Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: 46F altered at baseline, now AOx0; minimally responsive, eval for infection vs fluid overload History: as above Cardiomegaly with basilar opacities particularly retrocardiac as well as mild interstitial opacities more superiorly. While pulmonary edema is a consideration, aspiration/infection is also a likely possibility. No pneumothorax.

Output: Findings are suspicious for aspiration/pneumonia, possibly with superimposed edema.


Instruction: Generate impression based on medical findings.

Input: Reason: SOB with desaturation to 80's , now on NRB, check for fluid overload History: SOB Moderate cardiomegaly.Mild scarring of the right base and no acute findings.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.SOB and cough. Reticulonodular opacities in the dependent left lung consistent with aspiration bronchiolitis. These are new from the CT scan of 8/3/2015. Linear scarring in the left lung. Right chest port tip at the superior cavoatrial junction. Tracheostomy tube in place. No pleural fluid or pneumothorax. Lower thoracic spine vertebral body wedging.

Output: Aspiration bronchiolitis. If the patient remains symptomatic, short-term follow-up may be obtained in one week to exclude development of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Chest pain No cardiopulmonary abnormality

Output: Normal


Instruction: Generate impression based on medical findings.

Input: 69-year-old male. Guaiac-positive on exam history diarrhea for several weeks. Had virtual colonoscopy ? lesion transverse colon and sigmoid colon. Endoscopy sigmoid colon mass biopsied adenocarcinoma. CHEST: LUNGS AND PLEURA: Granuloma right lower lobe. No lung nodules or effusions.MEDIASTINUM AND HILA: Heavy granulomatous calcifications in the left hilum and subcarinal area. Coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN: LIVER, BILIARY TRACT: Please discrete mass is seen in the right lobe and medial segment of the left lobe. Largest lesion is seen in segment 5, measured on series 5 image 79/216, 3.4 x 2.9 cm. Lesion in segment 8 as measured on series 5 image 67, 2.5 x 1.9 cm.SPLEEN: Scattered calcific granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Extensive calcification of renal artery branches corresponding to highly reflective echoes seen on ultrasound. Simple cyst left lower pole.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification aorta. No evidence of aneurysm. Small shotty nodes. Number pathologic by size criteria.BOWEL, MESENTERY: No significant abnormality noted. Patient's reported neoplasm in the transverse colon cannot be identified on this exam. No evidence of ascites or carcinomatosis.BONES, SOFT TISSUES: Multilevel laminectomies. No evidence of lytic or blastic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Fat infiltration around the sigmoid colon with asymmetric wall thickening in the rectosigmoid on series 5 image 175 likely representing patient's known colonic neoplasm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Findings consistent with hepatic metastases. Heavy atherosclerotic disease. Granulomatous disease.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: syncope History: syncope No significant cardiopulmonary abnormality.Stable large right sided goiter.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: SOB at rest, wheezing on exam History: See above Cardiomegaly with bronchial wall thickening and interstitial opacities suggestive of aspiration or edema.No specific evidence of infection.Left subclavian ICD, leads unchanged in position.Right jugular catheter, tip in SVC.

Output: Bronchial wall thickening and interstitial opacities suggestive of edema or aspiration.


Instruction: Generate impression based on medical findings.

Input: Male, 27 years old.PA catheter placement. Lungs are clear. Heart size within normal limits. Right IJ Swan-Ganz catheter tip in the main PA. No pneumothorax or pleural effusions.

Output: Right IJ Swan catheter tip over the main PA. Clear lungs.


Instruction: Generate impression based on medical findings.

Input: Female, 28 years old.Reason: pleuritic chest pain History: see above Harrington rods are noted with mild-to-moderate residual thoracolumbar spinal curvature. Patchy right basilar opacity with small right pleural effusion. Left lung is clear. Mild cardiomegaly. No pneumothorax.

Output: Patchy right basilar opacity which may represent aspiration or pneumonia with small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 58 years old.Reason: SOB History: As above Line position stable. No significant change in bilateral perihilar and basilar opacities and small effusions.

Output: No significant interval change


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.History of hypoxia and shortness of breath. Enteric tube tip in the stomach body. Sternotomy fixation sutures noted.The cardiac silhouette is enlarged but stable.Bilateral pleural effusions are noted. Bilateral interstitial and airspace opacities are worsening.

Output: Bilateral pleural effusions with worsening edema and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Restrictive cardiomyopathy Interval extubation. Right jugular catheter again terminates in the mid SVCThe underlying cardiopulmonary appearance is significant for increasing patchy opacities more pronounced now in the right lung with mild improvement of the left lower lung. Moderate nonspecific cardiomegaly with moderate poorly visualized effusionsSpinal fixation chest wall distortion all similar given differences in positioning

Output: Shifting suspected pulmonary edema with overall mild interval increase


Instruction: Generate impression based on medical findings.

Input: 56-year-old female with carcinoma, status post right colectomy in 10/2006. 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: Subcentimeter hypodense lesion in the liver, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: 19 x 12 mm right adrenal nodule is unchanged.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 significant change from previous study.


Instruction: Generate impression based on medical findings.

Input: 50 year-old male with T-cell acute lymphocytic lymphoma with massive lymphadenopathy CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Extensive mediastinal and hilar adenopathy. An index anterior mediastinal node measures 1.8 x 1.7 cm on image number 36, series number 5.CHEST WALL: Extensive bilateral axillary and neck adenopathy. Index right axillary adenopathy measures 6.3 by 3.1 cm on image number 22, series number 5.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Spleen measures 13 x 8 .4 cm, borderline enlarged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: There are borderline enlarged retroperitoneal lymph nodes. An index left para-aortic node measures 9 by 9-mm image number 134, series number 5.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Enlarged bilateral para-iliac, obturator and inguinal adenopathy. Index right para-iliac lymph node measures 1.4 x 1 centimeter image number 160, series number 5. Another index right inguinal adenopathy measures 3.5 by 3.1 cm in image number 214, series number 5.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Mediastinal, hilar, neck, bilateral axillary, retroperitoneal and pelvic adenopathy as described above.Borderline splenomegaly.


Instruction: Generate impression based on medical findings.

Input: Reason: assess ETT position History: recent urgent overnight transportation ET tube tip approximately 1 cm above the carina.Dense airspace opacity in the left lower lobe and subsegmental atelectasis on the right, suggestive of aspiration.

Output: Low position of ET tube.


Instruction: Generate impression based on medical findings.

Input: HIV positive. Chest pain. Check for pneumonia Diffuse and largely interstitial fibrotic changes throughout all 4 quadrants greater in the right upper lobe and left lung base. No distinct superimposed focal airspace process, however small subtle changes can be missed without prior exams for comparison. Serial imaging is needed given patient's history and clinical question posed. The cardiac and mediastinal contours are grossly within limits given rotation

Output: Suspected extensive diffuse fibrotic changes without definite superimposed acute abnormality however exam severely limited without prior for comparison


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Reason: pls assess swan plcmt History: swan Swan-Ganz catheter tip in proximal right interlobar pulmonary artery. Other support hardware stable. Stable cardiomegaly.

Output: Swan-Ganz catheter tip in proximal right interlobar pulmonary artery.


Instruction: Generate impression based on medical findings.

Input: Age: 63 yearsGender: MaleReason for Study: Reason: IABP placement History: see above IABP marker in the aortic arch unchanged.Stable mild cardiac enlargement with atherosclerotic changes of the aorta.The lungs are clear.No pleural effusion.

Output: IABP marker in the aortic arch unchanged. No acute cardiopulmonary abnormality identified.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: Intubated, Check pulmonary status History: Intubated, Check pulmonary status Lines and tubes are unchanged. Low lung volumes makes detailed cardiopulmonary assessment difficult. Mild interstitial pulmonary edema again noted, slightly worse. Small pleural effusions Unchanged cardiomegaly. No pneumothorax.

Output: Slight increase in interstitial pulmonary edema. Small pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Dobbhoff tube placement confirmation Dobbhoff tube coiled in proximal stomach. Paucity of bowel gas. Please refer to concomitant chest radiography for additional findings.

Output: Dobbhoff tube coiled in proximal stomach.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.History of increased work of breathing, evaluate for pulmonary edema. The cardiomediastinal silhouette is stable.Bilateral pleural effusions with overlying interstitial pulmonary opacities are unchanged.

Output: No significant interval change.


Instruction: Generate impression based on medical findings.

Input: Male, 60 years old.Reason: eval for infiltrate, pulm edema History: c/f sepsis No acute cardiopulmonary abnormality.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 42 yearsGender: MaleReason for Study: Reason: pneumonia History: SOB after 5 days of URI symptoms Stable cardiomediastinal silhouette.Lungs are clear.No pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Male, 68 years old.Reason: assess for infiltrate History: alcohol withdrawal, stopped drinking 4 days ago, Clear lungs. No pleural effusion or pneumothorax. No acute bony abnormality. Normal heart size. Aortic atherosclerosis.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Male, 29 years old.Reason: chest tube placement History: s/p L VATS robotic neurofibroma resection Left apical chest tube remains in place. Small left-sided pleural effusion again noted. No convincing evidence of significant left-sided pneumothorax. Right lung remains clear. Unchanged heart size. Mild left-sided subcutaneous emphysema, as before.

Output: Left apical chest tube remains in place. No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: intubated, developing leukocytosis History: as above ET tube tip approximately 5 cm above the carina.Bilateral venous catheters unchanged. Left lower lobe atelectasis and consolidation.No new findings.

Output: Left lower lobe consolidation and atelectasis, likely related to aspirated secretions.


Instruction: Generate impression based on medical findings.

Input: Female, 73 years old.Reason: s/p thoracotomy, chest tube History: ptx, htx Right apical chest tube is again noted. This appears to have been slightly repositioned. No pneumothorax. Improvement in left basilar atelectasis. Mild right-sided subcutaneous emphysema. Unchanged heart size.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Headaches SHUNT DEVICE: An intracranial shunt device exits via a left frontal burr hole, courses down the left neck, left chest posteriorly, enters the abdomen and terminates within the central pelvis anteriorly. The course of the shunt device is similar to the prior examination. Portions of the shunt overlying the calvarium are radiolucent which limits evaluation however within these limits there is no evidence of discontinuity or kinking. The valve configuration is also similar to the prior exam measuring 170 mm of water.SKULL: No significant abnormality noted.CERVICAL SPINE: No significant abnormality noted.CHEST: No significant abnormality noted.ABDOMEN: No significant abnormality noted.

Output: VP shunt appearing similar to the prior exam without evidence of complication.


Instruction: Generate impression based on medical findings.

Input: Female, 25 years old.Abdominal discomfort. History of colitis. No focal airspace opacity, pleural effusions or pneumothorax. Normal cardiomediastinal silhouette.There is an irregular mucosal appearance and mural contour of the transverse and sigmoid colon which appears featureless suspicious for a nonspecific colitis.No gross pneumoperitoneum.

Output: There is an irregular mucosal appearance and mural contour of the transverse and sigmoid colon which appear featureless suspicious for a nonspecific colitis.


Instruction: Generate impression based on medical findings.

Input: Male, 34 years old.Hypoxemia. ET tube retraction. ETT tip 4 cm above the level of the carina.Bronchial wall thickening and hazy nodular opacities in the right lung consistent with acute aspiration.Enteric tube tip off the caudal margin of the film.Unchanged cardiomediastinal silhouette, consistent with history of complex congenital heart disease.

Output: ETT tip 4 cm above the carina. Signs of acute aspiration into the right middle and lower lobes.


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old.Reason: Tube placement History: hypercarbic respiratory failure Left chest tube, tip in apex with no pneumothorax.Left chest wall soft tissue emphysema is present extending to both sides of the neck and right supraclavicular area.ET tube tip approximately 4 cm above the carina.

Output: Left chest tube with no pneumothorax. ET tube tip approximately 4 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Prolonged cough and right-sided pain, exclude pneumonia. Scarring in the lung bases, right greater than left. Mild elevation of the left hemidiaphragm. Upper normal heart size. Probable emphysema.Within the right lung base, peribronchial opacities have progressed laterally but slightly improved more medially; these been present to varying extents on multiple examinations and although recurrent aspiration pneumonias possibility of the lack of clearance and chronicity is suspicious for endobronchial spread of neoplasm such as a mucinous adenocarcinoma which cannot be excluded.

Output: Chronic opacities in the right lower lobe with slow progression. Although this most certainly a component of chronic recurrent aspiration involved, indolent endobronchial spread of neoplasm (mucinous adenocarcinoma) cannot be excluded. Recommend chest CT and pulmonary medicine consultation for possibility of bronchoscopic evaluation.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: rule out chest metastasis History: hx of renal cell carcinoma, sp nephrectomy Unchanged cardiomediastinal silhouette, within normal limits. Large lung volumes. There is a retrosternal nodular opacity suspicious for a pulmonary nodule. A vascular stent projects over the upper mediastinum, just to the right of midline.

Output: Findings compatible with COPD, similar to prior. There is a retrosternal nodular opacity suspicious for a pulmonary nodule. CT is recommended for further evaluation of this finding.


Instruction: Generate impression based on medical findings.

Input: Female, 50 years old.Reason: Pulmonary edema Elevation the right hemidiaphragm again noted. Patchy basilar opacities with probable small pleural effusions. Moderate cardiomegaly, as before. No pneumothorax.

Output: Small pleural effusions with patchy basilar opacities which certainly could represent mild pulmonary edema versus atelectasis and/or aspiration.


Instruction: Generate impression based on medical findings.

Input: Reason: Follow up pnuemothorax History: pneumothorax Slightly increased right pneumothorax with the apex of the lung 3 cm from the chest wall.Upper zone predominant chronic interstitial disease, previously characterized by CT scan.

Output: Increased right pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: SOB, ho CHF History: SOB Normal heart size with pacemaker leads in place, unchanged from previous.No significant pulmonary modalities.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 64 yearsGender: MaleReason for Study: Reason: eval lun gfields History: preop Left-sided ICD with lead wires in the right atrial appendage, coronary sinus, and right ventricle.Right PICC line with its tip in the RA/SVC.Cardiac enlargement with pulmonary vascular redistribution.Perihilar/basilar edema and pleural effusions.Median sternotomy is intact with evidence of valvular replacements.

Output: Moderate/marked CHF.


Instruction: Generate impression based on medical findings.

Input: Age: 69 yearsGender: FemaleReason for Study: Reason: renal cancer surveillance History: as above The cardiomediastinal silhouette is unremarkable.Minimal left basilar scarring/discoid atelectasis.No focal areas of consolidation.No suspicious nodules or masses.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified. No evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Reason: intubated History: intubated ET tube tip approximately 2 cm above the carina with the neck in a flexed position.Catheter tip in the SVC.Diffuse nonspecific airspace and interstitial opacity, not significantly changed, with probable small pleural effusions.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old status post laparoscopy with left upper quadrant peritoneal biopsy, please evaluate for pneumothorax. Stable cardiomediastinal silhouette with mitral valve prosthesis.Low lung volumes. No new pulmonary opacity, pleural effusion or pneumothorax. Mild basilar scarring, unchanged.

Output: No pneumothorax.


Instruction: Generate impression based on medical findings.

Input: 75-year-old male with history of prostate cancer and rising PSA CHEST:LUNGS AND PLEURA: Scattered areas of pleural thickening and calcified plaques are again noted, most prominent in the right upper lobe. Referenced right lower lobe, 8mm nodule is unchanged on image number 84, series number 5.MEDIASTINUM AND HILA: Calcified right hilar and mediastinal adenopathy is unchanged.Heterogeneous, enlarged left lobe of thyroid extending into the superior mediastinum is unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hypodense lesion in the lateral segment of the left lobe of the liver is stable measuring 18 x 11 mm image number 85, series number 3. No etiology of this lesion is unknown. Other small, nonspecific hypodense lesions throughout the liver, are also stable. Reference lesion in the right lobe measures 15 x 12 nodes on image number 102, series number 3, slightly smaller compared to previous study. Hyperdense lesion in the inferior aspect of the right lobe of the liver, likely representing hemangioma is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small cysts are stable.RETROPERITONEUM, LYMPH NODES: Slight interval increase in the size of the retroperitoneal lymph nodes. A left para-aortic lymph node on image number 120, series number 3, now measures 14 x 12 mm. Previously closed, measuring 7 by 8mm image number 124, series number 3. Reference lymph node measures 8 by 8mm on image number 139, series number 3, not significantly changed from previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: New sclerotic lesion in the right lateral fourth anterior rib, suspicious for metastatic disease.Interval increase in the size of the lytic/sclerotic lesion in the left transverse process of T9 vertebral body.Other punctate sclerotic foci in the lumber vertebral bodies are unchanged.PELVIS:PROSTATE, SEMINAL VESICLES: Post prostatectomy without a mass.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic focus in the left anterior sacrum is unchanged. However, sclerotic focus in the left iliac bone on image number 182, series number 3 is more prominent than suspicious for progression of metastatic disease.OTHER: No significant abnormality noted

Output: Minimal interval increase in some of the retroperitoneal lymph nodes. New sclerotic bone lesions and minimal increase in the size of existing lesions, suspicious for metastatic lesions.


Instruction: Generate impression based on medical findings.

Input: Age: 27 yearsGender: MaleReason for Study: Reason: eval for PNA History: pt with hx of cough and sputum Decreased lung volumes with stable mild cardiac enlargement.Lungs are clear.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: weight loss. Smoker, question decreased breath sounds left base. Evaluate History: as above Normal heart size with a tortuous aorta.Large lung volumes, suggestive of COPD.No sign of pulmonary nodules or other significant change.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Age: 30 yearsGender: FemaleReason for Study: Reason: r/o pulm edema, pna, effusion History: shortness of breath, esrd Stable cardiac enlargement with prominence of the pulmonary artery compatible with pulmonary arterial hypertension.Mild pulmonary vascular redistribution.No focal airspace opacities.No pleural effusions.

Output: Cardiomegaly and pulmonary vascular redistribution without specific evidence of edema or infection.


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.History of aspiration. Stable cardiomediastinal silhouette. Low lung volumes with bilateral subsegmental atelectasis. Median sternotomy hardware and surgical clips in the left axilla are unchanged. No focal airspace opacity, significant pleural effusion, or pneumothorax.

Output: Low lung volumes with subsegmental basilar atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: s/p thoracentesis, please assess for pneumothorax Decrease in size of right pleural effusion. No significant pneumothorax. Left basilar pleuroparenchymal opacity, not substantially changed. No new focal pleural parenchymal opacity. Unchanged cardiomegaly. Iatrogenic devices are unchanged.

Output: Decrease in size of right pleural effusion. No significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: status post IVC filter placement 2/19 History: same Status post sternotomy for aortic valve replacement with chest tubes but no pneumothorax.Dense perihilar opacities could be edema although aspiration is also likely.Pleural effusions unchanged.Tracheostomy tube tip approximately 5 cm above the carina.

Output: Unchanged perihilar opacities which could represent edema and aspiration.


Instruction: Generate impression based on medical findings.

Input: ETT check Mild ETT repositioning an retraction, tip currently projects 5 cm from the carina. Right jugular catheter and NG are otherwise unchanged. More upright positioning likely accounts for differences in cardiopulmonary appearance with decreased layering of moderate effusions and basilar edema

Output: ETT repositioned


Instruction: Generate impression based on medical findings.

Input: Female, 49 years old.Reason: Evaluate for infiltrate History: fever, post-op Left lower lobe consolidation consistent with infection or atelectasis from mucous plugging, accompanied by left pleural effusion.Postoperative pneumoperitoneum.Right jugular catheter, tip in SVC.

Output: Left lower lobe opacity consistent with infection.


Instruction: Generate impression based on medical findings.

Input: Male, 83 years old.Reason: cause of SOB History: SOB Heart size normal.Basilar scarring unchanged with no specific evidence of infection or edema.No change in appearance of old healed right-sided rib fractures.No pleural effusion. No pneumothorax.

Output: No specific evidence of infection or edema. Findings stable compared to prior study.


Instruction: Generate impression based on medical findings.

Input: Male, 61 years old.Recto sigmoid neoplasm. Coronary atherosclerosis. Follow-up. Former smoker. Small lung volumes. Retrocardiac opacity with nonvisualization of the airway, most likely atelectasis. Patchy atelectasis elsewhere. No pneumothorax.

Output: Basal atelectasis.


Instruction: Generate impression based on medical findings.

Input: Bronchiectasis No cardiopulmonary abnormality observed.

Output: Normal


Instruction: Generate impression based on medical findings.

Input: 49-year-old female with history of Hodgkin's lymphoma status post chemotherapy complicated by organizing pneumonia. CT for restaging. CHEST:LUNGS AND PLEURA: Resolution of previously noted left upper lobe consolidation. No new areas of consolidation. No suspicious nodules or masses. No pleural fluid.MEDIASTINUM AND HILA: No pathologically enlarged hilar or mediastinal lymph nodes. Cardiac size is normal. No pericardial fluid.CHEST WALL: Multiple prominent axillary lymph nodes bilaterally, unchanged to smaller. A reference right axillary node measures 1.1 x 0.8 cm on axial image 20/217 which is smaller when compared to the prior exam where it measured 1.5 x 0.8 cm.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Cystic right adnexal structures are grossly unchanged.BLADDER: No significant abnormality noted.LYMPH NODES: Bilateral obturator adenopathy has not significantly changed in the interval. A reference left obturator node measures 1.6 x 3 .3 cm on axial image 178/217, grossly unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: 1.Unremarkable examination of the lungs with no evidence of new consolidation.2.Stable to smaller axillary and pelvic adenopathy as described above.3.No other significant interval change.


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.Reason: r/o PNA vs. vol overload History: hypoxic, decreased breath sounds o R Median sternotomy with mild cardiomegaly.Increasing right-sided opacity including a new probable right upper lobe pneumonia as well as a right subpulmonic effusion with overlying atelectasis.IVC double-lumen catheter has migrated through the tricuspid valve into the pulmonary outflow tract.

Output: 1. New right upper lobe pneumonia, with persistent right base atelectasis overlying a right pleural effusion.2. IVC catheter migrated to the pulmonary outflow tract.


Instruction: Generate impression based on medical findings.

Input: Female, 56 years old.Reason: eval for edema History: lower extremity swelling and sob Cardiomediastinal silhouette is within normal limits. No pleural effusions or pneumothorax. No focal pulmonary opacity.

Output: No specific evidence of edema. No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 64 yearsGender: MaleReason for Study: Reason: pneumothorax status History: pneumothorax, chest tube Right-sided chest tube has been repositioned with its tip directed medially in the right mid thorax.There is demonstration of a moderate size right apical pneumothorax.Stable cardiac mediastinal silhouette.Left retrocardiac opacity compatible with consolidation/atelectasis.Multiple calcified gallstones identified in the right upper abdomen.

Output: Interval repositioning of the right-sided chest tube. A moderate size right-sided pneumothorax is identified.


Instruction: Generate impression based on medical findings.

Input: Age: 65 yearsGender: MaleReason for Study: Reason: 65yo M with HnC now hypotensive. History: hypotension Right Port-A-Cath with its tip in the SVC.The cardiomediastinal silhouette is unremarkable.Lungs are clear.Pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.Reason: SOB History: Exertional dyspnea Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

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


Instruction: Generate impression based on medical findings.

Input: Female, 47 years old.Reason: Evaluate ETT tube and IABP placement History: ETT tube and IAB Mild cardiomegaly.No specific evidence of infection or edema.IABP catheter distal tip at the level of the top of the arch.ECMO cannulae unchanged.ET tube tip approximately 4 cm above the carina.Right jugular catheter with tip in right brachiocephalic vein.Left subclavian ICD, leads unchanged in position.

Output: Unchanged support devices.


Instruction: Generate impression based on medical findings.

Input: Male, 62 years old.Cough, concern for aspiration pneumonia, CHF. Enteric feeding tube tip projects over the gastric body. Bilateral opacities, compatible with pleural effusions/atelectasis. Stable cardiomediastinal silhouette.

Output: Bibasilar opacities are suggestive of pleural effusions/atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 26 years old.Patient complaining of chest pain rule out cardiopulmonary abnormalities. Spinal shunt poorly visualized by chest technique but appears similar in position.Normal lung volumes. No focal airspace opacities, pleural fluid or pneumothorax.

Output: No acute pulmonary abnormality. Please refer to recent separately reported bone-technique shunt series.


Instruction: Generate impression based on medical findings.

Input: Male, 28 years old.Reason: r/o Pneumothorax ; shortness of breath History: shortness of breath Right hemidiaphragm elevation with overlying atelectasis.Status post bilateral lung transplant.No significant pneumothorax.Heart size normal.

Output: No pneumothorax. Chronic appearing elevation right hemidiaphragm with overlying atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 32 years old.Reason: ? RUL infiltrate, hx of hemoptysis with multiple coils History: hemoptysis Upper lobe predominant bronchiectasis and architectural distortion consistent with cystic fibrosis. Multiple embolization coils and glue casts project over the upper thorax.No pneumothorax or visible pleural fluid. No new areas of opacity to suggest superinfection or gross pulmonary hemorrhage. No signs of pulmonary edema. Gastrostomy tube partially visualized.

Output: Chronic abnormalities consistent with cystic fibrosis, but no new opacity.


Instruction: Generate impression based on medical findings.

Input: Female, 67 years old.SOB evaluate for pulmonary edema. Multiple pill-shaped radiodensities project over the gastric air bubble.No pneumothorax.Hazy dependent opacity suggestive of atelectasis, this could be superimposed upon layering pleural fluid which cannot be excluded.Vascular redistribution, nonspecific in the setting of semierect positioning.No conclusive evidence of edema.

Output: Possible signs of mild hypervolemia, but no conclusive evidence of pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 43 years old, status post esophagectomy, now with pleuritic chest pain. Evaluate for PE. PULMONARY ARTERIES: Slightly limited examination secondary to poor contrast opacification. No pulmonary embolus to the lobar level. Nondiagnostic more distally.LUNGS AND PLEURA: Bilateral pleural effusions are new with adjacent compressive atelectasis. A right apical micronodule (axial image 27, series 8) is new and nonspecific. An additional right apical micronodule (axial image 39, series 8) is calcified and probably reflects prior granulomatous disease. MEDIASTINUM AND HILA: Cystic lesion in the right lobe of the thyroid is unchanged and likely benign.Subcentimeter prevascular soft tissue nodule on axial image 134, series 6, is unchanged. No evidence of pathologically enlarged hilar or mediastinal lymph nodes.The cardiac size is normal. No pericardial fluid. Coronary artery calcifications are noted.Postoperative change status post esophagectomy with a gastric pull-up is evident. An NG tube terminates within the gastric pull-up.CHEST WALL: Right chest wall port catheter, tip in the SVC.UPPER ABDOMEN: Ascites is new.

Output: 1.Slightly limited examination for PE, but no embolus to the lobar level. 2.Postoperative change as described above with new pleural effusions, atelectasis and ascites.


Instruction: Generate impression based on medical findings.

Input: Male, 87 years old.Follow up on pleural effusion. Clinically improving with less discomfort. Small residual right pleural effusion. No pneumothorax. The heart size is within normal limits. Chronic T12 compression fracture. No signs of pulmonary edema or pneumonia.

Output: Significant interval improvement in right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 64 years old.Reason: re-accumulation of pleural effusion History: sob Lower lung zone predominant interstitial opacities consistent with severe fibrosis are unchanged.Left lower lobe soft tissue opacity consistent with known tumor unchanged, with a small left pleural effusion.Moderate cardiomegaly.Right jugular catheter, tip in SVC.

Output: Small pleural effusion with known left basilar tumor and severe chronic fibrosis.


Instruction: Generate impression based on medical findings.

Input: Left thoracentesis Interval decrease in persistent moderate left pleural effusion with associated partial reexpansion of the underlying lung. Persistent small to moderate pleural effusions again observed now greater on the right. Underlying nonspecific opacities, likely atelectasisUnchanged right jugular port. No gross cardiac or mediastinal contour change.

Output: Interval increase left pleural effusion without associated underlying postprocedural complication


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Esophageal cancer status post esophagectomy with pull up and chest tubes placed. Enteric tube presumably in the neoesophagus. Right chest port unchanged in position. Bilateral chest tubes without significant sized pneumothoraces. Patchy atelectasis. Low lung volumes. Staple line projects over the left neck with adjacent subcutaneous emphysema. Postoperative pneumomediastinum.

Output: Postoperative changes with reduced lung volumes and patchy atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: cough x 3 weeks History: fever/cough Normal heart size with a calcified aortic arch.Perihilar bronchial thickening compatible with bronchitis but no sign of pneumonia.

Output: Findings compatible with bronchitis but no sign of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Female, 46 years old.Reason: is there pul edema History: chest pain, history pul hypertension Cardiac silhouette appears normal in size and configuration.Lungs are clear.No acute osseous abnormalities. Bilateral cervical ribs incidentally noted.

Output: No radiographic evidence of acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: Reason: sickle cell pt, fever, evaluate for infiltrate History: fever Mild cardiomegaly with vascular redistribution consistent with chronic anemia.Skeletal sclerosis consistent with sickle cell disease.No sign of pneumonia.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Status post ECMO. Hardware and devices unchanged. Improved aeration of the left lung with persistent moderate diffuse pulmonary opacities bilaterally. No pneumothorax. Small pleural effusions.

Output: Improved aeration of the left lung.


Instruction: Generate impression based on medical findings.

Input: Female, 30 years old.Reason: sickle cell pain with lymphocytosis History: back and chest pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality. No evidence of infection or infarction.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.TLC placement. Left jugular catheter tip at the confluence of the brachiocephalic veins with the SVC. Enteric tube projects over the expected location of the stomach. Endotracheal tube tip 4.5 cm above the level of the carina.No pneumothorax. Large right pleural fluid collection, not significantly changed. Basal atelectasis or scarring on the left.

Output: Appropriate position of left jugular catheter without pneumothorax. ETT tip 4.5 cm above the level of the carina.


Instruction: Generate impression based on medical findings.

Input: Female, 75 years old.Reason: pneumonia, alveolar hemorrhage History: Hypoxic respiratory failure, intubated Unchanged interstitial and airspace opacities with small pleural effusions.ET tube tip approximately 3 cm above the carina.An NG tube terminates in the stomach.

Output: Unchanged pulmonary opacities and pleural effusions. ET tube tip approximately 3 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Male, 25 years old.Preoperative evaluation. No focal airspace opacity, pleural effusions or pneumothorax. The cardiomediastinal silhouette is normal.

Output: Normal chest 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: Reason: ETT check History: ETT ET tube tip approximately 3 cm above the carina.Small lung volumes with diffuse nonspecific airspace opacity, with a somewhat patchy distribution suggestive of aspiration and/or infection.Catheter tip in the SVC.No significant change allowing for motion artifact.

Output: ET tube in acceptable position.


Instruction: Generate impression based on medical findings.

Input: Reason: 62 y/o F with history of lung transplant 2014. Now with heartburn/GERD and chronic cough. Esophogram to further evaluate, rule out hiatal hernia or other process History: GERD Scout radiograph of the chest showed stable rightward deviation of the trachea with fibrotic native right lung and transplanted left lung with nonspecific basilar opacities. Port-A-Cath tip in the right atrium.There is rightward deviation of the esophagus, possibly from right lung volume loss. During the exam, mild to moderate provoked gastroesophageal reflux was with Valsalva maneuvers was noted. Fluoroscopic evaluation of esophageal peristalsis demonstrated weak primary wave with escape and subsequent secondary and tertiary waves. Duodenal diverticulum measuring 19 x 17mm was noted.TOTAL FLUOROSCOPY TIME: 5 minutes 5 secondsEntrance dose: 100.70 mGy

Output: 1.Moderate to severe dysmotility. 2.Mild to moderate provoked gastroesophageal reflux.3.Duodenal diverticulum.


Instruction: Generate impression based on medical findings.

Input: Male, 64 years old.Reason: s/p RUL lobectomy History: Wheezing Right chest tube has been removed. There is no evidence of pneumothorax. Other findings stable.

Output: Right chest tube has been removed. There is no evidence of pneumothorax. Other findings stable.


Instruction: Generate impression based on medical findings.

Input: Shortness of breath Persistent focal right middle lobe opacity, not dissimilar to an exam 8/30/14. Questionable partial consolidation of the right middle lobe cannot be excluded and serial imaging would be needed however patient has also shown previously atelectasis and suspected mucous plugging in this region in the past. Serial imaging may indicate change and/or partial clearance a short-term. Remaining lungs are otherwise clear other than mild COPD changes. The cardiac and mediastinal contours are within limits.

Output: Nonspecific focal opacity in the right middle lobe, possible atelectasis and repeat possible mucus plugging, however serial imaging is needed to confirm and exclude an underlying or acute process


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: eval for CHF History: altered mental status and hypoxia Basilar predominant interstitial opacities is likely secondary to scarring/atelectasis. No large pleural effusion or pneumothorax is present. Cardiomegaly is unchanged.

Output: Cardiomegaly without specific evidence of edema.


Instruction: Generate impression based on medical findings.

Input: LVAD LVAD, ICD unchanged.Mild cardiomegaly. Clear lungs. Mildly decreased volumes

Output: No acute disease


Instruction: Generate impression based on medical findings.

Input: Female, 72 years old.Reason: 72 gi bleed, intubated and aspirated blood/hematemesis History: intubated, aspiration Lower lung zone opacities suggestive of edema and retrocardiac consolidation are unchanged.ET tube tip approximately 5 cm above the carina.Bilateral jugular catheters terminate in the SVC.

Output: No change in pulmonary opacities or support devices.


Instruction: Generate impression based on medical findings.

Input: Female, 59 years old.Reason: ETT, confirm position History: ETT Median sternotomy, with moderate cardiomegaly.Slight improvement in right basilar consolidation, but unchanged on the left accompanied by bilateral pleural effusions.ET tube tip approximately 3 cm above the carina.An NG tube extends below the lower margin of the image.Right jugular catheter, tip in SVC.

Output: ET tube tip approximately 3 cm above the carina. Persistent basilar opacities and pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Age: 48 yearsGender: FemaleReason for Study: Reason: eval for infiltrate or edema History: DOE The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions.

Output: No acute cardiopulmonary abnormalities are identified. No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: Male, 79 years old.Reason: eval for foreign body History: chest pain, dysphagia Interval extubation. Slight increase in basilar opacities. Stable medial right apical opacity. Unchanged heart size. No large pleural effusion or pneumothorax.

Output: Interval extubation with slight increase in basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old.Reason: hydropenumothorax with chest tube placement History: SOB Left basilar chest tube remains in place. Moderate-sized loculated left basilar pneumothorax, unchanged. Blunting of the costophrenic angles again noted. No new focal pleural parenchymal opacity. Unchanged heart size.

Output: Left basilar chest tube remains in place. Moderate-sized loculated left basilar pneumothorax, unchanged.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: line position ?carotid vs internal mammary History: misplaced Left jugular catheter, probably not carotid, but the upward direction of the tip suggests cannulation of the superior costal vein or an internal mammary vein branch.Small pleural effusions and left lower lobe consolidation unchanged.ET tube tip approximately 2 cm above the carina.An NG tube extends below the lower margin of the image.

Output: Left jugular catheter tip probably in an internal mammary vein branch or the superior intercostal vein.


Instruction: Generate impression based on medical findings.

Input: 48-year-old female with a LL, status post stem cell transplant, complaining of cough LUNGS AND PLEURA: Scattered areas of bronchiolar thickening and associated ground glass nodular opacities in the upper lobes, compatible with bronchiolitis/aspiration.Basilar scarring, unchanged.No pleural effusion identified.MEDIASTINUM AND HILA: Common origin of the left carotid and right innominate arteries. Right subclavian line with its tip in the SVC.No hilar or mediastinal lymphadenopathy.CHEST WALL: General changes in the thoracic spine.UPPER ABDOMEN: Fatty infiltration of the liver.

Output: Scattered focal areas of bronchial/bronchiolar thickening and associated ground glass nodular opacities compatible with bronchiolitis or aspirated secretions.


Instruction: Generate impression based on medical findings.

Input: Female, 23 years old.Left chest pain The cardiomediastinal silhouette is normal. No specific evidence of infection, edema, or pleural effusions.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Cardiovascular screening outside study revealed a mediastinal lymph nodes. LUNGS AND PLEURA: Limited without significant abnormality.MEDIASTINUM AND HILA: Limited region covered, revealing normal to upper normal sized right paratracheal and prevascular lymph nodes.CHEST WALL: Limited views. No significant abnormality.UPPER ABDOMEN: Not included.

Output: Limited region covered, revealing upper limits normal sized mediastinal lymph nodes which are probably of no significance. A repeat contrast enhanced chest CT in one year could insure stability.


Instruction: Generate impression based on medical findings.

Input: Female, 48 years old.Reason: Swan History: Swan Slight interval retraction of Swan-Ganz catheter, with the tip projecting over the mid right pulmonary artery. Unchanged left subclavian ICD. Stable cardiomegaly. No evidence of pulmonary edema/pleural effusions.

Output: Slight interval retraction of Swan-Ganz catheter. No pulmonary edema.


Instruction: Generate impression based on medical findings.

Input: Male, 55 years old.Reason: eval for worsening effusion and any sign of infection History: febrile, tachycardic Feeding tube extends inferiorly off the field-of-view. No substantial change in bibasilar pleural-parenchymal opacities. Layering left pleural effusion again noted. Unchanged heart size. No pneumothorax.

Output: No substantial change in bibasilar pleural-parenchymal opacities, left greater than right. Left layering pleural effusion again noted.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Reason: Evaluate ET positioning. History: See above. New probable probe device noted overlying the superior mediastinum. Lines and tubes are unchanged otherwise. Mild pulmonary edema. Worse right pleural effusion. Query small left pleural effusion. Mild bibasilar opacities.

Output: New probable probe device noted overlying the superior mediastinum. Lines and tubes are unchanged otherwise.Mild pulmonary edema. Worsening right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: 49-year-old female with history of renal transplant and fever of unknown origin CHEST:LUNGS AND PLEURA: Trace bilateral pleural effusions.MEDIASTINUM AND HILA: Borderline enlarged mediastinal lymph nodes. Index right paratracheal lymph node measures 1.7 x 1 cm on image number 30, series number 3. Calcifications near the heart. Trace pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple hypodense lesions in the liver which cannot be characterized as a lack of IV contrast. Index right lobe lesion measures 2.1-cm in diameter image number 74, series number 3.SPLEEN: 2-cm nonspecific densities within the spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys consistent with patient's known history of chronic renal failure.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive peritoneal calcifications throughout the abdomen and in the pelvis. These can be seen in patients with chronic renal disease undergoing dialysis, however, metastatic process cannot be excluded.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Transplant kidney is noted within the right iliac fossa. No evidence of hydronephrosis. Chief measures 13 cm, slightly enlarged.PELVIS:UTERUS, ADNEXA: Lack of IV contrast limits optimal evaluation.. There is soft tissue in the region of the uterus. Further evaluation with pelvic ultrasound and clinical history is recommended.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Peritoneal calcifications.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.

Output: Limited study due to lack of IV contrast. No CT findings to explain patient's fever.Borderline enlarged mediastinal lymph nodes.Extensive peritoneal calcifications. These can be seen in patients with chronic renal failure undergoing dialysis, however, metastatic peritoneal disease cannot be entirely excluded.Pelvic soft tissue density in the region of the uterus. Pelvic ultrasound is recommended for further evaluation of the uterus


Instruction: Generate impression based on medical findings.

Input: Female, 20 years old.Reason: evaluate for pneumonia History: shortness of breath, pleuritic pain, expiratory wheezing mostly in the left mid lung, scant in the right lower lung Cardiomediastinal silhouette is normal in size and configuration. Lungs are clear.Mild pectus excavatum deformity. No acute osseous abnormalities.

Output: No radiographic evidence of acute cardiopulmonary process.


Instruction: Generate impression based on medical findings.

Input: Male, 71 years old.Reason: eval lung fields, pneumoperitoneum History: s/p CABG, pneumoperitoneum Persistent although decreased in size pneumoperitoneum, with minimal residual right subdiaphragmatic air. Attention on follow-up.Motion artifact. Persistent mid lung and bilateral basilar consolidative opacities possibly representing combination of pulmonary edema and atelectasis.Possible small bilateral pleural effusions.Stable position of ET tube and right IJ vascular sheath.

Output: Improving pneumoperitoneum. Minimal residual right subdiaphragmatic free air.


Instruction: Generate impression based on medical findings.

Input: Male 17 years old with history of severe asthma and shortness of breath Cardiomediastinal silhouette within normal limits. No focal airspace opacities. No pleural effusions or pneumothorax.

Output: No acute cardiopulmonary abnormality with no specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Age: 61 yearsGender: MaleReason for Study: Reason: sob History: sob There is moderate cardiac enlargement.Decreased lung volumes with basilar atelectasis, more pronounced on the right.Small pleural effusions right greater than left.

Output: Cardiac enlargement with right basilar atelectasis and small effusions.


Instruction: Generate impression based on medical findings.

Input: Cough Right PICC line again extends into the axilla unchangedCardiopulmonary appearance again remains significant for borderline cardiomegaly with nonspecific mild atelectasis and questionable interstitial change, presumably chronic. Specifically no new superimposed focal airspace abnormality

Output: Right PICC line unchanged


Instruction: Generate impression based on medical findings.

Input: Male, 42 years old.Reason: pna v infiltrate History: SOB Right IJ central venous catheter and right-sided PICC remain unchanged. Partially visualized enteric tube now entering the left upper quadrant.Stable partially obscured cardiac silhouette.Pulmonary edema and bilateral pleural effusions remain unchanged, left greater than right.

Output: No significant change in pulmonary edema and bilateral pleural effusions accounting for differences in technique.


Instruction: Generate impression based on medical findings.

Input: 51 years old Male. Reason: icu History: icu. Iatrogenic devices are unchanged. No change in right pleural-parenchymal opacities. Left lung is unchanged. Unchanged cardiomegaly. No new pneumothorax.

Output: No substantial change in extrapleural opacity along the lateral aspect of right hemithorax. Cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Male, 49 years old.Reason: PICC placement, PNA?, good placement History: picc placement Moderate cardiomegaly.Mild interstitial edema and right pleural effusion but no evidence of pneumonia.Right PICC, tip in right axillary region.

Output: Right PICC, tip in right axillary region. Unchanged mild interstitial edema and a small right pleural effusion.


Instruction: Generate impression based on medical findings.

Input: 60-year-old male with fever, follow-up pneumothorax. Minimal residual right pneumothorax with small right pleural effusion. Mild bilateral interstitial opacities, likely secondary to aspiration.Staple line in the right lung, unchanged.

Output: Almost complete resolution with minimal residual right pneumothorax and small right pleural effusion. Mild bilateral interstitial opacities, likely secondary to aspiration.


Instruction: Generate impression based on medical findings.

Input: Female, 61 years old.Reason: rule out pulmonary edema or infection History: h/o CHF, worsening dyspnea on exertion and new cough Mild cardiomegaly.Abnormal interstitial markings suggestive of edema although there are no pleural effusions.No specific evidence of infection.

Output: Mild interstitial edema suggestive of CHF.


Instruction: Generate impression based on medical findings.

Input: Female, 38 years old.RCC evaluate for recurrence. Normal heart size. No visible lymphadenopathy or pulmonary masses. No pleural fluid.Subcentimeter nodular density projecting over the intersection of the right anterior fifth and posterior ninth ribs could reflect summation artifact or possibly costochondral calcification but is new from the prior study. This is not identified on the lateral film but may not be visible due to its small size.Interval placement of small clips or markers in the left breast.

Output: Small nodular density projecting over the right lower lung could represent summation artifact from calcification in the chest wall or soft tissues, an intrapulmonary nodule cannot be entirely excluded but is considered less likely. Correlation with CT to confirm benign etiology is suggested.


Instruction: Generate impression based on medical findings.

Input: Reason: hx b/l lung transplant, presenting w/cough and SOB, c/f atypical pna History: SOB, cough Moderately large bilateral pleural effusions.Diffuse mainly interstitial opacities suggestive of edema, slightly improved compared to previous.Heart size within normal limits.

Output: Bilateral pleural effusions without significant change. Slightly improved interstitial edema.


Instruction: Generate impression based on medical findings.

Input: 44 years old Male. Reason: assess IABP placement History: IABP. Lines and tubes are unchanged. Specifically, the IABP terminates 3 cm from the top of the aortic arch. Unchanged cardiomegaly. No large pleural effusion or pneumothorax.

Output: Lines and tubes are unchanged. Stable cardiomegaly.


Instruction: Generate impression based on medical findings.

Input: Female, 45 years old.Reason: cough, fever, diaphoresis History: cough Surgical clips project over the hepatic shadow on the lateral view, consistent with prior cholecystectomy.Cardiomediastinal silhouette is normal. No focal pulmonary opacity. Blunting of the costophrenic angles bilaterally appears chronic. No pleural effusion or pneumothorax.

Output: No acute cardiopulmonary disease.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: pulm edema vs consolidation History: longstanding cough Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No specific evidence of infection or failure.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female 36 days old Reason: f/u exam History: intoxated, s/p cardiac surgeryVIEW: Chest AP (one view) 2/1/15 at 347 hours. ET tube, NG tube, right IJ venous access, bilateral chest tubes , mediastinal clips, epicardial pacer leads and right atrial line with the tip at the IVC are unchanged. Interval removal of pericardial drain.Cardiac silhouette size is enlarged but stable. Persistent bibasilar opacities, mild lung vascular engorgement and diffuse lung haziness.

Output: No change in lung aeration after pericardial drain removal.


Instruction: Generate impression based on medical findings.

Input: Male, 65 years old.Reason: Exclude TB. Positive PPD. History: Exclude TB. Positive PPD. Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.No active TB.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 85 years old.Reason: Evidence of pneumonia? History: Coarse breath sounds, productive cough Dual-lumen port remains accessed. A left-sided pacemaker unchanged in position.Basilar streaky opacities of subsegmental atelectasis. No interval edema or pneumothorax. Heart size within limits of normal.

Output: No evidence of pneumonia.


Instruction: Generate impression based on medical findings.

Input: Age: 75 yearsGender: MaleReason for Study: Reason: cough - rule out infiltrate History: cough Stable cardiomediastinal silhouette.Minimal scarring/discoid atelectasis involving the lingula.No focal areas of consolidation.No pleural effusions.

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


Instruction: Generate impression based on medical findings.

Input: Male, 70 years old.Chest pain. Unremarkable cardiomediastinal silhouette.No focal pulmonary opacities, pneumothorax, or pleural effusions.

Output: No significant cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male 12 months old with history of intubation and sedation, evaluate ETT positionVIEW: Chest AP (one view) 3/9/2016 Endotracheal tube tip is located in between the thoracic inlet and carina, stable from prior exam. Enteric tubes with tips in the gastric body. Lower extremity PICC with tip at the IVC/right atrial confluence. Left chest tube unchanged in position. Left upper extremity PICC with tip in the SVC.Normal cardiothymic silhouette. Persistent left subpulmonic pneumothorax. Bilateral streaky opacities appear similar to prior exam.

Output: Endotracheal tube tip is located in between the thoracic inlet and carina, stable from prior exam. Unchanged multifocal opacities.


Instruction: Generate impression based on medical findings.

Input: Fever No cardiopulmonary abnormality. Bilateral jugular catheters appear similar and are unchanged in position

Output: No acute disease


Instruction: Generate impression based on medical findings.

Input: 72-year-old female with a restaging rectal cancer status post chemotherapy CHEST:LUNGS AND PLEURA: Biapical scarring is unchanged.Multiple small bullae identified bilaterally. Minimal area of scarring identified in the left lower lobe.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Small cysts are unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small low attenuation lesions in both kidneys most likely cysts, and is indeterminate.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left lower quadrant ileostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small presacral pocket of fluid is seen on image 191 series 3 is most likely consistent with postsurgical change although better visualized on today's imaging.BONES, SOFT TISSUES: Extensive sclerotic lesion involving the bilaterally iliac wing, ischium and pubic rami with underlying insufficiency fractures involving bilateral pubic rami, right ischium, right iliac spine, much more than prior MRI and CT.OTHER: No significant abnormality noted.

Output: 1. Small presacral pocket of fluid noted2. Extensive sclerosis involving the pelvic bones with multiple insufficiency fractures involving bilateral pubic rami, iliac wing, ischium and a few of these are new from prior CT and MRI. Further evaluation with MRI of the pelvis or plain film is recommended.


Instruction: Generate impression based on medical findings.

Input: Clamped CXR, intubated. Cardiomegaly with moderate to large layering pleural fluid collections, edema and atelectasis about the same. Interval extubation. No pneumothorax. Retrocardiac atelectasis.

Output: Interval extubation. Lung volumes about the same. Unchanged moderate to severe CHF and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 23 years old.Reason: pna History: Fever Unknown Origin Small lung volumes.Mild cardiomegaly.No specific evidence of infection.

Output: Small lung volumes but no reliable evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 65 years old.Reason: sob History: tube reposition - ett ET tube tip 5 cm above carina. NG tube tip at GE junction.Small bilateral pleural effusions, slightly increased, with basilar edema and atelectasis.

Output: ET tube tip 5 cm above carina. NG tube tip at GE junction.Small bilateral pleural effusions, slightly increased, with basilar edema and atelectasis.


Instruction: Generate impression based on medical findings.

Input: Male, 63 years old.Reason: chest pain History: chest pain No significant cardiopulmonary abnormality.Unchanged bullet fragments.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 37 years old.Reason: 37 yo female being evaluated as potential stem cell donor History: evaluate Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: Age: 77 yearsGender: FemaleReason for Study: Reason: hypotension History: hypotension The patient is markedly rotated.There are decreased lung volumes with cardiac enlargement.Basilar opacities are compatible with atelectasis.Probable moderate size hiatal hernia.Extensive vascular stent involving the right axillary, subclavian, and innominate vessels.Possible small right pleural effusion with blunting of the right costophrenic angle.

Output: Limited examination due to patient rotation. Bilateral basilar atelectasis/consolidation.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: spiked fever, possible aspiration History: spiked fever Stable cardiomegaly and bilateral pleural effusions, left greater than right. Tortuous aorta. Right chest port catheter tip projects over the SVC. Left basilar atelectasis. No pneumothorax. No new focal consolidation.

Output: Stable bilateral effusions and basilar opacities.


Instruction: Generate impression based on medical findings.

Input: Patient fell, hip and shoulder tenderness Chest: Mild unchanged cardiomegaly, largely left ventricular partially exaggerated by spinal changes and kyphosis. Marked tortuosity of the aorta and atherosclerotic disease appears stable. Mild basilar scarring and/or atelectasis without interval change or new superimposed acute abnormality. Right axillary clipsHip and pelvis: Moderate hip osteoarthritis with preservation of femoral head shape is observed. More minimal degenerative changes of the SI joints and symphysis. The remainder the pelvis appears intact, specifically no findings to suggest a fractureShoulder: Near severe osteoarthritic changes with pronounced narrowing of the acromiohumeral distance consistent with chronic rotator cuff injury. Near bone on bone narrowing, extensive subchondral cysts and sclerosis mixed with osteophytes. No discrete focal changes to suggest an acute or subacute finding such as a fracture, however given demineralization, serial imaging may be indicated if suspicion remains high

Output: Extensive to moderate scattered degenerative changes without evidence of distinct acute abnormality. Demineralization limits sensitivity, consider serial imaging given the possibility of occult fractures if suspicion remains high


Instruction: Generate impression based on medical findings.

Input: Chest pain Moderate nonspecific cardiomegaly with otherwise unchanged ICD. Swan-Ganz however has been report positioned and retracted with the tip projected at the takeoff of the right pulmonary artery.Lungs remain clear

Output: Swan-Ganz repositioned


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Reason: intubated History: intubated The endotracheal tube terminates approximately 7 cm from the carina. Increased basilar opacities. Unchanged heart size. No pneumothorax.

Output: Endotracheal tube, as above. Increased basilar opacities, likely atelectasis.


Instruction: Generate impression based on medical findings.

Input: Reason: assess position of impella History: assess position of impella Impellal device from the right subclavian artery with its tip projected in the area of the left ventricle, unchanged.Cardiomegaly with marked azygous venous distention.No sign of pulmonary edema or infection.

Output: Impellal device with no significant change.


Instruction: Generate impression based on medical findings.

Input: Male, 58 years old.Reason: eval repeat History: eval repeat Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.

Output: No significant abnormality.


Instruction: Generate impression based on medical findings.

Input: 70 year-old man with maxillary sinus cancer. Evaluate prior to chemo. CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema. Patchy air space opacities with focal bronchiectasis is redemonstrated in the right middle lobe and is unchanged. Tree in bud opacities and rosette of micronodules clustered in the inferior aspect of left lower lobe suspicious for aspiration and/or infection (image 84/119).MEDIASTINUM AND HILA: Mildly enlarged mediastinal lymph nodes are unchanged. Coronary artery calcifications. Left ventricular hypertrophy. No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple hypodense lesions in the liver compatible with cyst are unchanged. The gallbladder is normal in appearance. No evidence of intrahepatic or extrahepatic ductal dilatation.SPLEEN: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS: No significant abnormality notedPANCREAS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic disease of aorta.

Output: 1. No definite evidence of metastasis.2. Tree-in-bud opacities in the left lower lobe suspicious for aspiration and/or infectious process.


Instruction: Generate impression based on medical findings.

Input: Age: 79 yearsGender: MaleReason for Study: Reason: s/p esophagectomy History: s/p esophagectomy Stable cardiomediastinal silhouette.Small bilateral pleural effusions similar to the prior exam.Apical pleural thickening and calcification redemonstrated.No new pulmonary opacities noted.

Output: Persistent small pleural effusions. No acute cardiopulmonary abnormality identified.


Instruction: Generate impression based on medical findings.

Input: 30 year-old male with metastatic melanoma CHEST:LUNGS AND PLEURA: Subcentimeter pulmonary nodules in the right lower lobe, the left upper lobe, left lower lobe on image number 29 and 57 and 72, series number 4 are unchanged. No new lung nodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Surgical clips in the right side of the pelvis are unchanged.

Output: Stable exam without evidence of metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Bronchiolitis (RSV and adenovirus). Feeding tube placement.VIEWS: Chest and abdomen AP (two views) 12/27/15, 1357 Feeding tube tip is in antropyloric region.Lung volumes are large. Opacities in right upper, right lower, and left lower lobe persists. Left upper lobe opacities have increased. Cardiac silhouette size is normal.Bowel gas pattern is slightly disorganized. No dilated bowel loops are present.

Output: Increasing lung opacities. Slightly disorganized bowel gas pattern.


Instruction: Generate impression based on medical findings.

Input: Age: 63 yearsGender: FemaleReason for Study: Reason: chest tubes History: chest tubes 2 of the 4 chest tubes have been removed.NG tube is been placed with its tip in the stomach.Right IJ venous catheter unchanged.No evidence of a pneumothorax.Stable cardiomediastinal silhouette.Perihilar and basilar opacities similar to the prior examMild interval improvement in left retrocardiac atelectasis.No evidence of a pneumothorax.

Output: Removal of 2 of the 4 chest tubes without evidence of a pneumothorax. Interval placement of NG tube. Interval improvement of the left lower lobe atelectasis.


Instruction: Generate impression based on medical findings.

Input: Age: 82 yearsGender: FemaleReason for Study: Reason: evaluate left lung expansion s/p thoracotomy, T12 repair, chest tube placement History: post-op Left-sided chest tube with its tip at the apex.Small medial pneumothorax identified.Cardiac mediastinal silhouette is unremarkable.Small pleural effusions and mild basilar atelectasis.Lumbar stabilization hardware identified at the thoracolumbar junction.IVC filter noted.

Output: Left-sided chest tube with its tip at the apex. No evidence of a significant pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: Pt taking dasatinib. Febrile w/ cough and positional SOB. Assess for infection/effusion/infiltrate. History: as above Unremarkable cardiac and mediastinal silhouette. Patchy left lower lobe airspace opacity, with small areas of subsegmental atelectasis, unchanged or slightly increased compared to recent previous radiographs, but new since 8/14/2016. This is compatible with pneumonia in the appropriate clinical setting.A text page was sent to CHANDIRAMANI, ANISHA, at the time of reporting

Output: Left basilar airspace opacity and atelectasis, compatible with pneumonia.


Instruction: Generate impression based on medical findings.

Input: Tachypnea, recent stroke. 10/8/2016 Mild cardiomegaly with mediastinal widening chronic and unchanged. Moderate pleural fluid and mild interstitial edema, right greater than left.No pneumothorax.A peripheral catheter on the left terminates at the axillary/subclavian junction.

Output: Mild to moderate CHF. Left PICC at the axillary/subclavian junction.


Instruction: Generate impression based on medical findings.

Input: 67-year-old male assess extent of metastatic disease. History CHF, metastatic RCC, DM. No contrast please. CHEST:LUNGS AND PLEURA: Increase in size of right pleural effusion now moderate in degree with associated atelectasis or consolidation. Small left pleural effusion. Diffuse emphysematous changes redemonstrated. Coronary artery calcification redemonstrated. Index pulmonary nodules as follows.Right lower lobe superior segment nodule series 4 image 49, 5.4 x 6.2 mm.Nodule previously seen on series 5 image 91 is difficult to ascertain with certainty. It may correspond to the lesion on series 4 image 81 measuring 12.2 x 11.1 mm.Right middle lobe nodule very irregular in shape measured on series 4 image 68 a 0.8 x 8.1 mm.MEDIASTINUM AND HILA: Subcarinal node poorly visualized estimated on series image 50: 9.6 x 5.6 mm.CHEST WALL: No significant abnormality notedABDOMEN: The exam is not sensitive for detecting lesions the solid organs due to lack of intravenous contrast.LIVER, BILIARY TRACT: Accurate comparison cannot be made to previous due to lack of intravenous contrast. The liver lesions are probably unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left right nephrectomy bed without evidence of local recurrence. Right kidney shows some vascular calcifications. Retro-renal soft tissue nodule series 3 image 115 not significantly changed measures 12 x 9.6 mm.RETROPERITONEUM, LYMPH NODES: Abdominal aortic aneurysm unchanged.BOWEL, MESENTERY: Bowel normal. Minimal ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate unchanged.BLADDER: No significant abnormality notedLYMPH NODES: Small pelvic lymph nodes stable.BOWEL, MESENTERY: Minimal ascites. This is unchanged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral common iliac artery aneurysms redemonstrated.

Output: Comparison very limited due to lack of intravenous contrast. Increase in size of pleural effusions. Measurable tumor as above roughly stable.


Instruction: Generate impression based on medical findings.

Input: Reason: post-op[ History: post-op Large right pneumothorax is almost complete atelectasis of the right lung.Left perihilar and basilar opacity compatible with atelectasis and consolidation with a moderate effusion.Pneumoperitoneum consistent with recent surgery.

Output: Large right pneumothorax. This was discussed with clinical service by the resident on call.


Instruction: Generate impression based on medical findings.

Input: Male, 40 years old.Reason: pre kidney transplant evaluation History: pre kidney transplant Mild cardiomegaly in a left atrial enlargement pattern.No significant pulmonary or pleural abnormality.Left upper extremity vascular stent.

Output: Mild cardiomegaly, without edema or pleural effusions.


Instruction: Generate impression based on medical findings.

Input: Male, 73 years old.Reason: eval for placement of chest tube History: s/p chest tube for ptx Left chest tube placed, with significant improvement in, but not yet complete resolution of, a left pneumothorax.Small left pleural effusion.Mild left base subsegmental atelectasis.

Output: Left chest tube placement with improvement in a left pneumothorax.


Instruction: Generate impression based on medical findings.

Input: Reason: s/p evaucation of LU empyema with muscle flap History: s/p evacuation of LU empyema with muscle flap Postoperative findings in the left hemithorax with volume loss, apical opacification and subcutaneous emphysema.Venous catheter tip in the right axillary vein.No pneumothorax.A more recent radiograph has been interpreted.

Output: Extensive postoperative findings and subcutaneous emphysema.


Instruction: Generate impression based on medical findings.

Input: Female, 89 years old.Reason: edema? pna? History: shortness of breath Diffuse interstitial opacities have developed as well as bilateral pleural effusions and mild basilar atelectasis.Mild to moderate cardiomegaly noted.

Output: New diffuse interstitial opacities with pleural effusions consistent with edema although the distribution is slightly unusual. Atypical infection is in the differential diagnosis.


Instruction: Generate impression based on medical findings.

Input: 31-year-old male with a Epstein Barr viremia CHEST:LUNGS AND PLEURA: Nonspecific, focal ground glass opacities in the fissure in the right middle lobe on image number 41, series number 5, unchanged from previous study.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Liver is enlarged. Gallbladder is distended. There is layering sludge in the gallbladder. Gallbladder wall is normal in size. No evidence of pericholecystic fluid.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate left renal stone.RETROPERITONEUM, LYMPH NODES: Left therapy lymph nodes slightly enlarged and now measures 1.6 x 1 cm on image number 99, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted

Output: Minimal increase in the size of the left paraortic adenopathy, otherwise no significant change from previous study. Hydropic hydropic gallbladder without CT evidence of acute cholecystitis is unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 72 years old.Pre kidney transplant end-stage renal disease. Rule-out cardiomegaly or infiltrates. Normal cardiomediastinal silhouette. No focal air space opacities, pleural fluid or pneumothorax. Fixation screws noted in the left humeral head.

Output: Normal chest.


Instruction: Generate impression based on medical findings.

Input: Female, 53 years old.Reason: Chest tightness, DOE in patient with CHF with pEF. History: As above Mild cardiomegaly status post mitral valve repair via median sternotomy.Unchanged right pleural effusion and basilar atelectasis or scarring. No specific evidence of infection or edema.

Output: Right pleural effusion and right basilar atelectasis versus scarring. No change.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Right upper lobe wedge resection. Chest tube placement. Right chest tubes unchanged in position. Partially loculated pleural fluid on the right extending into the fissure, similar in volume, and associated with a small intrafissural pneumothorax component. Multifocal air space opacities, predominantly in the right lung, appear increased, some of which are now fluid.Mild subcutaneous emphysema right chest wall.

Output: Small right hydropneumothorax extending into the fissure. Worsening pulmonary opacities which may be the result of aspiration/infection and superimposed post operative pulmonary contusion.


Instruction: Generate impression based on medical findings.

Input: Chest tube placement Interval left chest tube projecting towards apex with underlying resolution of the previous described large pneumothorax. No significant midline shift or new additional cardiopulmonary abnormality. Mild patchy nonspecific opacity left lung base again nonspecific and possibly edema and/or hemorrhage given the overlying bullet

Output: Left chest tube placed


Instruction: Generate impression based on medical findings.

Input: Male, 77 years old.Reason: pulmonary edema History: sob Left lower lobe consolidation and left pleural effusion unchanged.Very small right pleural effusion.No specific evidence of edema.Right jugular catheter, tip at right atrial level.

Output: Small pleural effusions and basilar consolidation, but no reliable evidence of edema, and no interval change.


Instruction: Generate impression based on medical findings.

Input: Age: 44 yearsGender: FemaleReason for Study: Reason: eval for placement of PICC line History: s/p picc line Right PICC line and right IJ venous catheter with the tips in the SVC.ET tube and NG tube have been removed.Stable cardiomediastinal silhouette.Increase in left retrocardiac consolidation/atelectasis.Probable small left pleural effusion.

Output: Increasing left retrocardiac consolidation/atelectasis and small left pleural effusion.


Instruction: Generate impression based on medical findings.

Input: Female, 76 years old.Reason: Hi Diastolic dysfunction. ? infiltrates History: Cough Mild peripheral lung reticulation, increased from previous study. Status post right shoulder surgery. No pleural effusion or pneumothorax. No acute bony abnormality. Diffuse osteopenia with mild disc degeneration. Normal heart size.

Output: Mild interstitial lung disease, increased from previous study. Correlation with HRCT is suggested.


Instruction: Generate impression based on medical findings.

Input: Female, 60 years old.Cough and fever Unremarkable cardiomediastinal silhouette.Large lung volumes.No specific evidence of infection or edema.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Female, 69 years old. Overlying blanket obscures fine detail.Right central venous catheter terminates within the IVC.Interval placement of left central venous catheter terminating at the atrial caval junction.Endotracheal tube terminates about 4 cm above the level of carina.Enteric tube terminates within the gastric body though the sideholes terminates at the level of GE junction.Diffuse interstitial opacities which are nonspecific and essentially unchanged from the prior study.Basilar atelectasis.

Output: 1. Support devices as above2. Nonspecific diffuse interstitial opacities.


Instruction: Generate impression based on medical findings.

Input: Female, 68 years old.Reason: concern for aspiration pneumonia History: tachypnea, metabolic acidosis Cardiomegaly with minimal interstitial opacities possibly edema.No specific evidence of infection.An NG tube extends below the lower margin of the image.

Output: Cardiomegaly and possible edema. No specific evidence of infection.


Instruction: Generate impression based on medical findings.

Input: Female, 57 years old.Reason: progression of sarcoidosis History: cough Interval hardware placement at the right humeral head.Cardiomegaly not significantly changed. Calcified mediastinal lymph nodes increased in number. The pleural spaces are clear. No evidence of fibrosis or infection.

Output: Increased number of calcified mediastinal lymph nodes. Stable cardiomegaly. No evidence of pulmonary fibrosis or infection.


Instruction: Generate impression based on medical findings.

Input: Female, 54 years old.Reason: pre-op MVR History: na Large body habitus limits evaluation. Within this limitation, no pleural effusion or pneumothorax. Bronchial wall thickening. Moderate cardiomegaly.

Output: Cardiomegaly without overt signs of edema.


Instruction: Generate impression based on medical findings.

Input: Female, 51 years old.Reason: r/o pna, mass History: L lateral rib pain with hemoptysis Heart size normal.Lungs clear.No pneumothorax. No pleural effusion.

Output: No specific evidence of infection or edema.


Instruction: Generate impression based on medical findings.

Input: 62 years, Male. Reason: evaluate for obstruction History: abdominal pain CHEST: Streaky bibasilar opacities suggestive of atelectasis. There are small bilateral pleural effusions, right greater than left. The cardiomediastinal silhouette is unremarkable. There are calcified mediastinal lymph nodes.ABDOMEN: Inferior displacement of the large bowel loops may reflect an intra-abdominal fluid collection or post surgical change. A right lateral approach pigtail catheter is in place with the tip terminating in the right upper quadrant, unchanged from the prior CT examination. Suture line is seen in the left lower and left upper quadrants. Paucity of small bowel gas. No evidence of pneumoperitoneum.

Output: Paucity of small bowel gas but no evidence of obstruction.


Instruction: Generate impression based on medical findings.

Input: Female, 88 years old.Reason: eval for pneumonia History: SOB and cough. h/o CHF Cardiomegaly, stable from prior.Lung volumes are normal.The previously seen right upper lobe and left upper lobe consolidative opacities are less conspicuous than on prior. No radiographic findings to suggest pneumonia.No signs of pulmonary edema.Persistent small left pleural effusion. No pneumothorax.

Output: No radiographic findings to suggest pneumonia.Interval resolution of asymmetric bilateral heterogeneous opacities previously noted.


Instruction: Generate impression based on medical findings.

Input: Female, 74 years old.Reason: r/o pneumonia History: cough Cardiomediastinal silhouette is unchanged. Stable left hemidiaphragm elevation with possible diaphragmatic herniation and postoperative changes.Right retrocardiac opacity is compatible with postoperative changes of colonic interposition.Persistent left lower lobe consolidation.No pleural effusion or pneumothorax.

Output: Persistent left lower lobe consolidation/atelectasis.


Instruction: Generate impression based on medical findings.

Input: Female, 35 years old.Productive cough and chills. Upper normal heart size for age, unchanged. Scarring in the lingula. No focal airspace opacities to suggest pneumonia. Spina bifida occulta lower cervical and upper thoracic spine.

Output: No specific signs of pneumonia. Upper normal heart size, unchanged.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: ETT placement History: ETT Increasing left lower lobe consolidation with volume loss.Unchanged pleural effusions layering posteriorly.ET tube tip approximately 4 cm above the carina.An NG tube extends below the lower margin of the image.Right jugular catheter, tip in SVC.

Output: Worsening left lower lobe consolidation. ET tube tip approximately 4 cm above the carina.


Instruction: Generate impression based on medical findings.

Input: Reason: r/o source of chest pain History: chest pain 2 days Pneumomediastinum and subcutaneous emphysema in the neck and supraclavicular areas.No significant pulmonary abnormalities.

Output: Pneumomediastinum and subcutaneous emphysema.


Instruction: Generate impression based on medical findings.

Input: Age: 83 yearsGender: FemaleReason for Study: Reason: repositioned ett History: intubation ET tube has been mildly retracted with tip now 2 cm above the carina.Stable cardiomediastinal silhouette.Right upper lobe airspace opacity, left retrocardiac consolidation/atelectasis and pleural effusions exam.

Output: Interval retraction of the ET tube with its tip now 2 cm above the carina. Stable cardiopulmonary appearance.


Instruction: Generate impression based on medical findings.

Input: Male, 59 years old.Reason: Pre kidney transplant evaluation/end stage renal disease. Rule out cardiomegaly. Rule out infiltrates. History: Pre-Kidney transplant Clear lungs. No pleural effusion or pneumothorax. Normal heart size. No acute bony abnormality.

Output: No acute cardiopulmonary process on radiography.


Instruction: Generate impression based on medical findings.

Input: Reason: resp alkalosis History: tachpnea Probable moderate cardiomegaly.NG tube tip in the stomach.Small lung volumes with perihilar and basilar nonspecific opacity, increased from previous.Differential diagnosis includes aspiration and infection.

Output: Perihilar and basilar opacity, greater on the left, suggestive of aspiration and/or infection.


Instruction: Generate impression based on medical findings.

Input: Male, 66 years old.Reason: hx of bladder cancer, evaluate for metastatic disease History: see above No suspicious pulmonary nodules or masses. No acute pulmonary or pleural abnormality. The cardiac silhouette is unchanged. Degenerative changes of the thoracic spine.

Output: No suspicious pulmonary nodules or masses to suggest metastatic disease.


Instruction: Generate impression based on medical findings.

Input: Reason: altered mental status History: above Heart size about upper normal with a tortuous and calcified aorta compatible with age.NG tube tip in the stomach.Focal left diaphragmatic bulge, likely a small Bochdalek hernia.Embolization coils in the right side of the abdomen.No sign of pneumonia or other acute findings.

Output: No acute abnormalities.


Instruction: Generate impression based on medical findings.

Input: 72-year-old male with newly diagnosed non-Hodgkin lymphoma. CHEST:LUNGS AND PLEURA: Scattered micronodules. No suspicious nodules, masses, or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion. Coronary artery calcifications.CHEST WALL: No significant abnormality noted. ABDOMEN: LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive, confluent periportal and retroperitoneal lymphadenopathy (series 3, image 109).BOWEL, MESENTERY: Conglomerate of mesenteric lymph nodes in the left lower hemiabdomen (series 3, image 137) at the level of the aortic bifurcation measures 6.9 x 7.3 cm.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.

Output: Extensive periportal and retroperitoneal lymphadenopathy with a large conglomerate of mesenteric lymph nodes in the left lower abdomen.


Instruction: Generate impression based on medical findings.

Input: Male, 67 years old.Elevated WBC count immunocompromised patient. Rule out source of infection. Right jugular catheter unchanged in position.Normal heart size.Azygos pseudolobe, normal variant anatomy.No focal airspace opacities. Scarring in the left lower lobe.Elevation of the right hemidiaphragm is unchanged.

Output: No acute pulmonary abnormality; no visible signs of pneumonia by plain film technique. If there is continued clinical suspicion a reduced dose unenhanced thoracic CT would be suggested.


Instruction: Generate impression based on medical findings.

Input: 49-year-old female with history of PBC s/p OLT with interval PTX and subsequent pigtail catheter placement now post tube clamping Right pigtail catheter unchanged in position.Stable right apical pneumothorax.Left basilar linear atelectasis and/or scarring.

Output: Stable right apical pneumothorax s/p chest tube clamping.


Instruction: Generate impression based on medical findings.

Input: 83-year-old female with history of chest pain, evaluate for infection Decreased lung volumes.Stable cardiomegaly. No pleural effusions or pulmonary edema.No focal airspace opacities.

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


Instruction: Generate impression based on medical findings.

Input: 80 years old Female. Reason: s/p thoracentesis, r/o pneumothorax History: new pleural effusions, hypoxia. There is interval increased size of the bilateral pleural effusions. Stable diffuse pulmonary opacities are noted in both lungs. Retrocardiac consolidation is again noted.

Output: Interval worsening of the pleural effusions on the stable retrocardiac consolidation.


Instruction: Generate impression based on medical findings.

Input: Reason: daily eval w/device and swan in plan History: swan Swan-Ganz catheter tip in the right main pulmonary artery.Moderate cardiomegaly, unchanged.Mild lower zone airspace opacity, compatible with edema or infection, not significantly changed.

Output: Cardiomegaly and basilar airspace opacity without significant change.


Instruction: Generate impression based on medical findings.

Input: Female, 66 years old.Fever with possible neutropenia. Mild scarring at the left costophrenic angle. Lungs otherwise clear. No pneumothorax. Heart size within normal limits. Rotoscoliosis of the thoracolumbar spine.

Output: No acute cardiopulmonary abnormality.


Instruction: Generate impression based on medical findings.

Input: Male, 57 years old.Advanced NGT. NGT tip off the caudal margin of the film but can be followed to the stomach.Endotracheal tube tip 3 cm above the carina.Moderate right and small left pleural effusions with patchy atelectasis.

Output: NGT tip off the caudal margin of the film. Moderate right and small left pleural fluid collections.


Instruction: Generate impression based on medical findings.

Input: Male, 51 years old.Reason: admission for afib with rvr, acute pathology History: above Moderate cardiomegaly with pulmonary vascular redistribution.No specific evidence of infection or edema.Left subclavian single chamber ICD, lead in expected location of the RV apex.

Output: Moderate cardiomegaly with pulmonary vascular redistribution, but no evidence of edema.