Instruction: Generate impression based on medical findings.

Input: Age: 56 yearsGender: MaleReason for Study: Reason: s/p intubation, eval tube placement History: see above ET tube is in place with its tip for some is above the carina.Right-sided endobronchial tubes and right pleural drain unchanged.Right pleural effusion/thickening with similar in appearance to the prior exam.No new pulmonary opacities identified.

Output: Interval placement of an ET tube in satisfactory position. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: evaluate for left pleural chest tube position History: left pleural effusion Left chest tube not significantly changed in position with pigtail at the base.Left subclavian AICD and orphaned lead.Right PICC tip at the RA/SVC junction.Large left pleural effusion and lower lung atelectasis again noted.Severe cardiomegaly.

Output: Left chest tube not significantly changed in position.


Instruction: Generate impression based on medical findings.

Input: Age: 44 yearsGender: MaleReason for Study: Reason: 44M trached in MICU, ?trach placement History: 44M trached in MICU, ?trach placement Tracheostomy tube, enteric tube, and right IJ venous catheter unchanged.Stable cardiac enlargement.Basilar opacities compatible with atelectasis, edema, and effusions similar to the prior exam.

Output: Support devices unchanged. Stable cardiopulmonary appearance with basilar opacities compatible with atelectasis, edema, and small effusions.


Instruction: Generate impression based on medical findings.

Input: Reason: rule out worsening fluid overload History: sob Bilateral perihilar and lower zone opacity compatible with edema and moderate pleural effusions, slightly increased compared to previous.Heart size about upper normal.

Output: CHF with increasing pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Reason: Hx of RCC, surveillance History: as above Moderately severe cardiomegaly with vascular redistribution but no sign of pulmonary edema.Status post median sternotomy.No sign of metastatic disease are other significant interval change.

Output: Cardiomegaly with no acute change.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: ETT advanced 3cm, please eval placement History: as above Endotracheal tube terminates 6.5 cm from the carina. Enteric tube extends inferiorly off the field-of-view. No focal lung consolidation or evidence of overt left-sided heart failure. No large pleural effusion or pneumothorax. Unchanged heart size.

Output: No acute cardiopulmonary process on radiography.Endotracheal tube terminates 6.5 cm from the carina.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Reason: acs vs RAD History: SOB, wheezing The heart is normal in size.Homogeneous opacity in the retrosternal space, stable from priors and likely secondary to mediastinal lipomatosis.Lung volumes are normal. No abnormal focal lung opacities.No osseous lesions are present. Status post rotator cuff fixation on the right. Partially visualized ACDF.

Output: No abnormal radiographic findings to explain patient's symptoms.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: lung donor History: lung donor Left basilar consolidation and mild right base atelectasis.The right lung is clear than on the prior study.Mild cardiomegaly.ET tube tip approximately 4 cm above the carina.Right jugular catheter tip at right atrial level.

Output: Right lung improvement but persistent atelectasis and left base consolidation.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Cough and fever evaluate for pneumonia. Left chest port unchanged in position. Size. Moderate bronchial wall thickening and atelectasis in the lower lobes suggestive of aspiration. No specific evidence of pneumonia. Costophrenic angle blunting may be due to a minimal amount of pleural fluid.

Output: Moderate bilateral bronchial wall thickening and atelectasis, most likely the result of recent aspiration. If patient remains symptomatic, short-term plain film follow-up would be suggested to exclude development of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: evaluate for infection, aspiration History: head and neck cancer, fever Continued improvement in basilar opacities consistent with resolving aspiration or infection.Right upper lobe opacity nearly resolved.Small pleural effusions.Right jugular catheter, tip in SVC.Tracheostomy tube tip 8 cm above the carina.

Output: Improving basilar opacities consistent with aspiration or infection, the residua of prior events, or a recurrent aspiration event.


Instruction: Generate impression based on medical findings.

Input: Male, 17 years old.Reason: Rule out sarcoid History: uveitis Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No evidence of sarcoidosis.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: preop History: preop Improvement in basilar opacities. Stable cardiac enlargement. No acute pulmonary opacities. No pneumothorax.

Output: Improvement in basilar interstitial opacities. Otherwise no change.


Instruction: Generate impression based on medical findings.

Input: Age: 60 yearsGender: FemaleReason for Study: Reason: ETT readjustment History: as above ET tube is been mildly advanced with its tip now 3 cm above the carina.NG tube with its tip in the margin of the image.There are decreased lung volumes with stable cardiac enlargement.Nonspecific basilar opacities are compatible with atelectasis and pleural effusions.

Output: ET tube with its tip 3 cm above the carina. Stable cardiopulmonary appearance with cardiac enlargement and basilar opacities compatible with atelectasis and effusions.


Instruction: Generate impression based on medical findings.

Input: 52-year-old female with history of Crohn's disease. Now with small bowel obstruction ABDOMEN:LUNG BASES: Bilateral small pleural effusions and dependent atelectasis.LIVER, BILIARY TRACT: Fatty infiltration of the liverSPLEEN: 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: Proximal small bowel loops are distended measuring up to 4 cm. Distal small bowel loops in the right side of the abdomen are decompressed. The transition likely is in the point of herniation best seen on image number 95, series number 3. Moderate amount of fluid and a second herniation near the umbilicus in the abdominal wall. No free air to suggest perforation. Small amount of free fluid in the left upper and lower quadrant among the dilated small bowel loops.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid.

Output: Small bowel obstruction likely with the transition point at the level of the herniation the anterior abdominal wall. Loculated collection and a second herniation adjacent to the herniation causing obstruction.


Instruction: Generate impression based on medical findings.

Input: Age: 46 yearsGender: FemaleReason for Study: Reason: r/o pulmonary congestion History: chest pain The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: 63-year-old male with history of neuroendocrine cancer with liver and retroperitoneal metastases. Assess sites of disease. CHEST:LUNGS AND PLEURA: No significant abnormality noted. No suspicious nodules, masses, or pleural effusion. MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. Heart size normal. Coronary artery calcifications are noted in the left main coronary and circumflex arteries.CHEST WALL: No significant abnormality noted. ABDOMEN:LIVER, BILIARY TRACT: Hypervascular lesions of varying size and shape enhancing on arterial phase imaging involve all lobes of the liver, some which exhibits central areas of necrosis as was suggested by prior nuclear octreotide scan. At least one lesion appears to contain internal hemorrhage as a fluid-fluid level (aka hematocrit effect) is identified (series 10, image 32).For reference, a lesion in the right hepatic lobe (segment 8) measures 8.6 x 7.8 cm on arterial phase imaging (series 10, image 13); this lesion measures approximately 8.3 x 7.4 cm on precontrast imaging (series 3, image 25). Its margins are not discretely identifiable on portal venous phase imaging.SPLEEN/PANCREAS: No discrete lesions are seen within the pancreas or spleen. However, a cluster of hypervascular masses enhance on arterial phase imaging in the region of the pancreatic tail and the splenic hilum (series 10, image 41). Discrete fat planes are not identifiable, and therefore local invasion into the pancreas and spleen cannot be excluded. Additionally, it is difficult to localize several of the calcifications near the splenic hilum between arterial versus tumoral.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left lower pole nonobstructing renal stone. Normal right kidney.RETROPERITONEUM, LYMPH NODES: Two distinct heterogeneously enhancing masses identified in the retroperitoneum; one is above the left renal artery and vein while the other is below them. They are best appreciated on series 80769, coronal image 58. For reference, the more inferior mass measures 5.4 x 7.2 cm in the axial plane (series 11, image 142).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.

Output: Multiple hypervascular lesions involving the liver and and the retroperitoneum as detailed above and consistent with patient's history of metastatic neuroendocrine cancer with locations correlating to prior nuclear octreotide scan.


Instruction: Generate impression based on medical findings.

Input: Male; 77 years old. Reason: new right IJ triple lumen catheter - confirm placement History: hypotension New right jugular central venous catheter tip in upper SVC.Normal cardiac and mediastinal silhouettes.No abnormal pulmonary opacities or pleural effusions.

Output: Right jugular central venous catheter tip in SVC.


Instruction: Generate impression based on medical findings.

Input: Age: 75 yearsGender: MaleReason for Study: Reason: eval lung fields History: s/p AVR, CABG ET tube has been removed.Right IJ Swan-Ganz with its tip in the pulmonary artery.Chest/mediastinal tubes in place without evidence of pneumothorax.Stable cardiomediastinal silhouette with decreased lung volumes.Mild basilar atelectasis.No new pulmonary opacities identified.

Output: Interval extubation. Stable cardiopulmonary appearance without acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Cardiac arrest. Respiratory failure. Mediastinal widening similar to prior films this admission. Hardware and devices similar in position. Lung volumes remain low. Motion artifact degrades image quality. Mild basal atelectasis on the left. No visible pneumothorax or signs of acute aspiration or edema.

Output: No acute pulmonary abnormality. Low lung volumes. No acute change in mediastinal widening.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.SOB and URI symptoms. Lung volumes remain low, with bibasal atelectasis. Coarse interstitial opacity unchanged from most recent previous study but appears increased compared to remote prior examinations. No pneumothorax.

Output: Low lung volumes with basal atelectasis. Questionable interstitial abnormality versus artifact of underinflation; the possibility of a chronic indolent viral or atypical infection may be considered if the patient is immunocompromised. Suggest correlation with erect PA and lateral chest radiographs when feasible.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: Evaluate for pneumonia. History: pleurisy, cough Unchanged mild cardiomegaly. Bibasilar subsegmental atelectasis. No focal consolidation. Unchanged small bilateral pleural effusions.

Output: 1.No specific evidence of infection.2.Unchanged mild cardiomegaly, small bilateral effusions and bibasilar subsegmental atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.SOB and wheezing 3 days status post AUS placement.. Fine reticular opacities in the right lung base nonspecific but could be a result of aspiration bronchiolitis if the patient has undergone recent anesthesia. There is no evidence of pneumonia. Normal heart size.

Output: No airspace opacities to suggest pneumonia. Subtle pulmonary opacities could represent aspiration-related bronchiolitis or less likely infectious bronchiolitis in the appropriate clinical context


Instruction: Generate impression based on medical findings.

Input: 58 year-old male with history of mesothelioma. Please evaluate extent of disease. CHEST:LUNGS AND PLEURA: Stable pleural-based nodule in left lung apex.Previously noted nodule in the left lung fissure (series 4, axial image 23/113) remained stable, measuring 9 cm x 6 cm.Stable left-sided pleural thickening that is most pronounced at the posterior lung base with associated left-sided volume loss.At the level of the main pulmonary artery (series 3, axial image 47/243), the pleura measures 2 mm at the one o'clock position and 4 mm at the 3 o'clock position (stable).At the level of the right main pulmonary artery (series 3, axial image 51/243), the pleura measures 4 mm at the one o'clock position (stable).At the level of the coronary sinus (series 3, axial image 72/243), the pleura measures 4 mm at the 3 clock position, 4 mm at the 5 o'clock position, and 8 mm at the 7 o'clock position -- all measurements are stable.At the left lung base, the pleura at the 7 o'clock position measures 15 mm (stable).MEDIASTINUM AND HILA: Reference superior mediastinal lymph node (series 3, axial image 25/243) measures 9 mm x 7 mm and is stable on comparison to previous exam.Persistent pericardial effusion.CHEST WALL: The mass anterior to the cardiac apex at the level of the coronary sinus (series 3, axial image 75/243) remained stable at 26 mm in thickness. On series 3, image 72/243, this mass measures 28 mm x 47 mm (stable).In the anterior left lung base (series 3, image 84/243), the diaphragmatic nodule measures 10 mm x 15 mm, (stable).Previously noted cystic area in the left humeral head remains unchanged. Small sclerotic focus in lateral portion of the left seventh rib remains stable.ABDOMEN:LIVER, BILIARY TRACT: Previously noted hypodense lesions in the liver remain unchanged and too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal nodule on series 3, axial image 96/243, measuring 19 mm x 12 mm (stable).KIDNEYS, URETERS: Simple right renal cyst.RETROPERITONEUM, LYMPH NODES: Portacaval lymph node (series 3, image 100/243) measures 18 mm x 9 mm and is stable.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Cystic lesion in left ilium and a sclerotic area in the left sacroiliac joint remain unchanged from prior study. There is also a sclerotic area in proximal left femoral shaft which is also unchanged from prior study.OTHER: No other significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Stable scattered calcifications.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: No other significant abnormality noted.

Output: Overall stable exam on comparison to previous study as detailed above. Slight differences in measurements most likely secondary to technique.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: sob History: sob Mild cardiomegaly.Small lung volumes with without reliable evidence of edema or pneumonia.

Output: Mild cardiomegaly, without acute edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 50 years old.Reason: Worsening hypoxia, known pneumothorax History: Worsening hypoxia, known pneumothorax Extensive motion artifact obscures the right basilar chest tube previously noted. The right pneumothorax is not visualized, considering the limitations of technique.Very low lung volumes and basilar subsegmental atelectasis.Limited assessment of the cardiac and mediastinal contours.Right IJ venous catheter overlies the SVC.

Output: The right pneumothorax is not visualized, likely resolved in the interval, considering the limitations of a single AP view.Right chest tube in place, partially obscured by motion artifact.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: 68 M s/p cardiac surgery History: s/p cardiac surgery Status post median sternotomy with chest tubes but no pneumothorax.Postop atelectasis and pleural effusions with edema are present.ET tube tip approximately 6 cm above the carina. Right jugular Swan-Ganz catheter, tip in right main pulmonary artery.

Output: Postop pleural effusions and basilar opacities. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 91 years old.Reason: New O2 requirement, ADHF s/p diuresis w/ persistent O2 req History: see above Mild to moderate cardiomegaly.Improving pleural effusions and basilar atelectasis with no new findings.

Output: Improving pleural effusions and basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Age: 57 yearsGender: MaleReason for Study: Reason: chronic pancreatic History: elevated lipase The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Reason: intubated, PTX History: as above ET tube tip approximately 5 cm above the carina.Small right apical pneumothorax, not significantly changed since the previous exam though the subpulmonic component has resolved.Extensive pulmonary opacity compatible with metastatic disease, consolidation and atelectasis.Moderately large right pleural effusion with a catheter projected over the right lung base.

Output: Small persistent right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 42 years old.Reason: shortness of breath, hx of chf History: shortness of breath Mild cardiomegaly. Scattered calcified granulomas. No evidence of edema or infection.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Age: 38 yearsGender: FemaleReason for Study: Reason: hypoxemia History: hypoxemia Tracheostomy tube, left PICC line, and right IJ venous catheter unchanged.Decreased lung volumes with stable cardiomediastinal silhouette.Basilar airspace opacities are compatible with aspiration/infection.Bilateral pleural effusions.

Output: Stable cardiopulmonary appearance of bilateral basilar opacities compatible with aspiration/infection.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o PTX History: recent port placement, R chest pain, SOB Unremarkable cardiac and mediastinal silhouette. Mild chronic basilar interstitial opacities.Port catheter with its tip in the SVC.No pneumothorax or other acute change.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: eval lung fields History: dizziness Severe cardiomegaly and/or pericardial effusion unchanged.Linear scarring left mid lung, the lungs otherwise unremarkable.

Output: Severe cardiomegaly, but no other acute abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: copd vs pna History: Respiratory distress Study limited by rightward patient rotation. Probable mild interstitial pulmonary edema. Hyperinflation consistent with COPD. Small pleural effusions. No focal lung consolidation. No pneumothorax. Normal heart size.

Output: Mild interstitial pulmonary edema. No focal lung consolidation.


Instruction: Generate impression based on medical findings.

Input: 74-year-old female with stage III esophageal cancer status post XRT and chemo. CHEST:LUNGS AND PLEURA: A new nodular opacity in the right middle lobe (axial image 58/95) is probably flat in the craniocaudal dimension suggesting a benign process, possibly mucous plugging in a subsegmental bronchus. Continued follow-up is recommended.. Bi-basilar scarring and atelectasis is unchanged. Mild centrilobular emphysema noted.MEDIASTINUM AND HILA: Multiple hypoattenuating lesions within both lobes of the thyroid are stable. Right IJ thrombosis has resolved. A right-sided Port-A-Cath is in place.The cardiac size is normal. Minimal pericardial fluid is noted, unchanged. A right pretracheal lymph node is smaller measuring 1.6 by 1.0 cm on axial image 41/141. Small subcarinal lymph nodes are evident.An NG tube is in place with its distal tip in the region of the antrum. Thickening of the distal esophageal wall persists but is unchanged. The wall diameter measures approximately 14 mm on axial image 70/141.CHEST WALL: Multiple bone islands in the vertebrae are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Multiple subcentimeter hypoattenuating lesions in the liver appear stable to smaller. A small calcified gallstone is present in the gallbladder. No pericholecystic fluid.SPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small hypoattenuating lesions in both kidneys are unchanged.PANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications evident. Previously noted gastrohepatic lymph node is not well seen on the current exam, if present at all.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: As above.OTHER: No significant abnormality noted

Output: 1.Very small, new right middle lobe nodular opacity, probably benign. Recommend continued follow-up.2.Mild centrilobular emphysema and bibasilar scarring.3.Multiple thyroid lesions are stable.4.Small pericardial effusion unchanged.5.Thickened distal esophageal wall unchanged.6.Hypoattenuating lesions in the liver and kidneys are unchanged.7.Small gallstone.


Instruction: Generate impression based on medical findings.

Input: Altered mental status, chest pain Mild COPD without superimposed acute cardiopulmonary abnormality

Output: Mild COPD without acute disease


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: s/p MVR History: s/p MVR Interval removal of right IJ sheath, right-sided chest tubes and endotracheal tube. Status post median sternotomy and mitral valve surgery.Enlarged cardiac silhouette.Right midlung bandlike and bibasilar subsegmental atelectasis. No pneumothorax.

Output: Interval removal of support devices including right-sided chest tubes with no evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: ETT positioning, eval for infiltrate History: as above Enteric tube has been pulled back slightly now terminating just above the gastroesophageal junction. This could be advanced if clinically indicated. Endotracheal tube, terminating approximately 4 cm from the carina. No new focal pleural parenchymal opacity. No large pleural effusion or pneumothorax. Unchanged cardiomegaly. Tortuous thoracic aorta again noted.

Output: Lines and tubes, as above. No new focal pleural parenchymal opacity.


Instruction: Generate impression based on medical findings.

Input: Male, 40 years old.Reason: R/o PNA in patient with HF with new resp distress History: Hypoxia Severe cardiomegaly.Diffuse left-sided interstitial and airspace opacities are consistent with infection versus asymmetric edema, and/or accompanied by a left pleural effusion.Mild interstitial opacities developed in the right are also suggestive of edema.

Output: Severe cardiomegaly with pulmonary edema, and probable left lung pneumonia.


Instruction: Generate impression based on medical findings.

Input: 82-year-old male with history of renal cell carcinoma CHEST:LUNGS AND PLEURA: again noted multiple micronodules in both lungs. Index nodule in the right middle lobe is unchanged measuring 6 mm on image number 60, series number 4. Other micronodules are also grossly unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Large hepatic lesion now measures 2.7 x 2.5 cm image number 81, series number 3, unchanged from previous study. The second index right lobe lesion is also grossly unchanged measuring 2.1 x 2.7 cm on image number 99, series number 3. These lesions are difficult to see and measure due to lack of IV contrast.SPLEEN: No significant abnormality notedPANCREAS: Mass in the pancreatic tail measures 5.3 x 2 .8 cm, increased in size compared to previous study.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypodense lesion in the lower pole of the left kidney is unchanged. Lack of IV contrast limits the evaluation.RETROPERITONEUM, LYMPH NODES: Mild aneurysmal dilatation of abdominal aorta is unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: 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: Slight interval increase in the size of the pancreatic tail mass, otherwise no significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Age: 81 yearsGender: MaleReason for Study: Reason: pre-op CABG History: NA Left-sided ICD with lead wires and right atrial appendage and right ventricle.Cardiomediastinal silhouette is unremarkable.The lungs are clear.Pleural calcification noted.No pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: LVAD and pneumonia 2 left chest tubes are unchanged, one projects into the lung base and the other towards the apex at the level of aortic arch medially. No appreciable underlying pneumothorax.Swan-Ganz projects into the right pulmonary outflow tract. Dobbhoff, LVAD, tracheostomy tube and ICD are all otherwise unchanged.Persistent moderate CHF with retrocardiac opacity, likely atelectasis.

Output: CHF and atelectasis without superimposed new abnormalities


Instruction: Generate impression based on medical findings.

Input: Reason: 35 yo male with hx of dermatofibroma protuberans History: DFP Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: h/o breast cancer now with WBC >200K w blast crises and tachycardia shortness of breath History: tachycardia, shortness of breath, blast crisis Right chest port tip in the SVC. Surgical clips project over the left axilla.The cardiomediastinal silhouette is normal.Streaky bibasilar opacities are suggestive of subsegmental atelectasis. A nodular opacity overlying the right lower lung is likely a nipple shadow, though given the history of leukocytosis and malignancy, infection or metastatic disease are also considerations.

Output: 1.Bibasilar subsegmental atelectasis. 2.A nodular opacity overlying the right lower lung is likely a nipple shadow, though given the history of leukocytosis and malignancy, infection or metastatic disease are also considerations and this should be followed to imaging resolution.


Instruction: Generate impression based on medical findings.

Input: Female, 27 years old.Renal transplant on immunosuppression complaining of cough and chills rule out infection. Normal heart size. No focal pulmonary opacities or pleural fluid.

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


Instruction: Generate impression based on medical findings.

Input: Female, 90 years old.History of hypotension. Bilateral pacer generators are noted with right ventricular leads.The cardiac silhouette is enlarged.No focal pulmonary opacity or large pleural effusion.

Output: Cardiomegaly without acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: assess swan History: swan Cardiomegaly status post sternotomy.No specific evidence of infection or edema.IVC Swan-Ganz catheter slightly redundant in the right atrium, terminating in the right upper lobe.Prior left jugular catheter removed.

Output: IVC Swan-Ganz catheter redundant in the right atrium before terminating in the right upper lobe.


Instruction: Generate impression based on medical findings.

Input: CABG Mildly improving patchy opacities again persistent in both bases but greater on the right with elevated hemidiaphragm. Right chest tube again extends towards the hilar region without an associated pneumothorax. Mild cardiomegaly

Output: Right chest tube unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: hx of kidney cancer, evaluate for metastatic disease History: see above Large lung volumes consistent with COPD.No evidence of metastases or other significant abnormality.

Output: COPD, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Age: 62 yearsGender: MaleReason for Study: Reason: fevers, increasing O2 requirements History: fevers, increasing O2 requirements Right porta catheter with this tip in the SVC.Multiple pleural nodules as well as extensive right pleural thickening and effusion similar in appearance to the prior exam.No new focal areas of consolidation.Stable cardiomediastinal silhouette with evidence of mediastinal lymphadenopathy.

Output: No specific evidence of acute infection. Redemonstration of extensive pleural metastatic disease.


Instruction: Generate impression based on medical findings.

Input: 3-year-old male, cough, fever, hypoxiaVIEWS: Chest AP/lateral (two views) 5/18/2016, 17:48 Normal cardiothymic silhouette. No focal pulmonary opacity, pleural effusion, or pneumothorax. Peribronchial thickening and increased AP diameter of the chest are noted.

Output: Bronchiolitis/airway hyperreactivity pattern.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: s/p chest tube placement for pneumonthorax on the left History: chest tube placement, ptx, s/p cardiac arrest Chest tube with tip near lung apex probable small residual left pneumothorax significantly improved from the prior study. No change right upper lobe mass.Endotracheal tip approximately 5 cm from carina.

Output: Marked improvement in the left pneumothorax following placement of left-sided chest tube. No other significant interval changes.


Instruction: Generate impression based on medical findings.

Input: Age: 52 yearsGender: FemaleReason for Study: Reason: r/o acs/pna/edema History: sob Stable cardiac mediastinal silhouette.Decreased lung volumes.The lungs are clear.No pleural effusions.Surgical clips in the right hilar region and cervical stabilization hardware redemonstrated.

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


Instruction: Generate impression based on medical findings.

Input: Reason: distention History: distention NJ tube remains in place distal to the ligament of Treitz in the jejunum. There is mild kinking approximately 1 cm from the NJ-tube tip. Interval decrease in the amount of bowel gas. Small bowel previously measured remains at 3.1 cm. Visualized lower lung fields are without focal consolidation.

Output: Mild kinking approximately 1 cm from the NJ tube tip, decrease in amount of bowel gas, otherwise unchanged.


Instruction: Generate impression based on medical findings.

Input: Age: 73 yearsGender: FemaleReason for Study: Reason: dyspnea, hx of chf History: above There is mild cardiac enlargement with pulmonary vascular redistribution and prominence of the central pulmonary arteries.Increased perihilar interstitial opacities are suggestive of edema.No focal areas of consolidation.No pleural effusions.

Output: Mild cardiac enlargement with interstitial opacities suggestive of edema.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: s/p RIJ TLC History: s/p RIJ TLC Cardiomegaly with nonspecific interstitial opacities suggestive of edema with small pleural effusions.Status post extubation.Right jugular catheter, tip in SVC.Surgical drains overlie the left side of the chest unchanged.

Output: No change in interstitial edema following extubation, and no new findings.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: SOB History: fever Upper lung zone predominant interstitial and airspace opacities with bronchial wall thickening and small pleural effusions.Heart size normal.Right jugular catheter, tip in SVC.

Output: Pneumonia, possibly opportunistic, less likely pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.Reason: interval exam History: interval exam, s/p oht Orphaned ICD, left dialysis catheter with tip in SVC, right Swan Gantz catheter tip with tip in right pulmonary artery proximally, and enteric tube tip near pylorus, unchanged.No new pulmonary opacity. Heart size stable.

Output: Support hardware unchanged. No new pulmonary opacity.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Sickle cell disease with shortness of breath and concern for acute chest. Vascular stents are again noted in the left brachiocephalic/SVC. Low lung volumes and bibasilar atelectasis, not significantly changed. No superimposed focal pulmonary abnormality. No pleural effusion or pneumothorax. Stable Cardiomegaly. SVC filter in place.

Output: Cardiomegaly and bibasilar atelectasis without superimposed acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.New fever, pancreatic cancer. Small right pleural fluid collection. High normal lung volumes. Normal heart size. Mild thickening of the fissures on the right.

Output: Small right pleural fluid collection, this may be a sign of pulmonary embolus. Case discussed with the clinical service.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: ? rib fracture History: chest pain The heart is normal in size. Mild tortuosity of the thoracic aorta.Lung volumes in the upper limits of normal. Signs of upper lobe predominant emphysema.No abnormal focal lung parenchymal opacities.The pleural spaces are within normal limits.Healed fractures of the left ninth and 10th ribs again noted. No new acute displaced fractures are visualized.

Output: No new acute displaced rib fractures.Healed fractures of the left ninth and 10th ribs are again noted.


Instruction: Generate impression based on medical findings.

Input: Male, 44 years old.Reason: assess ij placement History: hypotension Low lung volumes with progression of basilar opacities. While likely secondary to atelectasis, aspiration cannot be excluded.No other interval change.

Output: Progression of patchy by basilar opacities which can represent aspiration or atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 48 years old.Reason: Pt w/ draining R-sided effusion. r/o primary pulmonary infection History: Recent febrile, tachycardic, tachypneic, w/ new SOB Right chest tube at lung base with loculated right pleural fluid and right basilar consolidation not significantly changed.

Output: Right chest tube at lung base with loculated right pleural fluid and right basilar consolidation not significantly changed.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: fever, eval for PNA History: fever Focal opacity left lower lobe, the lungs otherwise unremarkable.Heart size normal.

Output: Focal opacity left lower lobe suggestive of infection or simple atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 27 years old.Reason: cp History: cp No acute cardiopulmonary abnormality.

Output: No acute cardiopulmonary abnormality. Please see follow-up chest CT which demonstrated a subsegmental left lower lobe PE.


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Evaluate for position of LVAD. Elevated LDH. The radiopaque components of the LVAD are unchanged in position. Left subclavian ICD also unchanged in position.Severe cardiomegaly, about the same. No pneumothorax. Trace pleural fluid. Patchy groundglass and airspace opacities in the right lower lung field are new and could be the result of infection or aspiration.A portion of the left upper lobe is obscured by the pulse generator and cannot be assessed.

Output: New opacities in the right lung which could be due to aspiration or infection. Follow-up suggested. LVAD position appears unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: pneumonia? History: inc trach secretions Left basilar opacity appears similar to the prior exam. Small left effusion.Tracheostomy tube projection trachea.No other air space or interstitial opacities.The cardiomediastinal silhouette is otherwise unremarkable.

Output: Little interval change in left basal opacity likely representing effusion and atelectasis.


Instruction: Generate impression based on medical findings.

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

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 56 yearsGender: MaleReason for Study: Reason: eval volume status, status of pleural effusion History: recent thora, persistent hypoxia Bilateral pleural effusions with interval increase on the left compared to the prior exam.No pneumothorax postthoracentesis.Tracheostomy in place. Stable cardiomediastinal silhouette.

Output: Moderate sized bilateral pleural effusions with interval increase on the left. No evidence of a pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 27 years old.Productive cough rule out infiltrate Normal heart size. No focal airspace opacity, pleural fluid or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 57 yearsGender: FemaleReason for Study: Reason: right and left ventricular failure s/p subclavian balloon pump History: biventricular failure ] IJ Swan-Ganz has been retracted with its tip now in the right ventricle.Dobbhoff tube with its tip beyond the margin of the image.IABP marker within the aortic arch.Left-sided chest tube has been removed.Stable cardiac enlargement.Perihilar/basilar interstitial opacities compatible with edema.Pleural effusion similar to the prior exam.

Output: Swan-Ganz tip now in the right ventricle. IABP marker in the aortic arch. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: post-cardiac surgery lung eval History: post-cardiac surgery Patient status post TAVR Endotracheal tube terminates 5 cm from the carina. Right IJ sheaths are noted. Mediastinal drain/chest tube is noted. Mild pulmonary edema. Small pleural effusions. Normal heart size.

Output: Lines and tubes, as above. Mild pulmonary edema with small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: 38-year-old male with history of palatine adenoid cancer status post resection. Please for interval change. LUNGS AND PLEURA: Previously described micronodules (images 65 and 71, series 5) are stable in size and appearance compared to previous exams. No evidence of metastatic nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: 83 years old Male. Reason: s/p CABG with increasing o2 requirements History: fluid overload. The cardiac and mediastinal silhouette is enlarged with cephalization of pulmonary veins. There are diffuse bilateral interstitial changes. There is a small right pleural effusion. Questionable left small pleural effusion. Interval decrease of the right chest wall subcutaneous emphysema. There is no evidence of pneumothorax. The support devices are stable in position.

Output: The above findings are consistent with mild congestive heart failure.


Instruction: Generate impression based on medical findings.

Input: Abdomen pain, check for free air No discrete overt abdominal free air, however semiupright portable technique is limited in sensitivity. Please see correlating and more recently pending abdomen CT for sensitivityBorderline cardiomegaly, partially exaggerated due to technique and rotation. Early mild edema and small right effusion cannot entirely be excluded. Serial imaging will be needed

Output: Questionable mild early edema


Instruction: Generate impression based on medical findings.

Input: Age: 68 yearsGender: FemaleReason for Study: Reason: two month history of cough History: cough Stable cardiomediastinal silhouette.Scattered areas of scarring/discoid atelectasis similar to the prior exam.No new pulmonary opacities. 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, 63 years old.Reason: IABP History: IABP IABP is not visualized. Swan-Ganz catheter tip in proximal left pulmonary artery. Stable cardiomegaly with mild basilar edema.

Output: IABP is not visualized. Swan-Ganz catheter tip in proximal left pulmonary artery. Stable cardiomegaly with mild basilar edema.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: r/o pneumothorax s/p CT removal, assess VAD positioning History: s/p CT removal and LVAD insertion Interval removal of left chest tube. No evidence of significant pneumothorax. Other findings, including LVAD position, stable

Output: No evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: rule out infection History: stroke Median sternotomy, heart size normal.No significant pulmonary or pleural abnormality.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: evaluate for cause of dyspnea History: dyspnea Median sternotomy with mild cardiomegaly status post CABG.Right pleural effusion or pleural scarring, with adjacent lung base scarring. No reliable evidence of edema or pneumonia.

Output: Cardiomegaly with chronic right costophrenic angle scarring and/or small effusion. No reliable evidence of edema and no sign of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: S/p RIJ TLC, eval position History: see above Right jugular catheter tip in high right atrium. No evidence of pneumothorax.

Output: Right jugular catheter tip in high right atrium. No evidence of pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: r/o pneumo History: R side pleuritic CP Low lung volumes with basilar atelectasis. Mid and upper lung zones are clear.Cardiomediastinal silhouette is within normal limits.No pneumothorax or pleural effusion.

Output: Low lung volumes with basilar atelectasis. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 44 years old.Reason: s/p MVR History: crackles Venous catheter tip in SVC. Right chest tube unchanged with no evidence of pneumothorax. Stable cardiomegaly. Nonspecific basilar opacities likely due to edema and atelectasis.

Output: Nonspecific basilar opacities likely due to edema and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 26 years old.Reason: r/o infection History: dry cough, subjective fevers, chills Cardiomediastinal silhouette is normal. Mild left basilar atelectasis and nonspecific focal opacity near the right base. No pneumothorax or large pleural effusion. Right nipple ring.

Output: Mild basilar opacities, nonspecific and could be due to aspiration or early infection. Follow-up may be obtained if the patient remains symptomatic to exclude pneumonia if required.


Instruction: Generate impression based on medical findings.

Input: Female, 70 years old.Reason: infiltrate? History: cough, post-tussive emesis Median sternotomy for CABG.Small lung volumes with right basilar atelectasis or scarring the, possibly even pneumonia.Elsewhere, lungs are unremarkable.Partial collapse T10, unknown chronicity.

Output: Right basilar opacity possible infection, although atelectasis or scarring are also possible etiologies.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Heart failure Marked cardiomegaly, similar to prior.No specific evidence of infection or edema.

Output: Cardiomegaly without edema or pneumonia.


Instruction: Generate impression based on medical findings.

Input: Reason: wheezing History: wheezing, coughing and chest discomfort Mass like opacity in the left lower lobe area contiguous with the descending aorta, present in retrospect since 2008 but questionably increased in size and the differential diagnosis includes neoplasm.Normal heart size with a moderately tortuous aorta.

Output: Large mass like opacity contiguous with the descending aorta measuring approximately 6 cm in maximum dimension, for which a CT scan is recommended.


Instruction: Generate impression based on medical findings.

Input: Reason: verify placement of NG History: AMS NG tube tip in the area of the gastric antrum.No significant pulmonary abnormalities.

Output: NG tube tip in the stomach.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Reason: Evaluate for aspiration History: As above Postinflammatory right apical volume loss.No specific evidence of infection or edema.Heart size normal.Right jugular catheter, tip in SVC.Cholecystectomy clips.

Output: No acute abnormality. Right upper lobe chronic volume loss.


Instruction: Generate impression based on medical findings.

Input: Male, 44 years old.Reason: fever, hypotension History: fever, hypotension The cardiomediastinal silhouette is within normal limits.No focal pulmonary opacities, large pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 37 years old.History of presyncopal event with shortness of breath. Cardiomediastinal silhouette is normal. There are no focal pulmonary opacities or pleural effusions.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 24 yearsGender: MaleReason for Study: Reason: cough, fever, eval for pna History: cough, fever, eval for pna Focal area of consolidation airspace opacity involving the superior segment of the right lower lobe compatible with acute infection.The cardiomediastinal silhouette is unremarkable.The left lung is clear.No pleural effusions.

Output: Right lower lobe pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.History of hypoxia and patient status post right thoracentesis. The right central venous port catheter is seen with tip at the RA/SVC junction.There is stable cardiomegaly.There is an interval right thoracentesis with decrease in pleural effusion. Very small bilateral pleural effusions persist. Right basilar atelectasis is again noted. No pneumothorax.

Output: Interval right thoracentesis with decrease in right-sided pleural fluid. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 69 yearsGender: MaleReason for Study: Reason: s/p ascending root graft, CABGx2 History: same Left-sided pacemaker and right PICC line unchanged.Stable cardiomediastinal silhouette.Pleural effusions, pulmonary edema, and basilar atelectasis similar in appearance to prior exam.Right upper lobe consolidation redemonstrated.No new pulmonary opacities identified.Median sternotomy is intact.

Output: No interval change in the pulmonary edema, pleural effusions, basilar atelectasis, and right upper lobe consolidation.


Instruction: Generate impression based on medical findings.

Input: White count elevated No acute cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Septicemia check pulmonary status. Mild right basilar opacity unchanged. No pneumothorax. Normal heart size.Chronic appearing deformity of the left acromioclavicular region.

Output: Nonspecific right basal opacity could reflect aspiration or infection.


Instruction: Generate impression based on medical findings.

Input: Age: 96 yearsGender: FemaleReason for Study: Reason: eval for infection or edema History: SOB Decreased lung volumes with stable cardiac enlargement and pulmonary vascular redistribution.Small pleural effusions, right greater than left, slightly increased from the prior exam.Mild perihilar and basilar edema/atelectasis increased from the prior exam.

Output: Worsening CHF.


Instruction: Generate impression based on medical findings.

Input: Age: 83 yearsGender: FemaleReason for Study: Reason: r/o PNA History: febrile, O2 requirement Decreased lung volumes with persistent elevation of the left hemidiaphragm.Stable cardiomediastinal silhouette.Nonspecific basilar opacity suggestive of atelectasis. No new focal areas of consolidation.Partially imaged right shoulder arthroplasty.

Output: Nonspecific basilar opacities compatible with atelectasis. No new pulmonary opacities identified. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 51 yearsGender: MaleReason for Study: Reason: daily CXR History: daily CXR Support devices unchanged.Stable cardiac enlargement.Loculated right pleural effusion and interstitial/airspace opacities in the right lung similar in appearance the prior exam.Left retrocardiac consolidation/atelectasis and left pleural effusion redemonstrated.No new pulmonary opacities identified.

Output: Support devices unchanged. Stable cardiopulmonary appearance with cardiomegaly, pleural effusions, edema, and basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 28 years old.Reason: eval for infiltrate History: chest pain, HgbSS Unchanged cardiomegaly and markedly enlarged pulmonary artery. Bibasilar subsegmental atelectasis/scarring. No focal opacities to suggest pneumonia. No large pleural effusions or pneumothorax.Right-sided chest port tip projects to the right of midline in the atrium directed towards the pulmonary outflow tract

Output: No focal pulmonary opacity to suggest pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 37 years old.Reason: chest pain that is intermittent, bilateral arm tingling The lungs are clear. No pneumothorax or pleural effusion. The heart size is normal. The cardiomediastinal silhouette is unremarkable.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 59 yearsGender: FemaleReason for Study: Reason: assess for infection or edema History: cough, DOE Stable mild cardiac enlargement with pulmonary vascular redistribution.Lao chronic appearing interstitial opacities of the lung bases.Increased lung volumes compatible with COPD.No focal areas of consolidation.No large pleural effusions.

Output: Stable cardiac enlargement. COPD without acute abnormalities. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 76 years old.Reason: s/p CT removal History: SOB Left chest tube removed, the left pneumothorax larger than before.Mild right lower lung zone atelectasis.

Output: Enlargement of left pneumothorax following left chest tube removal. A follow-up radiograph has already been requested.


Instruction: Generate impression based on medical findings.

Input: Age: 24 yearsGender: FemaleReason for Study: Reason: eval for enlarged heart History: post partum, here with tachycardia, hx of syncope The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: 54-year-old female with history of gastric GIST, status post resection CHEST: Lungs are clear. No evidence of mediastinal adenopathy. Heart is unremarkable.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes involving the stomach. No evidence of recurrence.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Possible exophytic fibroid is unchanged.BLADDER: 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: Male, 98 years old.Reason: pre-op History: known TAA The heart is mildly enlarged and the aorta tortuous and not well-defined in its entirety ascending aspect.Moderate mid to lower lung zone opacities with pleural effusions are consistent with edema.Left perihilar soft tissue opacity should be further evaluated by CT to exclude a left hilar mass and less this is associated with the known thoracic aortic aneurysm.

Output: 1. CHF.2. Tortuous and ill-defined aorta with a possible left perihilar mass for which a thoracic CT is recommended.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p lung transplant History: s/p lung transplant Tracheostomy tube and venous catheters unchanged.Diffuse nonspecific pulmonary opacities suggestive of edema with moderately large pleural effusions.No pneumothorax or other new findings.

Output: Diffuse pulmonary opacity suggestive of edema with bilateral effusions and no acute change.


Instruction: Generate impression based on medical findings.

Input: Reason: post arrest History: post aresst ET tube tip approximately 2 cm above the carina.Small lung volumes with mild basilar atelectasis.Mild mediastinal widening is probably due to under inflation and semisupine position.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Female 50 years old Reason: eval for pneumonia History: bandemia Increased lung volumes.Stable cardiomediastinal silhouette.No focal airspace opacities.No pleural effusions or pneumothorax.

Output: No evidence of infection. No interval change from prior exam.


Instruction: Generate impression based on medical findings.

Input: 80 years, Male. Reason: ileus improved History: abdominal pain and nausea There are numerous dilated air-filled loops of small and large bowel, consistent with generalized ileus, not significantly changed when compared to the abdominal radiographs dated 9/22/2016. There is no evidence of intraperitoneal free air. Improving bilateral pleural effusions with adjacent atelectasis. Left subclavian pacemaker and leads unchanged.

Output: 1. Generalized ileus pattern, not significantly changed when compared to prior abdominal radiographs dated 9/26/2016.2. Improving bilateral layering pleural effusions and adjacent atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old. Right jugular catheter tip in SVC with no pneumothorax or other complications.Cardiomegaly, interstitial opacity and calcified pleural plaques unchanged.

Output: New catheter with no complications.


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: s/p left neck dissection, base of tongue resection, dht placement History: postop Dobbhoff tube tip at the GE junction. Staples overlie the left neck. Very small lung volumes with bibasilar atelectasis and right lower lobe atelectasis. No pneumothorax.

Output: Dobbhoff tube tip at the GE junction.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: assess ett History: intubated Unchanged pleural effusions and basilar opacities.ET tube tip approximately 6 cm above the carina.An NG tube terminates in the stomach, the side port above the GE junction.Right jugular catheter, tip at cavoatrial junction level.

Output: Unchanged pulmonary opacities and pleural effusions. ET tube tip approximately 6 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: 11 day old female with abdominal distention > 1.5 cm since this A.M., firm belly. Evaluate for obstruction.VIEWS: Chest and abdomen AP (two views) 2/24/2015 15:35 Left upper extremity PICC tip terminates at the confluence of the brachiocephalic veins. Interval removal of feeding tube.Cardiothymic silhouette is normal. No focal pulmonary opacities. No pleural effusion or pneumothorax.Mild to moderately dilated bowel loops with a disorganized gas pattern. No evidence of pneumatosis intestinalis, pneumoperitoneum or portal venous gas.

Output: Disorganized bowel gas pattern with mild to moderately dilated bowel loops.


Instruction: Generate impression based on medical findings.

Input: Female, 33 years old.History: Endometrial stromal sarcoma. Symptoms: Productive cough, fever, wheezing. Query pneumonia Right Port-A-Cath with tip in the SVC, unchanged in position from prior exam.Interval placement of the left central venous catheter with tip in the superior vena cava.No pneumothorax.Decreased lung volumes.Right midlung nodule identified on recent CT noted on the lateral view.Left basilar subsegmental atelectasis similar to the prior.No new pulmonary opacities identified. Small left pleural effusion.

Output: Interval placement of the left central venous catheter, tip in the SVC, no pneumothorax. No new focal areas of consolidation to indicate infection.


Instruction: Generate impression based on medical findings.

Input: SOB. Unchanged appearance of the carina mediastinal silhouette.Retrocardiac atelectasis without significant change. Mild dependent and basal atelectasis elsewhere. Mild bronchial wall thickening.

Output: Mild but worsening atelectasis. Unchanged chronic bronchial wall thickening. No specific signs of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: pna vs effusion History: sob Cardiomediastinal silhouette is unremarkable. Low lung volumes. No large pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.Reason: Sickle cell disease with chest pain and productive cough. The right chest port catheter terminates in the right atrium. There is enlarged cardiac silhouette, unchanged. Interstitial opacities most pronounced in the bases are not significant different than the previous study and likely chronic changes from sickle cell disease. Multifocal atelectasis in the left upper and right lower lobes.

Output: Chronic sickle cell changes with patchy atelectasis, suggest short-term follow-up.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: s/p left chest tube pull History: R/O pneumo Left upper lung zone surgical material is again seen. Interval removal of left chest tube. Cardiac size is upper limits of normal.No large pleural effusions or pneumothorax. Left basilar mild atelectasis unchanged.

Output: Interval removal of left chest tube. No evidence of a significant pneumothorax.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: Patient with history of lower periarthritis and on methotrexate. Evaluate for pulmonary lesions and liver architecture. CHEST:LUNGS AND PLEURA: Spiculated mass in the left upper pole measuring 2.4 x 1.9 cm image number 13, series number 5 suspicious for primary bronchogenic carcinoma.Right lower lobe nonspecific nodule measuring 6 mm number 64, series number 5. Focal atelectasis in the right lower lobe on image number 74, series number 5. Linear atelectasis in the left lower lingula.MEDIASTINUM AND HILA: Aortopulmonary window adenopathy largest measuring 2.2 x 1.6 cm image number 31, series number 4. Other smaller AP window lymph nodes are also present. Calcified right paratracheal adenopathy.Enlarged thyroid gland extending the mediastinum.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Numerous subcentimeter hypodense lesions throughout the liver, suboptimally evaluated on this single phase CT. Largest ones measure water density and likely represent cysts, however, further evaluation with liver MRI is indicated if there further characterization is clinically indicated.SPLEEN: No significant abnormality noted.PANCREAS: 11-mm hypodense lesion in the tail of the pancreas likely representing a cystic lesion. No evidence of pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral small renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Axial, scattered Omental nodules largest measuring 10-mm image number 118, series number 4.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: Left upper lobe mass with prevascular adenopathy suspicious for primary bronchogenic carcinoma.Subcentimeter indeterminate lesions in the liver. MRI of the liver is recommended if further clinical characterization as clinically indicated.Nonspecific mental nodules versus perigastric lymph nodes.Benign-appearing small right renal cyst.Nonspecific subcentimeter lesion in the body/tail of the pancreas which may represent focal fat versus a small most likely benign cystic lesion. Further evaluation with MRI may be helpful if characterization Is clinically indicated.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: PNA History: Cough Large lung volumes consistent with COPD.Heart size normal.No specific evidence of infection or edema.

Output: COPD, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: 90-year-old female with hypoxia on 4 to 5 L nasal cannula. Evaluate for pulmonary edema versus infection. Improving perihilar interstitial opacities and pleural effusions. No pneumothorax. Heart size upper limits of normal.

Output: Findings likely represent improving pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: PNA, effusions History: sob Left pleural effusion and consolidation unchanged consistent with infection. Stable cardiomegaly. Probable small right pleural effusion. Venous catheter and pacemaker unchanged.

Output: Left pleural effusion and consolidation unchanged, consistent with infection. Probable small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: ETT placement after 3cm pullback History: ETT placement after pullback Endotracheal tube is again at the carina and could be pulled back 3 to 4 cm. Swan-Ganz catheter terminates in the RPA. Intra-aortic balloon pump, unchanged. Right-sided pleural thickening or loculated effusion again noted. Right greater than left bibasilar opacities, not substantially changed.

Output: Endotracheal tube is again at the carina and could be pulled back 3 to 4 cm.


Instruction: Generate impression based on medical findings.

Input: 54 years old Male. Reason: eval for interval change History: tachypnea. Dobbhoff tube tip projects over the gastric body. Right pleural catheter is unchanged. Displaced right lower rib fracture is again noted. Lytic lesion of the left eighth rib. Bilateral pleural effusions are again noted with some degree of loculation on the left. Bilateral pulmonary opacities, consolidation versus atelectasis, is similar to that seen on the prior exam 2/25/15. Diffuse pulmonary nodules are again noted bilaterally. Overall no significant interval change since the prior exam.

Output: Diffuse pulmonary nodules are again noted bilaterally. Overall no significant interval change since the prior exam.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: Rule out edema/infection; wide mediastinum History: chest pain The cardiomediastinal silhouette is unremarkable.Large lung volumes, consistent with emphysema. No pleural effusion or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 63 year old female with lung cancer. CHEST:LUNGS AND PLEURA: Right lung radiation fibrosis is unchanged. Scattered micronodules are also unchanged. No new nodules or masses. No focal consolidation, edema or pleural fluid.MEDIASTINUM AND HILA: Right-sided Port-A-Cath in place with its distal tip in the SVC. Numerous collaterals about the right subclavian vein with attenuation of the contrast column in the SVC raises the question of SVC occlusion or thrombus.Cardiac size is normal. No pericardial fluid.Right paratracheal lymph node is unchanged measuring 1.0 x 1.3 cm on axial image 31/134. Right perihilar lymph node (previously described as a nodule) is also grossly unchanged measuring 1.4 by 0.9 cm on axial image 43/134.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small left renal hypodensities unchanged probably representing benign cysts.PANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic focus in the L1 vertebral body which could represent metastatic disease is unchanged. Previously noted metastatic lesions in the right ilium and sacral ala are not included within the field of view on today's exam.OTHER: No significant abnormality noted

Output: 1.Stable postradiation changes and pulmonary micronodules.2.Stable mediastinal reference nodes.3.Possible occlusion or thrombosis in the SVC.4.Stable sclerotic focus in the vertebral body of L1.


Instruction: Generate impression based on medical findings.

Input: 41-year-old female diffuse large B-cell non-Hodgkin's lymphoma status post 4 pedicles cycles of chemotherapy. Restaging. 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: The prominent in size measuring 23 cm cephalocaudad is seen on coronal image 44/104. There are no focal lesions in the liver the biliary tract is normal.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal nodule measures 2.2 x 1.4 cm and sixth image 85. This is a likely unchanged. Right adrenal gland is normal.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, 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: Previously seen soft tissue masses in the right sacrosciatic notch, abutting the right iliac bone, in the by back and in the iliac fossa are all decreased to the point that they are not visible and not measurable.Patchy sclerotic changes seen in the right iliac bone, unchanged. No new sites of disease.OTHER: No significant abnormality noted.

Output: Stable sclerotic changes right iliac bone. All soft tissue mass is of decreased to the point of then not measurable. The left adrenal nodule is unchanged. Nonspecific hepatomegaly (new).


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: tachypnea; eval for fluid overload vs PNA History: tachypnea Interval increase in extensive bilateral patchy and interstitial opacities . Interval removal of Dobbhoff tube. IVC filter and bilateral ureteral stents noted. Left-sided PICC line with tip in the right atrium.

Output: Increase in extensive bilateral patchy and interstitial opacities, consistent with edema but concomitant infection cannot be excluded.


Instruction: Generate impression based on medical findings.

Input: Age: 78 yearsGender: MaleReason for Study: Reason: dobhoff placement History: see above Dobbhoff tube has been advanced with its tip in the stomach. Cardiomediastinal silhouette is unremarkable.The lungs are clear.Contrast is identified within the cecum and right hemicolon.

Output: Interval advancement of the Dobbhoff tube with its tip in the stomach.


Instruction: Generate impression based on medical findings.

Input: 30-year-old HIV positive male with cough. Evaluate for infiltrate. Cardiomediastinal silhouette within normal limits.No acute focal airspace opacity.Azygos pseudolobe incidentally noted.No pneumothorax or pleural effusion.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.ETT placement. COPD with acute exacerbation. ETT tip 3.5 cm above the level of the carina. Enteric tube can be followed to the stomach.Moderate to large right pleural fluid collection tracking into the fissures with associated compressive atelectasis is unchanged. Patchy basal opacities bilaterally also unchanged.Unchanged mediastinal widening previously documented to represent lipomatosis.Enlargement of the central pulmonary vasculature. Amorphous calcification in the right mediastinum just above the level of the carina correlates to a mediastinal mass documented on prior CT scans and is poorly visualized by this technique.

Output: No significant change in pleural fluid and dependent atelectasis/consolidation. Persistent small areas of consolidation could potentially represent aspiration pneumonia in the appropriate clinical context.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Reason: ETT placement and is there evidence of worsening pneumonia History: ETT and PNA. ET tube tip 4 cm above the carina. Enteric tube side port is above the GE junction.Stable to mild Interval improvement of multifocal airspace and interstitial opacities, allowing for differences in technique and positioning. Residual multifocal opacities, right middle and right lower lobe predominant. Subsegmental atelectasis in the left lower lobe.Persistent moderate right pleural effusion and small left pleural effusion.

Output: Slight interval improvement of multifocal opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Pneumonia, bacteremia. Tracheostomy is grossly unchanged in position. The cardiomediastinal silhouette is within normal limits. Hilar and pulmonary vasculature are within normal limits. Bibasilar pleural effusions and opacities. There is minimal spinal prominent gas-filled loops of bowel in the upper abdomen.

Output: Stable cardiopulmonary findings including bibasilar effusions and airspace disease. Ileus versus small bowel obstruction redemonstrated.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: left pleural effusion 1/16 History: cough Small left pleural effusion may be reaccumulating, with recurring atelectasis in the left lower lobe.Elsewhere, the lungs are unremarkable.

Output: Slight enlargement of a left pleural effusion with increased basilar atelectasis since 2/10/2016, but not to the extent seen 2/2/2016.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Reason: ADHF vs underlying viral/pulm findings History: low output cardiac state, decreased fcn since URI Mild to moderate cardiomegaly.Mild interstitial opacities suggestive of edema.Minimal pleural effusions.

Output: Cardiomegaly with mild interstitial edema and very small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: status post port removal and replacement.VIEW: Chest AP The left chest port has been removed. A right chest port catheter has its tip in the right atrium. Right upper extremity PICC tip is also in the right atrium.Normal cardiomediastinal silhouette size. No focal pulmonary opacity, pleural effusion or pneumothorax. Unchanged sclerotic lesion in the right scapula.

Output: Right chest port catheter tip is in the right atrium.


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: sob History: sob The patient has been extubated, otherwise support devices are stable.There is cardiomegaly, the cardiomediastinal silhouette otherwise is grossly stable. Findings thoracostomy are again noted.Bilateral, diffuse pulmonary opacities with more focal areas of consolidation in the left lung base appears similar to the previous examination.

Output: Stable support devices post thoracostomy. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: IntubationVIEW: Chest AP Bilateral apical chest tubes in place. Endotracheal tube tip between the thoracic inlet and carina. Enteric tube with sidehole in the stomach. Right IJ venous catheter tip in the right atrium. Bilateral nephroureteral stents unchanged. Epidural catheter tip unchanged. Gastrostomy tube in place. Cardiomegaly unchanged. Bibasilar lung opacities improved from prior exam. There is a small right-sided pleural effusion. No evidence of pneumothorax.

Output: Bibasilar lung opacities improved from prior exam.


Instruction: Generate impression based on medical findings.

Input: Reason: tlc History: same ET tube tip approximately 6 cm above the carina.Right jugular catheter with its tip in the area of the right innominate vein.Focal opacity at right base consistent with subsegmental atelectasis or scarring.No pneumothorax.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Age: 54 yearsGender: MaleReason for Study: Reason: r/o fever source in mm patient History: fever Right PICC line has been repositioned with its tip now in the SVC.Enteric tube with its tip beyond the margin of the image.Stable cardiac enlargement.Perihilar/basilar edema and pleural effusions improved from prior exam.Persistent left retrocardiac consolidation/atelectasis.

Output: Interval improvement in pulmonary edema and pleural effusions. Persistent left retrocardiac consolidation/atelectasis may be a source of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: resp distress s/p hickman, pneumo? Mucus plug? History: resp distress Diffuse interstitial opacities with gradually enlarging pleural effusions.Heart size normal.No significant pneumothorax.Right jugular catheter, tip in SVC.Left jugular catheter tip in left brachiocephalic vein at the midline.An NG tube terminates in the stomach.

Output: Severe diffuse interstitial opacities with gradually enlarging pleural effusions suggestive of hypervolemia.


Instruction: Generate impression based on medical findings.

Input: Reason: shortness of breath, ESRD last dialysis on Monday History: short of breath Moderate cardiomegaly and mediastinal widening without significant change. Diffuse symmetrical mainly perihilar airspace and interstitial opacity compatible with edema with minimal pleural effusions, not significantly changed from the previous radiograph.Skeletal abnormalities compatible with renal osteodystrophy.

Output: Cardiomegaly and pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: ? Pneumonia History: leukocytosis Cardiomediastinal silhouette is unremarkable. Perihilar scarring appears similar to the prior exam. No focal airspace opacity or pneumothorax. Probable pleural effusions. Spinal stimulation lines unchanged.

Output: Bilateral pleural effusions. No definite evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: pulmonary edema? History: shortness of breath, missed dialysis Increase in mild interstitial pulmonary edema. Left-sided pleural process again noted. Moderate cardio megaly, as before. No pneumothorax.

Output: Mild interstitial pulmonary edema. Left pleural process, not substantially changed. Moderate cardiomegaly again noted.


Instruction: Generate impression based on medical findings.

Input: 58-year-old male with history of BIVAD. Endotracheal tube tip 1.5 cm above the carina. ECMO cannula and surgical sponges are unchanged. Remaining lines and support devices are unchanged. Low lung volumes. Increased left lung haziness. Nonspecific basilar opacities consistent with atelectasis/consolidation and small effusions.

Output: Increased left lung haziness which may represent layering pleural effusion. Nonspecific basilar opacities consistent with atelectasis/consolidation and small effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 75 years old.Reason: evaluate s/p TAVR Iatrogenic devices are unchanged. No new focal pleural parenchymal opacity. Unchanged cardiomegaly. No large pleural effusion or pneumothorax.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Male, 42 years old.Reason: eval for volume status, eval for PNA History: cough Central venous catheter again terminates just below the cavoatrial junction. No focal lung consolidation. No pulmonary edema. No pleural effusion or pneumothorax. Heart is again at the upper limit of normal.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Age: 42 yearsGender: MaleReason for Study: Reason: sob History: sob Stable cardiomediastinal silhouette with prominence of central pulmonary vasculature.The lungs are clear.No pleural effusions.Surgical clips identified within the neck.

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


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: cough x 1 month History: cough Large lung volumes can be consistent with COPD. No specific evidence of infection or edema. No large pleural effusion or pneumothorax.

Output: Large lung volumes can be consistent with COPD. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.5/28 thoracoscopic right upper lobectomy and mediastinal lymph node dissection for adenocarcinoma. Chills, shortness of breath and pain. Postsurgical volume loss from a right upper lobectomy. Low lung volumes with linear atelectasis at the left lung base. No pleural fluid or pneumothorax. Interval removal of right-sided chest tubes without significant residual pneumothorax.

Output: Left lower lobe subsegmental atelectasis.


Instruction: Generate impression based on medical findings.

Input: 25-year-old male with history of Hodgkin lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Stable residual triangular soft tissue density in the anterior mediastinum measuring 4 by 1.1-cm image number 45, series number 3. This likely represents residual thymic tissue/involvement by lymphoma and is unchanged.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: 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: 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: Stable examination.


Instruction: Generate impression based on medical findings.

Input: 41-year-old male with history of lung cancer. Evaluate for progression. CHEST: LUNGS AND PLEURA: Scattered ground glass opacities and nonspecific nodular opacities are slightly improved from prior. Septal thickening/scarring of the left base, similar to prior, with interval near resolution of small left pleural effusion.MEDIASTINUM AND HILA: Interval decrease in size of left hilar mass (series 5 image 52) measuring 2.7 x 2.4 cm (previously 3.9 x 3.4 cm).CHEST WALL: Right-sided Port-A-Cath passes through a stenoses right subclavian artery and terminates with tip in the superior cavoatrial junction. Opacification of numerous venous collateral vessels in the left anterior and posterior chest wall, similar to prior.ABDOMEN:LIVER, BILIARY TRACT: Hypodense lesion in segment 4 (series 3 image 98) now measures 1.4 x 1.4 cm (previously 2.0 x 1.8 cm).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal metastatic lesion (series 3 image 115), with interval decrease in size, now measuring 8.4 x 8 .0 cm (previously 10.3 x 9.8 cm), displacing the right kidney inferiorly. Indeterminate soft tissue nodule of the left adrenal gland is similar in size.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Interval improvement of para-aortic lymphadenopathy with index left para-aortic node (series 3 image 126) now measuring 1.1 x 0.5 cm (previously 1.8 x 1 .0 cm).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple sclerotic foci throughout the thoracolumbar spine and pelvis are slightly more prominent than prior with new T10 vertebral body lesion. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: As above.OTHER: Small amount of free pelvic fluid, similar to prior.

Output: Progression of osseous bone metastasis. Slight interval decrease of lung, liver, adrenal, and retroperitoneal index lesions.


Instruction: Generate impression based on medical findings.

Input: Male, 42 years old.Reason: on vent, PNA v ARDS History: SOB : Cardiomegaly.Interval removal of ET and enteric tubes.Stable position of right IJ central venous catheter overlying the superior cavoatrial junction. The right upper extremity PICC is partially obscured by pulsation artifact.Slightly worsened alveolar pulmonary edema. Left layering pleural effusion is unchanged. No pneumothorax.

Output: Worsening alveolar pulmonary edema. Assessment is limited by extensive motion artifact.Stable position of residual support apparatus.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Reason: presence of aspiration pna History: dysphagia Right IJ catheter tip in the SVC, unchanged.Small effusions and basilar opacities are unchanged, but may be in part related to aspiration.No significant pneumothorax.Apparent widening of the mediastinum is likely positional.

Output: Stable bilateral pleural effusions and right basilar and retrocardiac patchy opacities which may be in part related to aspiration.


Instruction: Generate impression based on medical findings.

Input: Male 69 years old Reason: hx of bladder cancer, evaluate for metastatic disease No focal consolidation, pleural effusion or pneumothorax. The heart and mediastinal contours are within normal limits for size. The bones and upper abdomen are unremarkable.

Output: No acute cardiopulmonary abnormality, no evidence of metastatic disease. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.


Instruction: Generate impression based on medical findings.

Input: Female, 36 years old.sarcoidosis leukocytosis. There are multifocal dense masslike airspace opacities bilaterally, most notably in the right lower lobe, compatible with history of nummular pulmonary sarcoidosis. Mildly improved aeration compared to prior chest radiograph without significant interval change in pulmonary opacities. No new focal pulmonary consolidation.

Output: No significant interval change in multifocal masslike airspace opacities compatible with nummular pulmonary sarcoidosis.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Reason: evaluate if OSH PICC is centrally placed for TPN History: arrived with PICC line and TPN Right PICC terminates in the cavoatrial junction.Cardiomediastinal silhouette is unremarkable. Bilateral moderate pleural effusions with underlying compressive atelectasis are noted. Retrocardiac consolidation is present.

Output: Bilateral moderate effusions with underlying atelectasis and retrocardiac consolidation.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Chest pain, evaluate for infectious process or bony abnormality. Normal heart size. Mild unfolding of the thoracic aorta. No obvious skeletal abnormality. Please note that chest technique has a limited sensitivity for osseous pathology. If clinically warranted, dedicated bone technique films of the are of interest would be recommended. Prominent costochondral cartilage calcification anteriorly on the right.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 32 years old.On ECMO therapy. Support devices stable.There is subsegmental atelectasis at the right lung base, otherwise no significant change in cardiopulmonary appearance.

Output: No significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 40 years old.Chest pressure. Rule out infection/mediastinum evaluation. Low normal lung volumes. Normal heart size. No focal airspace opacities, pleural fluid or pneumothorax. No mediastinal widening by plain film.

Output: No acute cardiopulmonary abnormality by chest radiograph.


Instruction: Generate impression based on medical findings.

Input: Check for edema. Shortness of breath following diuresis Persistent moderate to large right pleural effusion with underlying compression. Decreasing basilar edema with borderline cardiomegaly. Scattered calcified granuloma and suspected elevated right hemidiaphragmNo new superimposed focal air space process.

Output: Persistent right pleural effusion decreased right volume


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: 52 yo with history of asthma presents with sob and URI symptoms History: URI and SOB Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Line placement, pneumonia, infection. Left jugular Swan-Ganz catheter extends far distally into a branch of the right descending pulmonary artery.Left subclavian ICD unchanged in position. No pneumothorax.Hazy air space opacities bilaterally, slightly improved.

Output: Peripheral positioning of the Swan-Ganz catheter tip. Slight improvement in the multifocal air space opacities suspicious for infection.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: r/o infection History: cough and fever Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Very small right basilar nodular opacity less than a few millimeters, no further follow-up recommended at this time.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath and cough Give the mild differences in technique, no new cardiopulmonary abnormality

Output: No acute disease


Instruction: Generate impression based on medical findings.

Input: Female, 90 years old.Reason: Post TAVR - transcatheter aortic valve replacement History: evaluate after TAVR New aortic valve prosthetic is noted. The right atrial cardiac lead is slightly more medially positioned. The right ventricular lead is not substantially different. Small pleural effusions or thickening again noted with probable basilar atelectasis. No new focal pleural parenchymal opacity. Unchanged heart size. No pneumothorax.

Output: No new focal pleural parenchymal opacity.New aortic valve prosthetic is noted. The right atrial cardiac lead is slightly more medially positioned.


Instruction: Generate impression based on medical findings.

Input: Reason: assess ETT placement History: vent dependence ET tube tip approximately 2 cm above the carina. Bilateral chest tubes in place with no significant pneumothorax.Diffuse nonspecific interstitial opacity, slightly improved over the past 24 hours.Extensive subcutaneous emphysema.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Age: 72 yearsGender: MaleReason for Study: Reason: trach History: above Tracheostomy tube is identified with its tip 4 cm above the carina.Mildly decreased lung volumes.Cardiac size is normal with marked tortuosity of the aorta.Minimal basilar atelectasis.No focal areas of consolidation.No pleural effusions.

Output: Placement of a tracheostomy tube without complication.


Instruction: Generate impression based on medical findings.

Input: Increased work of breathing. Aortic arch, cardiac apex and stomach are left-sided. Left curve of the thoracic spine is noted. Cardiac silhouette size is normal. Minimal peribronchial wall thickening. No focal airspace opacity, pleural effusion or pneumothorax.

Output: Airway hyperreactivity/bronchiolitis pattern.


Instruction: Generate impression based on medical findings.

Input: Female, 63 years old.Reason: intubated History: intubated Support devices unchanged. No other interval change.

Output: No interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: cardiopulm process History: fever with SLE Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 38 years old. History: cough, fevers Large focus of consolidation within the right lower lobe. Normal heart size. No large pleural effusion or pneumothorax.

Output: Large focal area of consolidation in the right lower lobe consistent with pneumonia.


Instruction: Generate impression based on medical findings.

Input: Weakness and malaise No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: Male, 46 years old.Reason: ECMO, IABP, Swan History: ECMO, IABP, Swan Endotracheal tube, Swan-Ganz catheter, enteric tube, intra-aortic balloon pump, and ECMO catheter are unchanged. No new focal lung consolidation. No pneumothorax. Unchanged heart size. No large pleural effusion.

Output: No substantial change compared to previous study in lines and tubes.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: sob, fever History: shortness, chills No significant cardiopulmonary abnormality.No specific evidence of infection or edema.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Concern for pneumonia Very low lung volumes. New left basilar retrocardiac consolidation may represent left lower lobe atelectasis or pneumonia in the setting of leukocytosis.Possible trace left pleural effusion. No pneumothorax. Stable adequate position of ET tube and enteric tube.There is a new esophageal temperature probe which is coiled within the proximal esophagus. Repositioning is recommended.

Output: The new esophageal temperature probe is coiled within the proximal esophagus. Repositioning recommended.Worsening left retrocardiac consolidation may represent worsening left lower lobe atelectasis or superimposed pneumonia in the setting of leukocytosis.


Instruction: Generate impression based on medical findings.

Input: Bladder cancer with ileal conduit CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Numerous enlarged lymph nodes are seen in the mediastinum extending from the thoracic inlet to the esophageal hiatus. The largest conglomeration of lymph nodes measures 6.5 x 2.9 cm (series 3, image 27) in the prevascular region. Extensive retrocrural adenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Extensive hypodense, enhancing lesions are noted throughout all segments of the liver. A reference lesion in segment 2/3 measures 2.3 x 2.0 cm (series 3, image 82).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypodense renal parenchymal masses are identified. A reference lesion in the right midpole measures 3.6 x 3.1 cm (series 3, image 110). Mild right hydronephrosis/hydroureter is seen. Mild left hydroureter is seen. The right ureter is dilated just superior to its entrance into the ileal conduit. The upper half of the left ureter is mildly dilated.RETROPERITONEUM, LYMPH NODES: Extensive adenopathy is noted throughout the abdomen: peripancreatic, porta hepatis, pericaval, interaortocaval, and para-aortic lymph nodes are seen. The largest conglomeration measures 7.8 x 4.7 cm in the paraaortic region (series 3, image 111).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostatectomy. BLADDER: Cystectomy with ileal conduit.LYMPH NODES: 2.0 x 1.4 cm soft tissue density adjacent to numerous surgical clips (series 3, image 173) may represent internal iliac chain adenopathy versus postsurgical scarring. A mildly enlarged lymph node is seen in the midline of the lower pelvis (series 3, image 164. Mildly prominent left inguinal nodes are seen.BOWEL, MESENTERY: Mild rectal wall thickening is seen, possibly post radiation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Extensive thoracic, abdominal and pelvic adenopathy.Bilateral renal masses, which could represent metastases, though lymphoma is not excluded.Cystoprostatectomy with ileal conduit with mild right hydronephrosis/hydroureter.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Reason: picc line placement, ensure that it's centrally located History: picc line placement verification Left-sided PICC terminates in the superior aspect of the SVC. No new focal lung opacity. No large pleural effusion or pneumothorax. Normal heart size.

Output: Left-sided PICC terminates in the superior aspect of the SVC.