with a heart size upper normal otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: 45-year-old male with laryngeal cancer status post chemoradiation. LUNGS AND PLEURA: Right lower lobe micronodule is unchanged and likely benign (image 76/130). No new suspicious pulmonary nodules or focal air space opacities. No pleural effusions.MEDIASTINUM AND HILA: Small, not significantly enlarged mediastinal and axillary adenopathy, unchanged. Heart size is normal without pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: No evidence of intrathoracic metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Reason: S/p intubation History: COPD ET tube tip approximately 5 cm above the carina.Large hypovascular lungs with bronchial thickening compatible with COPD.Calcified granuloma and calcified lymph nodes on the left compatible with previous infection. Focal opacity at the right base unchanged since 2011, likely due to diaphragmatic eventration or Bochdalek hernia.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Clinical information PULMONARY ARTERIES: No evidence of PE. The main pulmonary artery is mildly enlarged, measuring 3.4 cm (image 92, series 4), compatible with pulmonary artery hypertension.LUNGS AND PLEURA: Mosaic attenuation pattern on expiration, not present on inspiration, consistent with small airways disease.MEDIASTINUM AND HILA: Cardiomegaly.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: A splenule is incidentally noted inferior to the spleen.

Output: 1. No evidence of PE.2. Enlarged main pulmonary compatible with pulmonary artery hypertension.3. Small airways disease.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: r/o pulmonary edema History: CHF with fluid overload Cardiomegaly, with only equivocal edema.No sizable pleural effusions noted.No specific evidence of infection.Left subclavian ICD and LVAD are unchanged.

Output: Cardiomegaly with only equivocal edema.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: eval pneumonia History: SOB No new focal lung consolidation. Mild basilar subsegmental atelectasis or scarring again noted. Mild cephalization again noted. Heart size at the upper limit of normal. No large pleural effusion or pneumothorax.

Output: No acute cardiopulmonary process on radiography. Mild cephalization again noted consistent with elevated left-sided cardiac pressure.


Instruction: Generate impression based on medical findings.

Input: 72-year-old male with history of papillar thyroid cancer status post chemo and radiotherapy. Please evaluate for extent of disease. CHEST:LUNGS AND PLEURA: Previously referenced ground glass nodule in right upper lobe (series 5, image 27) remains unchanged.MEDIASTINUM AND HILA: Unenlarged mediastinal lymph nodes.CHEST WALL: Stable degenerative changes of the spine.ABDOMEN:LIVER, BILIARY TRACT: Scattered hypoattenuating hepatic cysts remain stable.SPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple renal cysts bilaterally.PANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the spine.

Output: 1.No evidence of metastatic disease.2.Previously referenced right upper lobe ground glass nodule unchanged. Continued CT follow-up recommended in 6-12 months or as would have been performed for surveillance of patient's head and neck cancer.


Instruction: Generate impression based on medical findings.

Input: Sickle cell disease Persistent mild-to-moderate nonspecific cardiac megaly without additional cardiopulmonary abnormality

Output: Cardiomegaly without superimposed acute disease


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: swan in place, more SOB on 12/7 AM History: as above Right IJ Swan-Ganz catheter and left subclavian central venous line remain unchanged. Status post median sternotomy.Low lung volumes with slight interval improvement in pulmonary edema. Persistent bilateral pleural effusions and atelectatic changes, left greater than right.

Output: Slight interval improvement in pulmonary edema. No other significant interval changes.


Instruction: Generate impression based on medical findings.

Input: Male, 50 years old.IABP placement IABP marker is 2 cm from the top of the aortic arch. Right chest wall ICD with leads are unchanged.Cardiomediastinal silhouette is normal.No pleural effusion or pneumothorax.No focal airspace opacity.

Output: IABP marker is 2 cm from the top of the aortic arch.


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old.Reason: swan position History: swan Left IJ Swan-Ganz catheter has been retracted several centimeters, in the proximal right pulmonary artery. Left ICD electrode unchanged in position.Cardiomegaly is unchanged. No interval pulmonary edema. Nodular opacity at the right 3/4 rib interspace may be vascular in origin and can be confirmed on PA and lateral energy subtracted radiograph, if the patient can tolerate. No pneumothorax.

Output: Left IJ Swan-Ganz catheter has been retracted, tip in the proximal right pulmonary artery. Cardiomegaly stable.


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.Reason: PNA? History: R cp No focal pulmonary opacity, significant pleural effusion, or pneumothorax.Unremarkable cardiomediastinal silhouette.

Output: No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: Evalaute for acute cardiopulmonary process History: substernal chest pain No change in position dialysis catheter. Cardiomegaly but no new opacity

Output: Cardiomegaly but no new opacity


Instruction: Generate impression based on medical findings.

Input: Congestive heart failure Largely unchanged mildly increasing pulmonary opacities minimally in the right lung base and much more extensively in the left lung with near complete opacification. Large left effusion with a small right fluid collection. Persistent decreased lung volumes and suspected mild cardiomegalyLVADs, Dobbhoff, tracheostomy tube, ICD and 2 right jugular catheters are all otherwise similar

Output: Increasing near complete opacification of right lung nonspecific consolidation and hardware


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Reason: r/o PNA, cardiomegaly History: syncope No specific evidence of infection or edema.COPD.Heart size normal.

Output: COPD, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Swan-Ganz placement ETT has been minimally retracted, currently terminates 5 cm above the carina. NG extends down inferior to the film.Right jugular sheath remains kinked at the skin entry point without evidence of an associated Swan-Ganz catheter as history describedMarked cardiomegaly with otherwise grossly clear lungs.

Output: Kinked right neck jugular sheath and ETT repositioned


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old. Repositioning of ETT. Interval advancement of ETT, tip 2.5 cm above the carina. Left subclavian catheter tip in SVC, unchanged.Retrocardiac atelectasis, unchanged.

Output: Interval advancement of ETT, tip 2.5 cm of the carina.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: hypotension History: hypotension ,respiratory distress No significant cardiopulmonary abnormality.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.Reason: concern for pneumonia History: new O2 requirement, fever, cough Relatively low lung volumes with basilar opacities of subsegmental atelectasis. Associated infection is a consideration. Heart size is normal. No pneumothorax.

Output: Low lung volumes with basilar opacities representing a component of subsegmental atelectasis. Associated infection is a consideration.


Instruction: Generate impression based on medical findings.

Input: Male, 44 years old.Reason: PNA History: lactate 6.2 Lungs and pleural spaces are clear. Relatively low lung volumes. Cardiomediastinal silhouette is unremarkable.

Output: No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: R PICC line for TPN History: Placement of PICC, hematoma, htx, ptx Right-sided PICC terminates in the right atrium. Right IJ line has been removed. Enteric tube terminates distally within the stomach off the field-of-view. Right apical chest tube remains in place. Curvilinear lucency again noted at the right lung base. Diffuse pulmonary opacities with more confluent basilar opacities, unchanged. Small pleural effusions, as before. Unchanged cardiomegaly.

Output: Right-sided PICC terminates in the right atrium. Right IJ line has been removed.


Instruction: Generate impression based on medical findings.

Input: Male, 82 years old.Reason: productive cough x 10 days, eval for pna History: cough Cardiomegaly.Possible opacity seen in one of the costophrenic angles on the lateral view is nonspecific and could represent a site of infection or aspiration, the lungs otherwise unremarkable.Rib fixation hardware.

Output: Possible opacity seen on the lateral view in one of the lower lobes could be artifact or atelectasis although aspiration or infection are in the differential diagnosis.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: s/p thoracic surgery History: s/p thoracic surgery Unchanged pulmonary opacities. Right chest wall resection with postoperative contusion and pleural effusions. Tracheostomy tube, the tip at the level of the thoracic inlet.A Dobbhoff tube extends below the lower margin of the image.

Output: Unchanged pulmonary opacities and support devices.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Lung cancer right pleural effusion, S.O.B. Complete opacification of the right hemithorax with mild leftward mediastinal shift. Right chest port tip at the SVC/RA junction. Main pulmonary artery appears male mildly enlarged. No acute appearing findings on the left.

Output: Complete opacification of the right hemithorax with nonvisualization of the airways distal to the right main bronchus..


Instruction: Generate impression based on medical findings.

Input: Male, 36 years old.Reason: cough and fever History: cough Moderate spinal curvature. No focal lung consolidation. No pleural effusion or pneumothorax. Normal heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Male, 32 years old.Reason: eval lung fields History: eval lung fields - s/p lung transplant The support devices are unchanged in position.Extensive, left greater than right, pulmonary opacities not significantly changed. Pleural effusions track over the apices and into the azygos fissure. No pneumothorax.

Output: Extensive pulmonary opacities with pleural effusions, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: central line placement History: s/p line central line placement Moderate pulmonary opacities consistent with edema, with small pleural effusions.Mild cardiomegaly.Prior right jugular catheter removed.New left jugular catheter, tip at cavoatrial junction level.A Dobbhoff tube extends below the lower margin of the image.ET tube tip approximately 2 cm above the carina.

Output: Unchanged pulmonary edema with pleural effusions. ET tube tip approximately 2 cm above the carina, slightly low.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: eval lung fields History: s/p CABG Motion artifact. Bilateral chest drains are seen. ET tube tip is 5 cm above the carina. Right IJ central line in an internal jugular position. Cardiomediastinal silhouette is within normal limits allowing for semi-erect imaging technique and respiratory phase. Moderate bilateral pleural effusions. No pneumothorax.

Output: Mild hypervolemia without frank pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: worsening effusion? drain malfunction? infection? BRCA w/ pleurx cath, worsening SOB History: SOB Interval decrease in right pleural effusions. Increasing left pleural effusion.

Output: Interval decrease in right pleural effusions. Increasing left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: 71-year-old female with history of Narendra print tumor CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Marked intra-and extrahepatic biliary dilatation is unchanged. Pancreatic duct is also slightly prominent.SPLEEN: Collateral vessels around the stomach may be secondary to chronic occlusion of the splenic veinPANCREAS: Ill-defined mass in the tail of the pancreas is grossly unchanged and represents patient's known neuroendocrine tumor.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: cardiac arrest History: cardiac arrest New diffuse pulmonary opacity superimposed on previous left suprahilar opacity. Endotracheal tube terminates approximately 4 cm from the carina. Central venous catheter terminates near the cavoatrial junction. No large pneumothorax.

Output: New diffuse pulmonary opacity most consistent with pulmonary edema given history of cardiac arrest. Lines and tubes, as above.


Instruction: Generate impression based on medical findings.

Input: Male 58 years old Reason: volume overload History: volume overload Median sternotomy hardware noted.Stable cardiomegaly.No significant pleural effusions.Interval improvement in bilateral airspace opacities. No other focal airspace opacities.Vascular redistribution with mild interstitial edema.No significant pleural effusions.

Output: Interval improvement in bilateral airspace opacities. Mild pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: 47-year-old male with shortness of breath. Evaluate for underlying infection, edema. CHEST:LUNGS AND PLEURA: Moderate bilateral pleural effusions with adjacent atelectasis and consolidation. Confluent areas of groundglass opacities are seen in the lungs bilaterally along with bronchial wall thickening.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Heart size moderately enlarged without pericardial effusion. Moderate calcifications of the right coronary, left circumflex, and LAD arteries.CHEST WALL: No significant abnormality noted. UPPER ABDOMEN: No significant abnormality noted.

Output: Cardiomegaly with diffuse pulmonary edema and moderate pleural effusions bilaterally compatible with CHF.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: ett History: ett, leukocytosis Stable line position.No change in basilar opacities.

Output: No change in basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: RE-eval post removal of pericardial drain on 12/14th. History: left pleural effusion with chest tube to wall suction Left-sided chest tube remains unchanged in position. Stable to minimally increased left apical pneumothorax.Large left pleural effusion with adjacent pulmonary opacities, not significantly changed.Right-sided central venous catheter with tip projecting over the cavoatrial junction, unchanged.

Output: Stable to minimally increased left apical pneumothorax. Large left pleural effusion with adjacent pulmonary opacities, unchanged. Support devices unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: Rule out PNA History: DOE Moderate cardiomegaly.Bilateral perihilar interstitial and air space opacity, greater on the right, with several septal lines and thickening of the pleural fissures, compatible with pulmonary edema.Calcified lymph node in the right hilum.No specific evidence of pneumonia.

Output: CHF with pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Interval change-postop, chest closed. ETT 6.5 cm above the level of the carina. Hardware and devices similar in position. LVAD incompletely visualized and cannot be assessed.Edema and atelectasis is improving.

Output: Improving edema and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: check pulmonary status History: Pleural effusion. Left basilar opacity compatible with pleural effusion and atelectasis, not significantly changed.Right upper zone volume loss and opacity compatible with radiation fibrosis, unchanged.No new findings.

Output: Left pleural effusion and atelectasis with no significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 32 years old.Congenital tricuspid atresia and stenosis, postop. Redo sternotomy.Small lung volumes.Cardiomegaly.ET tube tip approximately 6 cm above the carina.Right jugular catheter, tip in SVC.Epicardial pacemaker and leads.No radiopaque foreign object.

Output: No radiopaque foreign object. This was discussed with the attending physician Dr. Ziemer on 2/19/2015 at 8:55 p.m. by the radiology resident on call.


Instruction: Generate impression based on medical findings.

Input: Reason: SOB History: SOB Unremarkable cardiac and mediastinal silhouette. Large lung volumes suggesting COPD.No sign of pneumonia or other acute disease.

Output: COPD with no acute findings.


Instruction: Generate impression based on medical findings.

Input: Male, 20 years old, with increased d-dimer. PULMONARY ARTERIES: Technically adequate exam. No pulmonary embolus.LUNGS AND PLEURA: Dense left lower lobe consolidation with associated ground glass opacity and centrilobular nodules may represent aspiration given the presence of debris within the left lower lobe bronchus. Superimposed infection, in the appropriate clinical context, may be considered as well. Several foci of air within this consolidation posterior to the cardiac border are of uncertain significance.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: 1.No PE. 2.Left lower lobe consolidation with endobronchial debris is most suggestive of aspiration. Superimposed infection cannot be excluded.3.4.


Instruction: Generate impression based on medical findings.

Input: Reason: ptx History: EPD Chest tubes directed towards the left apex with no significant pneumothorax.Nonspecific air space opacity at the left base compatible with atelectasis and consolidation.Gaseous distention of the stomach, decreased.

Output: Unremarkable postoperative chest.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: r/o pneumothorax, pna, edema, effusion, mass History: chest pain Cardiomediastinal silhouette is within normal limits. Lungs are clear of air space and interstitial opacities. There is no pneumothorax.

Output: No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: pleural effusions History: CHF Ef15%, chest pain Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Mild cardiomegaly. Defibrillator lead terminates in the expected location of the RV.

Output: Clear lungs.


Instruction: Generate impression based on medical findings.

Input: 74 years, Male. Reason: ng placement History: ng placement Pelvis is not included in field of view. NG tube tip lies below the field of view, side port appears to be in the proximal body of the stomach. Bibasilar airspace opacities are noted, please refer to concomitant chest radiograph for full thoracic findings.

Output: NG tube tip lies below the field of view, side port appears to be in the proximal body of the stomach.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: eval ETT, lung fields History: s/p LVAD New sternotomy with chest tubes, but no pneumothorax.Increased pulmonary opacities suggestive of edema and pleural effusions left larger than right.LVAD placement, partially imaged.Left subclavian ICD, leads unchanged in position.ET tube tip approximately 3 cm above the carina.Right jugular Swan-Ganz catheter tip in proximal right pulmonary artery.Left subclavian IABP, the marker projected over the aortic arch.

Output: Increased pulmonary opacities and pleural effusions following LVAD placement. ET tube tip approximately 3 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Age: 95 yearsGender: FemaleReason for Study: Reason: Evaluate for CHF History: Hypoxia, SOB Left-sided pacemaker unchanged.New moderate size right sided pleural effusion.Increased interstitial opacities suggestive of edema.Decreased lung volumes with cardiac enlargement.Severe changes of degenerative joint disease involving the glenohumeral joints bilaterally with probable loose bodies within the left shoulder joint capsule.

Output: Moderate-sized right-sided pleural effusion and pulmonary edema compatible with CHF.


Instruction: Generate impression based on medical findings.

Input: Female, 20 years old. Right IJ venous catheter has been placed with its tip in the SVC.No evidence of a pneumothorax.The cardiomediastinal silhouette is unremarkable.The lungs are clear.Partially imaged IVC filter.

Output: Interval placement of a right IJ venous catheter without complication.


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.Hypoxia No significant interval change in bilateral central predominant consolidations with subpleural sparing, which could represent noncardiogenic pulmonary edema..Possible small bilateral pleural effusions. No pneumothorax. Adequate position of ET tube overlying the mid trachea. The enteric tube coursing below the diaphragm.

Output: Adequate position of support apparatus.No interval change in bilateral central predominant consolidations, suggestive of noncardiogenic pulmonary edema. Correlate with patient's history.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Dyspnea on exertion in the lung transplant patient question worsening pneumonia. Left chest port unchanged in position.Unchanged cardiopulmonary appearance with postsurgical changes of bilateral lung transplant.Scarlike opacities at the lung bases, but no acute appearing abnormality.

Output: No acute pulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Reason: s/p bilateral lung transplant History: oxygen requirements Tracheostomy tube in place. 2 right-sided central venous line tip in the SVC. Patient is status post sternotomy. 2 right chest tubes and one left chest tube. Surgical clips and skin staples overlie the mediastinum, thorax, and upper abdomen.Cardiac borders are obscured by patchy bilateral hilar and basilar airspace opacities. Probable small-to-moderate left pleural effusion. Small bilateral pneumothoraces.

Output: Stable support devices. Stable pulmonary edema. Probable small-to-moderate left pleural effusion. Small bilateral pneumothoraces.


Instruction: Generate impression based on medical findings.

Input: Age: 72 yearsGender: MaleReason for Study: Reason: 72yo M w/ AMS, concern for aspiration History: as above ET tube and NG tube have been removed.Dobbhoff tube is in place with its tip in the stomach.Left-sided central venous catheter unchanged.Stable cardiomediastinal silhouette.Perihilar interstitial opacities, more prominent on the right on the compatible with edema and/or atelectasis.No focal areas of consolidation.No large pleural effusions.

Output: Interval extubation and placement of a Dobbhoff tube. Mild increase in right sided interstitial opacities compatible with edema and/or atelectasis possibly secondary to aspiration.


Instruction: Generate impression based on medical findings.

Input: Respiratory failureVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left central line and right chest tube again noted. Multiple surgical clips in the mediastinum. There is a lucency in the lower thoracic spine likely to represent air within the distal esophagus. Cardiothymic silhouette is enlarged. Patchy opacities at the right lower lobe and lingula. No pleural effusion or pneumothorax.

Output: Patchy atelectasis at the right lower lobe and lingula.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: evaluate for aspiration pneumonia History: evaluate for aspiration pneumonia Opacity at the left lung base periphery is suggestive of pneumonia or aspiration.Moderate cardiomegaly is stable.

Output: Left lower lobe airspace opacity consistent with infection or aspiration.