Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Reason: eval infection, oncology patient, fevers History: as above No significant cardiopulmonary abnormality.No specific evidence of infection.Right jugular catheter, tip in SVC.

Output: No acute abnormality. If there is continuing concern for infection, a CT is recommended given the patient's relative neutropenia.


Instruction: Generate impression based on medical findings.

Input: 78-year-old male with history of esophageal cancer CHEST:LUNGS AND PLEURA: Reference left upper lobe nodule is stable measuring 4-mm in image number 26, series number 12. Second right upper lobe nodule is also stable measuring 5 nodes on image number 41, series number 12. Other subcentimeter scattered nodular densities are also stable. Left lower lobe atelectasis and right lower lobe scarring/atelectasis is also stable. Bilateral small pleural effusions are stable.MEDIASTINUM AND HILA: Previously measured upper mediastinal soft tissue density is stable measuring 4.2 by 2.1-cm image number 16, series number 12. This ill-defined soft tissue density also extends to the neck in the prevertebral space.Reference AP window lymph node measures 13 by 15-mm on image number 39, series number 12, stable. Right hilar lymph node measures 16 x 15 mm in image number 48, series number 12, not significantly changed. Diffuse wall thickening of the esophagus with metallic esophageal stent is stable.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Again noted numerous metastatic lesions throughout the liver. Reference lesion in the left lobe measures 29 by 33-mm image number 113, series number 12th, not significantly changed.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Chronic occlusion of the splenic vein, 8 x 7 mm cystic lesion in the body of the pancreas on image number 103, series number 12th and calcifications in the tail of the pancreas are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change in the parenchymal, mediastinal, hilar, and hepatic metastatic disease. Appearance of the esophageal mass and pancreatic changes are also stable.


Instruction: Generate impression based on medical findings.

Input: 74-year-old female with history of colon cancer, status post right hemicolectomy CHEST:LUNGS AND PLEURA: Scattered subcentimeter nodules are unchanged. Dependent atelectasis.MEDIASTINUM AND HILA: Cardiomegaly. Index paratracheal lymph node is unchanged measuring 1.4 by 1.1-cm image number 27, series number 3. Other mediastinal lymph nodes are also unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nodular thickening of the left adrenal gland is unchanged.KIDNEYS, URETERS: Bilateral nonobstructive stones areRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Male, 22 years old.Reason: s/p R IJ permacath History: s/p R IJ permacath No significant cardiopulmonary abnormality.Right jugular catheter, tip in SVC.

Output: No significant abnormality. Right jugular catheter, tip in SVC.


Instruction: Generate impression based on medical findings.

Input: Reason: ET tube repositioned by anesthesia team History: satting from 100 to 91%, now more stable ET tube tip approximately 6 cm above the carina.ICD leads unchanged.Cardiomegaly with bilateral opacities, improved from previous, and decreased right pleural effusion which is now partially loculated in the pleural fissures.No new findings.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: hypoxia History: hypoxia New or worsening interstitial and airspace opacities suggestive of acute edema with superimposed aspiration or hemorrhage.Small right pleural effusion.Left subclavian catheter, tip in left brachiocephalic unchanged.Tracheostomy tube tip approximately 6 above the carina.

Output: Worsening pulmonary opacities consistent with edema with superimposed aspiration or hemorrhage.


Instruction: Generate impression based on medical findings.

Input: Age: 27 yearsGender: FemaleReason for Study: Reason: pneumothorax? History: new dyspnea with exertion The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified. No evidence of a pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.Reason: eval volume overload History: HD patient, SOB with CP, missed HD Unchanged central venous catheter. Low lung volumes makes detailed cardiopulmonary assessment difficult. Mild pulmonary edema. Slight increase in basilar opacities, likely atelectasis. Small pleural effusions, as before. Heart size again at the upper limit of normal. No pneumothorax.

Output: Slight increase in pulmonary edema with increased basilar atelectasis. Small pleural effusions, as before.


Instruction: Generate impression based on medical findings.

Input: Cardiomegaly Moderate nonspecific cardiomegaly without additional cardiopulmonary abnormality

Output: Moderate cardiomegaly


Instruction: Generate impression based on medical findings.

Input: Age: 45 yearsGender: FemaleReason for Study: Reason: ro pna History: back pain Cardiac size is normal.Prominence of the right hilum suggestive of lymphadenopathy.The lungs are clear.No pleural effusions.

Output: Hilar/mediastinal lymphadenopathy may represent sarcoidosis. No acute cardiopulmonary identified. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 80 yearsGender: FemaleReason for Study: Reason: eval ett, pulm edema History: hypoxemia, inc airway pressures ET tube with its tip 2 cm above the carina.Enteric tube with its tip beyond the margin of the image.Right Port-A-Cath with its tip in the SVC.Stable cardiomediastinal silhouette.Left upper lobe dense airspace opacity and increasing airspace opacity involving the right upper lobe suggestive of worsening infection and/or aspiration.Interval improvement in left basilar atelectasis.No large pleural effusions..

Output: Support devices unchanged with ET tube in satisfactory position. Increasing upper lobe airspace opacities suggestive of worsening infection/aspiration.


Instruction: Generate impression based on medical findings.

Input: 65-year-old female with history of breast cancer. Ground glass 5-mm nodule, left apex on 9/10 outside. Follow-up. CHEST:LUNGS AND PLEURA: 4-mm nodule in superior segment of left lower lobe. No other nodules identified. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: No significant abnormality noted.

Output: 4-mm nodule in left lower lobe. For a high-risk patient (smoking history for example), a follow-up CT at 12 months is recommended to confirm stability or resolution. No follow-up is needed in a low-risk patient.


Instruction: Generate impression based on medical findings.

Input: Female, 83 years old.Reason: cp History: cp Surgical clips in the abdomen and chest again noted.Low lung volumes. Cardiomegaly redemonstrated.No evidence of pleural effusions.No focal opacities. Please refer to the same day CT PE for more details.

Output: No acute cardiopulmonary abnormalities noted.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: eval lung fields History: s/p CABG Lines and tubes are unchanged. Low lung volumes makes detailed cardiopulmonary assessment difficult. Increased left basilar opacity. Stable right basilar pleural-parenchymal opacities. Unchanged heart size. No significant pneumothorax. Increased distention of the stomach.

Output: Increase in left basilar opacity, likely atelectasis or aspiration.Increased distention of the stomach.


Instruction: Generate impression based on medical findings.

Input: Reason: swan History: as above Swan-Ganz catheter tip in the right descending pulmonary artery.Cardiomegaly with small lung volumes and mild basilar atelectasis, unchanged.

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


Instruction: Generate impression based on medical findings.

Input: 59-year-old male with presumed primary retroperitoneal germ cell tumor status post chemotherapy 4 years ago. Evaluate for recurrence. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Extrarenal pelvis with parapelvic cyst, greater on the left are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No evidence of recurrence.


Instruction: Generate impression based on medical findings.

Input: Reason: PICC and Swan interval change History: PICC and swan Swan-Ganz catheter tip in the right main pulmonary artery.PICC from the left arm obscured by overlying hardware but extending at least to the left axilla.ICD leads unchanged.

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


Instruction: Generate impression based on medical findings.

Input: Reason: ETT History: ETT ET tube tip approximately 2 cm above the carina.Small lung volumes with basilar opacity compatible with atelectasis and aspirated secretions.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: r/o PNA History: cough, SOB, wheezing The cardiomediastinal silhouette is normal.Large lung volumes with increase lower lung lucency suggestive of COPD. Scattered calcified micronodules and calcified nodes likely reflect sequela of prior granulomatous disease. Linear opacity in the right upper lobe is consistent with scarring. No dense consolidation, pleural effusion or pneumothorax.

Output: Large lung volumes with increase lower lung lucency suggestive of COPD. Correlate with history or any clinical concern for alpha 1 antitrypsin deficiency. No acute cardiopulmonary findings.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 64 years old Reason: pneumatocele History: s/p traumatic OG tube placement into lung Interval improvement in bibasilar opacities. Mild residual atelectasis at the left base. No pneumothorax or significant pleural effusion is identified. Cardiomediastinal silhouette is stable. Redemonstration of enlarged pulmonary arteries compatible with pulmonary hypertension.

Output: Improving bibasilar opacities with no evidence of pneumothorax or significant pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 44 years old.Reason: Fever, cough History: fever, cough Lungs and pleural spaces are clear. Several left-sided calcified granulomas are present compatible with healed granulomatous disease. Heart size is normal.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: Pre-Kidney evaluation, end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: Pre-Kidney Transplant Mild cardiomegaly with increased upper zone blood flow.No sign of CHF or infection.

Output: Mild cardiomegaly with no acute disease.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for flash pulm edema? History: acute onset of brown fluid from ETT New loculated left pneumothorax at the left apex with an associated large pleural effusion and underlying consolidation. Cannula tip in the area of the main pulmonary artery and IVC cannula extending to the right atrium.Diffuse consolidation throughout the right lung, increased compared to previous.ET tube tip 7 cm above the carina. Bilateral jugular catheters, unchanged on the left but partially withdrawn on the right.Findings were discussed with the clinical service by the resident on call.

Output: Loculated left pneumothorax and diffuse bilateral consolidation, increased compared to previous. 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: Shortness of breath Large right pleural effusion with underlying mild to moderate bilateral basilar edema with cardiomegaly unchanged.

Output: Unchanged pleural effusions and edema.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.History: Productive cough and fever for past 2 months. Query pneumonia. Stable cardiomediastinal silhouette.Nonspecific bibasilar streaky opacification.Calcified granuloma projected over the left hilum.No focal pulmonary consolidation.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old. Febrile neutropenia. Evaluate for pneumonia. Right PICC tip in the mid right subclavian vein, unchanged.Stable cardiomediastinal silhouette.Right hemithorax postsurgical changes with associated volume loss.No new focal pulmonary opacity to suggest infection.

Output: No reliable evidence of infection. Stable postsurgical findings in the right hemithorax without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: assess for acute lung changes, movements in tubes or lines History: post operative respiratory failure Median sternotomy for valve replacement with chest tubes but no pneumothorax.Small pleural effusions noted.ET tube tip 7 cm above the carina.Right jugular Swan-Ganz catheter tip in right ventricular outflow tract.Left jugular catheter, tip in SVC.

Output: No pneumothorax. Unchanged support devices.


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Reason: 80yo M w/ respiratory sxs, eval for infection History: as above Right dialysis catheter remains in stable position, terminating in the midsuperior vena cava.Cardiomegaly is unchanged. Both lungs are fully inflated without pneumothorax. Pleural spaces remain clear.

Output: No evidence of infection or fluid overload.


Instruction: Generate impression based on medical findings.

Input: Female, 37 years old.Reason: cardiac History: syncope, sickle cell trait The heart size is normal.The lungs are clear. No focal pulmonary opacities.No pneumothorax or pleural effusion.Thoracic scoliosis.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female 58 years old Reason: Dobhoff tube placement assessment Dobbhoff tube coiled within the stomach with the tip in the gastric body. Pelvis not included in this field of view. Residual contrast material within the colon. Median sternotomy hardware and left chest wall ICD are noted.

Output: Dobbhoff tube coiled within the stomach with tip in the gastric body.


Instruction: Generate impression based on medical findings.

Input: 60 year-old female with metastatic RCC and history of breast cancer CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules are again seen, unchanged in size. Reference lesion in the right lung base measures 4 by 3.3 cm, minimally enlarged compared to previous study. Other nodules are also minimally enlarged to unchanged in size. No new nodules.MEDIASTINUM AND HILA: Small hypoattenuating thyroid nodules are unchanged. Small pretracheal lymph node measures 10 x 10 mm image number 33, series number 5. Another node in the anterior mediastinum measures 18 x 21 mm image number 29, series number 5, new from previous CT.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Numerous benign cysts in the liver, not significantly changed.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left kidney has been removed. Enlarge post cystic right kidney with innumerable cysts of various size and density are again noted. No obvious enhancement. Previously described hyperdense cysts is unchanged measuring 2.9 x 2.6 cm on image number 106, series number 5.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small amount of fluid and around the left hip joint.OTHER: No significant abnormality noted.

Output: Minimal interval increase in the size of to some of the lung nodules. New anterior mediastinal adenopathy.


Instruction: Generate impression based on medical findings.

Input: 70 year old female with history of renal cancer, assess for recurrence or progression. CHEST:LUNGS AND PLEURA: Stable bilateral pulmonary micronodules. MEDIASTINUM AND HILA: Small scattered mediastinal lymph nodes are unchanged. Heart size normal without pericardial effusion.CHEST WALL: No significant abnormality noted. ABDOMEN:The evaluation of solid abdominal organs is limited by the lack of IV contrast. Within this limitation, the following findings are noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Postsurgical changes status post left nephrectomy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Hiatal hernia is unchanged. Spigelian hernia involving a nondilated loop of small bowel is unchanged. Small ventral hernia involving a loop of small bowel is also unchanged. There is no evidence of obstruction or bowel wall thickening to suggest ischemic compromise.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No other significant abnormality noted.PELVIS:UTERUS, ADNEXA: The uterus is atrophic or has been surgically removed.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic changes of the right femoral head are unchanged.OTHER: No other significant abnormality noted.

Output: 1. No evidence of disease recurrence or metastatic disease.2. Stable pulmonary micronodules.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: h/o renal mass, evaluate for progression. Right chest wall ICD unchanged. No focal airspace opacity, pleural effusion, or pneumothorax.

Output: No acute cardiopulmonary abnormalities with no evidence of metastases.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: history of "abnormal CXR". I have no further details. Pt has history of lupus and normal PFTs History: see above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Cholecystectomy clips.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: c/f CHF History: see above Moderate left pleural effusion compressing the left lower lobe, worse than on prior studies.Small right pleural effusion.Cardiomegaly.

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


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: eval for ETT History: sob s/p intubation Endotracheal tube terminates in the right mainstem bronchus. This has been subsequently pulled back. Mild basilar opacities. Unchanged cardiomegaly without evidence of pneumothorax.

Output: Endotracheal tube terminates in the right mainstem bronchus. This has been subsequently pulled back.


Instruction: Generate impression based on medical findings.

Input: 59-year-old female with history of lung cancer with new pulmonary nodules on PET/CT of 1/5/2010. New mets versus inflammatory (patient also has history of aspirations, pneumonia). Patient presents with cough. CHEST:LUNGS AND PLEURA: Postsurgical changes from right upper lobectomy are unchanged. Right paramediastinal density is also stable and is likely secondary to post radiation changes. Several of the pulmonary nodules seen on prior PET/CT are not as clearly identified on the study. For example, the 12-mm right lung nodule which was moderately hypermetabolic on the PET/CT now appears less discrete (series 5, image 41), suggesting a postinflammatory etiology. Left upper lobe nodule along the major fissure (series 5, image 38) and a left lower lobe nodule (series 5, image 58) are reidentified and appear similar to the PET/CT and slightly more prominent when compared to prior CT chest from 9/18/2007.No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is enlarged without pericardial effusion.CHEST WALL: Tracheostomy tube is present.UPPER ABDOMEN: No significant abnormality noted.

Output: Postsurgical and post-radiative changes as described above. Several pulmonary nodules that were seen on prior PET/CT are not as clearly identified as well as reduced in size on this study, suggesting a postinflammatory etiology.


Instruction: Generate impression based on medical findings.

Input: Age: 58 yearsGender: MaleReason for Study: Reason: hypoxia History: hypoxia The cardiomediastinal silhouette is unremarkable.Persistent right lower zone airspace and interstitial opacity compatible with infection or aspiration.The left lung is clear.No pleural effusions.G-tube identified in place.

Output: Stable cardiopulmonary appearance with mixed airspace/interstitial right lower zone opacity.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Bilateral lung transplant evaluate for effusion/pneumo. SOB. Large pneumopericardium again noted. Tip of the Dobbhoff tube of the caudal margin of the film, other hardware, tubes and lines unchanged in position. Small pneumothorax on the right. Near complete opacification of the lung parenchyma bilaterally unchanged. Moderate pleural fluid bilaterally. Subcutaneous emphysema about the same.

Output: Small right pneumothorax. Moderate pleural fluid bilaterally and near complete opacification of the lung parenchyma about the same. Large pneumopericardium, presumably postoperative.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: malignant pleural effusion History: none Right Pleurx drain, the right hemithorax still completely opacified.Innumerable left-sided pulmonary metastases unchanged.

Output: Persistent right hemithorax opacification splenic Pleurx catheter was diffuse pulmonary metastases. No new findings.


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Reason: Preop AVR History: Preop AVR Cardiomediastinal silhouette is within normal limits. There is mild bibasilar subsegmental atelectasis. There is no radiographic evidence of edema or infection. Multiple right-sided rib fractures with callus formation, suggesting that they are acute or chronic.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: 69 years, Male. Reason: Obstruction History: N/V/D Chest: The cardiomediastinal silhouette is unremarkable. Low lung volumes with no abnormal pulmonary opacities, pleural effusion, or pneumothorax.Abdomen: Mild to moderate gaseous distention of colon without evidence of obstruction. No pneumoperitoneum. Loss of height of lower thoracic and lumbar vertebral bodies was also present on the prior CT.

Output: Mild to moderate gaseous distention of colon without evidence of obstruction.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Reason: hypoxia and sob History: as above Right hemithorax volume loss with pleural and parenchymal fibrosis.Left lung unremarkable.No significant pneumothorax.

Output: No change in right hemithorax volume loss with pleural and parenchymal fibrosis


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: chest tube placement History: s/p right thoracotomy RUL lobectomy, resection ribs 2-4 Patient is status post thoracotomy with 2 chest tubes placed, both terminating in the right apex. No right pneumothorax. Extensive right volume loss with rightward mediastinal shift. Chronic elevation of the left hemidiaphragm. Nonspecific right airspace opacities are likely postsurgical in etiology. Left basilar atelectasis. Extensive right subcutaneous emphysema.

Output: Post surgical changes including 2 chest tubes terminating at the right apex. Associated right volume loss with rightward mediastinal shift.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: SOB History: SOB and tachycardia Small lung volumes nonspecific basilar interstitial opacities suggestive of edema with very small pleural effusions.Heart size at least upper normal.Left subclavian catheter, tip at cavoatrial junction.

Output: Small lung volumes with the suggestion of basilar edema.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Reason: eval for edema History: h/o CHF, unknown EF, reports SOB. mild crackles in the Right base No evidence of significant edema or pleural effusions. Stable cardiomegaly. Dense punctate focus of calcification on the left, likely in the soft tissues, is unchanged.

Output: No evidence of significant edema or pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Swan replacement. Right jugular Swan-Ganz catheter tip at the level of the pulmonary outflow tract near the main pulmonary artery.Left subclavian ICD is unchanged in position.Larger of the central pulmonary vasculature suggestive of pulmonary hypertension.Scarring in the right lower lobe.

Output: Swan-Ganz catheter projects over the pulmonary outflow tract near the level of the main pulmonary artery, no pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 63 yearsGender: FemaleReason for Study: Reason: lines, worsening opacities History: comatose Support devices unchanged.Diffuse pulmonary opacities and pleural effusions similar in appearance to prior exams.No new pulmonary opacities identified.

Output: Support devices unchanged. Stable cardiopulmonary appearance with diffuse pulmonary opacities and pleural effusions


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: right sided chest pain, hx asthma and smoking The cardiomediastinal silhouette is normal. No focal pulmonary opacity, pleural effusion, or pneumothorax. Diffuse bronchial wall cuffing noted.

Output: Chronic bronchitis, reactive airway disease, or viral URI pattern.


Instruction: Generate impression based on medical findings.

Input: Male, 20 years old.Type for RF, ETT adjustment. ETT 3 cm above the level of the carina. Other tubes and lines unchanged. No acute change in airspace opacities near the left base consistent with aspirated secretions. Right hemithorax volume loss presumably due to lobar collapse as no radiographic signs of lobectomy are appreciated.

Output: ETT 3 cm above the carina. No acute change in pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: 74-year-old female newly diagnosed squamous cell carcinoma of the lung CHEST:LUNGS AND PLEURA: Large left upper lobe mass invading them left hilum and mediastinum extends into the subcarinal space. The mass measures 10.8 x 9.8 cm image number 27, series number 5. Round fluid density at the peripheral left upper lobe may represent a developing abscess due to obstruction. Correlation with clinical history is recommended. MEDIASTINUM AND HILA: Mediastinum is invaded by the mass. The mass encases the left main, left lower and lingular bronchi. Left main common artery is also a catheter by the mass.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple scattered subcentimeter lesions in the liver some of which are too small to accurate characterize but they are suspicious for metastatic disease. 14 x 13 mm right lobe lesion on image number 98, series number 5 and is suspicious for metastatic disease.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral hypodense lesions most are cysts, however, some of them are too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Posttraumatic changes in the right pubis bone. Significant degenerative changes throughout the bones.OTHER: Artifacts from the right hip prosthesis limit optimization of the pelvis. 3.7 x 2.2 cm hypodense lesion adjacent to the left ischium cannot be optimally characterized due to these artifacts.

Output: Left upper lobe mass invading the left hilum and mediastinum.Multiple hepatic lesions, some of which are too small to characterize but are suspicious for metastatic disease.Bilateral renal lesions, some of which cannot relatively characterize due to lack of IV contrast.


Instruction: Generate impression based on medical findings.

Input: Reason: cough, GERD 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: Male, 60 years old.IABP placement. IABP marker unchanged in position, projecting over the aortic arch and descending segment.Left subclavian ICD unchanged in position; the atrial lead is directed inferiorly in the projection of the right atrium, atypical in position but unchanged over multiple prior examinations including 8/13/2012.Hazy peripheral opacities in the right lung and proximal bronchial wall thickening suspicious for mild acute aspiration pneumonitis.

Output: Stable position of intra-aortic balloon pump. Signs of aspiration in the right lung.


Instruction: Generate impression based on medical findings.

Input: 41-year-old male with hypoxia, monitoring ARDS, now supine recent. Right IJ catheter tip in the SVC. Endotracheal tube tip 4 cm above the carina. Enteric tube sidehole in the stomach.No significant change in diffuse bilateral interstitial and airspace opacities and possible small pleural effusions. Normal cardiac mediastinal silhouette.

Output: No significant interval change in cardiopulmonary appearance allowing for differences in patient positioning/technique.


Instruction: Generate impression based on medical findings.

Input: Reason: post intubation History: post intubation ET tube tip approximately 4 cm above the carina.Catheter tip in the SVC.Focal airspace opacity in the left lower lobe likely secondary to aspirated secretions, unchanged.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: s/p TECAB, CT removal History: s/p TECAB Moderate left pleural effusion, small right pleural effusion and left basilar atelectasis unchanged. Improvement of persistent right basilar atelectasis. There is no pneumothorax. Unchanged cardiomegaly. Improved gastric distention.

Output: No pneumothorax. Improved right basilar atelectasis, but unchanged bilateral effusions and left basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lung fields History: s/p AVR, MVR Interval extubation.Swan-Ganz catheter tip in the main pulmonary artery.Chest tubes in place with a probable very small right apical pneumothorax.Bilateral mainly basilar opacities compatible with atelectasis and a small right pleural effusion.

Output: Small right apical pneumothorax and basilar atelectasis with no significant change.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Presented with sepsis, rule out pneumonia. Cardiomediastinal silhouette is stable. No focal airspace opacities, pleural effusion, or pneumothorax are identified.

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


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old. Reason: cardiopulmonary process History: SOB Interval removal of right central venous catheter.Stable cardiomegaly with distention of the deep systemic veins.Mild bibasilar interstitial opacities which are slightly decreased compared to prior study.Mild tracheal narrowing at the cervicothoracic junction unchanged since 2014.

Output: Cardiomegaly with questionable pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: 64-year-old female with bilateral sequential lung transplant 5 months prior. Heart size at the upper limit of normal. Stable postsurgical changes from previous bilateral lung transplant.Interval resolution of the retrocardiac opacity. Persistent bibasilar opacities compatible with scarring and/or atelectasis, greater on the left.Gastrostomy tube projects over the left upper abdomen.

Output: No acute cardiopulmonary abnormality. Unchanged bibasilar scarring and/or atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o active TB History: night sweats, history of TB exposure Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Likely CLL assess for lymphadenopathy. CHEST:LUNGS AND PLEURA: Two small nodules posteriorly in both lower lobes, on the left about 6 mm in diameter image 53/130 and on the right smaller, image 66/130.MEDIASTINUM AND HILA: One or two upper normal sized mediastinal lymph nodes but no extensive intrathoracic lymphadenopathy.CHEST WALL: Extensive bilateral axillary lymphadenopathy is present. A representative left axillary lymph node is about 3.3 x 1.9 cm image 21/163.ABDOMEN:LIVER, BILIARY TRACT: Less than 5-mm hepatic cyst like hypodensity in the dome of the liver, and the patient has undergone cholecystectomy.SPLEEN: The spleen may be slightly large.KIDNEYS, URETERS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedPANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal and mesenteric lymphadenopathy.BOWEL, MESENTERY: Extensive mesenteric lymphadenopathy noted above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: 1 Extensive axillary, mesenteric and retroperitoneal lymphadenopathy, sparing the mediastinum and hila; this is consistent with the provided diagnosis of CLL.2. Two small pulmonary nodules discussed above, for which a one year follow up is recommended or follow-up as part of the patient's other treatment.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for pathology History: low grade fever, stridorous breathing Catheter tip in the SVC.Increased left lower lobe opacity consistent with consolidation and atelectasis that may be related to aspirated secretions.

Output: New left lower lobe airspace opacity compatible with aspiration and possibly infection.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old. Reason: please confirm PICC line placement History: PICC line Interval placement of a right upper extremity PICC with tip in the SVC.New retrocardiac opacity with additional bibasilar interstitial opacities, septal lines and small bilateral pleural effusions.No pneumothorax.

Output: New bibasilar opacities and pleural effusions likely representing pulmonary edema and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: follow up post thoracoscopy History: feeling well post operatively Moderately large right pleural effusion with underlying consolidation and atelectasis, not significantly changed allowing for position and projection.No pneumothorax or other acute change.

Output: Persistent pleural effusion with underlying atelectasis and consolidation.


Instruction: Generate impression based on medical findings.

Input: Male, 22 years old. Right IJ venous catheter placed with its tip in the SVC.No evidence of a pneumothorax.Bilateral airspace interstitial opacities slightly worse than the prior exam.Stable cardiomediastinal silhouette.

Output: Placement of right IJ venous catheter without complication. Mild progression of air space opacities compatible with edema.


Instruction: Generate impression based on medical findings.

Input: Reason: PNA History: Cough and AMS Marked cardiomegaly with a tortuous aorta, unchanged.Surgical clips in the thyroid bed.No sign of pneumonia or CHF.

Output: Cardiomegaly with no acute findings.


Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Fever. Evaluate for pneumonia Interval removal of right-sided central venous catheter.Cardiomediastinal silhouette is normal. Left lower lobe streaky opacity likely represents subsegmental atelectasis. No pleural effusions or pneumothorax.

Output: 1.Left lower lobe streaky opacity compatible with subsegmental atelectasis, possibly related to aspiration.2.No significant evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male 52 years old Reason: r/o pneumonia History: cough Cardiomediastinal silhouette is unremarkable.No focal opacity or pleural effusion.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for interval change History: persistent hypoxia Patchy airspace opacity in the left lung with decreased volume compared to previous, compatible with infection and atelectasis.Catheter tip in the SVC.

Output: Focal predominately left-sided air space opacity, most compatible with infection/aspiration.


Instruction: Generate impression based on medical findings.

Input: Syncope and inconsistent blood pressure No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Bladder cancer status post cystectomy and tibial conduit evaluate for metastases. No pleural fluid or pneumothorax. Normal heart size. Tortuous thoracic aorta. No visible pulmonary nodules or masses.

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


Instruction: Generate impression based on medical findings.

Input: Reason: swan placement History: swan placement Swan-Ganz catheter tip in the right descending pulmonary artery.Cardiomegaly and ICD leads unchanged.No new findings.

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


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.Reason: 34M with chf sp thoracentesis. History: thoracentesis Stable markedly enlarged cardiac silhouette with pulmonary vascular redistribution.Interval decrease in size of right pleural effusion. No pneumothorax.Persistent bibasilar opacities.Right AICD with leads in the right atrium, right ventricle, and coronary sinus.

Output: Interval decrease in size of right pleural effusion. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Reason: assess pleural effusion History: s/p ECMO cannulation Lines and tubes are unchanged. No no substantial change in bibasilar opacities and pleural effusions. Cardiomegaly again noted. No acute bony abnormality. No pneumothorax.

Output: No substantial difference compared to previous study.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: is there an infiltrate History: vomiting Cardiomegaly with suggestion of basilar interstitial edema.No specific evidence of infection.

Output: Cardiomegaly and possible edema, but no sign of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.COPD with green sputum and increasing shortness of breath. Severe emphysema. No pneumothorax.Severe bronchial wall thickening bilaterally. No pleural fluid. No conclusive airspace opacities. Chronic rib deformity on the left. Metallic fragments project over the right thoracic inlet, present previously.

Output: COPD/emphysema with interval development of severe bronchial wall thickening consistent with bronchitis. No conclusive signs of pneumonia however.


Instruction: Generate impression based on medical findings.

Input: Metastatic renal cell carcinoma CHEST:LUNGS AND PLEURA: Multiple pleural-based nodules and masses are unchanged.MEDIASTINUM AND HILA: Right thyroid nodule is unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland is unremarkable. Right adrenal gland is not well seen.KIDNEYS, URETERS: Status post right nephrectomy. Left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Borderline enlarged retroperitoneal lymph nodes are unchanged. Previously described thrombus in the IVC is again seen. Thrombus is most likely tumor thrombus with a small extra table component at its superior margin, at the level of the right renal vein remnant. Thrombus extends inferiorly to the level of the mid IVC for approximately 6 cm.BOWEL, MESENTERY: Small nonenlarged mesenteric lymph nodes are unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Right adnexal cystic lesion measuring 5.2 x 4. 3-cm is grossly unchanged without any definite solid component.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: Multiple pleural-based, bilateral masses are unchanged.Possible tumor thrombus in the IVC as described above is unchanged. Borderline enlarged retroperitoneal and mesentery lymph nodes are unchanged.Right adnexal cystic lesion is unchanged.


Instruction: Generate impression based on medical findings.

Input: Age: 43 yearsGender: FemaleReason for Study: Reason: Sickle cell disease, chronic dyspnea, prior cough, assess for acute chest History: cough The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Male, 22 years old.Fever and pain in patient with sickle cell disease. Cardiomegaly and enlargement of the central pulmonary vasculature unchanged.Right basal airspace opacities consistent with pneumonia.

Output: Right basal opacity consistent with pneumonia.


Instruction: Generate impression based on medical findings.

Input: 50 year-old female stage IIIc ovarian carcinoma 9/06 BSO, 10/0623/07 therapy, additional therapy 4-11/07, 11/07, second look surgery 1/08 restaging measure lesions. CHEST:LUNGS AND PLEURA: Right middle lobe nodule image 59, unchanged, and measures 5.3 x 5.3 mm.Left upper lobe nodule paraspinal, image 22, unchanged, too small to measure.No new nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: The implant on the surface of the posterior aspect of the right lobe of the liver previously seen on image 104 is seen on the current study image 110/208. It measures 1.6 x 1.3-cm. Other implants in the region are unchanged.SPLEEN: Lesion either in the OR compressing splenic parenchyma previously seen on image 96 is seen on current study image 104 and measures 2.5 x 2.1.Hypodense lesion in the upper pole the spleen unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Kidneys unchanged. Left nephroureterostomy stent. Persistent hydronephrosis.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: Soft tissue implant seen in the distribution of the omentum and mesentery, largest in the upper abdomen are redemonstrated probably unchanged. These are all very irregular in shape and are not easily amenable to reliable reproducible measurements.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: The surgically absent.BLADDER: Distal and nephroureterostomy stent in place.LYMPH NODES: Small lymph nodes unchanged.BOWEL, MESENTERY: Complex and partially calcified masses in the left adnexa decreased in size. Largest individual component was measured previously on image 163 is now seen in image 169 where it measures 4.4 by 3.9-cm.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Decrease in size of pelvic mass. Other lesions are stable. No new lesions seen.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Placement of right subclavian line Endotracheal tube is unchanged in position. Interval removal of NG tube. New right subclavian line tip in the distal SVC. No significant pneumothorax. Increasing basilar opacity consistent with atelectasis and pleural effusions.

Output: 1.New right subclavian venous catheter without significant pneumothorax. 2.Increasing bibasilar opacity compatible with atelectasis/effusions.


Instruction: Generate impression based on medical findings.

Input: Age: 44 yearsGender: MaleReason for Study: Reason: edema History: sob Mild/moderate cardiac enlargement.Perihilar interstitial opacities compatible with edema.No focal areas of consolidation.Small pleural effusions.

Output: CHF/volume overload.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o kink/obstruction History: VPS history. Patient presents with headache. SHUNT DEVICE: Intracranial shunt exits the skull via a right frontal burr hole and courses down the scalp, neck, and anterior chest wall entering the abdomen and terminating anteriorly within the abdomen. Portions of the shunt overlying the skull are relatively radiolucent and hence difficult to evaluate but we see no evidence of kinking or discontinuity.SKULL: Note is made of a left posterior parietal burr hole and partially erupted molars but the skull is otherwise unremarkable.CERVICAL SPINE: The cervicothoracic junction is not well-seen due to overlying anatomy but the visualized cervical spine appears normal.CHEST: The lungs are underinflated but clear.ABDOMEN: Nonobstructive bowel gas pattern.

Output: No evidence of discontinuity or kinking of the radiopaque portions of the shunt catheter.


Instruction: Generate impression based on medical findings.

Input: Age: 45 yearsGender: FemaleReason for Study: Reason: ETT placement s/p proning History: ARDS ET tube with its tip 4 to 5 cm above the carina.Bilateral central venous catheters and enteric tube unchanged.Extensive pulmonary opacities compatible with ARDS.No new pulmonary opacities noted.

Output: Support devices unchanged. Stable cardiopulmonary appearance with extensive bilateral pulmonary opacities compatible with ARDS.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: pna? History: wheezing, copd, req continuous albuterol Minimal basilar subsegmental atelectasis, extending into the right costophrenic angle in the left mid to lower lung zone, otherwise unremarkable.No specific evidence of infection or edema.Unremarkable mediastinal contours and cardiac silhouette.

Output: Minimal basilar subsegmental atelectasis or scarring, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Male, 37 years old.Cough and fever question lung infiltrate. No acute cardiopulmonary abnormality. Normal heart size. No focal airspace opacities, pleural fluid or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 22 years old.Shortness of breath question edema or infection. Severe cardiomegaly and enlargement of the central pulmonary vasculature consistent with pulmonary hypertension. Distention of the SVC and azygos arch consistent with hypervolemia. Diffuse airspace opacities bilaterally compatible with severe acute edema.Diffuse skeletal sclerosis likely related to renal disease.

Output: Severe acute pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: lung infiltrate History: cough Questionable opacity in the posterior costophrenic angle on lateral view. This opacity is not visible on the PA view.Cardiomediastinal silhouette unremarkable.No pneumothorax or pleural effusion.

Output: Questionable opacity in the costophrenic angle on lateral view which is most likely summation artifact. However, infection or other process cannot be entirely excluded. Recommend follow-up with PA and lateral chest x-ray when feasible to further characterize. No other acute cardiopulmonary findings.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: ET placement History: ET placement Small lung volumes with interstitial and airspace opacities again worsening, accompanied by small pleural effusions.ET tube tip approximately 3 cm above the carina.An NG tube terminates in the stomach.A Dobbhoff tube extends below the lower margin of the image.Right jugular catheter, tip in SVC.

Output: Worsening pulmonary opacities suggestive of edema and/or aspiration. ET tube tip approximately 3 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Male, 76 years old.Reason: desaturation, eval for progression of bilateral opacities History: as above Right chest port unchanged. Diffuse right-sided pleural-parenchymal opacities unchanged. Left-sided interstitial and airspace opacity, superiorly, is unchanged.

Output: No change in bilateral lung opacities and right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 38 years old.Cough, rhonchi on exam question pneumonia. No focal airspace opacities. The lungs are well-inflated. No pleural fluid. Normal heart size.

Output: No acute cardiopulmonary abnormality. Normal chest.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: PTX History: s/p chest tube clamp Left chest tube unchanged. Cardiomediastinal silhouette is unremarkable. Left pleural effusion appears unchanged. Left lung base opacity is unchanged. Right lung is clear. Multiple chronic appearing bilateral rib fractures again noted.

Output: Left base opacity is unchanged.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: 67 yearsGender: FemaleReason for Study: Reason: 67yoF with CHF off diuretics for several days, eval for pleural effusion History: decreased breath sounds and dullness to percussion at L base The cardiomediastinal silhouette is unremarkable.The lungs are clear.Left pleural effusion and/or pleural thickening.

Output: Interval resolution of the previously noted left retrocardiac consolidation/atelectasis. Small residual left pleural effusion noted. No evidence of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 80 years old.Reason: s/p AVR History: s/p AVR Interval extubation. Stable position Swan-Ganz catheter.No significant change in low lung volumes with basilar atelectasis and pleural effusions.No pneumothorax.

Output: 1. Interval extubation2. Stable basilar opacities and effusions.


Instruction: Generate impression based on medical findings.

Input: 35 years old Female. Reason: 35F nasopharyngeal ca on chemo, p/w fever History: fever,. There is no evidence for infiltrate in both lung, pleural effusion or pneumothorax. There is a prominence of the main pulmonary artery. The tip of the Port-A-Cath projects over the SVC.

Output: Unremarkable examination


Instruction: Generate impression based on medical findings.

Input: ETT check Mild retraction of the ETT with the tip terminating at 4 cm above carina. NG unchanged.Cardiopulmonary appearance is similar with mixed scattered airspace opacities with persistent small pleural effusions and mild cardiomegaly.No new findings.

Output: ETT repositioned.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: eval chest tube History: as above Basilar consolidation, pleural effusions and basilar edema are unchanged.Right pleural drain, and no pneumothorax.Left jugular and left subclavian catheters both terminate in the left radiocephalic vein.

Output: No significant pneumothorax. Unchanged support devices. Stable basilar opacities and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: PTX History: SOB Right chest tubes with a small right apical pneumothorax, slightly improved.Other lung opacities endobronchial valves are stable.

Output: Very small right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: eval ETT, lung fields History: s/p AVR ET tube tip approximately 1 cm above the carina.Swan-Ganz catheter tip in the right main pulmonary artery.Basilar opacity compatible with small effusions and mild atelectasis.A more recent radiograph has been interpreted.

Output: Slightly low position of ET tube.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.History of peripheral vascular disease. The tip of the right IJ Swan-Ganz catheter overlies the distal right pulmonary artery, overall stable from prior studies.Intact median sternotomy wires. The heart is normal in size.Basilar subsegmental atelectasis.No pleural effusion or pneumothorax.

Output: Stable position of support apparatus. No new abnormal radiographic findings.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: 73M with recent cardiac surgery and endocarditis, maybe SOB at rehab, AKI, ?pneumonia, ?volume overload History: ASD closure,Tricuspid annuloplasty, mitral valve repair Improvement in basilar opacities. Resolution of small left-sided pneumothorax. Small pleural effusions noted. Unchanged cardiomegaly. No new focal pleural parenchymal opacity.

Output: Improvement in basilar opacities. Resolution of small left-sided pneumothorax. Small pleural effusions noted.


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old. Chest pain, SOB. Normal cardiomediastinal silhouette.Azygous pseudolobe, a normal variant.No evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: neoplasm RLL History: s/p lung resection, vats 10/20/15 Healed right rib fracture minimal edema nodule, the lungs otherwise unremarkable.Chronic blunting left costophrenic angle.Unremarkable mediastinal contours and cardiac silhouette.

Output: Status post right lung nodule resection without evidence of recurrent disease.


Instruction: Generate impression based on medical findings.

Input: Female, 90 years old.Reason: 90 y/o lady w/ altered mental Status History: AMS Median sternotomy presumably for CABG.Small lung volumes with a mild interstitial edema pattern, but no sign of infection.

Output: Cardiomegaly with mild edema consistent with CHF/hypervolemia.


Instruction: Generate impression based on medical findings.

Input: Tracheostomy tube Tracheostomy tube remains 6 cm above the carina.The Dobbhoff has been removed in the interval.Underlying diffuse bilateral mixed largely interstitial opacities compatible with edema and atelectasis with questionable partial consolidation of the left lower lobe, remains unchanged. Small effusions

Output: Dobbhoff removed


Instruction: Generate impression based on medical findings.

Input: History of sickle cell, fever Cardiomediastinal silhouette is within normal limits. No pleural effusions or pneumothorax. No focal pulmonary opacity.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 81 years old.Reason: fracture History: mvc There is a displaced fracture of the right humeral neck. Dedicated musculoskeletal imaging was performed subsequent to this radiograph.No evidence of displaced rib fracture or pneumothorax. There is evidence of healed granulomatous infection. Elevation of the right hemidiaphragm. Heart size is normal.

Output: Displaced rib fracture of the right humeral neck; dedicated musculoskeletal imaging was performed subsequent to this radiograph. No evidence of displaced rib fracture or pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: 69 y/o with dyspnea History: dyspnea Mild right upper lobe linear scarring or fissural thickening.No other significant pulmonary abnormality.Unremarkable mediastinal contours and cardiac silhouette.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 49-year-old female status post 6 cycles chemotherapy. Please review and compared to a previous scans following same measurements to evaluate difference. Please provide measurements for report. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Several small nodes are seen in the paratracheal pretracheal area, unchanged from the prior exam.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No interval change with 3 lesions consistent with hemangioma and a fourth lesion consistent with a simple cyst unchanged in size and appearance. No new lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Carcinomatosis unchanged in extent and distribution. As measured in the left abdomen just above the umbilicus image 133/223 the carcinomatosis is 1.6 cm in thickness comparable to the previous exam.Bowel is intrinsically normal. No evidence of obstruction or ascites. No new sites of disease.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Prominence and adnexa a left greater than right redemonstrated, unchanged. This could represent a component of carcinomatosis.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.

Output: Stable peritoneal disease. Stable small mediastinal nodes. No new sites of disease. Stable hepatic lesions as detailed in prior report, unrelated to the patient's malignancy..


Instruction: Generate impression based on medical findings.

Input: 59-year-old female with vulvar Paget's disease and history of uterus cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Unremarkable study.


Instruction: Generate impression based on medical findings.

Input: 76-year-old female with history of ovarian carcinoma status post chemotherapy and surgical intervention presenting with elevated tumor marker. Please evaluate for disease recurrence. CHEST:LUNGS AND PLEURA: Stable bilateral scarring. Stable left lower lobe micro-nodule best seenon series 4, image 53/102.New right pleural effusion. MEDIASTINUM AND HILA: Stable mediastinal and hilar adenopathy. Reference right hilar lymph node best seen on series 3, image 41/218 measures 1.9 cm x 1.2 cm (stable).CHEST WALL: There is a left periclavicular mass best seen on series 3, image 9/218 measuring 3.2 cm x 1.9 cm. ABDOMEN:LIVER, BILIARY TRACT: Innumerable hypoattenuating foci in both hepatic lobes, consistent with metastatic disease.SPLEEN: Previously noted hypoattenuating focus remains stable on comparison to previous exam.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable right renal cyst.RETROPERITONEUM, LYMPH NODES: Enlarged retroperitoneal lymph nodes are seen, for example on series 3, image 123/218.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No other significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Absent uterus. Previously seen left adnexal soft tissue focus in measures 1.1 cm x 1.1 cm in(series 3, image 177/218).BLADDER: No significant abnormality noted.LYMPH NODES: No significant pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Fluid is noted in right pelvis in the region of the vaginal cuff (series 3, image 182/218).

Output: 1.Innumerable hypoattenuating foci in both hepatic lobes with associated adenopathy, consistent with metastatic disease.2.Left periclavicular mass in anterior chest wall as detailed above.3.Fluid in right pelvis in the region of the vaginal cuff as above.4.New right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Reason: ptx? fracture? traumatic injury? History: kicked in chest, pleuritic chest pain Unremarkable cardiac and mediastinal silhouette. No significant pulmonary abnormalities.Very small amount of air in the soft tissues to the left chest wall.No displaced rib fractures are visible but chest radiographs are not sensitive in this respect.

Output: Small amount of subcutaneous emphysema on the left, likely related to recent trauma.


Instruction: Generate impression based on medical findings.

Input: 61-year-old female with metastatic breast cancer CHEST:LUNGS AND PLEURA: Multiple nonspecific micronodules are unchanged.MEDIASTINUM AND HILA: Left thyroid nodule is unchanged. No evidence of mediastinal adenopathy.CHEST WALL: Right chest port with its tip in the SVC. Multiple bone metastases within the axial and proximal appendicular skeleton are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Number of liver metastases has significantly increased. There are numerous metastatic lesions in both lobes of liver.First index lesion can no longer be measured accurately due to interval development of numerous coalescing metastatic lesions around it . Second index lesion measures 19 by 16mm image number 121, series number 4, significantly increased. Third index lesion measures 16 by 15-mm on image number 102, series number 4, not significantly changed .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: Extensive bone metastases are unchanged.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: Extensive bone metastases are unchanged.OTHER: Small amount of ascites.

Output: Interval increase in the number and size of the hepatic metastatic lesions. Bone metastases are stable.


Instruction: Generate impression based on medical findings.

Input: Age: 24 yearsGender: MaleReason for Study: Reason: Trach History: as above Tracheostomy, right pleural drain, and left-sided central venous catheter is unchanged.Marked deformity of the chest wall limiting evaluation.Stable cardiac enlargement.No definite new pulmonary opacities.Spinal stabilization hardware redemonstrated.

Output: Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Reason: eval for PNA History: productive cough Tracheostomy at the level of thoracic inlet.Cardiomediastinal silhouette appears unremarkable.Scoliosis redemonstrated and appears stable.Bibasilar opacities consistent with aspiration and atelectasis.No pleural effusions.

Output: Bibasilar aspiration and atelectasis. Short-term plain film follow-up suggested to rule out pneumonia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Reason: eval for consolidation History: coarse R lung sounds with wheeze Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: 64 64-year-old female, follow-up for lung nodules LUNGS AND PLEURA: Right lower lobe nodule (image 79, series 6) is basically unchanged, measuring 7 mm x 8 mm, previously, measuring 8 mm x 9 mm.Left lower lobe non-solid small nodule (image 73, series 6), now measures 4 mm x 4 mm, previously, measuring 5 mm x 4 mm..No other pulmonary nodules can be identified.MEDIASTINUM AND HILA: Hilar or mediastinal lymphadenopathy.Cardiac size is normal. There is minimal pericardial effusion/thickening unchanged.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: Stable right lower lobe and left lower lobe pulmonary nodules.


Instruction: Generate impression based on medical findings.

Input: 56-year-old male evaluate Swan placement. Right IJ Swan-Ganz catheter tip unchanged and may be either in the right interlobar pulmonary artery or right middle lobe pulmonary artery. Other supportive devices unchanged. Stable cardiomegaly and bilateral pulmonary opacities. No pneumothorax.

Output: Swan-Ganz catheter tip unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: PNA History: SOB COPD Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.With a history of lung cancer and pleural effusion presenting with shortness of breath. Please monitor for progression or new opacities. Persistent small bilateral pleural effusions. Unchanged left perihilar/perimediastinal fibrosis. No pneumothorax or focal lung opacity. Small cardiomegaly.

Output: Stable small bilateral pleural effusions and posttreatment scarring worst in the left upper lobe. No specific evidence of infection or fluid overload.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: eval lung fields, ETT, chest tubes History: s/p AVR The endotracheal tube tip terminates 4 cm above the carina. There are two mediastinal drains in place. Sternotomy hardware is intact. Right internal jugular Swan-Ganz catheter tip terminates in the main pulmonary artery. Epicardial pacer leads in place.No pneumothorax, pleural effusion or consolidation is evident. The cardiac and mediastinal contours are within normal limits for size.

Output: Endotracheal tube tip 4 cm above the carina. Right Swan-Ganz catheter tip is in the main pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: 71-year-old female with history of 3 days of malaise/fatigue/orthostatic symptoms and decreased by mouth intake with right-sided crackles. Evaluate for pneumonia or volume overload. Postoperative changes are seen in the left upper abdomen.There are bibasilar right greater than left linear opacities likely representing atelectasis or scarring. There is bronchial wall thickening and bronchiectasis. Unchanged minimal left-sided pleural thickening/small effusion. The left lower lobe is collapsed.

Output: Stable right-sided basilar scarring/atelectasis and left lower lobe collapse likely related to recurrent infection, aspiration or mucous plugging. No specific evidence of infection or edema. The appearance may indicate chronic indolent airway infection such as MAI. If clinically warranted, a CT may be obtained.


Instruction: Generate impression based on medical findings.

Input: Age: 55 yearsGender: MaleReason for Study: Reason: patient with balloon pump, likely misplaced, following History: none Left-sided ICD unchanged.Distal IABP marker at the level of L1 and proximal marker in the right innominate.Right PICC line with its tip in the axilla.Stable mild cardiac enlargement.Decreased lung volumes.The lungs are clear.No pleural effusions.

Output: Support devices unchanged with proximal IVP marker in the right innominate artery. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: 76-year-old male with head and neck cancer. Left iliac node. CHEST:LUNGS AND PLEURA: Scarring in the left lung base.Subcentimeter intrapontine there lymph nodes near the right major fissure.MEDIASTINUM AND HILA: 1 cm right-sided thyroid nodule. Right- it sided port with its tip in the distal SVC. Hypodensity within the right atrial appendage which may represent thrombus.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Simple left lobe hepatic cyst. Other subcentimeter densities in the liver are too small to characterize.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: Prostate gland is enlarged.BLADDER: Diffuse wall thickening involving the anterior wall of the bladder. This may secondary to cystitis, or, neoplasm cannot be excluded.LYMPH NODES: Right inguinal adenopathy measuring 16 x 13 mm image number 186 on series number 4.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Enlarged prostate gland.Focal wall thickening involving the anterior abdominal wall the bladder.Writing adenopathy.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Respiratory failure question pleural effusion. Hypoxemia. Endotracheal tube tip 3.5-cm above the level of the carina. Right jugular and subclavian catheters terminate at the SVC/RA junction. Dobbhoff and nasogastric tubes can be followed to the level of the stomach with tip Leon the caudal margin of the radiograph.No pneumothorax. Large layering left pleural fluid collection with associated compressive atelectasis and collapse of the lower loop, about the same. Small right pleural effusion with basilar opacity along the right hemidiaphragm unchanged.

Output: No acute change in large left pleural fluid collection. Right basal opacity is disproportionate to the volume of pleural fluid and and is now suspicious for pneumonia.


Instruction: Generate impression based on medical findings.

Input: Reason: effusion, edema, cardiomegaly History: worsening doe, hx of CHF Cardiomegaly with nonspecific perihilar interstitial opacities M. focal areas of subsegmental atelectasis or scarring.No visible pleural effusions.

Output: Cardiomegaly and nonspecific interstitial opacity which is at least partially chronic though there may be a component of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Reason: lumbar peritoneal shunt please evaluate tubing connectivivty, status, and valve with one view directly over valve for setting determination including ap and lateral view.. History: headaches ,possible shunt failure Some of the shunt tubing is partially visualized in the left flank area but better seen on abdominal radiographs which have been reported separately.Unremarkable cardiac and mediastinal silhouette. Small calcified granulomas and no acute abnormalities.

Output: Incompletely visualized shunt tubing and valve, but better visualized on the abdominal radiographs which will be reported separately.No significant cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Mitral valve replacement Postsurgical changes including mediastinal and left basilar chest tubes without significant underlying pneumothoraces. Swan-Ganz extends into the right pulmonary outflow tract, IABP marker extends into the aortic arch.ETT terminates 4 cm above the carinaPostsurgical changes also include moderately nonspecifically enlarged cardiac silhouette with decreased lung volumes. Basilar atelectasis with possible small right effusion otherwise observed. Please see subsequent report.

Output: Well-positioned ETT and postsurgical chest tubes


Instruction: Generate impression based on medical findings.

Input: Prematurity, pneumothorax.VIEW: Chest lateral (one view) 4/24/2016 at 1058 hours. ET tube, NG tube, umbilical lines and chest tubes are again noted and unchanged. Cardiac silhouette is non-sizable. Stable tension pneumothorax. If there pneumothorax is on the right or left cannot be ascertained with only lateral views.

Output: Persistent tension pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 29 years old.Reason: PNA, effusion History: HIV presenting with flu like symptoms No significant cardiopulmonary abnormality.No specific evidence of infection.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Cough and chronic smoker No acute cardiopulmonary abnormality. Minimal atherosclerotic changes of the descending aorta however otherwise observed with cardiac and mediastinal contours otherwise well within limits

Output: Atherosclerotic disease without acute pulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: Age: 93 yearsGender: FemaleReason for Study: Reason: r/o infection, volume overload History: weakness, shaking Recent lung volumes with stable cardiac enlargement.Increasing perihilar and basilar interstitial opacities compatible with edema.No focal areas of consolidation.Small right pleural effusion.

Output: Increasing pulmonary edema compatible with volume overload/CHF. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.Reason: r/o infection History: fever and sob Amorphous opacity in the right infrahilar region. No pleural effusion or pneumothorax. No acute bony abnormality. Heart is at the upper limit of normal.

Output: Amorphous opacity in the right infrahilar region which may represent early aspiration or pneumonia. Chest radiographic follow-up in 8 weeks is suggested for reevaluation.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Chest pain evaluate for pathology. Normal heart size. Sternotomy hardware and AVR in place. Coronary stent noted. Lung volumes appear upper normal. Nodular scarlike opacity at the left apex, not visible on prior examinations, incompletely characterized by this technique. Bronchial wall thickening and coarse peripheral opacity suggestive of aspiration/bronchiolitis

Output: Irregular nodular scarlike opacity left apex, probably post infectious scarring, though malignancy cannot be entirely excluded. Coarse reticular nodular opacities elsewhere suggestive of bronchiolitis which may be aspiration-related or infectious. Recommend 6-week follow-up PA and lateral chest radiographs and if the abnormalities persist at that time, then chest CT may be considered for further evaluation.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Evaluate for pleural effusion or pulmonary edema. Pedal edema. Moderate right pleural effusion. Trace pleural fluid on the left. Nonspecific right basal opacity, most consistent with atelectasis. Mild interstitial edema. Normal heart size.

Output: Moderate CHF with nonspecific right basal opacity, most likely reflecting atelectasis in the absence of signs of infection. Consider short-term plain film follow-up to assess for resolution.


Instruction: Generate impression based on medical findings.

Input: 43-year-old male with sigmoid colon cancer status post sigmoid resection. Baseline exam prior to chemotherapy and radiation therapy. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Low-attenuation lesions in the left lobe and the isthmus of the thyroid probably represent cysts.No pathologically enlarged hilar or mediastinal lymph nodes. The cardiac size is normal. No pericardial effusion.Soft tissue within the anterior mediastinum probably represents residual thymus.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral low-attenuation lesions probably represent benign cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes status post sigmoid colon resection with a diverting ileostomy in the right lower quadrant.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: As above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: No evidence of recurrent or metastatic disease. Other benign findings as described above.


Instruction: Generate impression based on medical findings.

Input: 67 years old Female. Reason: eval for cause of hypoxia History: somnolent, probable opoid overdose. The cardiac and mediastinal silhouette is enlarged with cephalization of pulmonary veins. Diffuse bilateral interstitial changes. Patchy opacities are noted in the lower lungs. Small lung volumes bilaterally. Small pleural effusions.

Output: The above findings suggestive of mild CHF. Suggest clinical correlation. Superimposed infection in the lower lungs cannot be excluded.


Instruction: Generate impression based on medical findings.

Input: Sickle cell disease. Chest pain No acute cardiopulmonary abnormality. Scattered unchanged mild osseous changes consistent with known sickle cell disease

Output: Osseous sequela of sickle cell disease without acute cardiopulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: Reason: eval for infiltrate History: bacteremia Normal heart size with ICD leads in place, unchanged from previous.PICC tip in the right axilla.Calcified lymph nodes and no acute pulmonary disease.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 33 years old.Reason: pneumonia History: left sided chest pain, sob Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Reason: post-bedside bronch History: post-bedside bronch Large bilateral layered out pleural effusions, greater on the right, with underlying edema and atelectasis.Possible small loculated pneumothorax at the right apex.Feeding tube traversing the esophagus.

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


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: assess for PNA History: febrile 38.4 The cardiomediastinal silhouette is unchanged.Basilar opacities, left greater than likely represent atelectasis. Left basilar aspiration of secretions or early infection cannot be excluded.Line position stable

Output: Left basilar opacity likely atelectasis however aspiration/early infection cannot be excluded. Recommend follow-up.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: daily cxr History: n/a Significant interval progression of right effusion and pulmonary opacities. Additional placement of right-sided chest tube. Remaining support devices are unchanged in position and appearance.

Output: Significant interval progression of right effusion and pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: S/p laparoscopic pancreatic debridement, difficulty placing NGT, evaluate for PTX History: Difficulty placing NGT The heart is normal in size.There is a new enteric tube coursing below the diaphragm. Feeding tube versus below the diaphragm and off the field-of-view.Persistent left lower lobe partial collapse, slightly worsened from prior.Left pleural effusion. No pneumothorax.The right IJ venous catheter overlies to superior catheter which was junction.

Output: No pneumothorax after recent placement of right IJ venous catheter.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: hypoxia History: hypoxia No acute abnormality.

Output: No acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: pulmonary edema History: SOB Jugular catheter tip in SVC.Cardiomegaly with pulmonary edema and pleural effusions, worse on the right, unchanged.

Output: Cardiomegaly with pulmonary edema and pleural effusions, worse on the right, unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: swan \T\ IABP positioning History: as above Aortic balloon catheter marker about 2 cm below the top of the aortic arch.Swan-Ganz catheter tip in the right main pulmonary artery.Right jugular catheter and ICD leads unchanged.Severe cardiomegaly with perihilar interstitial opacity compatible with edema.

Output: Line position stable.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old. Reason: hx of ataxia, getting metabolic infectious workup. History: hx of cough No focal lung consolidation. No large pleural effusion or pneumothorax. Heart is at the upper limit of normal. Postoperative changes again noted in the right shoulder region.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Persistent unchanged large perihilar tumor with extensive interstitial opacities are postobstructive airspace changes throughout the right upper, middle and lower lobes. Moderate effusion. Mild superimposed edema again cannot be excluded given similar changes the left without an associated perihilar mass.

Output: Large hilar mass with underlying extensive changes suggesting lymphangitic spread of tumor with superimposed mild to moderate perihilar bilateral edema with small effusions


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Vertigo, further evaluation of nodule. Nodular opacity projecting over the right first rib costochondral cartilage most likely represents abundant degenerative changes at the joint space, although it is asymmetric when compared to the left. The appearance is not significantly changed from a prior radiograph of 9/11/2004.No suspicious pulmonary nodules or masses. Upper normal heart size.

Output: No acute cardiopulmonary abnormality. Nodular opacity likely represents degenerative skeletal changes.


Instruction: Generate impression based on medical findings.

Input: Reason: sob History: sob, asthma, chf Marked cardiomegaly with an ICD lead extending to the apex of the right ventricle, unchanged.Blunting of the right costophrenic angle, unchanged, suggestive of scarring.No specific evidence of pulmonary edema or infection.

Output: Severe cardiomegaly with no acute change.


Instruction: Generate impression based on medical findings.

Input: Age: 55 yearsGender: FemaleReason for Study: Reason: et tube History: INTUBATED ET tube and NG tube unchanged.The cardiomediastinal silhouette is unremarkable.Patchy airspace opacities similar in appearance to the prior exam and compatible aspiration/infection.No new pulmonary opacities identified.No large pleural effusions.Fracture deformities of multiple ribs in the right hemithorax.

Output: Support devices unchanged. Stable cardiopulmonary appearance with bilateral patchy airspace opacities compatible with aspiration/infection.


Instruction: Generate impression based on medical findings.

Input: Reason: Intubated SICU patient History: Sepsis. ET tube tip approximately 3 cm above the carina.Catheter tip in the SVC.Small lung volumes with bilateral nonspecific perihilar airspace opacities, not significantly changed.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: eval SOB History: SOB Small pleural effusions with overlying atelectasis are present, right greater than left.Heart size normal.

Output: Small pleural effusions with overlying atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o pneumonia History: SOB Severe chronic interstitial disease, with upper zone predominance, as previously characterized by CT scan, not significantly changed from the previous radiograph.Underlying emphysema and pleural thickening.No sign of pneumonia or other acute change.

Output: Severe chronic abnormalities with no acute change.


Instruction: Generate impression based on medical findings.

Input: Congestive heart failure New right jugular catheter placed, tip extends into the SVC near the RA junction. LVAD in ICD unchanged.Underlying cardiopulmonary appearance again significant for marked cardiomegaly and questionable small effusions and left lower lung compression atelectasis. No discrete new superimposed focal air space process.

Output: Right jugular catheter placed


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Reason: evaluate for pneumothorax post pacemaker History: post pacemaker Stable position of left-sided pacemaker. Metallic valve in the mitral and aortic positions are again noted.Stable small pleural effusions and basilar subsegmental atelectasis. No pneumothorax.

Output: No interval pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 68 years old Male. Reason: central line placement History: see above. The cardiac and mediastinal silhouette is enlarged with cephalization of pulmonary veins, unchanged. Bilateral pleural effusion are unchanged. The intra-aortic balloon pump in the proximal descending aorta. There is no evidence of pneumothorax.

Output: Mild cardiomegaly and bilateral pleural effusions, unchanged.


Instruction: Generate impression based on medical findings.

Input: Pacemaker. Left subclavian dual-chamber pacemaker has been placed. No pneumothorax. Sternotomy hardware, skin staples and a valve prosthesis project over the mediastinum. Moderate pleural fluid with basal atelectasis suggestive of aspiration.

Output: Pacemaker leads in appropriate position. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: assess for recurrent pneumonia History: h/o recently treated CAP, persistent cough, fever Mild basilar scarring or subsegmental atelectasis noted.No specific evidence of infection or edema.Unremarkable mediastinal contours and cardiac silhouette.

Output: No significant abnormality. Mild basilar scarring.


Instruction: Generate impression based on medical findings.

Input: 51 years old Male. Reason: eval for infiltrates History: fever, cough. There is an ill-defined opacities in the lower lungs, left greater than right, which may represent infection. Probable small right pleural effusion.

Output: Ill-defined opacities in the lower lungs, which may be due to pneumonia. Suggest follow-up.


Instruction: Generate impression based on medical findings.

Input: Male, 86 years old.Reason: Evaluate for pneumonia History: Altered mental status, history of aortic regurgitation, mitral regurgitation Markedly enlarged, globular appearing cardiac silhouette is new compared to 2011 and concerning for pericardial effusion.Low lung volumes and bibasilar atelectasis/consolidation. Small pleural effusions.No pneumonia.

Output: 1. Markedly enlarged, globular appearing cardiac silhouette is new compared to 2011 and concerning for pericardial effusion.2. Nonspecific bibasilar opacities may represent atelectasis with pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Left IJ CVC placement. Left jugular catheter tip projects over the juncture of the left IJ and left brachiocephalic veins however also projects over the aortic arch level, therefore, correlation with blood drawn from the line is suggested to verify venous placement. Swan-Ganz catheter has been slightly retracted with tip now at the proximal right descending pulmonary artery level.Other hardware and devices unchanged.Retrocardiac opacity, most consistent with atelectasis. No specific signs of pulmonary edema. No significant pneumothorax.

Output: Left jugular catheter projects over the aortic knob. Suggest correlation with blood drawn from the line to confirm venous placement.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: evaluate for pneumothorax s/p thoracentesis History: thoracentesis Moderate right pleural effusion with overlying consolidation not significantly changed.Minimal left pleural effusion.Heart size normal.No significant pneumothorax.Right jugular catheter, tip in the right atrium.

Output: No significant pneumothorax. Persistent right pleural effusion and basilar consolidation.


Instruction: Generate impression based on medical findings.

Input: Female 36 years old Reason: r/o pneumonia History: cough/sob No focal opacity, pleural effusion or pneumothorax. Normal cardiomediastinal silhouette.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: H/O Bladder cancer eval for progression History: see above No evidence of pulmonary metastases. Calcified nodes and left lower lobe granuloma consistent with granulomatous disease.

Output: No evidence of pulmonary metastases.


Instruction: Generate impression based on medical findings.

Input: 23-year-old female with history of ulcerative colitis. Status post small bowel resection. CHEST:LUNGS AND PLEURA: Bilateral moderate pleural effusions which are increased in size compared to previous CT. The pendent atelectasis.MEDIASTINUM AND HILA: Nonocclusive thrombus in the right internal jugular vein.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Numerous mesenteric, borderline enlarged lymph nodes are identified, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Loculated fluid collections are noted around the spleen, between the stomach and pancreas. Small amount of ascites. The amount of ascites has decreased compared to previous study. No fluid and on the tip of the surgical drains. Percutaneous jejunostomy tube is in place.PELVIS:UTERUS, ADNEXAE: 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: Small amount of ascites.

Output: Interval decrease in the amount of ascites. Development of loculated fluid collection the left upper abdomen around the spleen and between the stomach and pancreas.Interval increase in the amount of bilateral pleural effusions.Interval development of thrombus in the right internal jugular vein.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Reason: monitor post PCI for STEMI History: chest pain Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Heart size at the upper limit of normal.

Output: Clear lungs. Heart size at the upper limit of normal.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: eval lung fields History: s/p MVR Interval removal of Swan-Ganz catheter without right pneumothorax. Trace residual left apical pneumothorax with maximal pleural separation from the chest wall of about 2 to 3 mm.Small pleural effusions. Other hardware and devices unchanged. Large volume of air and stool in the colon.Mild basal atelectasis but no evidence of pulmonary edema or pneumonia.

Output: Mild basal atelectasis. Trace left apical pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.Reason: central line placement History: Bleeding from permacath Stable cardiomegaly. No significant change in basilar opacities and right pleural effusion. Support devices stable.Interval placement of left central venous catheter with tip in the projection of right atrium. No pneumothorax.

Output: No pneumothorax following line placement. Findings of cardiomegaly and right pleural effusion are unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 21 years old.Reason: hemoptysis, known Wegener's, now with congestion/ purulent sputum History: hemoptysis Persistent or recurrent right lower lobe nodule consistent with known granulomatosis with polyangiitis.Elsewhere, the lungs are unremarkable.Unremarkable mediastinal contours and cardiac silhouette.

Output: Right lower lobe nodule consistent with known granulomatosis with polyangiitis.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.History of seizure or stroke, evaluate for infection. Left subclavian pacemaker unchanged. The atrial lead remains directly inferiorly, unchanged since 10/11/2014, suggestive of dislodgment from the atrial appendage.Moderate cardiomegaly and tortuous aorta, unchanged.Increased retrocardiac opacity compatible with atelectasis and probable effusion.

Output: 1.Cardiomegaly with increased left basilar atelectasis and probable effusion. Dedicated PA and lateral radiograph may be helpful for additional evaluation.2.Likely atrial appendage lead dislodgment, unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: Leukocytosis; evaluate for PNA History: as above Interval clearing of interstitial opacities suggestive of edema.Mild residual upper zone scarring.Catheter tip in the upper right atrium. No sign of pneumonia.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female 63 years old Reason: s/p lung transplant History: Dyspnea on exertion Post surgical changes related to lung transplant. Changes status post vertebroplasty of T7 are again noted. Cardiomediastinal silhouette is unchanged. No new focal airspace opacity or pleural effusion.

Output: Status post lung transplant, with no acute abnormality.