Instruction: Generate impression based on medical findings.

Input: Male 53 years old Reason: hx of OLT with elevated LFTs, evaluation of liver History: elevated LFTs LIVER: Liver measures 13.9 cm in length. The parenchyma is unremarkable, no focal liver lesion delineated. Main portal vein patent with normal directional flow, velocity measures 26 cm/sec. BILIARY TRACT: Common bile duct dilated in proximal to mid area, measuring up to 14 mm, distally tapers to 8 mm. Layering intraluminal linear focus seen in proximal common bile duct, no definite shadowing but choledocholithiasis or debris a consideration. Status post cholecystectomy. PANCREAS: Not well seen in entirety, particularly pancreatic tail, but visualized portions unremarkable.KIDNEYS: The right kidney measures 9.3 cm. The left kidney measures 10 cm. No hydronephrosis.SPLEEN: The spleen measures 8.5 cm. in length.

Output: 1. Common bile duct dilated in proximal to mid area, measuring up to 14 mm, distally tapers to 8 mm. Layering intraluminal linear focus seen in proximal common bile duct, no definite shadowing but choledocholithiasis or debris a consideration.


Instruction: Generate impression based on medical findings.

Input: 61-year-old male with thyroid nodule seen on recent soft tissue neck CT. RIGHT LOBE MEASUREMENTS: 2.2 x 2.7 x 5.7 cmLEFT LOBE MEASUREMENTS: 2.8 x 2.8 x 5.0 cm.ISTHMUS MEASUREMENTS: 0.7 cmRIGHT LOBE: Multiple right thyroidal cysts are visualized. In the superior right thyroid, a cyst measures 1 cm, in the mid right thyroid a cyst measures 1.0 x 0.7 cm with another measuring 1.0 cm.LEFT LOBE: Multiple partly cystic, partly solid nodules are visualized in the inferior left thyroid. One measures 1.4 x 1.5 cm and the second measures about 1.2 cm.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: A complex nodule that appears separate from the thyroid adjacent to the right thyroid tissue measures 2.3 x 1.7 cm is visualized.

Output: 1. Bilateral thyroid nodules as described above.2. A complex nodule that appears extrathyroidal adjacent to the right thyroid as described above is visualized. This may represent an exophytic thyroid nodule, however other pathology cannot be excluded.The thyroidal and extrathyroidal nodules would be amenable to ultrasound biopsy.These findings were discussed with Dr. Thomas at 4:40 PM on 1/13/2016 via telephone by the radiology resident.


Instruction: Generate impression based on medical findings.

Input: Female 61 years old; Reason: 61 year female, history of hypertension and abdominal pain, please evaluate right upper quadrant to evaluate for gall stones and any abnormalities History: pain LIVER: Mild increase in hepatic parenchymal echogenicity with coarsened echotexture. A 1.4 x 1.2 x 1.5 cm hypoechoic mass is noted in the segment 8 of the liver. Hepatic length measures 18.7 cm. The main portal vein is patent with normal hepatopedal flow with a peak velocity of 16.3 cm/s. GALLBLADDER/BILIARY TRACT: Gallstone within the gallbladder with the wall measuring 1 mm. The common bile duct measures 3 mm in diameter. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 8.7 cm and has a normal echotexture.KIDNEYS: The kidneys have normal corticomedullary differentiation. The right kidney measures 9.2 cm with no hydronephrosis. The left kidney measures 11.2 cm with no hydronephrosis. Simple appearing left renal cyst measures 1.6 x 1.6 x 1.4 cm.OTHER: No significant abnormality noted.

Output: 1.Increase in hepatic parenchymal echogenicity with coarsened echotexture consistent with fatty liver/hepatic parenchymal dysfunction. There is a 1.5 cm hypoechoic mass in the segment 8 of the liver, and neoplasm, including malignancy, cannot be ruled out. Further evaluation with dedicated contrast-enhanced cross-sectional study is recommended.2.Cholelithiasis without evidence of acute cholecystitis.These findings were discussed with Kimberly Harris at 11:45 AM, 6/15/2016.


Instruction: Generate impression based on medical findings.

Input: Female 32 years old Reason: known gallstones, RUQ pain rule out cholecystitis History: RUQ pain LIMITED ABDOMENLIVER: No suspicious focal hepatic lesion. Patent portal vein.BILIARY TRACT: No biliary dilatation.. No gallbladder wall thickening or pericholecystic fluid. Numerous gallstones. Gallbladder is mildly contracted. . PANCREAS: Visualized portions are unremarkableKIDNEYS: The right kidney measures 11 cm. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 11 cm. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 8 cm. in length. OTHER: No significant abnormalities noted.

Output: 1.Cholelithiasis in a contracted gallbladder with no sonographic signs of acute cholecystitis


Instruction: Generate impression based on medical findings.

Input: Male 37 years old Reason: Evaluate for splenic pathology History: LUQ pain Evaluation limited to the spleen. The spleen is normal in echogenicity, but increased in size measuring 15.9 cm. No focal lesion identified.

Output: Splenomegaly, with no focal lesion identified.


Instruction: Generate impression based on medical findings.

Input: Male 60 years old; Reason: Bilateral renal ultrasound for evidence of chronic disease History: CKD stage 5 vs ESRD RIGHT KIDNEY: The right kidney measures 13 cm in length. The cortex is slightly increased in echogenicity. No shadowing calculi or hydronephrosis is present. Simple appearing cysts are seen, the largest measuring 3 cm in the right upper pole.LEFT KIDNEY: The left kidney measures 11 cm in length. The cortex is slightly increased in echogenicity. No shadowing calculi or hydronephrosis is present. URINARY BLADDER: Visualized portions are unremarkableOTHER: No significant abnormalities noted.

Output: 1.Simple appearing right renal cyst. No hydronephrosis. Slight increased echogenicity of both kidneys can be seen in nonspecific medical renal disease.


Instruction: Generate impression based on medical findings.

Input: Female 49 years old Reason: evaluate for gall stones History: evaluate for gall stones, nausea vomiting LIVER: The liver measures 20.0 cm in length and demonstrates normal parenchymal echogenicity. No intrahepatic or extrahepatic biliary ductal dilatation is evident and no focal mass lesions are seen. The main portal vein is patent and demonstrates hepatopedal flow with a velocity of 0.3 m/s. GALLBLADDER, BILIARY TRACT: No cholelithiasis or choledocholithiasis is seen. The common duct measures 0.1 cm in diameter. PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 10.2 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.LEFT KIDNEY: The left kidney measures 9.2 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.SPLEEN: The spleen measures 8.0 cm in length.OTHER: No significant abnormalities noted.

Output: No evidence of cholelithiasis as clinically questioned.


Instruction: Generate impression based on medical findings.

Input: Male 39 years old with elevated alkaline phosphatase and ALT, evaluate for biliary dilatation and stones LIVER: Normal hepatic parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions. Hepatic length measures 14.5 cm. The main portal vein is patent with normal hepatopedal flow directed towards the liver with a velocity of 25.0 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is normal in echotexture with the wall measuring 2 mm. The common bile duct measures 2 mm in diameter. No cholelithiasis or choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 12.5 cm and has a normal echotexture.KIDNEYS: The kidneys have mildly increased echogenicity. The right kidney measures 11.2 cm and has normal vascular flow. The left kidney measures 10.4 cm and has normal vascular flow. OTHER: No significant abnormality noted.

Output: 1. Increased renal echogenicity suggestive of medical renal disease.2. No evidence of cholelithiasis or biliary ductal dilatation.


Instruction: Generate impression based on medical findings.

Input: 44-year-old female presurgery for a total pancreatectomy with auto islet transplant. Reason: Evaluate patency and Doppler portal vein. LIVER: The liver measures 15.8 cm in length. Irregularly echogenic liver parenchyma without focal lesion or ductal dilatation. Portal vein is patent with normal hepatopedal directional flow and a velocity of 22 cm/s.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy.PANCREAS: Punctate echogenic foci within the visualized body and tail of the pancreas, compatible with calcifications.RIGHT KIDNEY: The right kidney measures 11 cm. The cortex is of normal echogenicity. No shadowing calculi or hydronephrosis is presentLEFT KIDNEY: The left kidney measures 12.9 cm. The cortex is of normal echogenicity. No shadowing calculi or hydronephrosis is present.SPLEEN: The spleen measures 12.8 cm.OTHER: No significant abnormalities noted.

Output: 1. Patent portal vein with normal hepatopedal directional flow.2. Irregularly echogenic liver parenchyma consistent with fatty infiltration/parenchymal dysfunction with areas of fatty sparing. No focal lesions or ductal dilatation.3. Punctate echogenic foci within the visualized body and tail of the pancreas, compatible with calcifications and consistent with the patient's history of chronic pancreatitis.


Instruction: Generate impression based on medical findings.

Input: Female 73 years old; Reason: Rising creatinine, decreased urine output, r/o obstruction History: Decreased urine output RIGHT KIDNEY: The right kidney measures 10.3 cm in length. The cortex is mildly echogenic. Echogenic 9-mm focus near the upper pole likely represents a small stone within the collecting system. This was not imaged prior. No hydronephrosis.LEFT KIDNEY: The left kidney measures 11.4 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. URINARY BLADDER: No significant abnormality notedOTHER: No significant abnormalities noted.

Output: 1.Possible 9mm non obstructing right upper pole renal stone.2.Echogenic renal cortices suggestive of medical renal disease.3.No hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: Female 45 years old Reason: Eval of Thyromegaly History: RIGHT LOBE MEASUREMENTS: 7.1 x 2.1 x 2.7 cm, previously 7.3 x 1.9 x 2.6 cm.LEFT LOBE MEASUREMENTS: 5.7 x 1.5 x 2.6 cm, previously 6.6 x 2.1 x 1.7 cm.ISTHMUS MEASUREMENTS: 0.8 cm in thickness, unchanged.RIGHT LOBE: The right lobe of the thyroid demonstrates normal parenchymal echogenicity.LEFT LOBE: The left lobe of the thyroid demonstrates normal parenchymal echogenicity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Thyromegaly, not significantly changed from the prior examination.


Instruction: Generate impression based on medical findings.

Input: Male 29 years old Reason: eval liver and hepatobiliaru, check dopplers, History: ascites LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 19.6 cm in length. The parenchyma is mildly echogenic. The portal vein is patent with normal hepatopetal flow and a velocity of 30 cm/sec. Note is made of perihepatic ascites.BILIARY TRACT: The gallbladder is contracted.. Wall measures 2 mm in thickness. Common duct measures 3 mm. No intrahepatic or extrahepatic biliary ductal dilatation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 7.7 cm. The cortex is thinned and echogenic. No shadowing calculi or hydronephrosis is present. There is a simple 8 x 7 x 9 mm superior pole cyst.The left kidney is surgically absent.SPLEEN: The spleen measures 11.6 cm. in length. OTHER: No significant abnormalities noted.

Output: 1.Hepatomegaly with diffusely echogenic liver parenchyma which can be seen in hepatic steatosis.2.No intrahepatic or extrahepatic biliary ductal dilatation.3.Borderline splenomegaly.4.Ascites.5.Atrophic right native kidney.


Instruction: Generate impression based on medical findings.

Input: Reason: rule out obstruction History: decreased UOP RENAL TRANSPLANT: The transplant kidney measures 11.2 cm length. Normal echogenicity. No focal lesions. No hydronephrosis.LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No significant abnormality notedCOLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: Foley catheter is present, precluding evaluation of the bladder.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels. Right iliac artery peak systolic velocity is 2.5 m/s. The anastomosis is patent with a peak systolic velocity of 1.6 m/s and a resistive index of 0.87. The proximal renal artery is patent with a peak systolic velocity of 1 m/s and a resistive index of 0.88. The mid renal artery is patent with a peak systolic velocity of 1.4 m/s and a resistive index of 0.89. The distal renal artery is patent with a peak systolic velocity of 1 m/s and a resistive index of 0.84. There is diastolic dampening of the intrarenal vasculature, consistent with parenchymal resistance pattern. There is no evidence of renal artery stenosis.OTHER: No significant abnormality noted

Output: 1. No evidence of obstruction.2. The inflow and outflow vessels of the renal transplant are patent. There is mild diastolic dampening of the intrarenal vasculature, consistent with increased parenchymal resistance pattern. No evidence of renal artery stenosis.


Instruction: Generate impression based on medical findings.

Input: Male 90 years old Reason: eval for fluid collection in RUQ History: p/w sepsis and has purulent drainage coming from site of previous perc chole LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 15.7 cm in length. The parenchyma is mildly echogenic . No suspicious hepatic lesions. Main portal vein is patent with normal flow.BILIARY TRACT: The gallbladder has echogenic calculi with posterior acoustic shadowing. Wall measures 5 mm in thickness. There is a linear hypodense tract extending from the gallbladder to the skin compatible with a gallbladder to the skin fistula with a possible abscess along the tract.Common duct measures 4 mm . PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 8.4 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 8.8 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen is obscuredOTHER: There is a subcutaneous hypoechoic structure likely representing a dilated fistulous tract or abscess extends in the gallbladder to the skin surface.

Output: 1.Findings of cholelithiasis with a fistulous tract extending from the site of prior drain to the skin with a possible abscess along its tract.


Instruction: Generate impression based on medical findings.

Input: 26-year-old male with left-sided scrotal mass on screening exam RIGHT TESTIS: The right testis measures 4.9 x 2.4 x 2.6 cm. Symmetric parenchymal flow without focal lesion.LEFT TESTIS: The left testis measures 3.8 x 2.3 x 3.9 cm. Symmetric parenchymal flow without focal lesion.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: There is an extratesticular, calcific focus projecting near or from the left epididymis.

Output: Extratesticular, calcific focus projecting near or from the left epididymis. Favor benign etiology, such as post infectious or post inflammatory.


Instruction: Generate impression based on medical findings.

Input: Male 86 years old Reason: ?liver, choley and kidney abnormalities History: abnormal labs LIVER: The liver has a smooth contour. Liver measures 13 cm in length. The parenchyma is mildly coarse and echogenic. No suspicious hepatic lesions.BILIARY TRACT: The gallbladder has an anechoic lumen. Wall measures 2 mm in thickness. Common duct measures 3 mm. PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 10 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney is obscuredSPLEEN: Spleen measures 10.3 cm in lengthBLADDER: Urinary bladder has a thickened wall. There are coarse calcifications likely within the prostate. The bladder is decompressed by Foley catheter.OTHER: No significant abnormalities noted.ABDOMINAL AORTA: Proximal: 2.9 cmMid: 2.7 cmDistal: Obscured by bowel gas Right common iliac artery: Obscured by bowel gas Left common iliac artery: Obscured by bowel gas INFERIOR VENA CAVA: No significant abnormality notedOTHER: Main portal vein is patent with normal flow direction.

Output: 1.Partially imaged right kidney suggestive of chronic kidney disease.2.No sonographic findings of acute cholecystitis although the study is suboptimal due to poor penetration.3.No evidence of abdominal aortic aneurysm


Instruction: Generate impression based on medical findings.

Input: Female 58 years old with right knee pain, evaluate for Baker's cyst No loculated fluid collection, abscess, or hematoma identified within the subcutaneous tissues. Normal vascularity.

Output: No loculated fluid collection, abscess, or hematoma identified within the subcutaneous tissues.


Instruction: Generate impression based on medical findings.

Input: 37-year-old female with history of enlarged thyroid. RIGHT LOBE MEASUREMENTS: The right thyroid measures 4.3 x 1.4 x 1.0 cm.LEFT LOBE MEASUREMENTS: The left thyroid measures 3.6 x 1.0 x 0.8 cm.ISTHMUS MEASUREMENTS: The isthmus measures 0.1 cm.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No evidence of thyromegaly or thyroid nodules as clinically queried.


Instruction: Generate impression based on medical findings.

Input: 31-year-old female status post kidney transplant 1/26/2016 with low urine output. RENAL TRANSPLANT:LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: The transplant kidney measures 9.0 cm. No nephrolithiasis.COLLECTING SYSTEM/URETER: No hydronephrosis is seen.URINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels.Inflow and outflow vasculature are patent and within normal limits.OTHER: No significant abnormality noted

Output: Left iliac fossa transplant kidney without hydronephrosis or nephrolithiasis. Inflow and outflow vasculature appear intact.


Instruction: Generate impression based on medical findings.

Input: Female 55 years old; Reason: 55 y.o. F with HPT History: HPT RIGHT LOBE MEASUREMENTS: 1.6 x 1.5 x 2.9 cmLEFT LOBE MEASUREMENTS: 1.2 x 1.1 x 3.3 cmISTHMUS MEASUREMENT: 0.2 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1.Unremarkable appearance of the thyroid gland.


Instruction: Generate impression based on medical findings.

Input: 78-year-old female with history of breast cancer and elevated alkaline phosphatase LIVER: There is irregular mildly increased echogenicity of the liver. No focal hepatic lesion or mass is seen. The liver measures 14.2 cm in length. The main portal vein is patent with normal hepatopedal flow and velocity of 21 cm/s.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy No dilatation or cystic changes are noted of the intrahepatic or extrahepatic biliary ducts. The common hepatic duct measures 0.3 cm in diameter. No choledocholithiasis.PANCREAS: The pancreatic duct measures 0.1 cm in diameter. The head and proximal body of the pancreas are normal. The tail is obscured by bowel gas.RIGHT KIDNEY: The right kidney measures 8.8 cm in length and shows normal echotexture. No mass, stone or hydronephrosis.LEFT KIDNEY: The left kidney measures 9.1 cm in length and shows normal echotexture. No mass, stone or hydronephrosis.SPLEEN: The spleen is normal in echogenicity and measures 6.1 cm in length. OTHER: There is no free or loculated fluid.

Output: Mild, irregularly increased echogenicity of the hepatic parenchyma, which can be seen with fatty liver. No hepatic mass or ductal dilatation is seen.


Instruction: Generate impression based on medical findings.

Input: Male 73 years old; Reason: for suprapubic tube placement History: urinary retention Intraoperative sonographic guidance for suprapubic catheter placement. 2 images are provided the latter image showing the Foley catheter within the bladder.

Output: 1.Sonographic guidance for intraoperative suprapubic catheter placement


Instruction: Generate impression based on medical findings.

Input: Female 39 years old Reason: evaluate for signs of cirrhosis History: as above LIVER: Mild hepatomegaly, liver measures 18.8 cm in length. When interrogated with linear transducer, liver capsule appears fairly smooth. Main portal vein patent with normal directional flow, velocity measures 36 cm/s. BILIARY TRACT: Gallbladder unremarkable. No significant gallbladder distention, wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: Not well seen in entirety due to overlying bowel gas. KIDNEYS: Atrophic echogenic kidneys, compatible with underlying medical renal disease. The right kidney measures 5.1 cm. The left kidney measures 5.5 cm. No hydronephrosis.SPLEEN: The spleen measures 10.5 cm. in length. OTHER: Partially imaged small ascites and left pleural effusion.

Output: Mild hepatomegaly. Partially imaged small ascites and left pleural effusion.Atrophic echogenic kidneys, compatible with underlying medical renal disease.


Instruction: Generate impression based on medical findings.

Input: History of abdominal wall abscess status post drainage by IR in January 2015, now with recurrent fluid collection, please evaluate anterior abdomen for drainable fluid collection Site of incision interrogated with ultrasound and ovoid heterogeneous soft tissue structure containing small fluid centrally seen, structure measures approximately 12.1 x 6.3 cm. Aforementioned fluid component measures approximately 2.1 x 1.7 cm and within this area are small echogenic foci. Mildly increased vascularity also seen within and adjacent to ovoid structure.

Output: Heterogeneous fluid containing soft tissue structure at site of clinical interest as described, may reflect resolving abscess or organizing hematoma. Correlation with patient's laboratory values and clinical history/physical exam recommended.


Instruction: Generate impression based on medical findings.

Input: Female; 53 years old. Reason: history of papillary thyroid cancer, please evaluate for recurrence History: none RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Stable appearance with no significant abnormality noted.LEFT LOBE: A small hypoechoic nodule is again seen in the thyroid bed. This measures 3 x 2 x 2 mm (previously 3 x 2 x 2 mm).ISTHMUS: Stable appearance with no significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left neck level 2 lymph node measures 1.1 x 1.0 x 0.5 cm (previously 0.9 x 0.8 x 0.5 cm).OTHER: No significant abnormality noted.

Output: Stable exam with no definite evidence of recurrence or metastatic disease. Left level 2 lymph node is mildly enlarged, a reactive process is favored.


Instruction: Generate impression based on medical findings.

Input: Male 33 years old; Reason: Rule out hematoma History: Has pain at the biopsy site TRANSPLANT KIDNEY: The transplant kidney measures 12.6 cm in length. The cortex is echogenic. No shadowing calculi is present. COLLECTING SYSTEM/URETER: There is mild residual dilatation of the transplant collecting system.PERITRANSPLANT TISSUES: A small complex fluid collection is seen along the posterior portion of the transplanted kidney. This measures 2.3 x 1.4 x 1.3 cm on today's study. Previously the hematoma measured 30.6 x 4.5 x 12.6 cm.URINARY BLADDER: The bladder wall appears thickened however the bladder is not fully distended.OTHER: No significant abnormalities noted.

Output: 1.2.3 cm residual hematoma adjacent to the transplanted kidney.


Instruction: Generate impression based on medical findings.

Input: Female 45 years old Reason: Evaluate for L hydronephrosis. History: L flank pain; has a hx of ureteral stent in 2008 - removed RIGHT KIDNEY: Kidney measures 10.3 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 10.4 cm in length. Increased parenchymal echogenicity is suggestive of medical renal disease/parenchymal dysfunction. No hydronephrosis, shadowing calculus or massOTHER: Shadowing gallstone present within the gallbladder body/neck.

Output: Increased renal parenchymal echogenicity suggests medical renal disease, but no hydronephrosis. Cholelithiasis.


Instruction: Generate impression based on medical findings.

Input: 81-year-old male with acute renal failure. RIGHT KIDNEY: The right kidney measures 8.7 cm in length. The cortex is mildly echogenic. No shadowing calculi or hydronephrosis is present.LEFT KIDNEY: The left kidney incompletely evaluated secondary to overlying bowel gas. The left kidney measures 8.2 cm in length. The cortex is not well evaluated. No definite shadowing calculi or hydronephrosis is present.OTHER: The bladder is nondistended with Foley catheter in place. There is trace abdominal ascites.

Output: 1. The right kidney is mildly echogenic without evidence of hydronephrosis. The left kidney is not well evaluated on this examination. The right kidney's appearance is consistent with medical renal disease.2. Trace abdominal ascites.


Instruction: Generate impression based on medical findings.

Input: Female 37 years old; Reason: Nodules History: Goiter, hashimoto's, 2 first degree relatives with thyroid cancer. RIGHT LOBE MEASUREMENTS: 4.9 x 1.5 x 2.0 cmLEFT LOBE MEASUREMENTS: 4.9 x 1.6 x 2.0 cmISTHMUS MEASUREMENT: 0.6 cmRIGHT LOBE: The thyroid gland is diffusely heterogenous with multiple cystic areas. No discrete nodules.LEFT LOBE: The gland is diffusely heterogenous with multiple cystic areas. No discrete nodules.ISTHMUS: The gland is diffusely heterogenous with multiple cystic areas. No discrete nodules.LYMPH NODES: No regional lymphadenopathy.OTHER: No significant abnormality noted.

Output: Diffusely heterogenous gland suggestive of chronic thyroiditis. No discrete nodules, masses, or regional lymphadenopathy.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old. Reason: follow-up papillary thyroid cancer s/p thyroidectomy History: none RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy without focal mass.LEFT LOBE: Status post thyroidectomy without focal mass.ISTHMUS: Status post thyroidectomy without focal mass.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small benign-appearing left cervical lymph nodes are present.OTHER: No significant abnormality noted.

Output: No evidence of recurrent or residual disease in the surgical bed. No regional adenopathy.


Instruction: Generate impression based on medical findings.

Input: Female 60 years old Reason: HCV, eval for lesions History: HCV LIVER: Mild hepatomegaly, liver measures 21 cm in length. The parenchyma is echogenic and mildly coarsened in echotexture, no suspicious lesion. Liver contour within normal limits. Main portal vein patent with normal directional flow, velocity measures 31 cm/s. BILIARY TRACT: Gallbladder unremarkable. No intraluminal mobile shadowing echogenic foci seen to suggest cholelithiasis. No significant gallbladder distention, wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: Not well seen in entirety due to adjacent bowel gas but visualized portions unremarkable. KIDNEYS: The right kidney measures 12.8 cm. The left kidney measures 12.1 cm. No hydronephrosis. No perinephric free fluid.SPLEEN: The spleen measures 8 cm. in length. OTHER: No significant abnormality noted.

Output: Hepatomegaly and echogenic, mildly coarse liver parenchyma, likely reflecting underlying hepatic steatosis/parenchymal dysfunction. No suspicious liver lesion.


Instruction: Generate impression based on medical findings.

Input: Female 59 years old Reason: assess PV patency History: PVT LIMITED ABDOMENLIVER: Cirrhotic morphology. Patent vasculature.BILIARY TRACT: Status post cholecystectomy.PANCREAS: Visualized portions are unremarkable.KIDNEYS: The right kidney measures 12 cm. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 12 cm. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: Splenomegaly measuring up to 15 cm. OTHER: No significant abnormalities noted.

Output: 1.Cirrhosis with sequela of portal hypertension (splenomegaly). Patent vasculature.


Instruction: Generate impression based on medical findings.

Input: Male 64 years old Reason: patient with sudden rise in LFTs, febrile, eval for cholecystitis, vein clotting History: elevated LFTs, febrile LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 10.2 cm in length. The parenchyma is moderately echogenic . No suspicious hepatic lesions. Main portal vein is patent.BILIARY TRACT: The gallbladder contains layering sludge. Wall measures 3 mm in thickness. Common duct measures 7 mm. PANCREAS: The pancreas is obscured due to bowel gas.KIDNEYS: The right kidney measures 12.6 cm. The cortex is thinned and echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 12.7 cm. The cortex is thinned and echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 12.5 cm. in length. OTHER: No ascites.

Output: 1.Mildly distended gallbladder with sludge.2.Echogenic hepatic parenchyma suggestive of fatty infiltration.


Instruction: Generate impression based on medical findings.

Input: Male 68 years old Reason: evaluate liver architecture History: hypoalbuminemia LIMITED ABDOMENLIVER: Slightly echogenic and coarse liver parenchyma without focal lesion.BILIARY TRACT: Numerous shadowing gallstones without gallbladder wall thickening or pericholecystic fluid. Negative sonographic Murphy's signPANCREAS: Visualized portions are unremarkable.KIDNEYS: The right kidney measures 9.6 cm. The cortex is slightly echogenic. No shadowing calculi or hydronephrosis is present. The left kidney is not well seen due to overlying bowel gas.SPLEEN: The spleen measures 11 cm. in length. OTHER: Left pleural effusion.

Output: 1.Cholelithiasis without sonographic signs of cholecystitis.2.Echogenic slightly coarse liver is nonspecific but can be seen in diffuse hepatic dysfunction or fatty infiltration. No focal hepatic lesion.3.Left pleural effusion.4.Echogenic right kidney can be seen in nonspecific medical renal disease.


Instruction: Generate impression based on medical findings.

Input: Female 73 years old; Reason: assess for obstructive cause of elevated Cr History: history of pelvic radiation Limited exam, as patient is unable to lay flat and sensitive to ultrasound gel.RIGHT KIDNEY: The right kidney measures 8 cm in length. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. LEFT KIDNEY: The left kidney measures 9 cm in length. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. OTHER: Bladder not visualized. Slightly increased echogenicity of the liver could indicate fatty infiltration.

Output: 1.No hydronephrosis given limitations of exam. Mild fatty infiltration of the liver.


Instruction: Generate impression based on medical findings.

Input: Male 62 years old Reason: hyperthyroidism assessment of nodule please History: hyperthyroidism RIGHT LOBE MEASUREMENTS: 7.8 x 1.9 x 2.0 cm.LEFT LOBE MEASUREMENTS: 6.3 x 1.9 x 1.9 cm.ISTHMUS MEASUREMENTS: 0.4 cm thick.RIGHT LOBE: The right lobe of the thyroid demonstrates normal parenchymal echogenicity. 0.4 x 0.4 x 0.3 cm anechoic lesion in the midpole of the right thyroid lobe consistent with a colloid cyst.LEFT LOBE: The left lobe of the thyroid demonstrates normal parenchymal echogenicity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1.Thyromegaly.2.Probable right subcentimeter colloid cyst.


Instruction: Generate impression based on medical findings.

Input: Female 80 years old Reason: rising LFTs, worsening mental status, rule out hepatobiliary disease History: see above LIMITED ABDOMENLIVER: Hepatic fissures are mildly widened.. Liver measures 17 cm in length. The parenchyma is mildly coarse and echogenic . No suspicious hepatic lesions. Main portal vein is patent.BILIARY TRACT: Gallbladder has an anechoic lumen without calculi. Wall measures 4 mm in thickness. There is mild pericholecystic edema. Common duct measures 2 mm. PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 10.2 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 11.4 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 10.1 cm. in length. OTHER: Right pleural effusion

Output: 1.Coarsened hepatic echotexture suggestive of hepatic parenchymal dysfunction


Instruction: Generate impression based on medical findings.

Input: Male 52 years old Reason: Chronic HCV with thrombocytopenia evaluate liver parenchyma (cirrhosis?) and rule out any lesions. ALso evaluate for splenomegaly History: Chronic HCV with thrombocytopenia evaluate liver parenchyma (cirrhosis?) and rule out any lesions. ALso evaluate for splenomegaly LIVER: Liver measures 16.7 cm in length. The parenchyma is moderately echogenic with a smooth liver contour. A well-defined homogenous lobulated hyperechoic lesion seen in the left hepatic lobe measures 0.5 x 0.4 x 0.4 cm and does not demonstrate any internal vascularity. No ascites.Main portal vein is patent with hepatopedal flow and maximal velocity of 0.2 m/s.BILIARY TRACT: Gallbladder unremarkable. No significant gallbladder distention, wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: The pancreas is obscured due to bowel gas.KIDNEYS: The right kidney measures 10.9 cm. The left kidney measures 11.5 cm. There is no hydronephrosis or shadowing renal calculus.SPLEEN: The spleen measures 12.5 cm. in length. OTHER: No significant abnormality noted.

Output: Moderately echogenic liver parenchyma, with a well-defined hyperechoic lesion seen in the left hepatic lobe. If there is biopsy proven chronic HCV infection or liver disease, then further characterization with dedicated MRI is recommended. Otherwise, this statistically likely represents a hemangioma. No ascites.


Instruction: Generate impression based on medical findings.

Input: Left neck lymph nodes. Evaluate left cervical lymphadenopathy. There are few morphologically normal left cervical lymph nodes. Representative left level 5 lymph node measures 1.6 x 0.5 x 1.6 cm. Left supraclavicular lymph node measures 1.3 x 0.7 x 1.3 cm.

Output: Morphologically normal left cervical lymph nodes.


Instruction: Generate impression based on medical findings.

Input: 52-year-old man with acute kidney failure RIGHT KIDNEY: The right kidney measures 10.5 cm in length and shows slightly increased echogenicity. A subcentimeter simple renal cortical cyst is noted at the lower pole. No mass, shadowing calculi or hydronephrosis.LEFT KIDNEY: The left kidney measures 10.8 cm in length and shows slightly increased echogenicity. No mass, shadowing calculi or hydronephrosis.URINARY BLADDER: The urinary bladder is incompletely distended, limiting evaluation of the bladder wall.OTHER: There is no free or loculated fluid.

Output: Increased echogenicity of the renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone or hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: 57-year-old female with enlarged thyroid RIGHT LOBE MEASUREMENTS: 6.1 x 2.6 x 3.5 cm.LEFT LOBE MEASUREMENTS: 4.0 x 1.6 x 1.2 cm.ISTHMUS MEASUREMENTS: 0.5 cm in AP dimension. RIGHT LOBE: Normal, homogeneous echotexture. A dominant nodule in the mid/lower aspect of the right lobe measures 3.4 x 2.6 x 2.8 cm.LEFT LOBE: Normal, homogeneous echotexture. A hyperechoic focus at the inferior pole of the left lobe of thyroid measures 1.0 x 1.0 x 0.4 cm and may represent a thyroid nodule or a parathyroid gland.ISTHMUS: Normal echotexture.PARATHYROID GLANDS: No enlarged parathyroid gland identified.LYMPH NODES: No regional lymphadenopathy. OTHER: No significant abnormality noted.

Output: Thyromegaly. A dominant nodule in the mid/lower aspect of the right lobe is most compatible in appearance with a benign colloid nodule. Hyperechoic focus at the inferior pole of the left lobe of thyroid may represent a thyroid nodule or a parathyroid gland.


Instruction: Generate impression based on medical findings.

Input: 16-year-old female with headaches and periods of unresponsiveness. Hepatosplenomegaly on physical exam. LIMITED ABDOMENLIVER: The liver has a smooth contour. The parenchyma is normal in echotexture. Liver measures 14.9 cm in length. Portal flow is hepatopedal. No suspicious masses.BILIARY TRACT: The gallbladder has an anechoic lumen. No gallbladder wall thickening or pericholecystic fluid. No biliary ductal dilation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 9.5 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present.The left kidney measures 10.0 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present.SPLEEN: The spleen measures 9.4 cm. in length without significant abnormality.OTHER: None.

Output: 1.No hepatosplenomegaly seen on exam. No specific findings to correlate with patient's physical exam or symptoms.


Instruction: Generate impression based on medical findings.

Input: 73-year-old male with history of stone. Reason: Evaluate for kidney stone. RIGHT KIDNEY: The right kidney measures 8.1 cm. No mass, stone, or hydronephrosis. Midpole scar.LEFT KIDNEY: The left kidney measures 8 cm. No mass, stone, or hydronephrosis.OTHER: The bladder is nondistended.

Output: Negative renal ultrasound. No mass, stone, or obstruction.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: Acute and chronic systolic heart failure. Acute kidney injury in renal transplant. RENAL TRANSPLANT: Renal transplant measures 10.4 cm in length.LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No perinephric fluid collection.KIDNEY: Echotexture is within normal limits. There is prominent differentiation of the renal calices, nonspecific, similar to prior.COLLECTING SYSTEM/URETER: No hydronephrosis.URINARY BLADDER: No significant abnormality noted.4. Catheter in place.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels. Vasculature is patent. Resistive indices are mildly elevated measuring in the range of 0.7 to 0.9, increased from prior. The mid right renal artery velocity measures 90 cm/s. There is a normal iliac artery waveform.OTHER: No significant abnormality noted.

Output: 1.Elevated resistive indices may be secondary to parenchymal disease versus edema, new from prior. 2.Vasculature patent, without evidence of stenosis.


Instruction: Generate impression based on medical findings.

Input: Male 68 years old Reason: HCC screening LIVER: Liver measures 16.1 cm in length. The parenchyma is coarsened in echotexture. No focal liver lesion. Micronodular hepatic contour. Main portal vein patent, normal directional flow, velocity measures 30 cm/s.BILIARY TRACT: Status post cholecystectomy. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: Not well seen in entirety particularly tail due to overlying bowel gas. KIDNEYS: The right kidney measures 14 cm. Lower pole simple cyst measuring up to 1.1 cm. No hydronephrosis. Status post left nephrectomy.SPLEEN: The spleen measures 12.2 cm. in length. OTHER: No significant abnormality noted.

Output: Cirrhotic liver morphology. No suspicious lesion.Status post cholecystectomy.Status post left nephrectomy.


Instruction: Generate impression based on medical findings.

Input: Female 75 years old Reason: Evaluate for evidence of obstruction of peri-nephric abscess - 75 yo w AML p/w sepsis with infected UA and acute kidney injury not responsive to IV fluids History: oliguria, fever, likely pyelonephritis, acute kidney injury RIGHT KIDNEY: The right kidney measures 11.4 cm. Increased renal cortical echogenicity. No shadowing calculi or hydronephrosis is present. No perinephric free fluid. LEFT KIDNEY: The left kidney measures 9.1 cm. Increased renal cortical echogenicity. No shadowing calculi or hydronephrosis is present. No perinephric free fluid.BLADDER: Foley catheter seen in underdistended bladder.OTHER: Moderate ascites seen.

Output: Echogenic kidneys, consistent with medical renal disease. Ascites.


Instruction: Generate impression based on medical findings.

Input: Female 42 years old Reason: Evaluate for acute cholecystitis History: RUQ abdominal/R flank pain LIVER: Liver measures 16.2 cm in length. Main portal vein patent with normal hepatopetal flow and velocity measures 22 cm/sec. BILIARY TRACT: Multiple layering gallstones in gallbladder, no secondary signs of acute cholecystitis. No significant gallbladder distention or wall thickening. Unable to accurately assess for sonographic Murphy's sign due to reported recent receipt of pain medication. No intrahepatic or extrahepatic biliary duct dilatation. PANCREAS: Not well seen in entirety due to overlying bowel gas but visualized portions unremarkable.KIDNEYS: The right kidney measures 10.4 cm. The left kidney measures 11.2 cm. No hydronephrosis.SPLEEN: The spleen measures 10.8 cm. in length.

Output: Cholelithiasis. No secondary signs of acute cholecystitis.


Instruction: Generate impression based on medical findings.

Input: 80-year-old female with biliary colic, presents for evaluation of cholelithiasis. LIVER: Hepatic parenchyma is normal in echotexture without evidence of a suspicious lesion. Portal vein is patent with hepatopetal flow and velocities measuring 37 cm/s.GALLBLADDER, BILIARY TRACT: There are 2 nonshadowing hyperechoic foci adherent to the gallbladder wall measuring in aggregate 0.7 cm. No evidence of shadowing cholelithiasis. No pericholecystic fluid or gallbladder wall thickening. No intrahepatic or extrahepatic biliary ductal dilatation.p toPANCREAS: No significant abnormalities noted.KIDNEY: The right kidney measures 10.2 cm and the left kidney measures 9.9 cm without evidence of hydronephrosis.OTHER: No significant abnormalities noted.

Output: 1.No evidence of cholelithiasis or cholecystitis.2.2. Small gallbladder polyps.


Instruction: Generate impression based on medical findings.

Input: Female 69 years old; Reason: to eval CKD, renal cyst History: hx of renal cyst RIGHT KIDNEY: The right kidney measures 9.2 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. An interpolar cyst containing thin internal septation measures 2.6 x 1.5 x 3.1 cm (previously 2.3 x 2.2 x 1.6 cm). No internal vascularity or calcifications are noted.LEFT KIDNEY: The left kidney measures 9.6 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. URINARY BLADDER: The bladder is partially collapsed limiting evaluation.OTHER: No significant abnormalities noted.

Output: 1.Right interpolar minimally complex cyst. The cyst is slightly increased in size which can be a normal finding for renal cysts. The cyst is otherwise unchanged and no new suspicious features are identified.


Instruction: Generate impression based on medical findings.

Input: Male 70 years old; Reason: worsened renal function RIGHT KIDNEY: The right kidney measures 8.4 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. LEFT KIDNEY: The left kidney measures 10.6 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. OTHER: The bladder is non-distended, which limits evaluation.

Output: Echogenic kidneys compatible with medical renal disease. No hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: Flexor pollicis longus rupture The flexor pollicis longus tendon is seen at its distal attachment on the distal phalanx of the thumb. As it courses more proximally, the tendon appears slightly thickened but intact until the level of the thenar eminence, approximately 1.5 cm distal to the wrist crease where it terminates. The proximal torn end of the tendon appears thickened as lies approximately 2.5cm proximal to the wrist crease. Linear echogenicity deep to the torn proximal end of the tendon presumably represents orthopaedic hardware from distal radius fracture fixation.The collateral ligaments of the 1st MCP joint are suboptimally visualized due to osteoarthritis/osteophytes and joint subluxation. The ulnar collateral ligament is seen at its attachment upon the proximal phalanx however its attachment on the metacarpal is not well visualized. The radial collateral ligament is not well seen on this ultrasound exam, but appears intact on recent MRI.

Output: 1. Full-thickness tear of the flexor pollicis longus tendon and other findings as above.


Instruction: Generate impression based on medical findings.

Input: Male 72 years old Reason: cystic lesion noted on the R.side in R.retroperitoneal space (?kidney) History: none RIGHT KIDNEY: The right kidney measures 12.9 cm. No shadowing calculi or hydronephrosis is present. An exophytic inferior pole anechoic lesion with internal thin septation measures 4.4 x 4.2 x 4.6 cm.LEFT KIDNEY: The left kidney measures 11.7 cm. No shadowing calculi or hydronephrosis is present. An anechoic lesion with posterior acoustic enhancement measures 1.5 x 1.6 x 2.0 cm and is compatible with a simple renal cyst.BLADDER: No significant abnormality.OTHER: No significant abnormalities noted.

Output: 1.Right minimally complex renal cyst.2.Left simple renal cyst.


Instruction: Generate impression based on medical findings.

Input: Laryngeal carcinoma status post laryngectomy with neck swelling Thrombosed visualized portion of external left jugular vein. Diffuse surrounding edema. No loculated fluid collection.

Output: Thrombosed visualized portion of external left jugular vein. Diffuse surrounding edema. No loculated fluid collection.


Instruction: Generate impression based on medical findings.

Input: Male 58 years old Reason: Evaluate for radiographic evidence of liver disease, such as cirrhosis or fatty liver disease History: Abnormal LFTs, abdominal pain LIVER: Liver measures 19.6 cm in length. The parenchyma is coarsened in echotexture and mildly increased echogenicity noted. No focal liver lesion. Main portal vein patent with normal directional flow, velocity measures 30 cm/sec.BILIARY TRACT: Gallbladder unremarkable. No significant gallbladder distention, wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: Not well seen in entirety but visualized portions unremarkable.KIDNEYS: The right kidney measures approximately 14.2 cm, exophytic lower pole cyst present, measuring 4.3 x 4.1 x 4 cm. The left kidney measures approximately 13.1 cm. Please note however renal size measurements are approximate due to difficulty visualizing poles of kidneys secondary to overlying bowel gas.SPLEEN: The spleen measures 10.6 cm. in length. OTHER: Incompletely imaged right pleural effusion.

Output: Prominent liver and hepatic parenchyma coarsened in echotexture with mildly increased echogenicity, may reflect underlying hepatic steatosis/parenchymal dysfunction.Right lower pole renal cyst.Incompletely imaged right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male 54 years old; Reason: Patient with uptrending creatinine, concern for obstruction versus other mechanical process leading to low urine output and AKI. History: As above RIGHT KIDNEY: The right kidney measures 12 cm in length. The cortex is normal echogenicity. Right hydronephrosis.LEFT KIDNEY: The left kidney measures 11 cm in length and difficult to visualize. The cortex is grossly normal echogenicity. No shadowing calculi or hydronephrosis is present. URINARY BLADDER: Decompressed precluding evaluation.OTHER: Hyperechoic partially visualized liver parenchyma suggestive of fatty infiltration.

Output: 1.Mild to moderate right hydronephrosis.2.Fatty liver.


Instruction: Generate impression based on medical findings.

Input: Male 64 years old Reason: Assess for any functional defects causing oliguria History: Oliguria RIGHT KIDNEY: The right kidney measures 12 cm. No shadowing calculi or hydronephrosis is present. Increased renal cortical echogenicity. LEFT KIDNEY: The left kidney measures 12.7 cm. No shadowing calculi or hydronephrosis is present. Increased renal cortical echogenicity.BLADDER: Not well evaluated secondary to underdistended state, Foley catheter suggested.OTHER: Small free fluid, seen adjacent to spleen and suggested near gallbladder.

Output: No hydronephrosis. Increased renal cortical echogenicity likely reflecting underlying medical renal disease. Small ascites as above.


Instruction: Generate impression based on medical findings.

Input: Reason: R LQ/inguinal pain/tenderness, rule out soft tissue mass/cyst. Mildly limited by body habitus. No fluid collection or obvious mass seen. No obvious lymph nodes.

Output: No discrete lesion seen sonographically.


Instruction: Generate impression based on medical findings.

Input: 71-year-old male with recurrent UTI. RIGHT KIDNEY: The right kidney measures 12.0 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present.LEFT KIDNEY: The left kidney measures 11.3 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. In the upper pole of the left kidney is a 2.0 x 1.7 x 1.8 cm hypoechoic lesion, consistent with cyst.OTHER: The bladder is without significant abnormality.

Output: 1.No evidence of hydronephrosis or nephrolithiasis.


Instruction: Generate impression based on medical findings.

Input: Male 66 years old Reason: epigastric pain, ?cholelithiasis, pancreatic abnormalities History: epigastric pain and chest pressure with eating LIMITED ABDOMENLIVER: Normal echogenicity. No focal hepatic lesions.. BILIARY TRACT: No gallbladder wall thickening, pericholecystic fluid, or positive sonographic Murphy sign. No biliary dilatation.. PANCREAS: The visualized portions of the pancreas are normal.KIDNEYS: The right kidney measures 9 cm. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. NeedThe left kidney measures 9 cm. The cortex is normal echogenicity plus or. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 8 cm. in length. OTHER: No significant abnormalities noted.

Output: 1.No sonographic findings to explain patient's epigastric pain.


Instruction: Generate impression based on medical findings.

Input: 70-year-old male with metastatic prostate cancer and new findings on recent CT. Reason: Evaluate for metastatic disease. RIGHT LOBE MEASUREMENTS: 5.3 x 2.1 x 2.5 cmLEFT LOBE MEASUREMENTS: 4.8 x 1.7 x 2.1 cmISTHMUS MEASUREMENTS: 0.53 cm in the AP dimensionRIGHT LOBE: There is a heterogeneous solid nodule measuring 1.6 x 1.5 x 1.2 cm at the inferior pole.LEFT LOBE: There is a mixed cystic solid lesion measuring 0.6 x 0.6 x 0.7 cm at the inferior pole.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1. Heterogeneous solid nodule in the right thyroid lobe. This nodule is amenable to fine-needle aspiration.2. Subcentimeter mixed cystic solid lesion in the left thyroid lobe.


Instruction: Generate impression based on medical findings.

Input: 47 Reason: r/o adenopathy, recurrence History: h/o thyroid cancer RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. Again seen in the right thyroid lobe surgical bed is a hypoechoic nodule that measures 0.5 x 0.5 x 0.8 cm and previously measured 0.5 x 0.4 x 0.7 cm, overall unchanged from prior exam. An adjacent hypoechoic nodule in the right thyroid bed measures 0.3 x 0.2 x 0.4 cm and previously measured 0.4 x 0.2 x 0.4 cm.LEFT LOBE: No suspicious mass or lesion is identified in the left thyroid surgical bed.ISTHMUS: No suspicious mass or lesion is identified in the Isthmus surgical bed.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A subcentimeter right neck level 2 lymph node has benign-appearing features. A previously seen level 4 left neck lymph node measures 0.8 x 0.5 x 0.9 cm and previously measured 0.7 x 0.6 x 1.7 cm, does not appear significantly changed when accounting for differences in technique. Focal area of echogenicity seen on this examination likely represents fatty hilum, and was not seen on the prior exam. This lymph node is most likely reactive.A left neck level 5 lymph node measures 1.2 x 0.4 x 1.2 cm and has benign-appearing features and likely represents a reactive node.OTHER: No significant abnormality noted.

Output: Stable right thyroid bed subcentimeter hypoechoic nodules.


Instruction: Generate impression based on medical findings.

Input: Female 36 years old; Reason: Please evaluate for stone vs hydro; patient currently pregnant History: Elevated Cr in Pregnancy; multiple episodes of cyclic RLQ pain wrapping to Right flank / back. RIGHT KIDNEY: The right kidney measures 12 cm in length. The cortex is normal echogenicity. 6 mm stone in the inferior right kidney. Mild hydronephrosisLEFT KIDNEY: The left kidney measures 11 cm in length. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. OTHER: Bladder is unremarkable.

Output: 1.Mild right hydronephrosis. 6 cm nonobstructing right renal calculi. Ureters are not well visualized.


Instruction: Generate impression based on medical findings.

Input: Female 86 years old Reason: diffuse abdominal swelling -- r/o ascites, r/o mass History: diffuse abdominal swelling -- r/o ascites, r/o mass. Patient last consumed food about 4 hours ago. LIMITED ABDOMENLIVER: Normal hepatic echogenicity without focal lesion. BILIARY TRACT: Gallbladder is slightly contracted. Single gallstone without pericholecystic fluid, gallbladder wall thickening, or positive sonographic Murphy's sign. No significant gallbladder distention. Mild prominence of the common bile duct is age-appropriate.PANCREAS: Visualized portions are unremarkable.KIDNEYS: The right kidney measures 10 cm. The cortex is mildly echogenic. No hydronephrosis. 4 mm shadowing inferior right renal calculus.. The left kidney measures 11 cm. The cortex is mildly echogenic. No hydronephrosis. 3 mm shadowing stone in the left kidney.. SPLEEN: The spleen measures 7 cm. in length.

Output: 1.Nonobstructing nephrolithiasis as above. Otherwise, unremarkable.


Instruction: Generate impression based on medical findings.

Input: Male 71 years old Reason: high output drain, assess TIPS History: high output drain LIMITED ABDOMENLIVER: No measurements were obtained on this limited examination. There is redemonstration of a cirrhotic appearing liver.Further, there is redemonstration but limited evaluation of deeper hyperechoic right hepatic lesion.

Output: 1. Redemonstration of cirrhotic-appearing liver and incompletely evaluated right hepatic lesion.2. Minimally elevated hepatic arterial indices.3. TIPS appears patent without evidence of stenosis.


Instruction: Generate impression based on medical findings.

Input: Heart transplant workup LIVER: Liver measures 22.6 cm with increased echogenicity. Portal vein is patent with normal direction and velocity of 0.24 m/s. No suspicious hepatic mass is noted.BILIARY TRACT: Common bile duct measures 3 mm. Decompressed gallbladder wall measures 3 mm. No pericholecystic fluid collection. No gallstones noted.PANCREAS: Distal pancreas is obscured by overlying bowel gas. Visualized part is within normal limits.SPLEEN: Spleen measures 13.6 cm and is normal in echogenicity and configuration.KIDNEYS: Right kidney measures 12.8 cm with increased echogenicity and without hydronephrosis. Left kidney is not well seen due to overlying bowel gas. No renal calculi identified. ABDOMINAL AORTA: Proximal aorta measures 2.6 x 2.9 x 2.7 cm. Mid aorta measures 2.3 x 2.1 x 2.1 cm.INFERIOR VENA CAVA: IVC is patent.OTHER: Bladder without significant abnormality.

Output: Limited exam due to patient body habitus and positioning. 1.Hepatomegaly with increased echogenicity compatible with steatosis.2.Increased right kidney echogenicity compatible with medical renal disease.


Instruction: Generate impression based on medical findings.

Input: Male 59 years old Reason: assess for post renal obstruction, cause for ckd History: elevated cr RIGHT KIDNEY: The right kidney measures 11.2 cm. No shadowing calculi or hydronephrosis is present. Lower pole cyst measuring 5.5 by 4.3 x 4.2 cm with peripheral rim calcification and containing calcified septation, corresponding twinkle artifact seen. Increased renal cortical echogenicity.LEFT KIDNEY: The left kidney measures 11.1 cm. No shadowing calculi or hydronephrosis is present. Increased renal cortical echogenicity. BLADDER: Visualized portions unremarkable.Partially imaged cholelithiasis.

Output: 1. Calcified renal cyst as described, while Bosniak classification is technically directed towards cystic renal lesions seen on CT imaging, the sonographic characteristics demonstrated by this renal lesion would be consistent with a 2F lesion.2. Increased renal cortical echogenicity, consistent with medical renal disease.3. Incompletely imaged cholelithiasis.


Instruction: Generate impression based on medical findings.

Input: Female 31 years old; Reason: check for progression in size of thyroid nodules. RIGHT LOBE MEASUREMENTS: 6.1 x 1 x 1.5 cm, previously 5.6 x 1.3 x 1.2 cm.LEFT LOBE MEASUREMENTS: 6.3 x 1.9 x 1.4 cm, previously 6.2 x 1.2 x 1.1 cm.ISTHMUS MEASUREMENT: 0.3 cm, previously 0.2 cm.RIGHT LOBE: Again noted is hypoechoic nodule in the superior pole of the right thyroid lobe measuring 0.6 x 0.3 x 0.5 cm, not significantly changed as compared to prior exam and demonstrating a benign morphology.LEFT LOBE: Again noted is mixed cystic and solid nodule in the midpole of the left thyroid gland measuring 1.1 x 0.6 x 0.4 cm compared to 1 x 0.6 x 0.9 cm on prior exam, not significantly changed. Additional predominantly cystic nodule in the inferior pole of the left thyroid lobe measures 1.5 x 1.0 x 1.5 cm as compared to 1.6 x 1.4 x 1.7 cm on the prior exam, stable to slightly decreased in size.ISTHMUS: No significant abnormality noted.LYMPH NODES: No regional lymphadenopathy.OTHER: No significant abnormality noted.

Output: Stable bilateral thyroid nodules, as above.


Instruction: Generate impression based on medical findings.

Input: Female 56 years old Reason: pain in RUQ and the flank area. r/o renal path, gall stones. History: pain LIVER: The liver measures 13.7 cm in length and demonstrates normal parenchymal echogenicity. No intrahepatic or extrahepatic biliary ductal dilatation is evident and no focal mass lesions are seen. The main portal vein is patent and demonstrates hepatopedal flow with a velocity of 0.2 m/s. GALLBLADDER, BILIARY TRACT: No cholelithiasis or choledocholithiasis is seen. The common duct measures 0.5 cm in diameter. PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 9.1 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.LEFT KIDNEY: The left kidney measures 11.0 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.SPLEEN: The spleen measures 9.2 cm in length.OTHER: No significant abnormalities noted.

Output: No evidence of cholecystitis, cholelithiasis or choledocholithiasis. No specific findings seen to account for the patient's pain.


Instruction: Generate impression based on medical findings.

Input: Female 62 years old Reason: HCV please assess liver morphology and rule out HCC History: HCV LIMITED ABDOMENLIVER: The liver has a nodular contour. Liver measures 16.5 cm in length. The parenchyma is moderately echogenic. Within the right hepatic lobe, there is a new hypoechoic mass measuring 8.5 x 4.5 cm that invades the portal vein.BILIARY TRACT: The gallbladder has echogenic calculi with posterior acoustic shadowing. Wall measures 2mm in thickness. Common duct measures is obscured. PANCREAS: Mass near the pancreas likely representing malignant lymphadenopathy measures 5.7 x 3.5 cmKIDNEYS: The right kidney measures 10.1 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 11.6 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 12.5 cm. in length. OTHER: No significant abnormalities noted.

Output: 1.New large right hepatic lobe mass that invades the portal vein most suggestive of hepatocellular carcinoma.2.Follow up triphasic CT or MRI is suggested.3.Probable malignant upper abdominal lymphadenopathy.


Instruction: Generate impression based on medical findings.

Input: History malignant neoplasm of tonsil with painful lymph node Bilaterally symmetric level 2 cervical lymph nodes with unremarkable morphology. No evidence for adenopathy

Output: Bilaterally symmetric level 2 cervical lymph nodes with unremarkable morphology. No evidence for adenopathy.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for persistent lymphadenopathy History: as above There is a mildly enlarged lymph node noted within the left mid neck which measures 1.7 x 0.4 x 1.3 cm. No definite fatty hilum is visualized. It does not appear hypervascular.There is a benign-appearing lymph node noted within the left mid neck which measures 1 x 0.2 x 0.5 cm. No definite fatty hilum is visualized.There is a benign-appearing lymph node noted within the posterior neck which measures 1 x 0.9 x 0.4 cm. Fatty hilum is visualized.

Output: 1. Nonspecific mildly enlarged lymph node noted within the left mid neck, likely reactive.


Instruction: Generate impression based on medical findings.

Input: Male 68 years old Reason: liver or billary US. ?Fatty liver infiltration History: pt with hx of elevated transaminases LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 17.0 cm in length. The parenchyma is mildly coarse and echogenic. No focal hepatic lesion is identified.BILIARY TRACT: The gallbladder has an anechoic lumen. Wall measures 1 mm in thickness. The common bile duct measures 3 mm.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 10.5 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. No suspicious lesion identified.The left kidney measures 11.0 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. There is a an echogenic too small to characterize lesion in the left kidney measuring 0.7 x 0.5 x 0.5 cm.SPLEEN: The spleen measures 10.6 cm in length.OTHER: No significant abnormalities noted.

Output: 1.Diffuse mildly coarse and echogenic liver, probably nonspecific fatty infiltration/parenchymal dysfunction. No suspicious lesion identified.2.Subcentimeter too small to characterize lesion within the lower pole of the left kidney, may represent an angiomyolipoma, but is nonspecific. Further evaluation can be obtained with pre and post contrast cross-sectional imaging if clinically indicated.


Instruction: Generate impression based on medical findings.

Input: 80-year-old male with hepatitis C. Evaluate for HCC. LIVER: Echogenicity of the hepatic parenchyma is normal . No focal hepatic lesion or mass. The liver measures 16.8 cm in length. The main portal vein is patent with normal hepatopedal flow and velocity of 23 cm/s.GALLBLADDER, BILIARY TRACT: The gallbladder is incompletely distended, limiting assessment of the wall. Common tail artifact is noted within the fundus of the gallbladder, suggesting adenomyomatosis. There is no pericholecystic fluid. No cholelithiasis. The gallbladder wall is normal in appearance, measuring 0.2 cm in thickness. No dilatation or cystic changes are noted of the intrahepatic or extrahepatic biliary ducts. The common bile duct measures 0.7 cm in diameter. No choledocholithiasis.PANCREAS: The pancreatic duct is mildly dilated, as seen on recent CT. The head and proximal body of the pancreas are normal in appearance. The tail is obscured by bowel gas.KIDNEYS: The right kidney measures 10.2 cm in length, and the left kidney measures 10.0 cm in length. The renal pyramids are somewhat prominent bilaterally, suggesting a slight increase in cortical echogenicity. No mass, stone or hydronephrosis.SPLEEN: The spleen is normal in echogenicity and measures 8.8 cm in length. OTHER: There is no free or loculated fluid. Small nonenlarged lymph node adjacent to the pancreatic head shows normal morphology.

Output: 1.No focal hepatic mass is identified.2.Slightly increased echogenicity of the bilateral renal parenchyma can be seen with medical renal disease/parenchymal dysfunction. No worrisome mass, stone or hydronephrosis is seen.


Instruction: Generate impression based on medical findings.

Input: 86-year-old female with renal dysfunction. Reason: Evaluate for obstruction. RIGHT KIDNEY: The right kidney measures 8.5 cm. Echogenic parenchyma without mass, stone, or hydronephrosis.LEFT KIDNEY: The left kidney measures 7.7 cm. Echogenic parenchyma without mass, stone, or hydronephrosis.OTHER: The bladder is not well-visualized.

Output: Small bilateral kidneys with echogenic renal parenchyma compatible with medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: Questionable thyroid abnormality on prior ultrasound. Evaluate for nodule. RIGHT LOBE MEASUREMENTS: 6.8 x 2.2 x 2.9 cmLEFT LOBE MEASUREMENTS: 6.0 x 1.6 x 2.6 cmISTHMUS MEASUREMENTS: 0.6 cm. RIGHT LOBE: Small anterior cyst measuring 4 mm in diameter. No focal nodule. The background gland parenchyma is heterogeneous.LEFT LOBE: Small posterior cyst superiorly measuring 7 mm in diameter. No focal nodules. The background gland parenchyma is heterogeneous.ISTHMUS: Circumscribed, predominately solid, isoechoic nodule without internal vascularity or calcifications. It measures 1.5 x 0.4 x 1.2 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal appearing lymph nodes bilaterally.OTHER: No significant abnormality noted.

Output: Indeterminant isthmus nodule as described. The lesion is amenable to percutaneous biopsy if clinically warranted. Heterogeneous background gland parenchyma. Correlate with clinical history/signs of thyroditis.


Instruction: Generate impression based on medical findings.

Input: Clinical RIGHT LOBE MEASUREMENTS: Status post right lobectomy.LEFT LOBE MEASUREMENTS: 4.2 x 1.7 x 1.7 cm previously measured 3.7 x 1.5 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.3 cm previously measured 0.2 cm.RIGHT LOBE: No significant abnormality noted. No obvious focal mass or lesion is identified.LEFT LOBE: Again seen are several small scattered nodules. The largest upper pole predominantly solid appearing nodule measures 0.4 x 0.3 x 0.5 cm previous study measured 0.6 x 0.4 x 0.5 cm, overall not significantly changes appearance when accounting for differences in technique.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Again seen is a benign-appearing left level 3 node that is not pathologically enlarged and measures 0.8 x 0.4 x 0.7 cm and previously measured 1.1 x 0.8 x 0.5 cm.OTHER: No significant abnormality noted.

Output: 1.No suspicious mass or lesion identified in the right lobe surgical bed.2.Stable subcentimeter left superior pole nodule.


Instruction: Generate impression based on medical findings.

Input: Male 75 years old Reason: Evaluate hepatic cyst LIVER: Liver measures 15.5 cm in length. The parenchyma is increased in echogenicity. Dominant right hepatic lobulated cystic lesion measuring 8.6 by 7.8 x 7.8 cm. Multiple internal echoes/layering debris as well as avascular soft tissue echogenicity present within structure, which was not well seen on earlier exam and may be new. No significant surrounding hypervascularity. Additional smaller hepatic cyst formation suggested. Main portal vein patent with normal directional flow, velocity measures 40 cm/sec.BILIARY TRACT: Again seen at level of gallbladder fundus is cystic prominence, uncertain whether reflects adjacent hepatic cyst or gallbladder septations. Gallbladder unremarkable otherwise. No significant gallbladder distention, wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary duct dilatation.PANCREAS: Not well seen in entirety due to overlying bowel gas. KIDNEYS: Kidneys prominent, may be due in part to multiple underlying cysts, the right kidney measures 13.5 cm, while the left kidney measures 16.3 cm. Bilateral renal cysts with representative lesions in each kidney as follows: Right lower pole cyst measuring 8.1 x 5.7 x 5.7 cm. Bilobed cystic structure containing septation versus two cysts alongside one another, structure measures approximately 9.2 x 6.5 x 6.5 cm.SPLEEN: Not well seen, bowel gas seen in area.

Output: 1. Echogenic liver, likely reflecting underlying hepatic steatosis/parenchymal dysfunction.2. Dominant right hepatic lobulated cystic lesion measuring 8.6 by 7.8 x 7.8 cm. Multiple internal echoes/layering debris as well as avascular soft tissue echogenicity present within structure, which appears new. Findings likely reflect increased complexity of a hepatic cyst but if there is clinical concern for underlying neoplasm or superimposed infection, further evaluation with contrast enhanced CT or MRI recommended. 3. Prominent cyst-containing kidneys.


Instruction: Generate impression based on medical findings.

Input: Male 57 years old; Reason: appendiceal cancer with elevated creatinine History: elevated creatinine RIGHT KIDNEY: The right kidney measures 10 cm in length. The cortex is normal echogenicity. No shadowing calculi or hydronephrosis is present. LEFT KIDNEY: The left kidney measures 10 cm in length. The cortex is normal echogenicity. No shadowing calculi. Mild to moderate hydronephrosis is present. OTHER: Bladder is unremarkable. Left urinary jet is not well visualized. Right urinary jet is seen.

Output: 1.Mild to moderate left hydronephrosis.


Instruction: Generate impression based on medical findings.

Input: 21-year-old female presents with a headache, evaluate for malabsorption from lumbar peritoneal shunt. Sonographic interrogation of the right upper, right lower, left upper and left lower quadrants demonstrates no ascites or organizing fluid collection. Portion of LP shunt seen in right lower quadrant, unable to definitively see tip of catheter.

Output: No evidence of ascites, unclear whether this may reflect an impaired shunt. No fluid collection seen. Please refer to recent radiographic imaging of shunt tubing for additional findings and correlate with patient's clinical history to exclude malfunctioning shunt.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: Abnormal lymph node on prior ultrasound. Here for follow-up. RIGHT LOBE MEASUREMENTS: 5.5 x 1.6 x 2.2 cm, unchanged.LEFT LOBE MEASUREMENTS: 5.4 x 1.6 x 1.7 cm, unchanged.ISTHMUS MEASUREMENTS: 3 mm, unchanged.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: New right hypoechoic nodule measuring 0.5 x 0.3 x 0.4 cm, without internal vascularity, located posterior and inferior to the thyroid.LYMPH NODES: Right level 4 lymph node with abnormal rounded appearance with thickened cortex measuring 0.6 x 0.6 x 0.5 cm, unchanged. New left level 4 lymph node measuring 1.3 x 0.8 x 0.7 cm.OTHER: No significant abnormality noted.

Output: 1.Right hypoechoic nodule posterior and inferior to the thyroid. While this may represent a lymph node, recommend correlation with calcitonin and PTH to rule out parathyroid adenoma.2.Unchanged right level 4 lymph node and new left level 4 lymph node. While these are likely reactive lymph nodes, given rounded appearance and new left lymph node, follow up ultrasound recommended in 6 months


Instruction: Generate impression based on medical findings.

Input: Male 57 years old; Reason: cirrhosis? History: alcohol abuse, low platelets LIVER: Increase in hepatic parenchymal echogenicity with coarsened echotexture with no definite cirrhosis. No focal hepatic lesions. Hepatic length measures 17.5 cm. The main portal vein is patent with normal hepatopedal flow with a peak velocity of 19 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is normal in echotexture with the wall measuring 1 mm. The common bile duct measures 2 mm in diameter. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 14.9 cm and has a normal echotexture.KIDNEYS: The kidneys have normal corticomedullary differentiation. The right kidney measures 10.7 cm with no hydronephrosis. Simple appearing cyst measuring 1.1 x 1.1 x 1.4 cm identified. The left kidney measures 10.5 cm with no hydronephrosis. OTHER: No significant abnormality noted.

Output: Increase in hepatic parenchymal echogenicity with coarsened echotexture consistent with fatty liver/hepatic parenchymal dysfunction, with no definite cirrhosis. No hepatic mass or ductal dilatation identified.


Instruction: Generate impression based on medical findings.

Input: Female 73 years old Reason: history of multiple nodules, please evaluate for interval change History: none RIGHT LOBE MEASUREMENTS: The right thyroid lobe measures 2 cm in transverse, 2.1 cm in AP, and 5.8 cm in length.LEFT LOBE MEASUREMENTS: The left thyroid lobe measures 2.3 cm in transverse, 2.1 cm in AP, and 4.9 cm in length.ISTHMUS MEASUREMENTS: The isthmus measures 0.4 cm in thickness.RIGHT LOBE: Multiple heterogenous nodules are again noted in the right thyroid lobe. The largest nodule measures 1.1 x 0.9 x 1.1 cm in the upper pole (prior 1.2 x 0.9 x 0.9 cm).LEFT LOBE: Multiple heterogenous nodules are again noted. The largest nodule measures 1.7 x 0.9 x 1.4 cm (prior 1.8 x 1.1 x 1.3 cm).ISTHMUS: Hypoechoic nodule within the right border of the isthmus measuring 0.5 x 0.3 x 0.5 cm, (prior 0.4 x 0.3 x 0.5 cm).PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign morphology lymph nodes in the neckOTHER: No significant abnormality noted.

Output: Bilateral thyroid nodules without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female 53 years old; Reason: r/o thyroid nodule History: left side palpable nodule and tenderness on palpation RIGHT LOBE MEASUREMENTS: 4.7 x 1.5 x 1.5 cmLEFT LOBE MEASUREMENTS: 4.2 x 1.4 x 1.4 cmISTHMUS MEASUREMENT: 0.8 cmRIGHT LOBE: The thyroid gland is heterogenous in echotexture. No focal nodules are noted in the right thyroid lobe.LEFT LOBE: Thyroid gland is heterogenous in echotexture. A subcentimeter predominantly cystic nodule in the midpole of the left thyroid lobe measures 0.7 x 0.4 x 0.3 cm and demonstrates a benign morphology.ISTHMUS: No significant abnormality noted.LYMPH NODES: No regional lymphadenopathy.OTHER: No significant abnormality noted.

Output: Heterogenous thyroid gland with a subcentimeter nodule in the left thyroid lobe, favored to be benign in etiology.


Instruction: Generate impression based on medical findings.

Input: 72-year-old female with multinodular goiter RIGHT LOBE MEASUREMENTS: 4.5 x 2.3 x 7.1 cmLEFT LOBE MEASUREMENTS: 6.4 x 3.7 x 8.1 cmISTHMUS MEASUREMENTS: 1.4 cm in AP dimension. RIGHT LOBE: Enlarged heterogeneous gland. A large inferior pole heterogeneous predominantly solid nodule with some internal cystic components measures 2.7 x 1 0.7 x 2.6 cm, previously 3.4 x 2.0 x 2.7 cm.LEFT LOBE: Enlarged heterogeneous gland. A large predominantly solid inferior pole nodule measures 6.3 x 3.5 x 5.4 cm, previously 6.2 x 2.6 x 5.2 cm.ISTHMUS: Enlarged heterogeneous gland.PARATHYROID GLANDS: No enlarged parathyroid gland identified.LYMPH NODES: No regional lymphadenopathy. OTHER: No significant abnormality noted.

Output: Enlarged heterogeneous gland with stable appearance of bilateral thyroid nodules as detailed above.


Instruction: Generate impression based on medical findings.

Input: Reason: Rule out mass History: mobile hard superficial lump right lower abdominal quadrant; No drainage, redness, swelling, or pain was noted around this nodule. Soft tissue nodule in the subcutaneous tissue with central hypoechoic area measuring 1.1 x 0.8 x 0.9 cm at the location where patient palpates nodule.

Output: Soft tissue nodule in the subcutaneous tissue as above, differential diagnoses include soft tissue granuloma, fat necrosis, or focal area of cellulitis.


Instruction: Generate impression based on medical findings.

Input: Evaluate for incomplete voiding RIGHT KIDNEY: Measures 9.7 cm. No hydronephrosis or perinephric free fluid.LEFT KIDNEY: Measures 10.8 cm. No hydronephrosis or perinephric free fluid.BLADDER: Prevoid volume of 281 mL and postvoid residual volume of 9 mL seen.

Output: Satisfactory voiding, postvoid residual volume of 9 mL.


Instruction: Generate impression based on medical findings.

Input: Male 70 years old Reason: Evaluate for cirrhosis, biliary obstruction History: Elevated LFTs, h/o EtOH LIMITED ABDOMENLIVER: . Liver measures 14.9 cm in length. The parenchyma is echogenic, coarse. There is a 2.2 cm calcified mass in the right lobe of the liver with questionable internal vascularity. Mild biliary dilatation.BILIARY TRACT: Mild biliary dilatation. Common bile duct is of normal caliber. Gallbladder is not visualized.PANCREAS: Visualized portions are unremarkableKIDNEYS: The right kidney measures 12 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 12 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 8 cm. in length. OTHER: Large bilateral pleural effusions.

Output: 1.2.2 several calcified mass in the right lobe of the liver, indeterminate. If clinically indicated, liver protocol CT or short-term ultrasound follow-up can be performed, given history.2.Echogenic coarse parenchyma is nonspecific, but can be seen in diffuse infiltrative hepatic disease. Mild biliary dilatation could be related to a cholecystectomy, but correlate with surgical history.3.Large bilateral pleural effusions.4.Echogenic renal parenchyma can be seen in nonspecific medical renal disease


Instruction: Generate impression based on medical findings.

Input: Male 67 years old Reason: HCV, concern for cirrhosis, HCC History: recent dx cirrhosis LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 14.4 cm in length. The parenchyma is moderately echogenic BILIARY TRACT: The gallbladder has an anechoic lumen. Wall measures 2 mm in thickness. Common duct measures 3 mm. PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas. Hypoechoic lesion near the pancreatic head measures 2.2 cm and may represent a peripancreatic lymph node.KIDNEYS: The right kidney measures 10.4 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. Cortical cyst measures 1 cm.The left kidney measures 10.7 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 7 cm . in length. OTHER: No significant abnormalities noted.

Output: 1.Echogenic hepatic parenchyma without focal hepatic lesion.2.2.2 cm hypoechoic nodule near the pancreatic head may represent a prominent upper abdominal lymph node. Further evaluation of the triphasic CT of the upper abdomen to evaluate the liver and node is suggested.


Instruction: Generate impression based on medical findings.

Input: Hypertension; former smoker ULTRASOUND KIDNEYSRIGHT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Right kidney 8.4 cm in length.LEFT KIDNEY: Normal parenchymal echogenicity without worrisome mass, stone, or hydronephrosis. Benign renal cyst. Left kidney 9.5 cm in length.OTHER: Bladder nondistended

Output: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. Patent renal vasculature bilaterally without evidence for renal artery stenosis.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old. Reason: hx of kidney cancer s/p partial nephrectomy on right and now with left renal mass, evaluate change in size or characteristics History: see above RIGHT KIDNEY: Right kidney measures 10.5 cm in length with increased cortical echogenicity. Stable right renal cyst measures 2.3 x 2.2 x 2.1 cm.LEFT KIDNEY: Left kidney measures 11.0 cm in length with increased cortical echogenicity. Solid-appearing upper pole lesion measures 2.2 x 1.5 x 2.1 cm, previously 1.9 x 1.8 x 1.7 cm. OTHER: Urinary bladder is collapsed which limits evaluation.

Output: Slight increased size of the left upper pole renal mass


Instruction: Generate impression based on medical findings.

Input: Male 41 years old Reason: Gallstones, Cholecystitis, Cholelithiasis History: Hx of gallstones, RUQ abd pain LIVER: Liver measures 16.6 cm in length. No focal liver lesion. Main portal vein patent with normal directional flow, velocity measures 30 to 40 cm/s.BILIARY TRACT: Large amount of layering sludge and multiple gallstones in the gallbladder. No significant gallbladder distention, wall thickening or pericholecystic fluid. Mild intrahepatic biliary duct dilatation. No extrahepatic biliary duct dilatation. Unable to adequately assess for sonographic Murphy's sign due to patient's recent receipt of pain medications.PANCREAS: Not well visualized due to overlying bowel gas.KIDNEYS: The right kidney measures 10.4 cm. The left kidney measures 10.9 cm. No hydronephrosis.SPLEEN: The spleen measures 10.3 cm in length.

Output: Cholelithiasis and sludge in gallbladder. No secondary signs of acute cholecystitis.Mild intrahepatic biliary duct dilatation. Common bile duct normal in size.Pancreatic findings better delineated on recent CT imaging.


Instruction: Generate impression based on medical findings.

Input: Nexplanon contraceptive device left upper arm no longer palpable Unremarkable subcutaneous tissues without evidence for foreign body or loculated fluid collection

Output: Unremarkable subcutaneous tissues left upper arm without evidence for foreign body or loculated fluid collection. Specifically, implanted contraceptive device not identified


Instruction: Generate impression based on medical findings.

Input: Male 65 years old; Reason: 65yo M with h/o HNC with new acute kidney injury. History: new AKI RIGHT KIDNEY: The right kidney measures 13.5 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. LEFT KIDNEY: The left kidney measures 11.4 cm in length. The cortex is echogenic. No shadowing calculi or hydronephrosis is present.  URINARY BLADDER: No significant abnormality notedOTHER: No significant abnormalities noted.

Output: 1.Echogenic renal cortices compatible with medical renal disease.


Instruction: Generate impression based on medical findings.

Input: Reason: R/O parenchymal disease, obstruction History: hematuria, history of L renal v autotransplant RIGHT KIDNEY: Right kidney measures 11.4 cm and is normal in echogenicity without hydronephrosis. No evidence of renal calculi. Normal renal hilar flow noted.LEFT KIDNEY: Left kidney measures 11.7 cm and is normal in echogenicity without hydronephrosis. No evidence of renal calculi. Left renal vein is patent. Left renal artery is patent with resistive index of 0.6 and peak systolic velocity of 0.8 m/s.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted.

Output: Normal blood flow to the left kidney. No evidence of hydronephrosis or renal calculi.


Instruction: Generate impression based on medical findings.

Input: 76-year-old male with post-renal acute kidney injury. Evaluate for hydronephrosis. RIGHT KIDNEY: The right kidney measures 9.5 cm in length. The parenchyma is hyperechoic with loss of the corticomedullary junction suggesting medical renal disease. There are multiple small simple cysts, the largest of which measures 1.3 x 1.4 x 1.4 in the lower pole. No evidence of hydronephrosis.LEFT KIDNEY: Left kidney is obscured by overlying bowel gas.OTHER: The bladder is collapsed. Patient has a Foley catheter.

Output: Echogenic right kidney compatible with medical renal disease, without evidence of hydronephrosis. Left kidney not well visualized due to overlying bowel gas.


Instruction: Generate impression based on medical findings.

Input: Female 43 years old Reason: assess TIPS patency History: Budd Chiari/ascites LIVER: The liver measures 13.3 cm in length and demonstrates heterogeneous parenchymal echogenicity. A new hyperechoic focus is noted within the right hepatic lobe measuring 1.3 x 1.4 x 1.6 cm, which is nonspecific; however, special attention at follow-up is recommended. No intrahepatic or extrahepatic biliary ductal dilatation is evident and no focal mass lesions are seen. GALLBLADDER, BILIARY TRACT: No cholelithiasis or choledocholithiasis is seen. The common duct measures 0.4 cm in diameter. PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 11.7 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.LEFT KIDNEY: The left kidney measures 13.9 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.SPLEEN: The spleen measures 11.4 cm in length.OTHER: No significant abnormalities noted.

Output: 1.Patent TIPS with appropriate flow direction and velocity.2.Heterogeneous hepatic parenchymal echogenicity consistent with known Budd-Chiari syndrome.3.New hyperechoic focus in the right hepatic lobe is nonspecific; however, special attention follow-up is recommended.4.Right hepatic vein not well seen.


Instruction: Generate impression based on medical findings.

Input: Female 59 years old Reason: status of pancreatitis with pancreatic pseudocyst and question of gallstones. History: abdominal pain, nausea and vomiting. LIVER: The liver measures 16.5 cm in length and demonstrates increased parenchymal echogenicity. No intrahepatic or extrahepatic biliary ductal dilatation is evident and no focal mass lesions are seen. The main portal vein is patent and demonstrates hepatopedal flow with a velocity of 0.2 m/s. GALLBLADDER, BILIARY TRACT: The gallbladder is contracted and filled with sludge and stones, but no wall thickening or pericholecystic fluid is evident. The common duct measures 0.3 cm in diameter. PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 13.5 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.LEFT KIDNEY: The left kidney measures 12.7 cm in length and demonstrates normal parenchymal echogenicity. No hydronephrosis or hydroureter is evident, and no nephrolithiasis or ureterolithiasis is seen.SPLEEN: The spleen measures 15.3 cm in length.OTHER: There is a large anechoic collection in the upper abdomen measuring approximately 16.8 x 18.0 x 8.8 cm with a fluid fluid level consistent with a pancreatic pseudocyst .

Output: 1.Large pancreatic pseudocyst in the upper abdomen as detailed above.2.Increased hepatic parenchymal echogenicity consistent with hepatic steatosis.3.Gallbladder filled with stones and sludge, but no evidence of acute cholecystitis.4.Splenomegaly.


Instruction: Generate impression based on medical findings.

Input: 6-year-old female with a history of lymphoma presents with sepsis, elevated liver enzymes, and jaundice; evaluate for biliary obstruction. LIVER: Mild increase in hepatic parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions. Hepatic length measures 17 cm. The main portal vein is patent with normal hepatopedal flow directed towards the liver with a velocity of 30 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder is normal in echotexture with a thickened wall measuring 8 mm. The common bile duct measures 3 mm in diameter. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 14 cm and has a normal echotexture.KIDNEYS: The kidneys have normal corticomedullary differentiation. The right kidney measures 10 cm and has normal vascular flow. The left kidney measures 11 cm and has normal vascular flow. No evidence of hydronephrosis.OTHER: Small amount of ascites. Partially visualized bilateral pleural effusions.

Output: 1. Mild increase in hepatic parenchymal echogenicity with coarsened echotexture consistent with fatty liver/hepatic parenchymal dysfunction. No hepatic mass or ductal dilatation identified.2. Gallbladder wall thickening without definite evidence of cholecystitis. Etiology likely due to underlying hypoalbuminemia/ascites.3. Mild splenomegaly.4. Small amount of ascites.5. Partially visualized bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female 68 years old Reason: r/o nodules History: outside ultrasound had shown small thyroid nodules. 1 year follow up study RIGHT LOBE MEASUREMENTS: 5.2 x 1.7 x 2.3 cm.LEFT LOBE MEASUREMENTS: 3.1 x 0.8 x 1.7 cm.ISTHMUS MEASUREMENTS: 0.3 cm in thickness.RIGHT LOBE: The right lobe of the thyroid demonstrates normal parenchymal echogenicity. Two nodules identified within the right lobe of the thyroid. Heterogeneous solid nodule in the inferior lobe of the thyroid measures 0.9 x 0.7 x 2.4 cm. Spongiform nodule in the mid right thyroid lobe measures 1.2 x 1.0 x 0.8 cm.LEFT LOBE: The left lobe of the thyroid demonstrates normal parenchymal echogenicity.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Solid and spongiform nodules identified within the right lobe of the thyroid as detailed above.


Instruction: Generate impression based on medical findings.

Input: Male 76 years old Reason: RUQ ultrasound History: eval for biliary dilatation, stones, cholecystitis LIMITED ABDOMENLIVER: The liver has a smooth contour. Liver measures 15 cm in length. The parenchyma is severely echogenic . No focal hepatic lesions. Main portal vein is patent with normal flow.BILIARY TRACT: The gallbladder has echogenic calculi with posterior acoustic shadowing. Wall measures 4 mm in thickness. There is minimal pericholecystic edema. Common duct measures 5 millimeters. PANCREAS: The pancreas is obscured due to bowel gas.KIDNEYS: The right kidney measures 10.3 cm. The cortex is thinned and echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 12.2 cm. The cortex is thinned and echogenic. No shadowing calculi or hydronephrosis is present. Cyst at the upper pole measures 3 cm.SPLEEN: The spleen measures 12.9 cm. in length. OTHER: No ascites.

Output: 1.Cholelithiasis with minimal gallbladder wall thickening and mild pericholecystic edema. Imaging features would suggest early cholecystitis in appropriate clinical setting.2.Fatty liver.


Instruction: Generate impression based on medical findings.

Input: 27-year-old female status post thyroidectomy for thyroid malignancy. RIGHT LOBE MEASUREMENTS: Patient is status post thyroidectomy.LEFT LOBE MEASUREMENTS: Patient is status post thyroidectomy.ISTHMUS MEASUREMENTS: Patient is status post thyroidectomy.THYROID BED: In the right thyroidectomy bed, there is a typical-appearing lymph node, unchanged from prior exam measuring 0.4 x 0.4 x 0.8 cm. No other mass identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Benign lymph node visualized within the right neck, unchanged from prior examination.OTHER: No significant abnormality noted.

Output: Stable negative examination without evidence of recurrence or adenopathy. Stable lymph node right thyroidectomy bed.


Instruction: Generate impression based on medical findings.

Input: Female 72 years old with thyromegaly RIGHT LOBE MEASUREMENTS: 7.1 x 3.0 x 2.9 cmLEFT LOBE MEASUREMENTS: 7.2 x 2.8 x 2.4 cmISTHMUS MEASUREMENT: 0.9 cmRIGHT LOBE: Heterogeneous parenchymal echotexture with multiple cystic and subcentimeter solid nodules.-Hypoechoic inferior pole nodule measures 0.9 x 0.8 x 0.8 cm. No microcalcifications or increased vascularity.LEFT LOBE: Heterogeneous parenchymal echotexture with multiple cystic and septated nodules.-Cystic complex mid-pole lesion measuring 1.9 x 1.7 x 1.6 cm. No microcalcifications or increased vascularity.ISTHMUS: Heterogeneous parenchymal echotexture with a large cystic nodule measuring 2.4 x 1.5 x 1.0 cm. No microcalcifications or increased vascularity.LYMPH NODES: Mildly prominent benign appearing lymph nodes. OTHER: No significant abnormality noted.

Output: Enlarged thyroid with multiple cystic and subcentimeter solid nodules bilaterally. No regional adenopathyI 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 60 years old with h/o metastatic recurrent PTC now s/p thyroidectomy, RAI and 2 neck dissections, evaluate for thyroid cancer recurrence RIGHT LOBE MEASUREMENTS: Status-post thyroidectomy.LEFT LOBE MEASUREMENTS: Status-post thyroidectomy.ISTHMUS MEASUREMENT: Status-post thyroidectomy.RIGHT LOBE: Status-post thyroidectomy without evidence of mass or recurrence.LEFT LOBE: Hypoechoic region is again noted adjacent to the carotid artery measuring 0.9 x 0.7 x 0.7 cm, not significantly changed from prior exam.ISTHMUS: No significant abnormality noted.LYMPH NODES: Multiple benign-appearing lymph nodes are noted.OTHER: No significant abnormality noted.

Output: Stable hypoechoic region in the left thyroid bed without evidence of new lesion or nodal recurrence.


Instruction: Generate impression based on medical findings.

Input: Reason: Pt is a 36 y/o male with h/o testicular cancer, c/o new cystic lesion in abdomen, request ultrasound of abdomen to evaluate density of nodule History: testicular cancer, abdominal nodule Hyperechoic avascular nodule in the anterior abdominal wall measuring 1.4 x 1.2 x 0.6 cm corresponding to the nodule palpated by the patient. Small abdominal lymph nodes with normal fatty hilum.

Output: Hyperechoic vascular nodule in the anterior abdominal wall corresponding to the nodule palpated by the patient. While the sonographic characteristics of this lesion is compatible with a lipoma, ultrasound is relatively nonspecific with lesion characterization.


Instruction: Generate impression based on medical findings.

Input: Reason: left sided pain. Hx of renal cysts. ? enlargement of the cysts History: has left side pain off and on. No hematuria. RIGHT KIDNEY: The right kidney measures 15.5 cm in length and shows normal echotexture. There is a simple-appearing cystic structure within the lower pole of the right kidney which measures 7.2 x 6.2 x 7.9 cm. No mass lesion is evident within the right kidney. There are no shadowing calculi. There is no hydronephrosis.LEFT KIDNEY: The left kidney measures 10.9 cm in length and shows normal echotexture. There is a simple-appearing cystic structure within the lower pole of the left kidney which measures 4.0 x 4.6 x 4.1 cm. No mass lesion is evident within the left kidney. There are no shadowing calculi. There is no hydronephrosis.URINARY BLADDER: The urinary bladder is incompletely distended, but appears within normal limits. OTHER: There is no free or loculated fluid within the pelvis.

Output: Bilateral simple-appearing renal cysts, which are stable in size.