Instruction: Generate impression based on medical findings.

Input: 67-year-old female the saturation, crackles, recent colonoscopy. Rule-out pulmonary process or free air. CHEST:LUNGS AND PLEURA: Biapical scarring. Emphysema. Calcified right upper lobe nodule. No evidence of consolidation.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Presumed hepatic cyst in the left lobe.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Left para-aortic adenopathy on image number 99, series number 3 measuring 12 x 10 mm.BOWEL, MESENTERY: Mild wall thickening involving the left-sided:. No evidence of free air. Multiple enlarged lymph nodes near the splenic flexure associated with wall thickening. Correlation of these findings with patient's recent colonoscopy is recommended.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Mild left-sided colonic wall thickening. Colonic thickening is more prominence in the region of the splenic flexure associated with pericolonic and retroperitoneal adenopathy. Correlation of these findings with the recent colonoscopy to exclude neoplasm is recommended.


Instruction: Generate impression based on medical findings.

Input: Male, 39 years old.Reason: pls assess swan placement History: s/p swan placement Unchanged pleural effusions and nodular pulmonary opacities.Right jugular Swan-Ganz catheter pulled back to the right main pulmonary artery.ET tube tip approximately 5 cm above the carina.An NG tube extends below the lower margin of the image.

Output: Swan-Ganz catheter pulled back to the right main pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: DOE. Proximal muscle weakness, concern for possible rheumatologic disease. Bilateral basal peribronchial opacities with volume loss and possible mild traction bronchiectasis. Though not a plain film diagnosis this pattern is suspicious for myositis-related lung disease given the clinical history. Left basal nodule appears dense and well-circumscribed, favored to be a granuloma. Heart size is normal.

Output: Basal peribronchial opacities nonspecific but could potentially represent a manifestation of myositis-related lung disease. Recommend correlation with ILD protocol thoracic CT and myositis specific antibody panel.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lung fields History: s/p BIVAD, fluid overload, pleural effusion Small lung volumes with left lower lobe atelectasis, consistent with aspirated secretions, unchanged.Cardiopulmonary monitoring and support devices, unchanged.Left loculated or organized effusion.Moderate right basilar opacity, slightly increased, consistent with aspirated secretions and atelectasis.

Output: Slightly increased right basilar atelectasis and persistent left lower lobe atelectasis.


Instruction: Generate impression based on medical findings.

Input: 55-year-old male with history of head neck cancer. Status post CRT. Measurements please. CHEST:LUNGS AND PLEURA: Mild paraseptal emphysema and mild bronchiolitis, similar to prior study. No suspicious nodules, masses, or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal with trace pericardial effusion.Hiatal hernia.CHEST WALL: Right chest port catheter with catheter tip in distal SVC. ABDOMEN: LIVER, BILIARY TRACT: Subcentimeter hypoattenuating focus in the left hepatic lobe remains too small to characterize but remains unchanged from initial CT from 11/23/2010.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple renal cysts, bilaterally.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease of the descending aorta and iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.

Output: No evidence of metastatic disease. Mild bronchiolitis.


Instruction: Generate impression based on medical findings.

Input: Reason: hx aortic aneurysm History: aortic aneurysm LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Ectatic ascending aorta is overall stable. The ascending aorta at the level of the right pulmonary artery measures 3.9 x 3.7 cm, previously 4.0 x 2.8 cm. Supraclavicular aortic root measures 3.2 cm, unchanged. The mid ascending aorta measures 3.9 cm, unchanged. The mid descending aorta measures 2.3 cm, unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Mild intrahepatic biliary ductal dilatation with prominent common bile duct, presumably related to cholecystectomy. T2 hyperintensities within the liver likely represent cysts. Pancreatic divisum.

Output: 1.Stable ascending thoracic aortic ectasia.2.Pancreatic divisum. Incompletely assessed biliary duct dilatation presumably related to cholecystectomy.


Instruction: Generate impression based on medical findings.

Input: Male, 31 years old.Reason: shock, neutropenia, rule out infection Low lung volumes makes detailed cardiopulmonary assessment difficult. No focal lung consolidation or evidence of overt left-sided heart failure. No large pleural effusion or pneumothorax. Unchanged heart size. Unchanged port catheter.

Output: Low lung volumes makes detailed cardiopulmonary assessment difficult. No focal lung consolidation or evidence of overt left-sided heart failure.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Ongoing tachypnea evaluate pulmonary opacities. Patchy groundglass opacities bilaterally are becoming more confluent. No pleural fluid. Upper normal heart size.

Output: Pulmonary opacities are becoming more confluent. Absence of pleural fluid and septal thickening is atypical for edema, favoring infection or possibly pulmonary hemorrhage as the etiology.


Instruction: Generate impression based on medical findings.

Input: 82-year-old female with PE, DVT, COPD, now with increased SOB. Evaluate for pleural effusion. LUNGS AND PLEURA: Interval development of bilateral small pleural effusions with compressive atelectasis of the adjacent lung. Scattered micronodules, a few of which are calcified, most likely postinflammatory. No focal consolidation.MEDIASTINUM AND HILA: Cardiac size is normal. Small pericardial effusion. Borderline enlarged pretracheal lymph nodes. Atherosclerotic calcifications noted.CHEST WALL: Kyphosis and near complete compression fractures of two upper thoracic vertebral bodies are unchanged.UPPER ABDOMEN: Hiatal and bilateral Bochdalek hernias unchanged.

Output: Interval development of small bilateral pleural effusions. No other significant interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: eval for infiltration/effusion History: hypoxemia and dyspnea Mild cardiomegaly.Small lung volumes.No edema or pleural effusions.Possible evolving focal opacity left upper lobe projected over the anterior aspect of left rib most likely is artifactual although early infection is possible.

Output: Possible left upper lobe opacity, for which continued follow-up is recommended.


Instruction: Generate impression based on medical findings.

Input: Female, 20 years old.Evaluate for infection, edema, or effusion. History: productive cough, shortness of breath, fever. No focal airspace opacities, pleural effusion or pneumothorax. Heart size is within normal limits.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: chest pain History: cp Questionable new opacity in the mid aspect of the right lung which could represent aspiration or pneumonia. No pleural effusion or pneumothorax. No change in heart size given lordotic view.

Output: New questionable opacity in the mid aspect of the right lung. Consider chest radiographic follow-up in 8 weeks for reassessment.Findings verbally discussed with Dr. Kukulksi at 9:04 AM on 11/14/2015.


Instruction: Generate impression based on medical findings.

Input: Male, 83 years old. Reason: eval for mediastinal air History: esophageal tear seen on EGD Interval removal of NG tube. ET tube tip approximately 3 cm above the carina.The cardiomediastinal silhouette is unchanged. No evidence of pneumomediastinum. A linear vertical skinfold overlies the right aspect of the mediastinum.Nonspecific basilar opacities may represent atelectasis or edema. No new focal airspace opacity.

Output: Stable cardiopulmonary appearance. Specifically, no radiographic evidence of pneumomediastinum.


Instruction: Generate impression based on medical findings.

Input: Male, 36 years old.Reason: monitor swan placement History: CHF, s/p swan Severe cardiomegaly without acute edema.Impella unchanged in position.Right jugular Swan-Ganz catheter tip in proximal right main pulmonary artery.Surgical drain projected over the right chest wall stable.

Output: Cardiomegaly without acute edema or pneumonia. No significant pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: Rule out aspiration History: dysphagia, leukocytosis Left chest ICD lead and LVAD positions are unchanged. Valvular prosthesis. Median sternotomy hardware and surgical clips.Chronic appearing basilar interstitial opacities without new focal opacity to suggest infection. No large pleural effusion or pneumothorax. Heart size is normal.

Output: Chronic appearing basilar opacities, likely reflecting scarring, without specific evidence of infection. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Reason: h/o aspiration pneumonia, now extubated History: hypoxia Unchanged pulmonary opacities right greater than left with pleural effusions also right larger than left.An NG tube extends below the lower margin of the image.Right PICC, tip in the SVC.

Output: Unchanged pulmonary opacities consistent with edema and pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 50 years old.Chest pain and SOB. Left chest port tip at the SVC/artery level. Normal heart size. Lung volumes are low. No focal airspace opacities.

Output: No signs of CHF or pneumonia.


Instruction: Generate impression based on medical findings.

Input: 44-year-old female with productive cough and chills. Unchanged cardiomediastinal silhouette. No focal airspace opacity or pleural effusion. Mild bronchial wall thickening is suggestive of asthma or bronchitis.

Output: Mild bronchial wall thickening suggestive of asthma or bronchitis. No specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Chest pain. Normal heart size. Tortuous aorta appearing similar to prior.Small lung volumes with associated subsegmental basilar atelectasis. Basilar predominant mild chronic interstitial opacity appearing similar to prior. No visible effusions.

Output: Small lung volumes and chronic interstitial pulmonary opacities without acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Fever, ALL patient Mild basilar scarring greater on the left with suspected small effusion and/or pleural thickening. No superimposed acute new abnormalities. The cardiac mediastinal contours are within limits.Right jugular Hickman unchanged, tip extends into the mid SVC

Output: No evidence to suggest new superimposed acute abnormality upon previously described basilar scarring


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: Eval for PNA History: Cough No evidence of pneumonia. Nipple shadow on the right.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 85 years old.Reason: eval for signs of esophageal perf History: bil chest pain after food stuck in esophagus, vomiting, hx esophageal stricture and dilation The heart is normal in size. Severe tortuosity of the thoracic aorta.Lung volumes in the upper limits of normal. No abnormal focal lung opacities..Mild degenerative changes of the thoracic spine. The sternal wires are intact.No pleural effusion or pneumothorax. Left midlung calcification, possibly pleural or intercostalNo evidence of pneumoperitoneum or pneumomediastinum.

Output: No evidence of pneumoperitoneum or pneumomediastinum.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Shortness of breath. Evaluate for infection/edema. Minimal bibasilar atelectasis. No pleural effusions, likely scarring at the right costophrenic angle. No focal pulmonary opacities to suggest infection.Cardiomegaly.

Output: Minimal bibasilar atelectasis with right costophrenic angle scarring. No evidence of infection or pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 20 years old.Reason: Evaluate for acute chest History: Rib pain Small lung volumes.Mild cardiomegaly.No specific evidence of infection or edema.

Output: Mild cardiomegaly, without evidence of acute infection or infarction.


Instruction: Generate impression based on medical findings.

Input: Reason: 85F with IABP for NSTEMI, assess placement. History: iabp, multi-vessel nstemi Balloon catheter tip in the proximal descending aorta, projected 2 cm below the top of the aortic arch.Normal heart size with a calcified aortic arch.Small lung volumes with diffuse coarse interstitial opacity suggestive of fibrosis, possibly with a component of superimposed edema.

Output: Balloon catheter in the proximal descending aorta.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: Crackles, h/o pna History: above Two right central catheters remain in stable position.Decreased size of bilateral pleural effusions, now small. Mid to lower zone opacities compatible with edema. Severe cardiomegaly unchanged over several examinations. No pneumothorax.

Output: Mild pulmonary edema with small bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Reason: ADHF, cardiogenic shock History: as above Cardiomegaly with ICD leads andAortic balloon catheter in place. The balloon catheter marker is at the level of the aortic arch. Interval removal of a Swan-Ganz catheter.Cardiomegaly with mild basilar opacity compatible with interstitial edema and atelectasis.

Output: Interval removal of Swan-Ganz catheter and no other significant change.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: Evaluate for source of infection History: Febrile, history of recent PE Large extrapulmonary lesion along the lateral aspect of the hemithorax with underlying rib destruction again noted. Mild left basilar subsegmental atelectasis or scarring. Small hiatus hernia. No focal lung consolidation. Unchanged heart size.

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


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: s/p neck dissection and sternotomy, r/o pneumothorax History: intubated, s/p neck dissection and sternotomy Status post resection of a large right paratracheal mediastinal mass presumably a goiter. Surgical drains overlie this region, and there is no pneumothorax.Small pleural effusions are present, with patchy left base opacity.ET tube tip in low, within 1 cm of the carina.

Output: Low ET tube. Status post mediastinal mass resection with no pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 92 yearsGender: FemaleReason for Study: Reason: chest pain, hx of CAD, NSTEMI, CHF History: chest pain x30min, no SOB or LE edema Stable cardiomediastinal silhouette.Mild elevation right hemidiaphragm with minimal basilar atelectasis.No focal areas of consolidation.No large pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 37 years old.Jejunal interposition. ETT tip in the expected location of the right mainstem bronchus.Other hardware and devices unchanged.Layering pleural fluid and atelectasis about the same. Mild septal thickening on the right suggestive of edema.High density material at the bases suggests previously aspirated barium.Pleural calcifications on the right.Pneumomediastinum is no longer visible.

Output: Right mainstem bronchus intubation. No acute change in pleural fluid, atelectasis or mild edema.


Instruction: Generate impression based on medical findings.

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

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 46 yearsGender: MaleReason for Study: Reason: Evaluate for pulmonary infiltrates History: Inhalational injury ET tube with its tip 4 cm above the carina.Enteric tubes with the tips beyond the margin of the image.Stable cardiomediastinal silhouette.Patchy pulmonary opacities slightly improved from the prior exam.

Output: Support devices unchanged. Patchy pulmonary opacities within the right lung is mildly improved.


Instruction: Generate impression based on medical findings.

Input: Check Swan-Ganz Swan-Ganz extends into the right pulmonary outflow tract, minimally retracted one to 2 cm. ICD in remaining cardiopulmonary appearance otherwise unchanged and most significantly demonstrates marked nonspecific cardiomegaly

Output: Swan-Ganz minimally retracted yet remains in the right pulmonary outflow tract


Instruction: Generate impression based on medical findings.

Input: Age: 77 yearsGender: FemaleReason for Study: Reason: r/o acute process History: shortness of breath Stable cardiac mediastinal silhouette.The lungs are clear.No pleural effusions.Marked degenerative changes in thoracic spine

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: hemoptysis, hx of lung cancer History: hemoptysis, hx of lung cancer Right upper lobe nodule, with an adjacent fiducial marker.No other significant abnormality.No evidence of edema or pneumonia, or hemorrhage with regard to the clinical history provided.

Output: Known right upper lobe nodule. No new findings and no source of hemoptysis.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Atrial fibrillation. Evaluate for cause arrhythmia. No focal consolidation, pleural effusion or pneumothorax. Normal cardiomediastinal silhouette.

Output: No evidence of infection, or other acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: s/p LVAD and recent pump exchange History: chest tube removal Interval placement of a left PICC that terminates at the expected mid left subclavian vein. Interval removal of right IJ sheath. The remaining support devices, including a percutaneously deployed aortic valve and left ventricular assist device, are unchanged.Decreased size of trace pleural effusions with improved aeration of the lung bases. No interval pneumothorax.

Output: No pneumothorax following placement of left PICC and removal of right IJ central catheter. Improved aeration of the lung bases following deployment of percutaneous aortic valve.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: 67yr old female with history of MM; pre-auto sct evaluation History: evaluate Right chest port is low lying with the catheter tip in the IJ/high SVC.The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax.Multiple rib lesions are noted, most notably in the posterior left sixth rib, compatible with known multiple myeloma.Additional degenerative changes are present in the spine and shoulders.

Output: No acute cardiopulmonary process is identified. Multiple osseous lesions compatible with known multiple myeloma. Overlying chest port, with tip high in the SVC.


Instruction: Generate impression based on medical findings.

Input: Age: 61 yearsGender: MaleReason for Study: Reason: s/p R lobectomy History: s/p R lobectomy Left-sided chest tube unchanged.Moderate amount of subcutaneous emphysema along right lateral chest wall with persistent right apical pneumothorax.Stable cardiomediastinal silhouette.Basilar opacities compatible atelectasis similar to the prior exam.No new pulmonary opacities identified.

Output: Persistent right apical pneumothorax with subcutaneous emphysema along the right lateral chest wall.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old with esophageal perforation. Undergoing esophagectomy with thoracotomy.RFO trigger: Surgery length greater than 8 hours RFO trigger: R/O RFO Suspected RFO location: CHEST Name of suspected RFO: INSTRUMENTS No evidence of radiopaque retained foreign object. Interval tracheostomy placement.Enteric tube with tip at the gastroesophageal junction and side hole in the mid esophagus.Diffuse bilateral opacities and pleural effusions consistent with postsurgical changes. Multiple surgical drains bilaterally. Surgical clips projecting over the mediastinum.

Output: No radio-opaque retained foreign object.The findings were discussed by telephone with the attending surgeon, Dr. Vigneswaran, at 5:00 p.m.. on 2/3/2015.


Instruction: Generate impression based on medical findings.

Input: Cough for one week Interval removal of the right jugular port. Lungs otherwise remain unremarkable without underlying cardiopulmonary abnormality

Output: No acute disease and right port removed


Instruction: Generate impression based on medical findings.

Input: 59-year-old female with history of Sjogren's. Please evaluate nodule and provide follow-up time parameter. LUNGS AND PLEURA: Previously noted spiculated mass in the lingula measures 5.2 x 5 mm (series 5, image 29), relatively unchanged accounting for differences in technique. Nodule the right upper lobe on image 106, generally unchanged but should be followed.Diffuse interlobular and intralobular septal thickening seen along with a very mild axial interstitial thickening and areas of centrilobular groundglass especially in the lung bases. Cystic emphysemaNumerous, thin-walled cysts with groundglass opacities and centrilobular nodules, stable. Areas of bronchiectasis are also noted in the lower lobes. Stable biapical scarring. Scattered micronodules bilaterally (less than 4 mm) also unchanged.MEDIASTINUM AND HILA: Small mediastinal lymph nodes (stable).CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: 1.Stable spiculated nodule in lingula, recommend serial CT follow-up in 3 to 4 months.2.Cystic lung disease unchanged, LAM vs LIP.3.Underlying mild centrilobular emphysema.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.AMS, cirrhosis evaluate for pneumonia. TIPS and embolization coils project over the midline abdomen.Low lung volumes. Normal heart size. No focal pulmonary opacity.

Output: No signs of pneumonia or other acute pulmonary process.


Instruction: Generate impression based on medical findings.

Input: Hyperhidrosis and chest pain No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Female, 84 years old.Reason: SOB, chest pain History: SOB, chest pain Small lung volumes.Heart size at least upper normal.No specific evidence of infection or edema.Mediastinal width is normal for degree of inflation.

Output: Heart size at least upper normal, but no reliable evidence of edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Age: 81 yearsGender: FemaleReason for Study: Reason: PNA, bone fracture History: fall, cough The cardiomediastinal silhouette is unremarkable.Left suprahilar masslike opacity with left upper lobe subsegmental atelectasis.No pleural effusions.No obvious fractures.

Output: Left suprahilar masslike opacity. Retrieval of previous imaging and/or CT the chest with IV contrast is recommended.


Instruction: Generate impression based on medical findings.

Input: Staging for newly diagnosed lung cancer CHEST:LUNGS AND PLEURA: Right upper lobe mass measuring 1.3 x 1.3 cm on image number 24, series number 5. Right-sided pleural catheter placed for pneumothorax. Right lower lobe segmental atelectasis. Minimal residual right-sided pneumothorax.MEDIASTINUM AND HILA: Right-sided supraclavicular adenopathy measuring 3 by 2 cm on image number one, series number 3, incompletely imaged. Extensive mediastinal adenopathy. Index right superior mediastinal adenopathy measures 2.1 x 2.5 cm on image number 15, series number 3. Precarinal adenopathy measures 2.3 by 1.6 cm on image number 32, series number 3. The esophagus is dilated throughout its course.CHEST WALL: Subcutaneous emphysema on the right side likely secondary to recent biopsy.ABDOMEN:LIVER, BILIARY TRACT: 9-mm hypodense lesion in the left lobe of the liver image number 63, series number 3 likely represents partial volume averaging with the surrounding fat. Pneumobilia is present.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Laxity of the anterior abdominal wall with protruding nonobstructed bowel loops in the midline.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Right upper lobe mass consistent with patient's known history of lung cancer. Mediastinal and right supraclavicular adenopathy.Right-sided pneumothorax catheter there was minimal amount of residual right-sided pneumothorax and extensive right-sided subcutaneous emphysema.


Instruction: Generate impression based on medical findings.

Input: Reason: eval pulm edema History: pancreatitis Left lower zone opacity compatible with atelectasis, consolidation and effusion, unchanged.Small right effusion.NG tube tip in the stomachPort catheter tip in the SVC.

Output: Small effusions, greater on the left with underlying atelectasis, not significantly changed.


Instruction: Generate impression based on medical findings.

Input: 97-year-old female with large necrotic breast mass. Evaluate for breast malignancy. CHEST:LUNGS AND PLEURA: Nonspecific scattered micronodules. No suspicious nodules, masses, or pleural effusion.Several, thin-walled intrapulmonary cysts are noted.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal with small pericardial effusion. Vascular calcifications of the right coronary, left circumflex, and the LAD arteries.CHEST WALL: Right breast mass (series 3, image 28) measures 5 x 4 cm. It extends from the pectoralis muscle to the skin at the anterior breast. It contains central areas of low attenuation which may represent necrosis versus dilated ducts.Degenerative changes of the spine. UPPER ABDOMEN: 6-mm hypoattenuating focus in the spleen (series 3, image 71) is a nonspecific finding. Given the finding of a right breast mass, a metastasis from a primary breast malignancy is a possibility.Well-defined, hypoattenuating foci in the deliver a compatible with cysts, which were seen on a prior abdomen ultrasound from 2004.Bilateral adrenal nodules, nonspecific.

Output: 1. Right breast mass with central low attenuation areas possibly representing areas of necrosis versus dilated ducts. Dedicated breast imaging is recommended for further evaluation.2. Nonspecific hypoattenuating focus in the spleen. Given the finding of a right breast mass, a metastasis from a primary breast malignancy is a possibility.3. Nonspecific bilateral adrenal nodules.


Instruction: Generate impression based on medical findings.

Input: Male, 76 years old.Reason: ET tube placement, progression of lung process History: MICU Minimal lower lung zone opacities and left lower lobe consolidation with pleural effusions are gradually worsening over the last day, consistent with edema and possible aspiration.ET tube tip approximately 5 cm above the carina.An NG tube terminates in the stomach.

Output: Gradually worsening basilar opacities consistent with edema and/or aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: 74M w/ COPD, ESRD w/ SOB, wheezing- r/o PNA vs pulm edema History: SOB, wheezing Cardiomegaly with perihilar bronchial wall thickening and possible edema accompanied by small pleural effusions, improved compared to the prior study.Left brachiocephalic stent.Pancreatic calcifications identified.

Output: Bronchial wall thickening consistent with asthma or chronic bronchitis, with the suggestion of superimposed edema, improved compared to last month.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: eval ETT / aspiration History: as above Left subclavian line has been removed. No pneumothorax. Other lines and tubes, are again noted. The enteric tube appears to been advanced slightly. No substantial change in bibasilar pleural-parenchymal opacities. No new focal pleural parenchymal opacity. Small left pleural effusion. Unchanged heart size.

Output: Left subclavian line has been removed. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: eval prior to vq scan History: see above Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o infection History: AMS Bilateral upper lobe scarring and volume loss with multiple calcifications, consistent with previous granulomatous infection.No change and no sign of active infection.Unremarkable cardiac and mediastinal silhouette.

Output: Bilateral upper lobe scarring with no sign of active infection.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: hypoxia, WOB, likely fluid overload History: WOB Small lung volumes with patchy interstitial and airspace opacities and pleural effusions, less well-inflated.Heart size normal.

Output: Unchanged pulmonary opacities and pleural effusions with decreased inflation.


Instruction: Generate impression based on medical findings.

Input: Cough and shortness of breath Marked CHF with cardiac enlargement, basilar edema and large layered effusions with decreased lung volumes. Concern for superimposed left lower lung partial consolidation must also be considered in this limited evaluation

Output: Suspected CHF with possible left lower lobe nonspecific partial consolidation/opacity


Instruction: Generate impression based on medical findings.

Input: 48-year-old female with generalized tonic-clonic seizures. Multiple enhancing lesions on brain MR CHEST:LUNGS AND PLEURA: 2.7 x 2.6 cm mass in the right lower lobe.MEDIASTINUM AND HILA: Mediastinal and large right hilar adenopathy. Reference precarinal adenopathy measures 3.2 x 2.3 cm. (Image number 34, series number 3.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Fat infiltration of the liver with mild hepatomegaly..SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus is not visualized. Ovaries are likely unremarkable.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Right lower lobe mass, suspicious for a primary bronchogenic carcinoma. Metastatic adenopathy in the mediastinum, and right hilum.Fatty infiltration of the liver with hepatomegaly.


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.End-stage renal disease and trach status post thoracentesis. No significant pneumothorax.Small to moderate left pleural effusion.Atelectasis at the left base slightly worse.Patchy nodular opacity right upper lobe unchanged.Tubes and lines unchanged.

Output: No significant pneumothorax. Increasing atelectasis at the left base. Patchy opacity right upper lobe could be the result of aspiration or infection.


Instruction: Generate impression based on medical findings.

Input: Female 78 years old Reason: Pneumothorax; Post device placement in EP Lab History: Post device placement in EP Lab Left subclavian pacemaker with leads unchanged in position. Epigastric surgical clips are in place.Mild bibasilar subsegmental atelectasis. No pleural effusion, pneumothorax or evidence of infection.

Output: No acute cardiopulmonary abnormality or significant interval change. No evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: sp MV replacement History: - Moderate cardiomegaly with basilar edema and small pleural effusions.Chest tubes unchanged with no pneumothorax.ET tube tip approximately 3 cm above the carina.Left subclavian pacemaker, leads unchanged in position.Right jugular Swan-Ganz catheter tip in right ventricular outflow tract.A Dobbhoff tube extends below the lower margin of the image.

Output: Unchanged cardiomegaly with pleural effusions, no pneumothorax. Stable support devices.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Altered mental status. Cardiomediastinal silhouette is unchanged with tortuous aorta. Focal eventration of the left hemidiaphragm compatible with known Bochdalek hernia.Mild basilar chronic interstitial opacities without superimposed airspace opacity to suggest pneumonia.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 34 years old.Reason: interval change, hardware placement History: iabp Support devices are unchanged in position.Cardiomegaly is not changed when accounting for patient position. The right apex is excluded from the field-of-view. No evidence of interval pneumothorax or edema.

Output: Support devices remain in stable position.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.ETT, OGT. Shortness of breath. Endotracheal tube is been advanced, now situated at the right mainstem bronchus orifice.Moderate edema and atelectasis, slightly improved. Pleural fluid volume similar to previous. NGT extends to the stomach. Cervical spine stabilization hardware incompletely assessed.

Output: ETT at the right mainstem bronchus orifice. Slight improvement in edema and atelectasis, though remains moderate.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: Increased work of breathing History: as above Improvement in patchy multifocal opacities in the right lung and in right pleural effusion. Small left pleural effusion with mild left basilar opacity is again noted. Unchanged heart size. No pneumothorax. Central venous catheter, unchanged in position.

Output: Improvement in patchy opacities in the right lung and small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Age: 56 yearsGender: MaleReason for Study: Reason: Pulled back swan History: Swan IJ Swan-Ganz with its tip still within the right descending pulmonary artery.Left-sided ICD unchanged.Stable cardiac enlargement.Mild right pleural effusion/thickening similar to the prior exam.

Output: Swan-Ganz catheter still within the right descending pulmonary artery. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: eval for PNA History: cough Right hemithorax deformity from prior surgery.Prominent interstitial opacities bilaterally likely represent a chronic change. Radiopaque density overlying the upper thoracic vertebral bodies likely representing a stimulator device.

Output: Chronic deformity and chronic lung changes with no obvious acute abnormality. Follow-up recommended if clinically indicated.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Reason: hx of bladder cancer, evaluate for metastatic disease History: see above No focal consolidation, effusion, or pneumothorax. No pulmonary nodules visualized.Unremarkable cardiomediastinal silhouette.

Output: No acute abnormalities. No evidence of metastasis on this study.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Male 59 years old Reason: Evidence of pneumonia History: Chest pain The cardiomediastinal silhouette is normal.Bilateral pleural calcifications are suggestive of prior asbestos exposure.No focal pulmonary opacities to suggest pneumonia.No pleural effusions or pneumothorax.

Output: Pleural calcifications suggestive of prior asbestos exposure similar in appearance to the prior CT. No specific evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: evaluate lung fields post op History: s/p left upper lobectomy Decreasing left subcutaneous emphysema. The more superior the 2 chest tubes have been removed. There is now a small pleural effusion. No significant pneumothorax. No other interval change.

Output: Status post removal of one of the 2 left-sided chest tubes. Small residual pleural effusion. No other significant changes.


Instruction: Generate impression based on medical findings.

Input: Age: 47 yearsGender: MaleReason for Study: Reason: ETT tube advanced, check placement History: see above ET tube slightly advanced with tip now 4 cm above the carina.Left IJ venous catheter unchanged.Stable cardiac enlargement with nonspecific basilar opacities compatible with atelectasis.

Output: ET tube advanced with its tip now centimeters above the carina. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Fevers and worsening productive cough. History of left upper lobe cavitary lesion. Normal heart size. Large lung volumes with flattening of the diaphragm. No focal airspace opacities. Linear scarring at site of prior posterior left upper lobe cavitary lesion.

Output: No visible signs of pneumonia. Scarring at site of prior upper lobe cavitary lesion.


Instruction: Generate impression based on medical findings.

Input: 29-year-old male with history of retroperitoneal pheochromocytoma and status post resection and recurrence in the bladder status post partial cystectomy. CHEST:LUNGS AND PLEURA: Clustered nodularity in the left lower lobe is again seen and not significantly changed. Scattered micronodules predominantly in the right lung are also unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant lymph nodes are unchanged measuring 25 x 13 mm image number 142, series number 3.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No significant change from previous CT.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: Dyspnea on exertion. Stable cardiomegaly. Stable position of the dual pacemaker leads allowing for differences in projection, terminating in the right atrium and right ventricle. Bibasilar scarring or atelectasis is unchanged. No new focal opacities or pneumothorax.

Output: Stable appearance of the chest with no evidence acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: 75-year-old male with metastatic prostate cancer and liver metastases. Evaluate disease status. CHEST: LUNGS AND PLEURA: Stable micro-nodules in the right lobe, unchanged from previous exam.MEDIASTINUM AND HILA: Coronary artery calcification.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple new hypodense lesions in both lobes of the liver consistent with metastatic disease. The previously existing lesions have increased in size. Reference lesion measures 4.2 x 4.5 cm on image number 80, series number 4. Diffuse fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged asymmetric prostate gland indenting the bladder has increased in size. The left-sided prostate lesion displaces and invades the bladder wall.BLADDER: The urinary bladder is moderately distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Ill-defined, subtle sclerotic areas within the pelvic bones are unchanged. Low density round sclerotic foci in the thoracic vertebral bodies are unchanged.OTHER: No significant abnormality noted

Output: Interval increase in the size of the patient's known prostatic mass.Increased number and size of hepatic metastases.Numerous subtle, low-density sclerotic lesions in the bones are unchanged and suspicious for metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Clinical concern for pneumonia. There are unchanged multifocal airspace opacities in the left lower lobe as well as a right upper lobe. Associated areas of lucency are suspicious for cavitation. Possible small bilateral pleural effusions.Left internal jugular central venous catheter tip terminates the cavoatrial junction.The cardiac and mediastinal contours are within normal limits for size.

Output: Multifocal airspace opacities consistent with infection similar to the prior exam with findings suspicious for cavitation. Chest CT may be of benefit for further evaluation.


Instruction: Generate impression based on medical findings.

Input: 77-year-old male with vomiting and abdominal distention. Rule out small bowel obstruction. ABDOMEN:LUNG BASES: Marked emphysema. Right-sided subcentimeter nodule image number 9, series number 4 is unchanged. Mild scarring in the right lung base.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign-appearing left renal cyst.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic changes involving the abdominal aorta. Ectatic abdominal aorta. On image number 52, series number 3 abdominal aorta measures 35-mm (AP) by 38-mm (transverse. At this level. There is also focal bulging in the abdominal aorta.BOWEL, MESENTERY: Proximal small bowel loops are dilated, measuring up to 2.5-cm. Distal small bowel loops are completely decompressed consistent with a small bowel obstruction. Transition point appears to be in the midline around the umbilicus around image number 75, series number 3. Contrast material in the colon suggests a partial obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate is enlarged.BLADDER: Bladder is distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Partial proximal small bowel obstruction.Severe atherosclerotic changes with infrarenal abdominal aortic aneurysm. Abdominal aorta cannot be optimally evaluated due to lack of IV contrast. Focal posterior bulging of the aorta at the level of the renal arteries may represent a small saccular aneurysm.


Instruction: Generate impression based on medical findings.

Input: Reason: fx? ptx? History: MVC, pain Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.No visible fractures or pneumothorax.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Intubation Unchanged ETT, terminating 3 cm above the carina. NG and right jugular catheter also in good positionThe cardio mediastinal silhouette is similar with moderate tortuosity and no interval change. Nonspecific minimal basilar mixed interstitial and airspace opacities are again observed, likely atelectasis or scarring, greater in the right middle lobe. No definite effusions, however evaluation is limited with semiupright positioning

Output: ETT unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.Reason: fluid overload? edema? History: chest pain Fine perihilar interstitial and airspace opacity likely due to edema is unchanged. Stable cardiomegaly. Support hardware stable.

Output: Fine perihilar interstitial and airspace opacity likely due to edema is unchanged.


Instruction: Generate impression based on medical findings.

Input: Bullet fragments, injury in 2011. Now with acute pain with exercise. No cardiopulmonary abnormality. 2 small buckshot is observed in the soft tissues overlying the left abdomen wall and left breast

Output: No acute abnormality


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old.Reason: ? cause of chest pain History: left chest pain with some feeling of choking (no real SOB) Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. Increased tortuosity of the thoracic aorta.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: 25-year-old male with pneumonia, effusion, widened mediastinum. History of CHF. Severe globular cardiomegaly, unchanged.Interval increase in interstitial and airspace opacities, suggestive of edema and atelectasis.Decreased lung volumes.Presternal ICD is noted, unchanged.

Output: Interval increase in interstitial and airspace opacities, suggestive of hypervolemia/edema.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Chest pain, assess for acute process. Elevation of the right hemidiaphragm. Bronchovascular crowding in the right base consistent with atelectasis. No specific signs of pulmonary edema. There may be a small right pleural effusion.

Output: Questionable small right pleural effusion with hazy opacity in the right lung base most likely reflecting atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: effusion History: effusion Complete opacification of the left hemithorax consistent with effusion and atelectasis, with minimal residual aeration.Diffuse opacity in the right lung consistent with edema, unchanged.Catheter tip in the SVC.

Output: Extensive bilateral abnormalities with no significant change.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: eval ETT placement History: newly intubated ET tube tip at carina. Lungs hypoinflated with persistent perihilar airspace opacity.

Output: ET tube tip at carina.


Instruction: Generate impression based on medical findings.

Input: 56-year-old male with syncope, status post post fall. Amplatzer occluder device projects over the interatrial septum, position unchanged.No focal airspace opacity is evident.The cardiomediastinal silhouette is normal.Tortuosity of aorta commensurate with age.

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


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: infiltrate History: stroke Large lung volumes. Nodular opacities projecting over the anterior sixth rib may represent calcified cartilage. Recommend PA and lateral radiograph. Otherwise, the lungs are clear. The heart size is normal.

Output: No specific evidence of aspiration or infection. Nodular opacity at anterior right sixth rib can be better characterized with an energy subtracted PA and lateral radiograph.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: SOB History: SOB, wheezing Diffuse pulmonary opacities with pleural effusions, unchanged. Unchanged central venous catheter. No pneumothorax.

Output: Unchanged diffuse pulmonary opacities and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female 39 years old Reason: chest pain History: chest pain The cardiomediastinal silhouette is normal.No pleural effusion or pneumothorax. No abnormal pulmonary opacities suggest infection.

Output: No acute cardiopulmonary abnormality without interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 85 years old.Reason: pls assess ETT placement History: s/p intubation Interval removal of external defibrillator pads. The endotracheal tube terminates 3 cm above the carina. The Dobbhoff tube remains unchanged in position, within a hiatal hernia. Pacemaker electrodes are stable with the atrial electrode directed away from the left atrial appendage.Progressive perihilar opacities and small pleural effusions. Mild cardiomegaly stable.

Output: Increased perihilar edema with small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: eval trach, r/o pneumo, BiVADs History: sob Large left effusion or hemothorax compressing the left lung.Overall small lung volumes with lower lung zone predominant edema and atelectasis.No significant pneumothorax.Left jugular and left subclavian catheters terminate in the SVC/artery junction level.Tracheostomy tube tip approximately 5 cm above the carina.A Dobbhoff tube extends below the lower margin of the image.Left subclavian ICD, leads unchanged in position.Biventricular LVAD's unchanged.

Output: No change in pulmonary opacities and a large left pleural effusion or hemothorax compressing the left lung.


Instruction: Generate impression based on medical findings.

Input: Female; 75 years old. Reason: eval acute process History: CP, SOB Stable cardiomegaly. Aortic valve prosthesis and median sternotomy hardware are unchanged. Retained surgical needle or needle fragment projected over the manubrium is unchanged since prior exam.Mild basilar interstitial opacities and septal lines are compatible with mild edema and interspersed atelectasis. No areas of focal consolidation or significant pleural effusions.

Output: Mild pulmonary edema without evidence of acute infection.


Instruction: Generate impression based on medical findings.

Input: Female, 78 years old.Reason: 78 yo with chf and rsv infection, hypoxia, concern for secondary pneumonia History: hypoxia Cardiomegaly with lung zone edema and small pleural effusions, the right base slightly improved.Left subclavian ICD, leads unchanged in position.

Output: CHF with pulmonary edema, but no specific evidence for infection.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: rule out chest metastasis History: renal cell carcinoma Large lung volumes without evidence of suspicious pulmonary nodules or masses. No acute cardiopulmonary abnormality.

Output: COPD without evidence of metastatic disease or acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: Check Pulmonary Status History: Check Pulmonary Status Improved pulmonary opacities and increased lung volume. Persistent left basilar atelectasis or aspiration.Heart size normal.Stable tubes and devices.

Output: Interval improvement in pulmonary opacities with no new findings.


Instruction: Generate impression based on medical findings.

Input: Male, 82 years old.Reason: Evaluate for pneumothorax s/p thoracentesis History: Pleural effusion, hemoptysis Interval decrease in right pleural effusion with no evidence of pneumothorax.

Output: Interval decrease in right pleural effusion with no evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 81 years old.Reason: pleurx insertion History: pleurx insertion Left hemithorax volume loss with a left pleural effusion, with improvement in left basilar consolidation and inflation.The right lung remains unremarkable.IVC filter.

Output: Improvement in left lung inflation and left basilar consolidation, with a persistent left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: ARDS, resolving, eval lung fields Lines and tubes are unchanged. Low lung volumes makes detailed cardiopulmonary assessment difficult. No substantial change in diffuse pulmonary opacities given differences in inspiration. Small pleural effusions. No pneumothorax. Unchanged heart size.

Output: No substantial change in diffuse pulmonary opacities given differences in inspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Occupational screening for tuberculosis. Normal heart size.No visible lymphadenopathy on this single view. No focal pulmonary opacities or visible pleural fluid.Severe scoliosis.

Output: No acute pulmonary abnormality. No signs of active intrathoracic tuberculosis.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Shortness of breath evaluate pulmonary edema and atelectasis. Moderate cardiomegaly. The thoracic aorta is tortuous.No pleural fluid or signs of pulmonary edema. Lung aeration has improved with near complete resolution of atelectasis.Severe osteophyte formation of the thoracic spine. Cervical spine fixation hardware partially visualized.

Output: Atelectasis has nearly resolved with minimal subsegmental foci remaining at the lung bases. No signs of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Reason: Signs of aspiration ? History: Possible aspiration, new oxygen requirement Unremarkable cardiac and mediastinal silhouette. Mild streaky opacity at the lung bases compatible with subsegmental atelectasis and/or scarring.No specific evidence of pneumonia.

Output: Mild basilar atelectasis or scarring and no other specific evidence of aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 39 years old.Acute respiratory infection. Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No specific evidence of infection.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 24 years old.Reason: 2013 Tuberculosis exposure in the past. Tb screening History: 2013 Tuberculosis exposure in the past. Tb screening No significant cardiopulmonary abnormality.No active TB.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: fluid status? History: sob Cardiomegaly with pleural effusions and lower lung zone edema, not significantly changed.Multiple support devices are unchanged in position.

Output: Pulmonary edema and pleural effusions, and support devices.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Shortness of breath. History of breast cancer. Persistent and slightly enlarged left large pleural effusion, which results in almost completely passive collapse of the left lung.Small to moderate right layering pleural effusion, worsened from prior.The cardiac and mediastinal contours are obscured.There is limited assessment of the right lung. Persistent right mid lung and basilar heterogeneous opacities.Extensive sclerotic metastatic lesions involving the axial and appendicular skeleton are again noted.The ET tube terminates approximately 4.4 cm above the carina. The enteric tube coursing below the diaphragm.Right IJ venous catheter in place, unchanged in position.

Output: Large left pleural effusion, slightly increased in size from prior. Consequent almost complete passive collapse of the left lung. The cardiac and mediastinal contours are obscured.


Instruction: Generate impression based on medical findings.

Input: Female, 82 years old.Chest pain evaluate lung fields. Mild elevation of left hemidiaphragm. The lung volumes appear enlarged, suggestive of COPD/emphysema. Upper normal heart size. No focal airspace opacities, pneumothorax or pleural fluid.

Output: Large lung volumes suggestive of COPD/emphysema, but no signs of pneumonia or other acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: eval ETT, lung fields, IABP position History: s/p IABP Balloon catheter tip in the proximal descending aorta approximately 6 cm below the top of the aortic arch.ET tube tip approximately 3 cm above the carina. Swan-Ganz catheter tip in the right main pulmonary artery.Bilateral linear to pleural effusions with underlying atelectasis.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Reason: eval pleural effusion History: known pleural effusion, pigtail in place Interval extubation.Pigtail catheter projects over the right costophrenic angle area, unchanged.Mild basilar opacities consistent with atelectasis and possibly small effusions.

Output: Interval extubation and no other significant change.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Reason: hx of kidney cancer, evaluate for metastatic disease History: see above The cardiac and mediastinal silhouette is normal. No suspicious pulmonary nodules or masses. Punctate right midlung nodule correlates with presumed inflammatory nodule noted on prior chest CT.No significant pulmonary or pleural abnormality. Please note that the right lateral costophrenic angle is not included in the field-of-view on the frontal radiograph.

Output: No suspicious pulmonary nodules or masses.


Instruction: Generate impression based on medical findings.

Input: History of head and neck cancer, status post chemoradiation and surgery. Check response. LUNGS AND PLEURA: Multiple areas of bronchiectasis seen in both lungs, with lower lobe predominance subpleural reticulation, traction bronchiectasis and honeycombing, consistent with interstitial lung disease, unchanged.Peripheral nodular opacities in both upper lung zones, which may represent areas of bronchial impaction and inflammation, unchanged.No new pulmonary nodule. No pleural effusion.MEDIASTINUM AND HILA: Mildly enlarged mediastinal lymph nodes, unchanged in size.Marked aortic and coronary artery calcification, unchanged. Normal cardiac size. No pericardial effusion.CHEST WALL: Median sternotomy and evidence of prior CABG.ABDOMEN:LIVER, BILIARY TRACT: A calculus in the gallbladder body, unchanged.SPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small hypodense circumscribed lesions, most likely representing cysts, unchanged.PANCREAS: Degenerative changes in L4/5 level, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted..BOWEL, MESENTERY: No significant abnormality noted.. Unchanged anterior abdominal herniaBONES, SOFT TISSUES: Degenerative changes throughout the spine, most severe at the L4-5 level..OTHER: Probable occlusion of the left limb aorto-iliac graft in its proximal aspect.Unchanged extensive atherosclerotic disease throughout the aorta and its branches.

Output: 1. No new findings to suggest metastatic disease.2. Multifocal bronchiectasis and interstitial lung disease with UIP-like pattern, unchanged.3. Probable occlusion of the left limb aorto-iliac graft in its proximal aspect.4. Unchanged cholelithiasis


Instruction: Generate impression based on medical findings.

Input: Age: 61 yearsGender: MaleReason for Study: Reason: r/o pulmonary opacities, vs edema History: chf vs infections Mild cardiac enlargement unchanged.Right basilar airspace opacity may represent infection.Mild left retrocardiac scarring/discoid atelectasis.Probable small pleural effusions.Sternotomy is intact.

Output: Right basilar airspace opacity suggestive of infection and/or edema with small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 43 years old.Reason: assess for rll infiltrate History: fever Moderate to marked enlargement of cardiac silhouette consistent with known pericardial effusion. Right internal jugular central venous catheter tip is at the superior cavoatrial junction. Superior IAPB markers noted at the T6 - T7 level.  ICD leads ae unchanged.  Bibasilar opacities are seen on prior CT are also unchanged.

Output: No significant interval change


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Reason: change in chest tube/lung History: hydropneumothorax s/p CT Left chest tube with a loculated large left effusion, but some reexpansion of the apex as well as the base.Hypoinflated right lung with basilar edema.Right subclavian port catheter, tip at cavoatrial junction.

Output: Left chest tube with a loculated left effusion, unchanged since yesterday evening but improved compared to before the chest tube was placed.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: pna? sob? History: above XR CHEST PA/LATERAL 4/2/2016 10:52 A The lungs are clear of airspace opacities. Azygos lobe again incidentally noted.The cardiomediastinal silhouette remains normal.There is a questionable 9 mm nodular lesion projecting just inferior to the right clavicle. Recommend a follow-up apical lordotic view to further evaluate. If present at that time. Follow-up CT chest can be obtained.No pleural effusion. No pneumothorax.

Output: Questionable 9 mm right apical nodule. Recommend initial follow-up with apical lordotic view of the chest.No other acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.Reason: AM CXR History: AM CXR history of shortness of breath. Enteric tube extends beyond the field of view study. Left upper quadrant cyst gastrostomy and embolization coils unchanged.Right chest tube directed medially with no evidence of pneumothorax. Small right pleural effusion with basilar atelectasis unchanged. Left lower lobe now better aerated.

Output: Right chest tube directed medially with no evidence of pneumothorax. Small right pleural effusion with basilar atelectasis unchanged. Left lower lobe now better aerated.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: r/o infection History: hypoxia, SOB Stable cardiomediastinal silhouette.Bronchial wall thickening and coarse reticular/nodular opacities are slightly more pronounced than on the previous study.No significant pleural effusion or pneumothorax.Stable degenerative changes in the thoracic spine.

Output: Slightly increased coarse, basilar predominant reticular/nodular opacities suggestive of worsening infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath Left basilar scarring. Left lower lobe left lower lobe retrocardiac opacity noted. No large pleural effusion or pneumothorax. Normal heart size.

Output: No pneumothorax. Left lower lobe left lower lobe retrocardiac opacity noted.


Instruction: Generate impression based on medical findings.

Input: 75-year-old man stage III colorectal cancer, status post resection. Restaging evaluation. CHEST:LUNGS AND PLEURA: A granuloma right lung base unchanged. Small nodule or intrapulmonary in noted series 5 image 48, unchanged. No new nodules or effusions.MEDIASTINUM AND HILA: Granulomata and coronary artery calcification. No pathologic size nodes.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: There is 3 punctate nonspecific hypodensities in the posterior segment of the right lobe of the liver; two are in series 3 image 97 which were not seen previously, one on image 99 which was seen previously and additionally a small sub-centimeters subcapsular hemangioma on image 90. The two new nonspecific hypodensities could be followed. There is no biliary dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Indistinctness along the right upper pole anterior aspect kidney probably related to the previous surgery.RETROPERITONEUM, LYMPH NODES: No pathologic size lymph nodes. There is infiltration of soft tissue tracking from the surgical bed in the right lower quadrant to the region of the inferior jugular the duodenum and the previously measured small lymph node is probably resected no longer visible. No measurable lymph nodes.BOWEL, MESENTERY: Postsurgical changes right lower quadrant. No bowel wall thickening or dilatation. No ascites. Diverticulosis colon.BONES, SOFT TISSUES: Moderately sclerotic lesion with some lucent areas within seen within the vertebral body of L1, unchanged in the previous exam. The appearance is likely benign.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate measuring 7.1-cm transverse by 6-cm AP.BLADDER: Bladder wall thickening.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Postsurgical changes. No definite measurable adenopathy. Nonspecific hypodensities in the liver two of which are new but may not have been seen previously due to their small size. Granulomatous disease. Stable small nonspecific pulmonary nodule or node. Bone lesion L1 likely benign.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: 68 yo f s/p intubation, eval loc of ETT and interval change in bilateral effusions and infiltrates History: na ET tube tip 4-5 cm above carina. Venous catheter stable. NG tube extends beyond the field-of-view of study.No change in diffuse airspace and interstitial opacity with pleural effusions

Output: ET tube tip 4-5 cm above carina.


Instruction: Generate impression based on medical findings.

Input: Female, 71 years old.Reason: concern for aspiration Unchanged pulmonary opacities consistent with ARDS on a background of fibrosis. Bilateral pleural effusions are not significantly changed. Calcifications of the aortic arch. Right PICC in axillary vein.

Output: Unchanged pulmonary opacities consistent with ARDS or possibly evolving fibrosis.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: 64M with history of RCC, annual surveillance imaging History: as above The cardiomediastinal silhouette is within normal limits. No focal consolidation, significant pleural effusion or pneumothorax.No evidence of metastatic disease.

Output: No acute cardiopulmonary process is identified, without interval change.


Instruction: Generate impression based on medical findings.

Input: Age: 70 yearsGender: MaleReason for Study: Reason: Preop TECAB History: Preop TECAB The cardiomediastinal silhouette is unremarkable.The lungs are clear.No pleural effusions.Degenerative changes noted in the thoracic spine.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: eval lung fields History: chest tube Support hardware unchanged in position.Stable cardiomegaly with bilateral opacity consistent with edema and atelectasis, unchanged.

Output: Stable cardiomegaly with bilateral opacity consistent with edema and atelectasis, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: Evaluate for pneumonia History: Cough The cardiac and mediastinal contours are within normal limits.Left apical calcified nodule and calcified left hilar lymphadenopathy, sequela of prior granulomatous infection. No signs of pneumonia, as clinically questioned.No pleural effusion or pneumothorax.

Output: No radiographic findings to suggest pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.History of HIV with sharp chest pain when she laughs. Right hilar lymphadenopathy with airspace opacity in the anterior segment of the right upper lobe and medial segment of the right middle lobe compatible with pneumonia. Subsegmental atelectasis or scarring at the right lung base. There may be a miniscule volume of pleural fluid on the right.

Output: Multifocal airspace opacities with associated hilar lymphadenopathy in the right lung most consistent with pneumonia. Serial radiographic plain film follow-up to complete resolution recommended.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: Any infiltrate = pneumonia? History: cough, rhonchi Left lower lobe air space opacity consistent with infection.Elsewhere, the lungs are unremarkable.Unremarkable mediastinal contours and cardiac silhouette.

Output: Left lower lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: pleural eff History: SOB Improvement in basilar opacities with residual consolidation left greater than right.Pleural effusions have diminished, although remain in the fissures.Left PICC, tip at cavoatrial junction.

Output: Improving pulmonary opacities and pleural effusions with no new findings.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: eval apical ptx History: apical ptx Right apical pneumothorax is now no longer perceptible. Ectopic gas in the lateral aspect of the right upper quadrant the abdomen has decreased in conspicuity.Increase in bibasilar opacities. Unchanged heart size.

Output: Improvement in ectopic gas, as above.Increase in bibasilar atelectasis or consolidation.


Instruction: Generate impression based on medical findings.

Input: Cough and SOB question pneumonia. Low normal lung volumes. Upper normal heart size. No focal airspace opacities, pleural fluid or pneumothorax.

Output: No signs of pneumonia. No acute pulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: s/p lung transplant History: POST-OP LUNG TRANSPLANT; ADMISSION TO ICU Postsurgical changes, status post bilateral lung transplant.Bilateral chest tubes in place.Endotracheal tube tip is in the right mainstem bronchus requiring positioning.Small bilateral effusions , left greater than right. Possible air-fluid level in left pleural space. Recommend follow-up.

Output: Postsurgical changes following bilateral lung transplant, as described above.Endotracheal tube will require repositioning as tip is seen within the right mainstem bronchus.


Instruction: Generate impression based on medical findings.

Input: Female, 40 years old.Reason: infectious process? History: New onset cough with dark sputum No significant cardiopulmonary abnormality.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 74 yearsGender: FemaleReason for Study: Reason: Hx of HCAP, with pulmonary edema, increased secretions through tracheostomy, R/o pul edema/ Pneumonia History: coughing , incresaed tracheostomy secretions Support devices unchanged.Stable current mediastinal silhouette.Pleural effusions and basilar atelectasis slightly improved from the prior exam.

Output: Mild interval improvement in the pleural effusions and basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Age: 68 yearsGender: MaleReason for Study: Reason: eval inflation, lines/tubes History: type II resp failure Tracheostomy tube and NG tube unchanged.Right lower lobe extensive bullous disease with volume loss in the right upper lobe redemonstrated.Stable nonspecific pulmonary opacities.No new pulmonary opacities identified.

Output: Support device unchanged. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Reason: eval for infiltrate History: chest pain s/p delivery Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 88 years old.Status post aortic valve replacement. Postsurgical appearance is unchanged including sternotomy and aortic valve replacement. Unchanged moderate bilateral pleural effusions with adjacent atelectasis. Diffuse reticulonodular opacities are unchanged from prior examination.

Output: No significant change in bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: s/p reintubation with worsening oxygenation History: tachypnea Lower lung zone patchy airspace opacities unchanged.Retrocardiac consolidation is unchanged.Aortic endograft stable.ET tube tip approximately 6 cm above the carina.Right jugular catheter, tip in SVC.Left jugular catheter tip in left brachiocephalic vein near the midline.A Dobbhoff tube terminates in the stomach.

Output: Unchanged lower lung zone airspace opacities possibly infection or aspiration.


Instruction: Generate impression based on medical findings.

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

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: assess PNA History: assess PNA Patchy multifocal nodular and airspace opacity, worse on the right, consistent with given diagnosis of pneumonia though underlying solid nodules, potentially due to to malignancy, cannot be excluded and this should be followed to imaging resolution.

Output: Patchy multifocal nodular and airspace opacity, worse on the right, consistent with given diagnosis of pneumonia though underlying solid nodules, potentially due to to malignancy, cannot be excluded and this should be followed to imaging resolution.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath No cardiopulmonary abnormality. Cardiac contours exaggerated by marked scoliosis

Output: No acute disease


Instruction: Generate impression based on medical findings.

Input: Male, 44 years old.History of increasing pleuritic pain and cough. Right ventricular defibrillator lead unchanged.The cardiac silhouette is unchanged.Right pleural effusion appears to have increased. Right basilar opacity has also increased. There is a new right upper lobe opacity adjacent to the fissure. There is left subsegmental atelectasis.Callus formation from right posterior rib fracture again noted.

Output: Increase in right pleural effusion, right upper lobe, and right basilar opacities suggesting worsening pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: post op, eval ETT, lung fields History: s/p CABG Small lung volumes post op, with chest tubes no significant pneumothorax.Postop basilar atelectasis is present.ET tube tip at the level of the thoracic inlet.Right jugular Swan-Ganz catheter tip in right interlobar pulmonary artery.

Output: Postop atelectasis but no pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 72 yearsGender: FemaleReason for Study: Reason: repositioned Triple lumen History: na Right IJ venous catheter is been repositioned with its tip now in the SVC. Stable cardiomediastinal silhouette.Mediastinal tube has been removed. Bilateral chest tubes unchanged.No evidence of a pneumothorax.Mild basilar atelectasis.

Output: Right IJ venous catheter repositioned with its tip now in the SVC. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: please evaluate lungs after RLL resection History: shortness of breath Right chest wall soft tissue emphysema at possible anteriorly located right hydropneumothorax following chest tube removal.Unchanged basilar atelectasis.

Output: Two right chest tubes removed with basilar atelectasis and a small loculated right hydropneumothorax as well as right chest wall soft tissue emphysema.


Instruction: Generate impression based on medical findings.

Input: Male 57 years old Reason: Pre-Kidney evaluation, end stage renal disease. Evaluate for cardiomegaly and infiltrates. History: Pre-Kidney Transplant Moderate cardiomegaly with retrocardiac atelectasis. Low lung volumes with small bilateral pleural effusions and subsegmental atelectasis. No evidence of pulmonary edema or infection.

Output: Cardiomegaly and small bilateral pleural effusions compatible with fluid overload.


Instruction: Generate impression based on medical findings.

Input: Male, 41 years old.Reason: r/o ptx s/p temp line placement History: temp line placement Cardiomegaly with perihilar edema.No specific evidence of infection.Left jugular catheter, tip at cavoatrial junction.

Output: Cardiomegaly, and/or pericardial effusion, with pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: eval for infiltrate History: shortness of breath Cardiomediastinal silhouette is within normal limits. No specific evidence of infection or edema. No pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: There is transitional lumbosacral anatomy, with 6 lumbar-type vertebrae. For the purposes of this exam, the last fully formed disc is designated as L6-S1.There is mild rightward convexity of the mid to lower thoracic spine. The spine is in normal sagittal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. The distal spinal cord and conus are within normal limits with the conus terminating at the lower limits of normal, at the L2-L3 level. Prone images are not optimal, although do not appear to demonstrate significant ventral motion of the distal cord/conus.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the spine. There is no evidence of abnormal positioning of the cerebellar tonsils, which are rounded in morphology.The bladder is significantly distended.

Output: 1.Transitional lumbosacral anatomy as detailed above. If surgery is to be contemplated, correlation with imaging of entire spine is recommended.2.No MR evidence of Chiari malformation, as clinically questioned.3.Low normal positioning of the conus at the L2-L3 level without evidence of fatty filum. Prone imaging is suboptimal, although does not appear to demonstrate significant ventral motion of the distal cord.4.Mild rightward convexity of the thoracolumbar spine


Instruction: Generate impression based on medical findings.

Input: Reason: s/p OR History: Vent suppor ET tube tip approximately 2 cm above the carina.Catheter tip in the SVC.NG tube tip in the stomach.Bilateral nonspecific opacity compatible with atelectasis and pleural effusions.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Age: 91 yearsGender: FemaleReason for Study: Reason: phlegm for one week History: phelgm for one week, eval for possible CAP The cardiomediastinal silhouette is unremarkable.Minimal right basilar scarring/discoid atelectasis.Scattered calcified granulomas.No focal air consolidation.No pleural effusions.

Output: No acute cardiopulmonary abnormalites identified without interval change. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: 55-year-old female with history of thyroid cancer. Evaluate for disease. CHEST:LUNGS AND PLEURA: Multiple nodules bilaterally, the majority of which have increased in size since prior study. Reference right middle lobe nodule (series 5, image 35) measures 9 x 8 mm; previously measuring 7 x 7 mm. Additionally, a right lower lobe nodule (series 5, image 58) measures 9 x 9 mm; previously measuring 6 x 5 mm.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.CHEST WALL: Sclerosis of the L1 pedicle on the right is unchanged and remains compatible with metastasis.UPPER ABDOMEN: Subcentimeter hypoattenuating focus in the left hepatic lobe is too small to characterize but appears unchanged.

Output: 1. Interval increase in size of the majority of pulmonary metastases.2. Osseous metastasis to the pedicle of L1 vertebra, unchanged.


Instruction: Generate impression based on medical findings.

Input: 72-year-old male with history of metastatic lung carcinoma to evaluate for disease progression LUNGS AND PLEURA: Right middle lobe masses demonstrates an increase in size measuring 4.3 cm x 3.7 cm (coronal image 43) previously measuring 3.8 cm x 2.9 cm in period. This measures 4.3 cm x 5.9 cm (image 58, series 5), previously, measuring 4.2 cm in .7 cm on axial images.Left lower lobe nodules (image 45 and image 57, series 5) have increased in size as well. No new nodules identified.Centrilobular emphysema .MEDIASTINUM AND HILA: Aortic and coronary calcifications.Calcified mediastinal lymph nodes. No hilar or mediastinal lymphadenopathy identified.Aberrant origin of the left vertebral artery.CHEST WALL: There are no changes within the thoracic spine.Stable sclerotic focus in a rib on the left.UPPER ABDOMEN: Calcifications within the spleen. Stable hypo-dense lesion in the right upper kidney.

Output: Progressive interval increase in the right middle lobe mass and left lower lobe nodules. No new sites of disease identified.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p pacemaker placement, History: pacemaker placement Pacemaker leads projected in the area of the right atrial appendage and right ventricular apex, with no pneumothorax or other complications.Bilateral pulmonary opacity compatible with edema with moderate pleural effusions.

Output: Pacemaker with leads in expected locations, with no visible complications.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: interval change History: as above Mild to moderate cardiomegaly with basilar consolidation unchanged left greater than right.Left jugular Swan-Ganz catheter tip in right main pulmonary artery.Right jugular Cordis sheath unchanged, tip in the SVC.Left subclavian ICD, leads unchanged in position.

Output: Unchanged basilar consolidation left greater than right. Stable support devices.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: Hx of ESRD with sepsis History: sepsis New right upper lobe airspace opacity suggestive of pneumonia.Mild to moderate cardiomegaly.Small pleural effusions.Left subclavian pacemaker, leads unchanged in position.

Output: Right upper lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: Unknown, 34 years old.Reason: ET tube History: ET tube ET tube tip projects approximately 4 cm above the level of the carina.Enteric tube tip and sidehole project over the gastric body. Esophageal temperature probe is at the level of the thoracic inlet.Left internal jugular central venous catheter tip projects over the mid SVC.Normal cardiomediastinal silhouette. No new pulmonary or pleural abnormalities.

Output: Endotracheal tube remains in appropriate position. Otherwise stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Reason: shortness of breath History: shortness of breath Heart size without upper normal with small lung volumes.Moderate perihilar bronchial thickening which may be related to bronchitis or asthma.No sign of pneumonia.

Output: Probable bronchial thickening but no sign of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluating for LLL pna, pt with fever, cough \T\ acute onset left lower chest pain/lateral rib History: evaluating for LLL pna, pt with fever, cough \T\ acute onset left lower chest pain/lateral rib Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Check pulmonary status. Acute respiratory failure. Low lung volumes. Left jugular catheter projects over the low right atrium/RV and may be slightly retracted. Endotracheal tube and unchanged position. Focal atelectasis at the right lung base posteriorly similar to previous. Retrocardiac atelectasis/consolidation and a small pleural effusion on the left unchanged.

Output: Low position of right jugular catheter which can be followed at least to the level of the low right atrium and possibly the RV.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: Source of acute cough/sputum production History: cough, sputum production Nonspecific bronchial wall thickening suggestive of asthma or chronic bronchitis.No specific evidence of infection or edema.Unremarkable mediastinal contours and cardiac silhouette.Healed right rib fractures.

Output: Bronchial wall thickening, without specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: 46-year-old female being treated for disseminated histoplasmosis, evaluate for pneumonia LUNGS AND PLEURA: Left upper lobe nodule and (image 36, series 4) slightly decreased in size, measuring now 7 mm x 9 mm, previously, measuring 9 mm x 11 mm.No other pulmonary nodules or abnormalities identified.No pleural effusion.MEDIASTINUM AND HILA: Continued interval decrease in mediastinal lymphadenopathy. Reference prevascular lymph node (image 28, series 3) now measures 7 mm x 7 mm, previously, measuring 11 mm x 8 mm.Right cardiophrenic reference node (image 75, series 3) is stable, measuring 9 mm x 5 mm.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: Mild interval decrease in the mediastinal lymphadenopathy and left upper lobe pulmonary nodule. No new pulmonary abnormalities identified.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: h/o URI sxs for 2.5 weeks, rales on right side, please r/o PNA History: see above Cardiac silhouette is normal in size.Right midlung and lingular linear opacities likely atelectasis/scarring. No focal consolidation, sizable effusion or pneumothorax.

Output: Minimal linear atelectasis/scarring. Otherwise, no evidence of acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: Male, 89 years old.Reason: assess for pnfection vs edema, 89 yo with weakness and dry cough History: weakness Left-sided dual-lead pacemaker with leads in the right atrial appendage and right ventricular apex. Azygos pseudolobe, normal variant. Basilar interstitial opacities and probable small pleural effusions. No focal lung opacities suggest pneumonia.

Output: Basilar interstitial opacities and probable small pleural effusions. No focal lung opacities suggest pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 32 years old.Reason: eval lungs History: eval lungs Right internal jugular central venous catheter with tip at the confluence of the brachiocephalic veins. Low lung volumes. Moderate cardiomegaly.No focal consolidation.No pleural effusion or pneumothorax.

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


Instruction: Generate impression based on medical findings.

Input: Age: 74 yearsGender: MaleReason for Study: Reason: right lung biopsy History: none Right central venous catheter with its tip in the SVC.Right upper lobe paramediastinal opacity similar to the prior exam.No evidence of pneumothorax postprocedure.Stable cardiomediastinal silhouette.Left lung is clear.

Output: No evidence of a pneumothorax post biopsy.


Instruction: Generate impression based on medical findings.

Input: 68 years old Female. Reason: Infiltrates History: fever. There is no evidence for infiltrate in both lung, pleural effusion or pneumothorax. Cardiac size is normal.

Output: Unremarkable examination


Instruction: Generate impression based on medical findings.

Input: Age: 42 yearsGender: MaleReason for Study: Reason: r/o pna History: cough The cardiomediastinal silhouette is unremarkable.Mildly decreased lung volumes with scattered areas of basilar scarring/discoid atelectasis.No focal areas of consolidation.No pleural effusions.

Output: Minimal basilar scarring/discoid atelectasis. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: eval infection, edema, effusion History: chest pain Linear scarring at right lung base. No focal consolidation, effusion, or pneumothorax.Mildly tortuous aorta. No cardiomegaly.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: eval IABP placement History: IABP in place Aortic balloon pump radiopaque marker is 2 cm from the top of the aortic arch. ICD is unchanged. Stable cardiomegaly and bibasilar scarring.

Output: Aortic balloon pump radiopaque marker is 2 cm from the top of the aortic arch.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Age: 47 yearsGender: FemaleReason for Study: Reason: eval lung fields History: sob Stable cardiomediastinal silhouette with right sided aortic arch.Basilar opacities are compatible with atelectasis/scarring similar to the prior exam.No new pulmonary opacities identified.No pleural effusions.

Output: Basilar scarring/discoid atelectasis unchanged from the prior exam. No acute abnormalities identified.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: assess ETT position, changes in lung fields History: s/p intubation Persistent left base opacity consistent with infection or aspiration.ET tube tip approximately 4 cm above the carina.An NG tube extends below the lower margin of the image.Right jugular catheter tip at SVC/artery junction level.

Output: Persistent left basilar opacity consistent with infection or aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: eval for pna History: productive coguh Right port tip in SVC. Calcified granuloma on the left.Streaky bibasilar opacities likely aspiration or atelectasis. No definitive evidence of pneumonia.

Output: Streaky bibasilar opacities likely aspiration or atelectasis. No definitive evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Reason: ventilator dependence, interval film History: above Tracheostomy tube in place.Bilateral opacity compatible with edema, atelectasis and pleural effusions, not significantly changed.No new findings.

Output: Edema, atelectasis and effusions with no significant change.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.SOB. Left jugular chest port tip projects over the right atrium.Low lung volumes with motion artifact.Basal atelectasis and small to moderate pleural effusions bilaterally.Diffuse skeletal sclerosis consistent with known osseous metastatic disease.No visible pulmonary nodules, though assessment is limited given underinflation.

Output: Small to moderate pleural effusions with basal atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 25 years old.Reason: neutropenic fever History: neutropenic fever The right port is no longer access. The left central catheter remains stable in position.Lobular contour of the left mediastinum correlates to a known anterior mediastinal mass, smaller when compared to 3/15/2015. Associated left lower lobe atelectasis. The right lung is clear with no pneumothorax.

Output: Known left anterior mediastinal mass without evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 66 yearsGender: MaleReason for Study: Reason: Fever and SOB History: SOB and fever The cardiomediastinal silhouette is unremarkable.Mild basilar scarring/discoid atelectasis without focal areas of consolidation.Focal eventration of the left hemidiaphragm.No pleural effusions.Degenerative changes and anterior wedging of several mid thoracic vertebrae similar in appearance to the prior exam.

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


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: puylm edema desatting History: pulm edema. ET tube 2 cm from the carina. Right IJ catheter tip in the mid SVC. Second right IJ catheter tip obscured, though likely also in SVC.Low lung volumes.Retrocardiac atelectasis/consolidation.No new focal pulmonary opacity or pneumothorax.Persistent small bilateral pleural effusions.Stable cardiomediastinal silhouette.

Output: Persistent small bilateral pleural effusions. Retrocardiac atelectasis/consolidation.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: eval lung History: eval lung Right pneumonectomy, one of the chest tubes removed with no change in the right hemithorax appearance. Left lower lung zone opacification and pleural effusion are unchanged.Tubes and catheters are unchanged.

Output: Right chest tube removed leaving one in place, status post pneumonectomy with stable left-sided opacities.


Instruction: Generate impression based on medical findings.

Input: Intubated. AV canal repair.VIEW: Chest AP Endotracheal tube tip is between thoracic inlet and carina. A chest tube is present in each hemithorax. Right neck and mediastinal surgical clips are identified. There are two atrial lines. Epicardial pacer leads remain in place. Cardiomegaly unchanged. There are bilateral small pleural effusions not significantly change. Bilateral hazy lung opacities unchanged. There is soft tissue edema.

Output: Bilateral small pleural effusions not significantly changed.


Instruction: Generate impression based on medical findings.

Input: Age: 63 yearsGender: FemaleReason for Study: Reason: eval for PNA History: O2 requirement Dobbhoff tube is been placed with its tip beyond the margin of the image.Chest/mediastinal tubes unchanged.IABP marker in the aortic arch.Stable marked cardiac enlargement.Pulmonary vascular redistribution, perihilar edema, and pleural effusions similar in appearance to the prior exam.Again identified are vascular stents within the right subclavian, right innominate, and SVC.

Output: Interval placement of a Dobbhoff tube. Remaining support devices unchanged. Stable cardiopulmonary appearance with cardiomegaly, edema, basilar atelectasis and pleural effusions.