Instruction: Generate impression based on medical findings.

Input: Reason: 44 yo F s/p IABP, eval placement History: NA Swan-Ganz catheter tip in the right descending pulmonary artery.Balloon catheter in the proximal descending aorta, not significantly changed.Cardiomegaly with vascular redistribution.Left lower lobe opacity compatible with compressive atelectasis.

Output: Aortic balloon catheter tip projected about 2 cm below the top of the aortic arch.


Instruction: Generate impression based on medical findings.

Input: Reason: Infiltrates History: fever Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.Postsurgical abnormalities in the right hemithorax.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 80 years old.Evaluate for pneumothorax. Post device placement in the AP. No focal consolidation, pleural effusion or pneumothorax. Left chest wall ICD, unchanged. Unchanged cardiomegaly. Atherosclerotic calcifications of the thoracic aorta. No pneumothorax.

Output: No pneumothorax, or other acute finding.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: FeverVIEW: Chest AP Cardiothymic silhouette normal. Right chest port with tip in the SVC. No focal lung opacity. No pleural effusion or pneumothorax.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: SOB assess lung function after extubation. . Exam degraded by motion artifact. Interval extubation. Lung volumes low normal, similar previous. Cardiomegaly with mild-to-moderate pulmonary edema. Retrocardiac opacity favored to represent atelectasis. Costophrenic angle blunting may indicate pleural fluid.

Output: Mild to moderate CHF and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: persistent cough History: cough Mild new peripheral and basilar reticulation. No new focal lung consolidation. No or large pleural effusion or pneumothorax. Heart size at the upper limit of normal. No acute bony abnormality. Mild disc degeneration. Pectus excavatum.

Output: Mild peripheral and basilar reticulation which may represent postinfectious or postinflammatory residua. Early fibrosis may also have this appearance.


Instruction: Generate impression based on medical findings.

Input: Female, 42 years old.Reason: r/o PTX following b/l thora History: s/p b/l thoracenteses No pneumothorax following thoracentesis.Persistent pleural effusions and basilar opacities noted.

Output: No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Swan-Ganz check Swan-Ganz continues to project in the main pulmonary outflow tract short of the bifurcation. Mild nonspecific cardiomegaly without additional new cardiopulmonary abnormality. Please note however motion heavily degrades sensitivity

Output: Swan-Ganz unchanged


Instruction: Generate impression based on medical findings.

Input: Swan-Ganz check Swan-Ganz remains well advanced with tip projected into the right lower lobe artery. ICD unchangedMarked cardiomegaly without distinct superimposed additional cardiopulmonary abnormality

Output: Swan-Ganz unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 69 years old.Reason: fever in leukemic Central venous catheter terminates near the cavoatrial junction. Enteric tube terminates within the body of the stomach. Improvement in lung volumes No new focal pleural parenchymal opacity. Skinfold overlies the right lower hemithorax. No large pleural effusion or pneumothorax. Unchanged heart size.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Female 48 years old Reason: infiltrate? History: sob. Brown productive cough Minimal streaky left basilar opacity suggests atelectasis/scarring. There is no focal consolidation, pleural effusion or pneumothorax.The cardiomediastinal contours are within normal limits for size.The imaged skeleton and upper abdomen are unremarkable.

Output: Minimal streaky left basilar opacity suggests atelectasis/scarring.


Instruction: Generate impression based on medical findings.

Input: Male, 93 years old.Reason: PNA History: previous PNA Chronic appearing basilar opacities, with small pleural effusions.Resolution of prior right basilar pneumonia, with no evidence of current edema or infection.COPD.Heart size normal.

Output: Resolution of prior right basilar pneumonia, with chronic appearing basilar opacities and COPD, with small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: ETT check ETT retracted, tip projects 6 cm above the carina. No additional cardiopulmonary changes. See subsequent reports reported

Output: ETT repositioned


Instruction: Generate impression based on medical findings.

Input: Reason: et eval History: et ET tube tip approximately 3 cm above the carina.Small lung volumes with mild basilar opacity compatible with aspirated secretions and atelectasis.No new findings.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Reason: chest pain History: chest pain x 3 days Normal heart size with a moderately tortuous aorta.Small lung volumes with streaky basilar opacities, unchanged from previous, compatible with scarring and subsegmental atelectasis.This finding raises the question of recurrent aspiration.

Output: Basilar scarring and atelectasis, unchanged from previous, which may be secondary to recurrent episodes of aspiration. No acute findings.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: IABP, swan in place History: IABP, swan in place Cranial IABP marker in aortic arch. Venous catheter tip in SVC. Swan-Ganz catheter tip in right pulmonary artery.Stable cardiomegaly and mild pulmonary edema.

Output: IABP marker in aortic arch.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Reason: pna? cavitation? mass? History: night sweats x1 month Heart size normal.Lungs clear. Hyperexpansion lung fields. No pneumothorax. No pleural effusion.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 85 years old.Reason: eval ETT History: patient intubated Endotracheal tube terminates 3 cm are two carina. Nasogastric tube unchanged.Multifocal opacities throughout the right upper and mid zones and left perihilar region suspicious for aspiration, increasing over last 24 hours. Persistent retrocardiac consolidation and atelectasis. The left costophrenic angle is excluded from the field-of-view but the size of the left small pleural effusion is unchanged. No interval.

Output: Multifocal opacities, predominately right-sided, suspicious for aspiration, progressive over the last 24 hours. Stable retrocardiac consolidation and small left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female 81 years old with history of chest pain, rule out acute process Stable cardiomediastinal silhouette. Bibasilar streaky opacities without focal consolidation. No pleural effusions or pneumothorax.

Output: Stable cardiopulmonary exam without specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 39 years old.ET tube. ETT tip 3.5 cm above the level of the carina. Enteric tube incompletely visualized. Left jugular catheter unchanged in position.Diffuse pulmonary opacities with left greater than right basal atelectasis and consolidation. Probable small to moderate pleural effusions.

Output: ETT tip 3.5 cm above the level of the carina. No acute change in diffuse pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Reason: Intubated Patient History: See Above ET tube tip approximately 3 cm above the carina.Swan-Ganz catheter tip in the right main pulmonary artery.Right jugular catheter tip in the SVC. Aortic balloon catheter in the proximal descending aorta, unchanged.Diffuse nonspecific pulmonary opacity, compatible with edema, slightly improved since the previous day.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Congestive heart failure Tracheostomy tube, NG, and Dobbhoff and right jugular catheters are all unchanged. Left chest tube again projects towards midline across the lung base.Decreased lung volumes with suspected left lower lobe partial consolidation versus atelectasis is combined with small effusions. Superimposed mild CHF is observed large in a perihilar distribution. Cecil report

Output: Increasing mild CHF superimposed upon previous findings and left chest tube placement


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: 59 y/o M with endocarditis, intubated History: Endocarditis Endotracheal tube terminates 4 cm above the carina. Remaining support devices are unchanged in position.Severe bilateral, right greater than left, airspace and interstitial opacities. Small bilateral pleural effusions. No significant pneumothorax.

Output: No significant change in the severe airspace and interstitial opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Reason: chest pain History: chest pain Unchanged left lower lobe nodule, stable for at least 4 years.No specific evidence of infection or edema.Heart size normal, the aorta tortuous.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Increasing oxygen requirement. Shortness of breath Enlarging bilateral pleural effusions greater on the right with underlying compression atelectasis and more nonspecific patchy opacities greater on the left. Possible left and right lower lobe partial consolidation must also be considered. Mild cardiomegaly

Output: Large pleural effusions with nonspecific bilateral basilar changes, possibly representing CHF versus partial consolidation


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old. Enteric tube traversing the esophagus and coiled in the stomach with its tip below the inferior margin of the radiograph.Mild basilar opacity compatible with atelectasis.No sign of a venous catheter in the chest.Poorly defined radiolucency over the upper abdomen may represent free intraperitoneal air.A text page was sent to Dr.Elliot at the time of reporting.

Output: Possible free intraperitoneal air. A subsequent radiograph has been scheduled and will likely be helpful for clarification.


Instruction: Generate impression based on medical findings.

Input: Age: 45 yearsGender: MaleReason for Study: Reason: pneumonia, effusion, cardiomegaly, aspiration, widened mediastinum History: COPD exacerbation after snorting heroin PTA, shortness of breath The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Reason: S/P1/21/15 Pleurectomy, Decortication, Thoracotomy, Bronchoscopy, mediastinal lymph node dissection History: follow up Left loculated anterior hydropneumothorax with underlying atelectasis.Partial resolution of subcutaneous emphysema.Port catheter with its tip in the SVC.

Output: Left loculated hydropneumothorax and resolving subcutaneous emphysema.


Instruction: Generate impression based on medical findings.

Input: Male, 54 years old.Reason: eval, pt with seizure like episode Partially visualized right nephroureteral stent. Spinal hardware is again seen. Persistent low lung volumes with increased bibasilar opacities which may represent atelectasis or aspiration. Cardiothymic silhouette is within normal limits and unchanged. No pneumothorax.

Output: Persistent low lung volumes with increased bibasilar opacities may be secondary to aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 83 years old.Reason: eval for pneumonia History: cough Right mammoplasty is present. No significant change when compared to prior. No focal consolidation to suggest pneumonia. Heart size is normal. Mild tortuosity of the descending thoracic aorta.

Output: No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 25 years old.Dyspnea question acute process. Normal heart size. Low normal volumes. No focal airspace opacities, pleural fluid or pneumothorax.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: 65-year-old female with history of adrenocortical carcinoma status post left adrenalectomy in October of 2007. Please evaluate for recurrence. CHEST:LUNGS AND PLEURA: No significant abnormality noted. No evidence of effusion, focal consolidation, or pleural thickening. MEDIASTINUM AND HILA: Large, asymmetric thyroid goiter, larger on the right than the left, with tracheal displacement to left. Findings are unchanged on comparison to prior exam.Previously noted infracardiac mass (coronal image 63/136), which contains focal calcification, remain stable.CHEST WALL: No significant abnormality noted. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No masses visualized adrenalectomy bed. Contralateral adrenal gland is unchanged from prior exam.KIDNEYS, URETERS: Stable benign renal cysts bilaterally. Stranding in the perirenal fat bilaterally, which is nonspecific and stable in comparison to prior exam.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No other significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Stable, calcified uterine fibroids.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 other significant abnormality noted.

Output: Status post left adrenalectomy. No evidence of metastatic recurrence. Stable infracardiac 2 centimeter mass. Right thyroid goiter with mediastinal extension.


Instruction: Generate impression based on medical findings.

Input: Patient fell, lymphocytosis Mild diffuse chronic appearing changes, largely interstitial with questionable minimal bronchiectasis. All unchanged. No superimposed acute abnormality. No effusions.The cardiac and mediastinal contours remain within limits given the patient's mild rotation.Visualized osseous structures appear intact

Output: Chronic appearing changes without acute disease


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.Reason: eval progression of infiltrates s/p iHD with rapid improvement in pulm symptoms History: improving cough and SOB, but persistent 02 requirement Near resolution of upper lobe opacities.Increased left lower lobe consolidation and left effusion.Unchanged right pleural effusion with basilar atelectasis.Status post extubation and NG tube removal.IVC catheter, tip at right atrial level.

Output: Improvement in upper lobe opacities, worsening in the left base, and persistent effusions. In general, improvement overall.


Instruction: Generate impression based on medical findings.

Input: Female, 86 years old.Reason: cough History: cough Basilar opacities seen best on the lateral view suggestive of infection or aspiration.Heart size upper normal, the aorta tortuous.

Output: Basilar pneumonia or aspiration, best seen on the lateral view.


Instruction: Generate impression based on medical findings.

Input: 4-month-old with pneumothorax.VIEW: Chest AP (one view) 12/28/16, 2248 Endotracheal tube tip is between thoracic inlet and carina. Enteric tube tip is in stomach. Right internal jugular line has its tip in superior vena cava. There are three chest tubes.Small right pneumothorax is seen at the base. The right lung is opacified and contains air bronchograms centrally. The left lung is overinflated. Streaky opacities are present in the left lower lobe. Cardiothymic silhouette is normal.

Output: Small right pneumothorax. Collapse of right lung.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: cause of SOB History: SOB, hx of cancer Lower lung zone scar like opacities or subsegmental atelectasis.Small right pleural effusion or pleural scarring noted.Heart size normal.No sign of metastases.

Output: Linear scarring or subsegmental atelectasis, with a small right effusion or pleural scarring. No evidence of metastases.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Status post aborted central line placement bilaterally. No pneumothorax. Right jugular chest port tip at the SVC/artery junction. Enteric tube looped in the stomach with the tip at the gastric fundus.Worsening airspace opacity in the right lower lobe.

Output: No pneumothorax. Worsening right lower lobe airspace opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 51 years old.Reason: Eval for PNA History: Worsening cough, asthma, SOB Global cardiomegaly.Signs of pulmonary venous hypertension associated with diffuse bilateral perihilar reticular opacities consistent with interstitial pulmonary edema.Focal areas of scarring in the left midlung are again noted, stable from multiple priors.The pleural spaces are within normal limits. Mild diffuse fissural thickening is noted.No osseous lesions are present.

Output: Signs of interstitial pulmonary edema, pulmonary venous hypertension and persistent cardiomegaly.Left midlung scarring, stable from prior studies.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Increased oxygen requirements Right internal jugular central venous catheter tip is at the superior cavoatrial junction.Cardiomediastinal silhouette is normal.Small amount of fluid in the right minor fissure. No pneumothorax.Minimal left basilar subsegmental atelectasis. Increased haziness in the lung bases.

Output: Minimal left basilar subsegmental atelectasis. Increasing haziness in the lung bases and small right pleural effusion may represent fluid overload.


Instruction: Generate impression based on medical findings.

Input: Male, 32 years old.Reason: intubated, vvECMO History: intubated post-op No change in pulmonary opacities including edema and loculated effusions.Chest tubes are present with no pneumothorax.ET tube tip approximately 5 cm above the carina.An NG tube extends below the lower margin of the image.Left jugular introducer unchanged.Right jugular catheter tip low in the right atrium.Left PICC, tip in SVC.

Output: Unchanged pulmonary opacities. No change in support devices.


Instruction: Generate impression based on medical findings.

Input: Age: 48 yearsGender: FemaleReason for Study: Reason: eval mediastinum History: Chest pain, radiation to back The cardiomediastinal silhouette is unremarkable.Minimal scarring/discoid atelectasis in the left lung base.No focal areas of consolidation.No pleural effusions.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Status post mitral and aortic valve replacement. Low lung volumes with persistent bibasilar atelectasis. There has been interval improvement of septal lines and edema. Unchanged support hardware. Unchanged small left pleural effusion.Question of tiny right apical pneumothorax.

Output: Improving pulmonary edema with stable left pleural effusion. Question of tiny right apical 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: Female, 66 years old.Reason: sob History: as above Right chest tube removed with no pneumothorax.Unchanged right-sided opacities, but improvement on the left.Stable small pleural effusions.

Output: Overall improvement in pulmonary opacities. No pneumothorax following chest tube removal.


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Reason: ? Infiltrate History: cough Chronic appearing left hemidiaphragm elevation with overlying atelectasis, unchanged.Elsewhere, the lungs are unremarkable without reliable evidence of infection.Heart size normal.

Output: Elevation left hemidiaphragm. No reliable evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Male, 25 years old.Diffuse wheezing evaluate for pneumonia or edema. Severe bronchial wall thickening. No atelectasis. No pneumothorax or pleural fluid. Normal heart size.

Output: Severe bronchial wall thickening which may be seen in reactive airways disease or viral bronchitis/URI.


Instruction: Generate impression based on medical findings.

Input: Reason: tachypnea, hypoxia History: tachypnea, hypoxia The heart size upper normal.Diffuse airspace and interstitial opacity, suggestive of edema with moderate pleural effusions.NG tube tip in the stomach.

Output: Pulmonary edema with pleural effusions, new since the previous radiograph.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: cticu patient, s/p trach, s/p lung transplant History: desaturation, s/p bronchoscopy Enteric tube tip near the duodenal bulb. Tracheostomy tube unchanged.No significant change in bilateral pulmonary opacities and bilateral pleural effusions.

Output: No significant change in bilateral pulmonary opacities and bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: IABP placement History: IABP placement IABP catheter replaced now with a right subclavian introducer, the proximal marker 4 cm below the top of the aortic arch.Moderate cardiomegaly. No specific evidence of infection or edema.Left subclavian ICD, leads unchanged in position.Right jugular catheter, tip in SVC.

Output: IABP catheter replaced now from a right subclavian route.


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: Pneumothorax; Post device placement in EP Lab History: Post device placement in EP Lab Cardiac vein lead has been repositioned now oriented more superiorly along its distal margin. Other cardiac leads are unchanged. No new focal lung consolidation. No pleural effusion or pneumothorax. Unchanged heart size. No acute bony abnormality.

Output: Repositioning of cardiac vein lead.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: r/o mass History: chest pain and unexplained weight loss Possible retrocardiac opacity versus artifact.Elsewhere, the lungs are unremarkable.Heart size normal.

Output: Possible retrocardiac opacity, and given the patient's clinical history a thoracic CT is recommended.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: eval SGC positioning History: SGC in place Cardiomegaly.The tip of the IABP is localized approximately 4.3 cm below the top of the aortic arch.The Swan-Ganz catheter with IVC approach has been retracted and tip overlies the heart. Repositioning is recommended.No signs of pulmonary edema.No pleural effusion or pneumothorax.

Output: Abnormal position of the Swan-Ganz catheter, overlying the heart, possibly within the right atrium or right ventricle. Repositioning is recommended.Notification: Findings communicated to Dr. Keast by Dr. Bueno at time of dictation on 10/26/2016.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Weakness. Evaluate for pneumonia. Bibasilar interstitial opacities, consistent with aspiration, atelectasis, pneumonia, or edema. No pleural abnormalities.Cardiomediastinal silhouette within normal limits.

Output: Bibasilar interstitial opacities, consistent with aspiration, atelectasis, pneumonia, or edema.


Instruction: Generate impression based on medical findings.

Input: Reason: asthma, worsening cough History: asthma, worsening cough Unremarkable cardiac and mediastinal silhouette. No significant pulmonary abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Reason: respiratory status History: intubated ET tube tip approximately 1 cm above the carina.Catheter tip in the SVC.Small lung volumes with basilar opacity, greater on the left, compatible with atelectasis and effusion.Interval removal of a Swan-Ganz catheter.

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


Instruction: Generate impression based on medical findings.

Input: Male, 29 years old.Reason: volume status, aspiration History: acute decompensation Cardiomegaly, with small lung volumes and the suggestion of edema.No specific evidence of infection.

Output: Cardiomegaly and possible edema without evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: Confirm ETT placement History: Respiratory Failiure, Intubation Interval intubation with endotracheal tube tip approximately 3 cm above the carina.Stable cardiac enlargement.Streaky basilar opacities likely atelectasis. Vascular congestion and some degree of edema.No large pleural effusion. No pneumothorax.

Output: Interval intubation with basilar atelectasis and some degree of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Shortness of breath and chest pain. Evaluate for CHF. Diffuse interstitial opacities, consistent with patient's known pulmonary fibrosis, with possible overlying mild pulmonary edema.Cardiomegaly unchanged. Left chest wall ICD unchanged.

Output: Pulmonary fibrosis with possible overlying mild pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old. Chest pain, SOB. Small lung volumes with basilar atelectasis. No reliable evidence of infection or edema.Unremarkable cardiac and mediastinal silhouette.

Output: Small lung volumes with basilar subsegmental atelectasis.


Instruction: Generate impression based on medical findings.

Input: Tobacco use. Check for pneumothorax following shortness of breath episode Interval decrease in size of what it remains a moderate to large right pleural effusion with suspected loculation. Underlying R shoulder reexpansion of the right lung, however overall patchy opacities are observed bilaterally with moderate cardiomegaly concerning for edema in a perihilar distribution. Questionable small associated left effusion. Interval placement of a right chest tube coiled across the lung baseSternotomy and prosthetic heart valve

Output: Right chest tube placed with interval decreasing size of the large right pleural effusion. Concern for interval increasing diffuse mild edema


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Reason: hx of + TB skin test or qft + History: No significant cardiopulmonary abnormality.No active TB.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 24 years old.Reason: hypoxemia History: same Low lung volumes with basilar opacities likely related to atelectasis. No other interval change

Output: Basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Persistent moderate right pleural effusion with overlying atelectasis and small lung volumes. No additional new abnormality

Output: Right pleural effusion with atelectasis


Instruction: Generate impression based on medical findings.

Input: Reason: SOB History: SOB Cardiomegaly with bilateral mainly lower zone airspace and interstitial opacity compatible with edema, not significantly changed from previous.No new findings.

Output: CHF with pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.History: Esophageal cancer, status post esophagectomy. Left subclavian catheter with tip in the SVC, unchanged from prior radiograph.Stable cardiomediastinal silhouette with fluid/debris in the neoesophagus.No pulmonary or pleural abnormalities.

Output: No acute cardiopulmonary abnormalities, stable from prior radiograph.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: 72-year-old female with history of chest on therapy CHEST:Biapical scarring, more prominent on the left is unchanged. Left upper lobe, Focal pleural thickening is unchanged.No evidence of mediastinal adenopathy.ABDOMEN:LIVER, BILIARY TRACT: Small, hypodense lesions in the liver, are unchanged.SPLEEN: No significant abnormality notedPANCREAS: Slightly prominent pancreatic duct, unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral parapelvic cysts are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small, mesentery, soft tissue density is unchanged, measuring 13 by 9-mm image number 126, series number 9. The second reference lesion with calcifications has changed. Its shape and location, but grossly unchanged and measures 30 x 18 mm Schommer 143, series number 9.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Right adnexal cystic lesion is unchanged and measures 2.2 x 2.9 cm in image number 177, series number 9. Adjacent soft tissue density lesion with calcifications may represent a parenchymal part of the ovary and measures 15 x 60 minutes. On image number 100 73, series number 9.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 significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Chest tube check Interval marked decrease in the previously described large pleural effusion, currently a moderate to small effusion persists. Left chest tube remains with tip projected into the apex. Underlying cardiopulmonary appearance otherwise similar

Output: Decreasing left pleural effusion with an unchanged left chest tube


Instruction: Generate impression based on medical findings.

Input: Metastatic prostate cancer CHEST:LUNGS AND PLEURA: Scattered micronodules unchanged.MEDIASTINUM AND HILA: Index right hilar lymph node is slightly enlarged measuring 1.1 x 1.4 cm in image number 42, series number 3.CHEST WALL: Metastatic left scapular and sternal lesions are unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index aortocaval reference node is unchanged measuring 7 by 5 mm on image number 120, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in the size and density of some of the sclerotic bone metastases involving the pelvic bones and lumbar vertebral bodies.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Interval increase in the size and density of some of the sclerotic bone metastases involving the pelvic bones and lumbar vertebral bodies.OTHER: No significant abnormality noted

Output: Interval increase in the size and density of some of the sclerotic bone metastases involving the pelvic bones and lumbar vertebral bodies.Minimal interval increase in the size of the right hilar lymph node


Instruction: Generate impression based on medical findings.

Input: Age: 78 yearsGender: MaleReason for Study: Reason: TTE with EF 36% History: see above Decreased lung volumes with moderate/marked cardiac enlargement demonstrating interval increase in size.There is significant tortuosity of the aorta.Left basilar subsegmental atelectasis and/or scarring.No focal areas of consolidation.No large pleural effusions.

Output: Cardiac enlargement demonstrating interval increase in size. No specific evidence of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Age: 53 yearsGender: MaleReason for Study: Reason: sob History: sob Support devices unchanged.Stable cardiomediastinal silhouette.Decreased lung volumes with pulmonary opacities similar to the prior exam.Persistent left retrocardiac consolidation/atelectasis in pleural effusions.No new pulmonary opacities identified.

Output: Support devices unchanged. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Female, 18 years old.Reason: eval for focal consolidation History: chest pain; sickle cell dz; hx of acute chest No acute cardiopulmonary abnormality. Osseous changes of sickle cell disease.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: s/p cardiac surgery History: s/p cardiac surgery Cardiopulmonary monitoring and support devices, unchanged.Cardiomegaly with extensive bilateral airspace opacity which are nonspecific but compatible with edema/ARDS, hemorrhage or infection.No pneumothorax or other acute change.

Output: Cardiomegaly and extensive nonspecific pulmonary opacity without significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 79 years old.Reason: s/p enucleation of a right upper lobe nodule and mediastinal lymph node dissection for a suspected lung cancer History: follow up Two right chest tubes unchanged with no significant pneumothorax.Right hemithorax posterior to volume loss.Hyperexpanded left lung.

Output: No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 47 years old.Reason: Port positioning History: port No significant cardiopulmonary abnormality.Right subclavian catheter, tip at cavoatrial junction.Unchanged spinal stimulator hardware.

Output: No significant abnormality. Right subclavian port catheter tip at cavoatrial junction, unchanged.


Instruction: Generate impression based on medical findings.

Input: Male 75 years old Reason: 75 y/o M with history of liver/kidney transplant on cellcept and prograf with cough and fevers at home for 1 week. Rule out PNA. History: fevers, productive cough, crackles at RLL The cardiomediastinal silhouette is normal.Air space opacity at the right base may represent pneumonia or aspirate.No pleural effusion or pneumothorax.

Output: Air space opacity at the right base may represent pneumonia or aspirate.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Reason: Eval for cardiopulmonary disease. History: Tachycardia No significant cardiopulmonary abnormality.Median sternotomy.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Male 66 years old Reason: VAD patient History: s/p VAD placement Right brachiocephalic arterial stent visualized. Right PICC terminates in the right axillary vein.Remaining support devices unchanged from prior exam.Sternotomy hardware noted.Increased left lower lobe opacities with small left pleural effusion and/or thickening.Cardiomediastinal silhouette stable.

Output: Left lower lobe atelectasis and/or scarring. Small left pleural effusion and/or thickening.


Instruction: Generate impression based on medical findings.

Input: Age: 43 yearsGender: FemaleReason for Study: Reason: line eval History: line adjustment Right IJ venous catheter with its tip in the SVC.Stable cardiomediastinal silhouette.No new pulmonary opacities.

Output: Right IJ venous catheter with its tip in the SVC.


Instruction: Generate impression based on medical findings.

Input: Male 31 years old Reason: r/o pneumonia History: RUQ pain Redemonstration of posterior stabilization rods and levoscoliosis of the thoracic spine.Cardiomediastinal silhouette is stable.No focal opacity or pleural effusion is identified.

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


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: chest wall resection History: - Two right apically directed chest tubes are unchanged in position.Deformity of the right lateral chest wall with surgical staples in the lateral right upper lobe. No significant pneumothorax. Improved aeration of the left lower lobe. Persistent elevation of the left hemidiaphragm with likely small left pleural effusion. Heart size remains stable.

Output: Improved aeration left lower lobe with possible small left pleural effusion. Postsurgical findings right lateral chest wall without significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Age: 57 yearsGender: FemaleReason for Study: Reason: infection History: CP and cough The cardiomediastinal silhouette is unremarkable.The lungs are clear.No pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Male, 50 years old.Reason: please compare History: please compare Moderate cardiomegaly with lower lung zone opacities suggestive of pleural effusion and patchy consolidation, unchanged.ET tube tip approximately 4 cm above the carina.An NG tube terminates in the stomach.

Output: Unchanged cardiomegaly and pulmonary opacities with no new findings.


Instruction: Generate impression based on medical findings.

Input: Reason: f/u PTX History: same Right chest tube in place with no significant pneumothorax. Dialysis catheter tip at the SVC/R junction.Tracheostomy tube unchanged.Cardiomegaly with bilateral opacity compatible with edema, atelectasis, basilar consolidation and small effusions. No new findings.

Output: Cardiomegaly with edema, atelectasis, consolidation and small effusions. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 47-year-old male with CLL and fevers and chills consolidation on chest CT. Positive CMV viremia but no improvement despite treatment with ganciclovir and [?]. Assess other source of fever. CHEST:LUNGS AND PLEURA: There is been some improvement in the previous identified infiltrates. The some groundglass appearance persists in the posterior paramediastinal parenchyma and perihilar area. There is still some areas of consolidation along the posterior mediastinum. No new sites of disease. No pleural effusions.MEDIASTINUM AND HILA: Extensive bilateral axillary and mediastinal adenopathy is identified unchanged. For baseline purposes a high central left axillary node is measured on series 6 image 15 is 4.9 x 2.9 cm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Normal size no focal lesions.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy in the distal retroperitoneum best identified on coronal images and also along the proximal iliac chains. These a small nodes clustered.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Osseous structures normal. Lipoma left abdominal wall unchanged.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: No significant abnormality noted

Output: Persistent but improving airspace disease. Extensive adenopathy unchanged most marked in the axilla and mediastinum but some in the retroperitoneum as well. No specific cause for fever or other than the air space disease.


Instruction: Generate impression based on medical findings.

Input: Age: 77 yearsGender: MaleReason for Study: Reason: evaluate for pneumonia History: recurrent fever Right Port-A-Cath unchanged.Stable cardiomediastinal silhouette.Right perihilar consolidation similar to the prior exam.No large pleural effusions.

Output: Right perihilar consolidation unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: Check Pulmonary Status, COPD History: Check Pulmonary Status, COPD Interval resolution of a left upper lobe focal opacity.Basilar opacities compatible with atelectasis and effusions, unchanged.Catheter tip in the SVC.

Output: Interval resolution of left upper lobe opacity.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for PNA or effusion History: SOB Normal heart size with mediastinal shift to the right.Fibrosis and volume loss at the right base, unchanged from previous.No specific evidence of pneumonia.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 31 years old.Reason: PNA v URI History: cough Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

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


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath Diffuse fine nodular interstitial opacities are unchanged, previously characterized by CT where the suggestion of lymphocytic interstitial pneumonia or follicular bronchiolitis was made. Atypical infection is also in the differential diagnosis.No significant sized pleural effusions.Heart size normal.

Output: Unchanged finding nodular interstitial opacities consistent with lymphocytic interstitial pneumonia/follicular bronchiolitis as previously suggested, or disseminated atypical infection.


Instruction: Generate impression based on medical findings.

Input: Age: 93 yearsGender: FemaleReason for Study: Reason: Evaluate for PNA History: hx COPD, SOB x2-3 days w/cough Stable mild cardiac enlargement.Mild basilar atelectasis and/or scarring.No new pulmonary opacities.No pleural effusions.Large hiatal hernia redemonstrated.

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


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.History of transient alteration of awareness, evaluate for pneumonia. Cervical fusion hardware noted. Portacatheter tip in the RA/SVC junction.The cardiomediastinal silhouette is stable.No focal pulmonary opacities or large pleural effusions.

Output: No evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female 40 years old Reason: 40F s/p ex lap with aspiration History: tachycardia, low grade fever. Loss of the left hemidiaphragm again noted and compatible with pleural effusion and underlying atelectasis.Cardiomediastinal silhouette is upper limits of normal.Interval placement of endotracheal tube which is 4 cm above the carina. NG tube in distal esophagus.Low lung volumes.

Output: NG tube in distal esophagus.Left pleural effusion and basilar opacity which may represent infection or atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 33 years old.Reason: ? infection History: ? infection No significant cardiopulmonary abnormality.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Intubated. Endotracheal tube tip is about 4 cm above the carina. Increased interstitial and air space opacities more prominent on the right. Small bilateral pleural effusions. Stable cardiomediastinal silhouette. Enteric tube tip is out of the field of view.

Output: Right greater than left interstitial and airspace opacities consistent with right-sided pulmonary edema. Persistent small bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Reason: eval lung fields History: s/p AVR Swan-Ganz catheter tip in the right main pulmonary artery.Interval extubation.Moderate cardiomegaly with basilar opacity compatible with atelectasis and small pleural effusions.No pneumothorax or other acute change.

Output: Basilar atelectasis and small pleural effusions with no acute change.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: rule out pulmonary edema History: shortness of breath Increased right upper lobe atelectasis and persistent left mid to lower lung zone patchy opacities.Small lung volumes.Small left pleural effusion.

Output: Atypical edema versus aspiration with increased right upper lobe atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Pneumonia versus edema. Hypoxemia. Stable cardiomediastinal silhouette, with mild cardiomegaly.Bibasilar opacities likely representing atelectasis, possibly from aspiration.No significant pleural effusions.

Output: Bibasilar atelectasis, possibly representing aspiration.


Instruction: Generate impression based on medical findings.

Input: 52 year-old female breast cancer with recent complaints of back pain CHEST:LUNGS AND PLEURA: Biapical scarring, more prominent on the right side.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hyperdense lesion at the edge of the right lobe liver image number 67, series number 3 is new from previous CT but likely represents a benign lesion. No other focal lesions in the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No evidence of metastatic disease in the chest abdomen or pelvis.


Instruction: Generate impression based on medical findings.

Input: Cardiogenic shock Mediastinal chest tubes, cardiac catheters, ICD, Dobbhoff and right jugular catheters are all unchanged.Moderate cardiomegaly an underlying nonspecific patchy basilar opacities again greater on the left also similar

Output: Chest tubes essentially and effectively unchanged


Instruction: Generate impression based on medical findings.

Input: 54-year-old female with metastatic pancreatic carcinoma CHEST:LUNGS AND PLEURA: Several scattered bilateral pulmonary nodules are unchanged. Index and lingular nodule image number 47, series number 5 measures 6 mm, unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration, unchanged. Expected pneumobilia with biliary stent in place. Segment 8 lesion measures 15 x 12 mm image number 89, series number 3.Fatty infiltration limits a full evaluation of the liver for focal lesions. Given these limitations, no new focal lesions are seen.SPLEEN: Unremarkable.PANCREAS: Pancreatic mass has increased in size and now measures 5.8 by 3-cm in image number 98, series number 3. The mass encases the extrahepatic main portal vein. Splenic vein is chronically thrombosed. Celiac trunk is invaded by the mass.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small fat containing ventral hernia is unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Right ovarian cystic lesion, increasing in size compared to previous study. Now, it measures 3.7 by 2.9 cm on image number 177, series number 3.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: Interval increase in the size of the patient's known pancreatic mass. Hepatic lesion is unchanged.Interval increase in the size of the right ovarian cystic lesion.


Instruction: Generate impression based on medical findings.

Input: Female, 41 years old.Reason: ptx, History: inc sob s/p spont ptx at osh with chest tube placed Moderate right pneumothorax, 2.2 cm separation between pleural surfaces.No chest tube identified despite the clinical history provided.Right chest wall soft tissue emphysema is present.Subsegmental atelectasis may be the result of aspirated secretions or mucous plugging.

Output: No chest tube visualized. Moderate right pneumothorax. A subsequent radiograph showed tube had been placed.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: assess lines and tubes History: s/p IABP Cardiomegaly with vascular congestion . Stable prior postoperative change. No other focal lung opacities.No pleural effusion. No pneumothorax.

Output: Cardiomegaly with vascular congestion.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: assess ET tube positioning after being History: ET tube placement Endotracheal tube is approximately 1cm above the carina. Surgical clips project over the right axilla and mediastinum. Right chest port has tip overlying the right atrium.Volume loss of the right hemithorax more accentuated with associated atelectasis when compared to the prior. Increased pulmonary edema bilaterally with relative sparing of the left upper lobe. No change in cardiac mediastinal silhouette. Questionable bilateral pleural effusions. No pneumothorax.

Output: Increased pulmonary edema bilaterally. Accentuated volume loss of the right hemithorax. Endotracheal tube approximately 1 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: 58-year-old female status post colostomy for obstruction from metastatic colon cancer CHEST:LUNGS AND PLEURA: Scattered subcentimeter nodules in both lungs. A referenced nodule measures 5 noted on image number 49, series number 4. Left-sided pleural effusion. Bilateral dependent atelectasis.MEDIASTINUM AND HILA: Esophagus is dilated with oral contrast throughout its course. Moderate-sized hiatal hernia.CHEST WALL: Unremarkable.ABDOMEN:LIVER, BILIARY TRACT: Large heterogeneous hilar mass with multiple bilobar satellite lesions causing severe intrahepatic biliary dilatation despite the percutaneous biliary drainage catheter is again seen. Cholelithiasis, unchanged.SPLEEN: Hypodense splenic lesion measures 7 mm on image number 16, series number 3, unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left kidney is atrophic with multiple areas of cortical scarring. Solid appearing focal lesion within the right kidney is unchanged. This may represent a focal area of infection versus metastatic lesion.RETROPERITONEUM, LYMPH NODES: Multiple enlarged lymph nodes at the porta hepatis and retroperitoneum are unchanged. Efferents lymph node measures 16 x 12 mm on image number 103, series number 3 in the left para-aortic region.BOWEL, MESENTERY: Metallic stent is seen within the sigmoid colon. The wall of the colon is thickened, most prominent in the descending colon. This may be secondary to colitis. Mild dilatation of the small bowel is unchanged. This may be secondary to ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Ascites has increased within the interval.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Previously measured mass in the sigmoid colon is not well seen due to placement of the metallic stent but is probably unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Interval increase in the amount of ascites and generalized anasarca. Interval placement of a metallic stent in the sigmoid colon.Interval development of diffuse colonic wall thickening suspicious for colitis.Left-sided moderate pleural effusion.Scattered bilateral small nodules, nonspecific, metastatic lesions cannot be excluded.Hepatic hilar mass with bilobar satellite hepatic metastases causing biliary dilatation is unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: Is there infection? History: fever Single lumen chest port with tip in projection of superior vena cava.Low lung volumes with basilar atelectasisUnremarkable cardiomediastinal silhouette.No pleural effusion. No pneumothorax.

Output: No acute cardiopulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: Male, 76 years old.Reason: assess LLL infiltrate one admitting cxr for resolution or other pathology (nodule) History: as above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Right jugular catheter, tip at cavoatrial junction level.

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


Instruction: Generate impression based on medical findings.

Input: Male, 46 years old.Reason: ETT, mucosal sloughing, ARDS History: ETT, mucosal sloughing, ARDS Persistent low lung volumes and bilateral basilar subsegmental atelectasis.Small bilateral layering pleural effusions are unchanged. No pneumothorax.The ET tube overlies the mid trachea, in adequate position. There are 2 enteric tubes coursing below the diaphragm.The right IJ venous catheter overlies the SVC. Right subclavian HD catheter overlying the superior cavoatrial junction.

Output: Stable position of support apparatus.Persistent bilateral small layering pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Age: 67 yearsGender: FemaleReason for Study: Reason: Chest discomfort worse with deep breath. Evaluate for intrathoracic pathology History: Chest discomfort left side worse with deep breath. The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Reason: s/p BL lung transplant History: CTICU patient Moderate cardiomegaly and bilateral interstitial opacities are compatible with edema and moderate bilateral pleural effusions. Small partially loculated hydropneumothorax appears similar compared to prior examination with pigtail drain in place. Enteric feeding tube tip extends beyond the inferior margin of the image.

Output: Pulmonary edema, pleural effusions, and stable partially loculated right apical hydropneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Dizziness, weight loss, decreased appetite, elevated WBC. No pleural fluid or pneumothorax. No focal airspace opacities, pleural fluid or pneumothorax. Normal heart size.

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


Instruction: Generate impression based on medical findings.

Input: Reason: ET plccmt History: as above ET tube tip approximately 4 cm above the carina.NG tube tip in the stomach.Moderate cardiomegaly with basilar opacity compatible with atelectasis, not significantly changed.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old.Reason: eval for cardiomegaly History: chest pain Mild-to-moderate cardiomegaly, unchanged. Low lung volumes. No new focal lung consolidation. No large pleural effusion or pneumothorax. Large patient body habitus.

Output: Unchanged mild-to-moderate cardiomegaly. No new focal lung consolidation.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: r/o lung infection History: prod cough, low grade fever Focal right infra hilar window opacity which may represent a pulmonary nodule versus vascular artifact. Further evaluation with cross-sectional imaging is suggested. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size.

Output: Focal right infra hilar window opacity which may represent a pulmonary nodule versus vascular artifact. Further evaluation with cross-sectional imaging is suggested.No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for wide mediastinum History: trouble swallowing and fullness in your chest Normal heart size with a moderately tortuous aorta, unchanged from previous.No other visible mediastinal abnormalities.No significant pulmonary modalities.

Output: Moderately tortuous aorta and no significant change.


Instruction: Generate impression based on medical findings.

Input: Male 3 years old Reason: monitor pneumonia History: respiratory failureVIEW: Chest AP (one view) 11/4/2015 at 0625 hours. ET tube, feeding tube and bilateral chest tubes as well as central line unchanged. Interval NG tube placement. Tip is at the stomach.Cardiac silhouette size is top normal. Persistent bibasilar opacities and bilateral pleural effusions.

Output: No change in multifocal opacities and bilateral pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Age: 89 yearsGender: MaleReason for Study: Reason: 89M with worsening hypoxia History: SOB, desat to 70s Increased lung volumes compatible with COPD.Stable cardiomediastinal silhouette.Pleural effusions and left retrocardiac consolidation/atelectasis are similar to the prior exam.No new pulmonary opacities identified.Right PICC line with the tip in the right subclavian vein.

Output: Stable cardiopulmonary appearance with pleural effusions end left retrocardiac consolidation/atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Fever question infiltrates. Right jugular chest port tip at the SVC. Normal heart size. Calcified thoracic aorta. No focal airspace opacities, pleural fluid or pneumothorax.

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


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Fall from 17 feet. Normal cardiomediastinal silhouette.No pneumothorax.Multiple approximately 1 cm ovoid opacities in the lungs bilaterally may represent granulomas but are indeterminate.No displaced fracture of the imaged ribs.

Output: 1. No pneumothorax.2. Bilateral ovoid opacities may represent granulomas but are indeterminate. Evaluation with CT or 3-6 month follow up PA/lateral radiographs with dual energy may be helpful.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Malignant melanoma scalp and neck evaluate lung fields. Status post right thoracotomy and wedge resection. Tiny (2 to 3 mm) right apical pneumothorax and minimal (5 mm) pneumothorax in the deep right costophrenic sulcus. Right chest tube in place. Right hemithorax volume loss. Lung volumes overall slightly decreased. Basal atelectasis. Small volume of pleural fluid on the left.

Output: Small right pneumothorax. Interval slight decrease in lung volumes with basal atelectasis.


Instruction: Generate impression based on medical findings.

Input: Age: 54 yearsGender: FemaleReason for Study: Reason: eval lung fields History: lightheaded Left-sided ICD and LVAD unchanged.Stable cardiac enlargement.Scattered areas of scarring/discoid atelectasis.No focal airspace consolidation.No pleural effusions.Median sternotomy intact with evidence of a mitral valve replacement.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Reason: pneumothorax History: post thoracentesis on the left No sign of pneumothorax or other acute change.Cardiopulmonary monitoring and support devices, unchanged. Bilateral nonspecific airspace disease without significant interval change.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Reason: eval pulmonary edema History: pulmonary edema Cardiomegaly with mild interstitial edema and small right pleural effusion, improved.Moderate cardiomegaly.Right jugular Swan-Ganz catheter removed leaving the introducer.

Output: Improving pulmonary edema and pleural effusions consistent still with CHF.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Reason: r/o pneumonia History: dyspnea. Cardiomediastinal silhouette within normal limits.No acute focal airspace opacity. Left lower lobe subsegmental atelectasis/scarring.No pneumothorax or pleural effusion.

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


Instruction: Generate impression based on medical findings.

Input: Swan-Ganz placement Swan-Ganz remains in the right pulmonary outflow tract. ICD unchanged.Marked nonspecific cardiomegaly with calcified right hilar lymph nodes are all similar. Persistent mildly decreased lung volumes

Output: Swan-Ganz unchanged


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Syncope and dizziness. No focal consolidation, pleural effusion or pneumothorax. Normal cardiomediastinal silhouette.

Output: No acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: Reason: SOB History: SOB Small lung volumes with resolving interstitial opacity compatible with edema.Small pleural effusions and basilar atelectasis.Catheter tip in the SVC.

Output: Resolving pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: eval pneumonia History: respiratory failure from trach collar to vent Lines and tubes are unchanged. Diffuse pulmonary opacities, not substantially different compared to previous study though opacities appear slightly more coarse than more remote studies, for example dating back to 8/18/2015. Left lower lobe atelectasis, unchanged. Mild cardiomegaly, unchanged. No pleural effusion or pneumothorax.

Output: No substantial difference compared to last study though pulmonary opacities appear more coarse compared to more remote studies suggesting possible superimposed fibrotic evolution of diffuse alveolar damage.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: S/p esophagectomy History: Daily CXR Two right chest tubes unchanged with no pneumothorax.Unchanged basilar opacities suggestive of atelectasis with small pleural effusions.An NG tube still traverses a gastric pull-up.

Output: Unchanged pulmonary opacities. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 62 years old.Reason: r/o acute process History: noted bulging on right supraclavicular area with forced expiration. Chronic right upper lobe predominant volume loss.Left lung unremarkable.No evidence of lung herniation as questioned in the clinical history provided.Heart size normal.

Output: Postinflammatory right hemithorax volume loss, otherwise unremarkable.


Instruction: Generate impression based on medical findings.

Input: Male, 35 years old.Reason: eval for free air under the diaphragm History: abd pain, decreasing ileostomy output, fever, tachycardia No active gas is noted. Patchy bibasilar opacities with small lung volumes, as before. Small pleural effusions. Unchanged heart size. Iatrogenic devices are unchanged.

Output: No evidence of ectopic gas. Increase in patchy bibasilar opacities and small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: CHEST: Exam limited by field of view and range of coverage.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted.

Output: No significant abnormality noted in the extracardiovascular portions of the examination.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Recent outside hospital intubation for respiratory failure, long-standing tobacco use. Normal heart size. Central pulmonary vasculature is at least upper normal in caliber. Tortuous thoracic aorta.No pleural fluid or pneumothorax. Mild elevation of the right hemidiaphragm. Scarring or atelectasis at the left lung base. No visible pulmonary nodules or masses.

Output: Minimal scarring or atelectasis at the left lung base, but no acute pulmonary abnormality otherwise.


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.Reason: pna? edema? History: cough, chest pain Moderate cardiomegaly.Mild right basilar abnormality could be evolving edema or aspiration. Right subclavian catheter, tip in SVC.

Output: Cardiomegaly and possible right basilar opacity.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: EKG abnormaliities History: EKG Cardiomediastinal silhouette is normal. Lungs are clear of airspace and interstitial opacities. There is no pneumothorax.

Output: No cardiopulmonary abnormality


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: bilateral pigtails, hx of right PTX, left hemothorax. Eval for interval change History: asx Moderate to severe cardiomegaly, with mild interstitial edema and left lower lobe consolidation, unchanged.Small pleural effusions are stable.Bilateral pleural drains unchanged with no pneumothorax.Left subclavian ICD, leads unchanged in position.Right PICC, tip in the SVC.

Output: Unchanged cardiomegaly with edema and left lower lobe consolidation. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: Shortness of Breath History: Shortness of Breath Moderately severe cardiomegaly with ICD leads in place. The right atrial lead is directed towards the anterolateral wall of the atrium and the right ventricular lead tip is slightly above the ventricular apex. A resynchronization left ventricular lead is also present.Diffuse interstitial opacity with septal lines at the bases and small pleural effusions compatible with CHF.Multiple small nodular opacities predominantly in the upper lung zones many of which are calcified, and calcified mediastinal and hilar lymph nodes compatible with chronic granulomatous disease, most likely sarcoidosis or possibly silicosis.

Output: CHF.


Instruction: Generate impression based on medical findings.

Input: Lung transplant Mild COPD changes with post lung transplant surgical clips and sternotomy. No evidence of superimposed new acute abnormality

Output: Postsurgical changes without superimposed acute disease


Instruction: Generate impression based on medical findings.

Input: Male, 20 years old.Reason: r/o pna History: flu-like symptoms The lungs and pleural spaces are clear. Heart size is within limits of normal.

Output: Specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Male, 56 years old.Chest tube unclamped. Pneumothorax. Interval decrease in size of left inferolateral pneumothorax, with maximal pleural separation from the chest wall of about 5 mm. Small bilateral pleural fluid collections, on the left pleural fluid appears loculated.Multifocal airspace opacities, tubes and lines unchanged.

Output: Decreased size of left pneumothorax, now around 5 mm in size.


Instruction: Generate impression based on medical findings.

Input: Female, 55 years old.Shortness of breath Right chest port with tip in the SVC.Marked atelectasis of the left lower lobe, slightly improved compared to prior.Small right and moderate left pleural effusions.Obscured cardiomediastinal silhouette.

Output: Improved left lung atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: ETT repositioned History: ETT ET tube tip approximately 1 cm above the carina.Focal basilar opacity with atelectasis and probable small effusions, improved compared to previous.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Female, 20 years old.Reason: eval for pneumonia History: eval for aspiration Lower lung zone nodular opacities appear bronchocentric.No pleural effusions.Heart size normal.A feeding tube extends below the lower margin of the image, and the NG and ET tubes been removed.

Output: Lower lung zone opacities suggestive of aspiration given recent intubation, although atypical infection including viral etiologies are in the differential diagnosis.


Instruction: Generate impression based on medical findings.

Input: Female, 87 years old.Reason: consolidation History: consolidation LLL Enteric tube terminates in the distal gastric body.Stable cardiomegaly mediastinal silhouette.Interval increase in bilateral pleural effusions and basilar predominant air space opacities suggestive of pulmonary edema.

Output: Interval worsening of pulmonary edema and effusions.


Instruction: Generate impression based on medical findings.

Input: Age: 31 yearsGender: FemaleReason for Study: Reason: r/o opacity. Concern for acute chest History: sickle cell disease, cough The cardiac mediastinal silhouette is unremarkable.Perihilar and basilar mild interstitial opacities are similar to the prior exam and compatible with edema.No focal airspace opacities.No pleural effusions.Mild dextroscoliosis of the thoracic spine.

Output: Chronic appearing interstitial opacities similar to prior exam. No acute abnormalities identified. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o infiltrate History: sob Normal heart size with a marked scoliosis. No significant pulmonary abnormalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 78 years old.Reason: right chest tubes x 2 History: right chest tubes x 2 Two right chest tubes unchanged with improvement in a right pneumothorax although it remains moderate sized.Nonspecific atelectasis stable.

Output: Improvement in right pneumothorax with two right chest tubes in place.


Instruction: Generate impression based on medical findings.

Input: 60-year-old male with a history of a squamous cell cancer of the left nasal cavity, evaluate for metastases LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Mildly prominent pretracheal and subcarinal lymph nodes without definite evidence of hilar or mediastinal lymphadenopathyCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Small incidental bilateral renal cysts

Output: No evidence of metastatic disease


Instruction: Generate impression based on medical findings.

Input: Male, 74 years old.Shortness of breath. Right dual lumen chest port accessed by needles. Port catheter tip projects over the area of the SVC/RA junction. Left pacemaker with RA and RV leads, unchanged in position.Improved lung aeration with slightly decreased basilar lung opacities compatible with atelectasis/consolidation and effusions. No pneumothorax is evident.

Output: Slightly decreased basilar lung opacities.


Instruction: Generate impression based on medical findings.

Input: Home PICC, need confirmation of location. History of pulmonary fibrosis. Right upper extremity PICC projects over the SVC.Mild cardiomegaly.Reticulonodular appearance of the lung parenchyma and low normal lung volumes may be consistent with known ILD; assessment for lung nodules is markedly limited by technique.

Output: Right PICC projects over the SVC.


Instruction: Generate impression based on medical findings.

Input: Male, 19 years old.Shortness of breath. History of chronic PE and lupus. Unchanged cardiomegaly and enlargement central pulmonary vasculature. Moderate pulmonary edema-like opacities and pleural fluid. Embolization coils project over the upper abdomen. The abdomen was shielded.

Output: Moderate diffuse opacities most likely reflecting pulmonary edema. Lupus pneumonitis is considered less likely but is not excluded. Please refer to separately reported chest CT for further characterization.


Instruction: Generate impression based on medical findings.

Input: Female, 36 years old.Reason: eval for evidence of rib fx, or other cause of R sided rib pain History: R sided chest wall pain, pleuritic. Heart size is normal.Low lung volumes. Right lower lobe wedge-shaped opacity is consistent with a pulmonary infarct. There is no pleural effusion or pneumothorax.

Output: Right lower lobe opacity is consistent with a pulmonary infarct as seen on the subsequent CT.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Reason: sob History: sob Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Reason: assess for mass? pneumonia? History: SIADH - appears chronic Unremarkable cardiac and mediastinal silhouette. Multiple calcified upper zone nodules and calcified hilar and mediastinal lymph nodes compatible with previous infection.No sign of pneumonia or mass.

Output: Evidence of previous granulomatous infection with no active disease.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: s/p DC-PM implant --> r/o pneumothorax and evaluate lead positions History: as above Left subclavian dual chamber pacemaker placed, without complication. Leads are in appropriate position.Median sternotomy status post aortic valve placement.

Output: Left subclavian pacemaker placement, without complication.


Instruction: Generate impression based on medical findings.

Input: Permacath repositioning Interval near-complete removal of the right jugular dialysis catheter, tip projects outside the jugular into the neck soft tissues. The second right jugular catheter, tracheostomy tube, LVADs and ICD are all otherwise unchangedPersistent mildly decreased volumes with cardiomegaly and diffuse mild to moderate edema as well as nonspecific basilar opacities greater on the left; preventing exclusion of left lower lobe partial consolidation.

Output: Repositioning of one of the 2 right jugular catheters, currently extravascular


Instruction: Generate impression based on medical findings.

Input: Colostomy placement and shortness of breath Interval development of small effusions and basilar streaky densities suggesting atelectasis, however increased cardiac size representing moderate nonspecific cardiomegaly and vascular redistribution raise concern for early mild CHF. Serial imaging will be important to exclude.Extensive calcified hilar lymphadenopathy consistent with old healed granulomatous disease exposure

Output: Questionable early mild CHF and new cardiomegaly


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: sob, eval for chf History: sob Mild cardiomegaly.Increased interstitial markings, more so than 2/3/2016, suggestive of edema or aspiration.Bronchial wall thickening may be present.Possible small pleural effusions.

Output: Increased markings suggestive of edema with bronchial wall thickening and small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: History of pancreatic cancer. Status post Whipple procedure. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: In reference prevascular lymph node measures 9 x 6 mm on image number 32, series number 1447.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: New hepatic lesion measuring 10 x 12 mm image number 73. Pneumobilia and mild biliary prominence persists.SPLEEN: No significant abnormality noted.PANCREAS: Status post Whipple procedure. Body and tail of the pancreas are unremarkable. Soft tissue infiltration around the porta hepatis and SMA and SMV likely representing tumor infiltration is unchanged. Stenosis of the SMV close to the portal confluence is also unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Prison described soft tissue infiltration the retroperitoneum is unchanged.BOWEL, MESENTERY: Entire colon and small bowel demonstrates extensive wall thickening and edema, unchanged. This may secondary to congestion versus infection. Stenosis of the SMV close to the confluence may be secondary to chronic thrombus versus tumor invasion.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: No significant abnormality noted.OTHER: Small amount of ascites.

Output: Status post Whipple surgery. Extensive wall thickening involving the entire gastrointestinal tract, congestion versus infection, is unchanged. New hepatic metastases.Infiltrative soft tissue in the retroperitoneum and around the porta hepatis is also unchanged.


Instruction: Generate impression based on medical findings.

Input: Reason: Compare to prior - left upper lobe pneumothorax History: possible pneumothorax Probable moderate anterior left pneumothorax. Left subclavian catheter tip in the SVC.Right jugular catheter tip also in the SVC.ET tube tip approximately 4 cm above the carina.Left retrocardiac opacity compatible with atelectasis and effusion.Subcutaneous air in the left supraclavicular region.

Output: Probable moderate anterior left pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 32 years old.Reason: evidence of fluid overload or infection History: hypoxia Right central venous catheter terminates in the SVC. Bilateral interstitial opacities and small bilateral effusions are not significantly changed. No pneumothorax. Moderate cardiomegaly is unchanged. Interval decrease in the size of the upper quadrant bowel loops.

Output: No significant change in small bilateral pleural effusions and interstitial opacities compatible with edema.


Instruction: Generate impression based on medical findings.

Input: Male, 84 years old.Reason: intubated History: intubated Unchanged left basilar atelectasis.No specific evidence of edema.An NG tube extends into the distal stomach but may be coiled in the hypopharynx.ET tube tip approximately 3 cm above the carina.Right jugular catheter, tip in SVC.Left subclavian pacemaker, leads unchanged in position.

Output: Unchanged left basilar atelectasis. The NGT may be coiled in the hypopharynx.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: hx of bladder cancer, evaluate for metastatic disease History: see above Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No evidence of metastases.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 64 yearsGender: FemaleReason for Study: Reason: F/u placement pigtail catheter History: Chronic L-sided pleural effusion Left pigtail catheter has been removed.Bilateral central venous catheters unchanged.Stable cardiac enlargement with prominence of the pulmonary artery similar to the prior exam.Bilateral pleural effusions, left greater than right, and left basilar consolidation/atelectasis redemonstrated.

Output: Liver removal of the left chest pigtail catheter. Stable cardiopulmonary appearance. No pneumothorax identified.


Instruction: Generate impression based on medical findings.

Input: Age: 68 yearsGender: MaleReason for Study: Reason: eval ETT, lung fields History: s/p MVR, afib ablation Right-sided chest tubes identified with the tips directed inferiorly.It is noted that one of the chest tubes the side-port is extrathoracic in location.No pneumothorax identified.Probable pneumomediastinum.ET tube with its tip 4 cm above the carina.Right IJ venous catheter with its tip in the SVC.Stable cardiac enlargement with left pleural effusion and left-sided pulmonary opacities compatible with edema.Basilar atelectasis left greater than right.

Output: Postoperative chest with moderate amount of left pleural fluid and left-sided pulmonary opacities compatible with edema.Basilar atelectasis more prominent on the left.Right-sided chest tubes with one of the tubes at the side port extrathoracic in location.


Instruction: Generate impression based on medical findings.

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

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: eval right pleural effusion History: As above Stable bibasilar opacities and pleural effusions, right greater than left. Unchanged iatrogenic devices. No pneumothorax. Unchanged heart size.

Output: No substantial difference compared to previous study.


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: recent surgery; low-grade fever History: low-grade fever Mild cardiomegaly status post sternotomy.Small lung volumes with small pleural effusions.No specific evidence of infection or edema.Right jugular Swan Gantz biventricular ICD, leads in appropriate positions.

Output: Small pleural effusions, but no specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Newborn 22 week gestational age patient with respiratory distress and possible pneumothorax.VIEW: Chest right lateral decubitus (one view) 04/30/16, 2239 Endotracheal tube tip is at carina. Umbilical venous line has its tip in right atrium. Umbilical arterial line tip is at T9.Cardiothymic silhouette is normal. No pneumothorax is seen. Hazy lung opacities are noted.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: follow up chest tube History: chest tube 1 of the 2 right-sided chest tubes has been removed. There is no change in the right hydropneumothorax. Left lung stable.

Output: 1 of the 2 right-sided chest tubes has been removed. There is no change in the right hydropneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: new fever, please evaulate for PNA History: as above Cardiomegaly with mild nonspecific basilar opacity which may represent aspiration and/or atelectasis. Small right pleural effusion.

Output: Findings suggestive of CHF with possible infection or aspiration of the lung bases.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: intubated and sedated History: above ET tube tip approximately 2 cm above the carina.Catheter tip in the SVC.NG tube tip in the stomach with the sidehole at the GE junction.Small lung volumes with nonspecific basilar opacity compatible with atelectasis and consolidation.

Output: Lines stable. No change in basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Age: 66 yearsGender: MaleReason for Study: Reason: eval IABP placement History: Subclavian IABP Left-sided ICD and IVP marker unchanged.Stable cardiac enlargement.Perihilar/basilar interstitial opacities, right greater than left, similar to the prior exam.No new pulmonary opacities identified.

Output: Support devices unchanged with IABP marker in the proximal descending aorta. Stable cardiopulmonary appearance with cardiomegaly and pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: eval lung fields History: s/p MVR One right IJ sheath has been removed. Interval extubation and removal of the nasogastric tube. 2 right-sided chest tubes are unchanged in position. A complete mitral annuloplasty ring remains in place.Stable cardiomegaly. Increasing airspace opacities favoring edema. Right greater than left small pleural effusions. No pneumothorax.

Output: Increasing pulmonary opacities favoring edema with right greater than left pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Reason: iabp placement History: none Cardiomegaly, without edema or pleural effusions.Left subclavian ICD unchanged.IABP proximal marker projects over the aortic arch.

Output: Unchanged support devices. Cardiomegaly, without edema.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o acute chest History: sickle cell; VOC Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: 44 year old female with shortness of breath. Streaky left basilar opacities are consistent with atelectasis/scarring. There is no pleural effusion or pneumothorax. The bones and upper abdomen are unremarkable.

Output: Mild left basilar atelectasis/scarring.


Instruction: Generate impression based on medical findings.

Input: Reason: aspiration History: hypoxia Dense bilateral predominantly upper zone airspace opacity compatible with aspiration and infection, unchanged. Catheter tip in the SVC. No new findings.

Output: Diffuse predominantly upper zone opacity compatible with aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: CXR History: Generalized abdominal pain. The heart size is normal. The thoracic aorta is tortuous. There is no focal pulmonary opacities, pleural effusion, or pneumothorax. Hiatal hernia is again noted.

Output: No acute cardiopulmonary abnormality on radiography.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, 96 years old.Fever, cough. Small lung volumes with increased basilar opacity, partly due to atelectasis and possibly due to edema. There are questionable small bilateral pleural effusions. No pneumothorax. The heart size is upper limits of normal.

Output: Bibasilar opacities which may reflect mild CHF or possibly aspiration; a PA/lateral radiograph is recommended for further evaluation when feasible.


Instruction: Generate impression based on medical findings.

Input: Female, 52 years old.Reason: ETT placement History: tachypnea Interval intubation with the endotracheal tube 5 cm above the carina. Stable position right central catheter.Increasing perihilar patchy opacities favoring edema. Likely trace pleural effusions. Cardiac silhouette is now obscured.

Output: Progressive perihilar opacities suggestive of worsening edema.


Instruction: Generate impression based on medical findings.

Input: Male, 21 years old.Reason: hypoxemia History: hypoxemia Pleural effusions in the lower lung zone edema pattern with left lower lobe atelectasis slightly worse.ET tube tip approximately 2 cm above the carina.NG tube high, the side port above the GE junction. Left subclavian catheter, tip in SVC.Right upper quadrant drainage catheter.

Output: Pleural effusions, edema and left lower lobe atelectasis, the latter slightly worse.


Instruction: Generate impression based on medical findings.

Input: FAP syndrome. Stage III colon cancer completed treatment on 8/04. 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: Several scattered hepatic hypodensities are unchanged in size, all subcentimeter. Cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: A 13 x 8 mm left adrenal nodule (series 3, image 73) is unchanged from 2/4/04.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: One wall of a nonobstructed loop of bowel protrudes through a ventral incisional hernia (series 3, image 118). Colectomy with ileorectal anastomosis. Prominent lymph nodes just superior to the anastomosis are relatively stable.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The left ovary is enlarged with multiple small follicles, though the dominant cyst has resolved.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: Overall stable examination.Enlarged left ovary with resolution of the dominant cyst.


Instruction: Generate impression based on medical findings.

Input: Female, 98 years old.Reason: hydropneumothorax s/p thora on 8/24, please eval History: pleural effusion Enlarging left pleural effusion but no pneumothorax today.Impression of the left lung base is unchanged.Right lung unremarkable.

Output: No significant pneumothorax. Reaccumulating left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: 65-year-old female with history of renal cancer CHEST:LUNGS AND PLEURA: Calcified left lower lobe nodule is unchanged. Linear atelectasis in the left lower lobe are also unchanged.MEDIASTINUM AND HILA: Calcified mediastinal and left hilar lymph nodes are unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post partial left nephrectomy. No evidence of recurrence. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: No significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: Age: 36 yearsGender: FemaleReason for Study: Reason: pt with severe chest pain after amphotericin, eval pulm edema, pulm abnormalities History: as above Decreased lung volumes with stable cardiomediastinal silhouette.Right central venous catheter has been removed.Decreased lung volumes with scattered areas of scarring/discoid atelectasis and nonspecific interstitial opacities similar in appearance to the prior exam.No new focal areas of consolidation.No large pleural effusions.Skeletal abnormalities compatible sickle cell disease.Contrast identified in the splenic flexure.

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


Instruction: Generate impression based on medical findings.

Input: Reason: evaluate for bronchitis History: chronic cough Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.

Output: No significant abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 59 yearsGender: FemaleReason for Study: Reason: ro asp History: sob Decreased lung volumes with stable cardiomediastinal silhouette.No focal areas of consolidation.No pleural effusions.

Output: No acute cardiopulmonary abnormalities identified without interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 26 years old.Reason: ARDS, intubated, tube placement History: as above Cardiomegaly, with pulmonary opacities improving in the left lower lobe.ET tube tip approximately 6 cm above the carina.Right jugular catheter, tip in SVC.An NG tube extends below the lower margin of the image.

Output: Improving pulmonary opacities.


Instruction: Generate impression based on medical findings.

Input: Male, 53 years old.Reason: pre-op History: pre-op Moderate multichamber cardiomegaly.Small pleural effusions and mild basilar interstitial opacities may represent edema although mild chronic basilar fibrosis is also possible. No specific evidence of infection.

Output: Moderate cardiomegaly with small pleural effusions. Basilar interstitial opacities could be a combination of edema and fibrosis, but there is no evidence of infection.


Instruction: Generate impression based on medical findings.

Input: 88 year-old male with prostate cancer. Pelvic pain, lymphadenopathy CHEST:LUNGS AND PLEURA: The lungs are emphysematous. Small bilateral pleural effusions are identified, right greater than left. Scarring is noted in the apices. Calcified left lower lobe granuloma.MEDIASTINUM AND HILA: Enlarged lymph nodes are seen in the bilateral supraclavicular regions and as well as throughout the mediastinum. Some of these lymph nodes are calcified. For reference purposes, a paratracheal lymph node measures 2.1 x 1.6 cm (series 3; image 65).Cardiomegaly. Pacemaker. Diffuse aortic and coronary calcifications. Scattered ulcerative plaques are identified throughout the aorta.CHEST WALL: Diffuse osseous metastasesABDOMEN:LIVER, BILIARY TRACT: Calcified granulomataSPLEEN: Calcified granulomataPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypodense renal lesions are seen bilaterally, the largest of which are definitively cysts. Some of these lesions are too small to characterize. Bilateral cortical scarring is identifiedRETROPERITONEUM, LYMPH NODES: Several mildly enlarged mesenteric and retroperitoneal low-density lymph nodes are seen, increased in size. For reference, a periaortic lymph node measures 18 x 14 mm (series 3; image 127), previously 14 x 10 mm.Aortobiiliac stent graft is again identified. The aneurysm sac has slightly increased in size from measuring 3.9 x 3.8 mm (series 3; image 142), previously 3.5 x 3.5 cm. the graft remains patent.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse osseous metastasesOTHER: Atherosclerotic disease is noted, affecting the origins of the renal arteries. Mild narrowing of the origin of the celiac artery is noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder diverticulum.LYMPH NODES: Enlarged right external iliac lymph node is identified, increased in size.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse osseous metastasesOTHER: Mild ascites.

Output: Diffuse osseous metastasesDiffuse adenopathy, which has progressed in the abdomen. No comparisons available for the thoracic adenopathy, which could be due to granulomatous disease and/or metastatic disease.Mild increase in the size of the aneurysm sac status post EVAR


Instruction: Generate impression based on medical findings.

Input: Male, 52 years old.Shortness of breath. Lung volumes are lower. Persistent left lower lobe opacity consistent with atelectasis, pneumonia, or aspiration. Small left pleural effusion again noted. Increased diffuse pulmonary opacity. Superior margin of the intra-aortic balloon pump terminates 4 to 5 cm from the top of the aortic arch, as before. Other lines and tubes are not substantially different compared to previous study.Unchanged heart size.

Output: Increase in diffuse pulmonary opacity which may at least be partially related to lower lung volumes. Findings may represent pulmonary edema. This can be reevaluated at the time of imaging follow-up.Persistent left lower lobe opacity consistent with atelectasis, pneumonia, or aspiration. Small left pleural effusion, as before.